Hills Publications Water therapy may be way to rehabilitation By Dawn Frasieur ALBANY - The new stairs at Albany Pool make entering and exiting more convenient for any swimmer who uses the facility. But for someone with a limiting physical handicap, they're almost a necessity. It was that type of person that Dr. Alan Ling had in mind when he donated the stairs for community use. Among those who can now get in and out more easily are his own "pool therapy" patients. Ling, whose practice is entitled Physical Therapy Innovations, has had tremendous success using water as a physical therapy tool. Charles Novascone is a typical success story, he said. Novascone is 76 years old. More than a year ago, a disc operation led to an infection, a second operation, and the loss of the use of his legs. "It was completely gone," he said. "I had no strength. They were just like ru1ber and would collapse under me. Novascone was bedridden in the hospital for three months; after his release last summer, he was confined to a wheel chair. He had met Ling in the hospital and his daughter encouraged him to seek Ling's help for recovery. "I went to the clinic, did exercicies. I progressed slowly," said Novascone. "Then he recommended I go to the swimming pool. That's when I started improving by leaps and bounds." Novascone learned to exercise in the water. Ling explained to him how the water would keep him buoyant, bringing the vital exercise for his legs much closer within reach. As exercise and movement became easier, Novascone experienced a change in attitude as well. "Within a few weeks after the pool therapy began, I got stronger and more confident. I could walk there without any assistance. It really helped me out a great deal," he said. After just a few weeks in the pool, Novascone was out of his wheelchair. He can now walk around the house without a cane, which he uses when he's out in public. And he's setting new goals. "I'm contemplating going out and doing a little putting on the putting green," he said. "My putter will be like a cane." Novascone is an avid golfer. He's also enthusiastic and hopeful about the game becoming a part of his life again, as he gets stronger. By next year, he said, he hopes to be back on the course. Several individuals were responsible for the idea of placing stairs in the Albany pool. The need for stairs first occurred to Ling when talking to a member of a pool exercise class designed for arthritis sufferers. "She said she was thinking of quitting the class," he said. "After the exercises, she was just too tired to get herself out of the pool with no stairs available. How are they going to keep themselves in shape if it's not accessible?" he asked. Peggy McQuaid, director of the pool, was supportive of the idea, and was instrumental in the recent establishment of an aquatic therapy program involving several physical therapists. The school district was actually supposed to go in "50-50" on the project, said Ling, but the budget kept getting cut. Eventually, he decided to underwrite the whole thing. "In this instance, it was necessary for the private sector to assist the public sector in a joint venture that would enhance many lives, give greater accessibility to a therapeutic medium, and promote dignity to many so that they could continue their maximum .functional independence," Ling said. Dr. Steven Isono, MD, orthopedic surgeon and medical consultant for the A.H.S. football team, was also involved in the effort, as was the aquatic staff of Physical Therapy Innovations, physical therapist Sheri Ser, assistant Lucy Stefke and Michele Long. "The use of water to rehabilitate lower extremity, injuries, paralytic conditions, spine problems and general deconditioning has been an under-utilized yet powerful medium," said Ling. "Getting people in and out of the pool safely has been the biggest deterrent at Abany pool." The Albany Unified School District accepted Ling's donation of the pool stair unit, valued at $1400, at its June 13 meeting. The stairs include a slanted ladder designed to give easy pool access to the "elderly, arthritic. expectant mothers, y()un~.: learners or anyone uncomfortable with vertical ladders," according to the accompanying literature. It is constructed of non-corrosive stainless steel rails and fiberglass, with slip-resistant tread steps. Reprinted from July 18, 1991 RETURN TO TOP

Hills Publications Working in water comes naturally By Dawn Frasieur El Cerrito physical therapist Alan Ling believes that swimming is an exceptional therapy tool. "Little babies swim before they n can walk," he said. "It's such a natural thing. You eliminate gravity and move freely without restricting forces." Ling is enthusiastic about the use of such a natural approach to therapy. For that reason, he shies away from machines in his practice. "We don't use many machines," he said. "I believe people heal better with touch." Ling described what he does as a kind of "touching for healing." The combination of comfort and skill is the key, through hands that have been trained and have thus become therapeutic tools. Ling doesn't believe people should depend on technology so much and sees his approach as something of "a step backward" that has produced remarkable results. He became interested in pool therapy during his first job as a physical therapist. He had a spinal cord injury patient who had great difficulties walking on his own. "The minute I threw him in the pool, he walked without me touching him." Ling became excited by the