by Debra Frank, MS, MS


Water Works Wonders

Everyone can do it! Regardless of swimming skill, age, weight, height, or disability, exercise in the water allows the body a quality workout, stimulating visceral, cardiopulmonary, neurological and muscular responses, with less stress than comparable land or weight-bearing activities. Water's gentle massage, combined with a structured and scheduled workout program, can assist you in regulating your blood sugars, and, as with any form of exercise, can increase your sensitivity to insulin. A workout in the water is fun, too.

Since water diminishes the effects of gravity, it lessens joint stress, and increases general joint flexibility. In the water, buoyancy increases resistance, so the arm and leg muscles work when you push down as well as when you push up. Since buoyancy enhances range of motion, many folks can do exercises in the pool that they could not do on land. And water's buoyancy cushions the body, decreasing the chances of injuries common in land exercise.

You burn more calories, working out in the water, than you do with the same exercises on dry land. It is important to test your blood sugar more frequently, and of course there is the possibility of hypoglycemia (as with any exercise program), but in the water its onset may be less acute. People who are otherwise advised not to participate in "land-based" exercise programs are often steered toward water fitness, by their medical team.

It is imperative that you inform your personal medical team of your participation in any exercise program, so they can discuss your individual adjustments in medication and food. It is your responsibility to inform the instructor of your diabetes, and to make him/her familiar with any special needs you may have. Of course all discussion will take place in confidence, and will allow you to develop a long-term successful fitness program.

Water based exercise programs have been around for centuries, and are the primary phase one rehabilitation programs in Europe, but Americans still have trouble finding facilities and instructors for "Aqua/Water Exercise." Most YMCA's have qualified programs, as do many of the larger health club facilities. Many public recreation programs offer similar, but may not be led by a certified instructor. Ask! The Aquatic Exercise Association and the American College of Sports Medicine have training and certification programs throughout the country, and their graduates are getting into every pool and puddle available.

Exercise of any form increases self-image, body-image, and self-esteem. Choosing a program that allows you to participate, no matter what level you start at or what barriers you face, is a sound idea.

And don't make too much of those "barriers." In my classes I use the "buddy system." We assist each other. This allows the visually impaired, the motor impaired, and those with cardiac conditions to keep up with the group, but work at their own pace, setting their own goals. Nobody is left out. I know that even if somehow there is a cure for diabetes, or a magic formula for fitness, I will continue doing my water exercises. Thirty years from now I will be laughing and counting in the pool, with a tight body and a serious gray bun on top of my head. It truly makes me feel good about me.

In March of 1996 I had the pleasure of talking to a diabetic support group at South Nassau Hospital in Oceanside, New York. Following that presentation, one of the women asked me about my Water Exercise Classes at Hofstra University. Because of her chronic neuropathy, she was afraid to exercise, or even to walk. Since she could not swim, she had not previously embraced the idea of water exercise. With a little positive reinforcement, she decided to register for the 12-week summer season. When she came to the first class she was so surprised to see me and many of my students with makeup on, lipstick and all, hair pinned neatly on our heads. By the end of the first class she was beaming. Her body was moving better than it had in years, and her feet, protected by water socks, were feeling no pain. Since that first class she has been joined by another woman from her support group, and by her husband. She and I test our blood sugars after class, and if necessary, we sip an orange juice or hand one another a glucose tab.

Writer's note: It just occurred to me how much passive (as well as active) exercise and therapy I get from the water. As I sit down to finish this article I just came out of my weekly "bath and shave" ritual. Once a week, over and above my daily showering and pampering, I do my best to take a bath. Usually it will be in the evening, before the beginning of a hectic week, or like tonight, when I need to chill out and relax before tying up loose ends and finishing deadlines. Warm water works wonders in my tense body. It is so rejuvenating and relaxing, and there I have time to massage my feet and do the other hygienic things we often rush when we shower. My mom was the one who started it all--over two decades ago, before exercise of any form was part of the diabetic medical protocol, my mom put me on the swim team. When I got out of control, whether from being a typical adolescent or from being off the diabetic Richter scale, she would put me in the bath for a while to "chill out." Of course an hour later I had to scrub the entire bathroom, tile by tile, but the lesson was learned and the wonders of water were etched into my lifestyle.