possibilities of water therapy, and has since continued his study to learn all he can about alternative approaches to his profession. . Ling is convinced that pool therapy is a proven successful approach to a number of physical problems. "I've seen 50 to 100 percent improvement within the first nine sessions for simple problems, like neck ache," he said. It can also be fun. "In pool class we sometimes just play," he said. "Therapy shouldn't be 20 of these, 30 of those. Therapy can hurt and be uncomfortable. You need to give people a mental and physical break." And the best part of the approach is that patients can continue their own therapy once trained, simply for the price of pool admission. Ling believes that most physical therapists are not trained to look at the whole person. He finds they "tend to shy away" from the emotional complications that come with treating people' 'with really serious disorders.' Dr. Stephen Isono, a local orthopedic surgeon, has been something of a mentor for Ling in that regard. "He stresses quality care" and is committed to the whole patient, said Ling. "He treats. the person, not the part. And he has a high success rate. I like that. "Aquatic therapy forces you to treat the whole body," he added. "It's better to integrate than to treat parts separately. "Look at all the different subdivisions in the medical profession that just treat backs," he pointed out. "Even' in therapy there are specializations. I see everything. It will remind me to treat persons, not parts." Ling has the same "holistic" approach to the medical field in general. He believes that all the disciplines should work together, from physical therapists to chaplains and others who can tap into a patient's spiritual resources. On the other hand, he said, "No one doctor can do it alone." And with so many choices of disciplines, he finds that' 'people get confused. Who do you go see? You have to trust someone to direct you." Someone with a recurring neck , problem may be suffering pain because he's depressed, for example: While Ling would never write off a problem with "It's all in your head," he might suggest seeing a trained counsellor to deal with the roots of the problem. "I could treat the neck problem," he said. "But it might not be the neck that's causing it." Other patients come more for "physical comfort" or a respite from the stresses of their lives. "I would direct someone like that to a' good massage therapist," he said, perhaps someone who also has counselling training. "We have 85-year-old patients taking care of 82-year-old spouses," he explained. "There's incredible stress. When they come to see us, they're saying, 'Here's someone to take care of me." Ling has encountered, a few problems. In general, he finds that a fear of the water can be overcome. "When we're injured, . we have no control over our environment," he said. But with supervision and trained personnel willing to put in some time, he's found that even injured patients won't be afraid. Ling doesn't believe age is the critical factor in recovery possibilities. General health and fitness are much more important, he said. So is the attitude. "It has to be a team effort. If you invest in people, you bring' out the fight in them. They fight for you, then they fight for themselves," he said. "I've been doing this 80 hours a week for three years. I'm still excited about it. "It's (a combination of) service and education. We teach people 'I how to take care of themselves. That's the bottom line." Reprinted from July 18, 1991 RETURN TO TOP

West County Times Water therapy give lift to aching backs ALBANY - Bonita Claytor was pushing a cart bearing a 500-pound liquid nitrogen cylinder when the small steel wheels got caught on the leading edge of a carpet. She tried to tilt the cart and landed in the hospital. "I lost the feeling in my foot and my leg," said Claytor, 42, a lab technician at Chevron Research Co. in Richmond. "I didn't know that 1 had hurt my back." The jelly-like substance in the disk between Clayton's lumbar vertebra and sacrum had herniated, or squirted out, and was pushing on her spinal nerves, causing muscle weakness. and severe lower back pain. Now Claytor, 42, of East Richmond Heights feels pretty good. She credits a month of twice-weekly exercise sessions in the Albany Pool with allowing her to get off pain medication and ease back into her normal routine. She was at the pool Thursday doing jumping jacks and bicycle-pedaling. "While you're in the water, you don't feel the pain," she .said. "I can. walk a lot better now; I'm not limping as much. My stamina is better." Aquatic therapy, also known as hydrotherapy or water therapy, is fast gaining acceptance as the exercise of choice for people recovering from a variety of ailments. And since it is less costly than physical therapy, more and more insurance companies are paying for it. "The industry just exploded in '94," said physical therapist Alan Ling, a former employee of Brookside Hospital in San Pablo who now runs his own clinic, Physical Therapy Innovations of EI Cerrito. The body's natural buoyancy in water counteracts the stress of the body's weight on the spine on land, allowing certain muscles to relax in a way they can't outside the water. "In warm water, people don't tense up," said Mary Essert, Ling's business partner and a part-time employee of the Albany Unified School District, which owns the pool. "On land, you're always fighting gravity," Ling said while massaging Barbara Chill during Thursday's. exercise session. Chill, 55, a warehouse worker at Costco in Richmond has had lower back pain since a wooden table fell off a cart onto her ankle at work. The pain sometimes extends down to her leg, she said. The massage stimulates the blood supply to the injured areas, Ling said. The principles behind water therapy are not new. "Hydrotherapy has been around since the Romans in the fourth century (A.D.)," said Essert, an EI Cerrito resident who has published articles and has lectured nationwide -on fitness, especially in older people. Most water therapy patients are aging baby boomers, many of whom injured their joints running, and older people, Essert said. But pregnant women, people recovering from strokes and those with . various degrees of paralysis also benefit from the treatment. The group at pool Thursday consisted largely of people with back ailments like Clayton and Chill, but a few people were being treated for arthritis or newly healed fractured limbs and joints. Some did jumping jacks and cross-country skiing motions, while others walked or ran forward, backward or sideways, using their (arms and legs for locomotion, controlling the intensity of the exercise by varying the leverage and range of motion of their limbs, as Essert said. Others wore flotation belts of varying degrees of buoyancy, which encourages them to flex at the waist, to protect the lower back. This strengthens the abdominal and back musculature, Essert said. Reprinted from Sept. 3, 1995 RETURN TO TOP

Nancy Kerrigan Fights Back With Water Therapy February 7, 1994 Boston With the opening ceremonies of the 1994 Winter Olympic Games just around the comer, world famous figure skater Nancy Kerrigan has a lot of work to do to get ready. As if regular Olympic preparation weren't enough. Kerrigan is also battling the knee injury she sustained during an attack on her at last month's United States Figure Skating Championships in Detroit. A few years ago, returning to competition so quickly was simply unheard of for elite athletes. The rehabilitation of such serious injuries used to take several months at the least. But now, thanks to advancement in water therapy and rehabilitation, athletes like Kerrigan can rehabilitate their injured limbs using no-impact water exercises. Working out in the water not only allows Kerrigan to strengthen her knee, but also to maint the conditioning level of the rest of her body so she is still in excellent shape when she returns to competition. Water therapy worked for Bo Jackson. He trained in the water after undergoing hip replacement surge two years ago and was able to return to the playing field with the Chicago White Sox last summer. Water therapy has also worked for gold medal Olympic athletes like marathon Joan Benoit Samuelson, hurdler Roge: Kingdom, and miler Steve Scott. Since her accident, Kerrigan has been training in Boston pools using a floatation device called a WET VEST. The vest holds her upright in deep water and allows her to work out without touching the bottom oft pool. This "no-impact" aspect of deep water exercising is what makes it so successful for rehabilitation and training. According to Dr. Igor Burdenko of the Water & Sports Therapy Institute in Wayland, MA, water is the only place an athlete can go to get no-impact, gravity tree exercise. At his facility, he treats all types of sports injuries with his revolutionary new therapy. Burdenko says that deep water therapy is highly effective for man: reasons. First of all, water exercise creates absolutely no impact on the body. If a body is suspended in deep water using some type of floatation device, the support decreases gravitational pull and reduces stress on the joints, muscles, tendons, and ligaments. Since the feet do not touch the bottom, neuromuscular trauma is virtually eliminated. This allows a person to simulate any movements in water that he or she would so on dry land without the disadvantages of bone-jarring impact. Therefore, a runner who jog five miles a day around a track can do the same in the pool and eliminate the risk of impact-related injury. Secondly, the unique resistance that water offers allows an athlete to more effectively work an injured body pan. Water resistance is on average between 12 and 14 times greater than resistance encountered on dry land. This means an increased workload on the muscles being worked, without an increased workload on the cardiovascular system and the joints. Injuries heal more quickly using this enhanced workout so athletes such 8 Kerrigan are able to return to competition faster than ever before. Thirdly, and very important for rehabilitation, working out in the water allows an athlete to use a full range of motion for all muscles because there is no gravitational pull on the body. During water therapy, the muscles are subjected to isokinectic contractions, which means that an even amount of tension is placed on the muscle throughout a full range of motion. This is much more effective for rehabilitating injured muscles than weight-lifting, which employs isometric or eccentric contractions, and does not work the muscles evenly. This full range of motion even helps improve flexibility so many times athletes feel better than ever after a week or two of water therapy. Keep your eyes on Lillehammer this month to see Nancy Kerrigan's name added to the list of famous athletes using water rehabilitation and therapy! For more information: Dr. Igor Burdenko, Water & Sports Therapy Institute, 508-650-3666 RETURN TO TOP