are rowing machines good for knee joints? | live healthy

are rowing machines good for knee joints? | live healthy

Rowing machines offer excellent cardiovascular workouts while providing resistance for your upper and lower body, but they aren't right for everyone. The repetitive motion of bending your knees as you row can help build strong muscle around the knees, but it can also cause pain in people with certain conditions. Ask your doctor if rowing is the right exercise for your before climbing on the machine.

Rowing machines help build strong knees by working the quadriceps in the front of the thighs and the hamstrings in the back. When these muscles aren't worked equally, an imbalance in their strength can lead to pain in your knees or other areas, such as your back. Rowing provides resistance to both in continuous motion, so it can help prevent knee pain if you aren't currently experiencing any.

Rowing machines can make existing knee problems worse, particularly if you have trouble with arthritis or other pain that's not muscle-related or if you're currently recovering from a knee injury. At the minimum with the least amount of resistance programmed into the rowing machine you're pushing your full body weight with your knees. Adding resistance to that can stress your knees even more. The repetitive motion combined with the deep knee bend required on a rowing machine can make arthritis and existing knee pain worse.

After checking with your doctor to ensure rowing is safe for your knees, ask a trainer to teach you the proper form for the machine. Pushing from your heels rather than your toes helps reduce the risk of knee pain as you row. You should keep your back straight and move your legs in a full range of motion extend them fully as you push back, for example, rather than leaving your knees slightly bent. When you enter the recovery phase of the move, which is when you're moving forward and bending your knees again, allow your arms to straighten first until the bar reaches your knees before you bend them. This helps you keep the proper body position and cadence to your exercise.

When using the rowing machine isn't the best choice for you, several options exist to take it easy on your knees while still burning calories. In the gym, seek out an elliptical machine, for example, which is lower impact even than walking although walking is another exercise option. Swimming and water aerobics take pressure off your joints, helping you exercise without stressing your knees. A stationary bicycle might be the best choice for a resistance workout that's not weight-bearing. You can control the pedal resistance without pushing against your body in any way.

the acute effects of flotation restricted environmental stim... : the journal of strength & conditioning research

the acute effects of flotation restricted environmental stim... : the journal of strength & conditioning research

Morgan, PM, Salacinski, AJ, and Stults-Kolehmainen, MA. The acute effects of flotation restricted environmental stimulation technique on recovery from maximal eccentric exercise. J Strength Cond Res 27(12): 34673474, 2013Flotation restricted environmental stimulation technique (REST) involves compromising senses of sound, sight, and touch by creating a quiet dark environment. The individual lies supine in a tank of Epsom salt and water heated to roughly skin temperature (3435 C). This study was performed to determine if a 1-hour flotation REST session would aid in the recovery process after maximal eccentric knee extensions and flexions. Twenty-four untrained male students (23.29 2.1 years, 184.17 6.85 cm, 85.16 11.54 kg) participated in a randomized, repeated measures crossover study. The participants completed 2 exercise and recovery protocols: a 1-hour flotation REST session and a 1-hour seated control (passive recovery). After isometric muscle strength testing, participants were fatigued with eccentric isokinetic muscle contractions (50 repetitions at 60s1) of the nondominant knee extensors and flexors. Blood lactate, blood glucose, heart rate, OMNI-rating of perceived exertion for resistance exercise (OMNI-RPE), perceived pain, muscle soreness, and isometric strength were collected before exercise, after treatment, and 24 and 48 hours later. A multivariate analysis of covariance found that treatment had a significant main effect on blood lactate, whereas subsequent univariate analyses of variance found statistical significance with the immediate posttreatment blood lactate measures. The results indicate that flotation REST appears to have a significant impact on blood lactate and perceived pain compared with a 1-hour passive recovery session in untrained healthy men. No difference was found between conditions for muscle strength, blood glucose, muscle soreness, heart rate, or OMNI-RPE. Flotation REST may be used for recreational and professional athletes to help reduce blood lactate levels after eccentric exercise.

To maximize overall performance, an athlete must focus on both training and recovery. However, this period of rest after a training session is frequently overlooked, and over time, this may lead to overtraining and underperformance. During immediate recovery from intense bouts of exercise, the body often experiences acute muscle soreness because of acidic conditions of the blood, or lowering of the blood's pH, that stems from an accumulation of lactic acid, lactate, or H+ (2,5,14). To combat this increase and the decrement in performance after exercise, individuals often partake in 1 or more recovery techniques. Over the past decade, many recovery methods have been systemically investigated, including massage, cryotherapy, contrast water immersion therapy, active recovery, compression garments, and sleep (3). Several of these methods are associated with enhanced postexercise muscular recovery and performance along with a concomitant reduction in blood lactate (1,9,15,19,23,38). Each of these methods have limitations, such as risk of further tissue damage with massage, potentially extreme discomfort from cryotherapy or contrast water immersion, or the expense of numerous compression garments. Furthermore, all these techniques have a small effect size.

However, a relatively unexplored method of recovery, flotation restricted environmental stimulation technique (REST), may have a greater effect size and fewer limitations. Flotation REST involves reduction of environmental stimuli so that the human senses of sight, sound, and touch are compromised. The use of flotation has been in use since its invention in 1977 by John C. Lilly, in which the participant floated in a warm water and Epsom salt solution (33). The individual floats supine in an enclosed or open vinyl-lined tank with no light and water heated to roughly skin temperature (3435 C) by a waterbed heating system. Participants float with arms to their side to mitigate the sensation of touch via their hands against their body and the surrounding environment (13,35). The tanks are not airtight and are filled with roughly 757.08 L of water mixed with 362.87 kg of Epsom salt so that the individual is capable of floating. The water is filled with Epsom salt (magnesium sulfate, MgSO4) to a concentration (1.81 kg:3.79 L) considerably higher than that of the Dead Sea, allowing for effortless flotation in a solution that does not cause skin irritation (12).

Flotation REST has been used for a variety of ailments that include chronic pain (16), anxiety (16), and hypertension (13,18,34). It has also been used as a stress management medium to lower blood pressure, heart rate, and increase muscle relaxation for an overall sense of better well being (11). However, no studies, to the current knowledge of the researchers, regarding flotation REST and recovery from intense exercise have been performed. This is important because flotation REST has previously shown decrements in heart rate (11), blood pressure (13,18,34), and lactate (31). Therefore, the purpose of this study was to determine the effects of flotation REST on the recovery from an acute bout of strenuous eccentric knee extensions and flexions compared with a seated passive recovery. It was hypothesized that there would be a reduction in blood lactate, heart rate, perceived exertion, and perceived pain with enhanced recovery of knee extensor and flexor isometric strength with greater alleviation of delayed onset muscle soreness (DOMS) after a 1-hour session of flotation REST compared with a passive recovery period.

To investigate the effects of REST on recovery, a randomized crossover design was used where each participant acted as their own control. For the purposes of this study, we intended to use healthy normal population individuals before including a specialized population of either unhealthy or athletic populations. These untrained men were asked to participate to determine if the experimental protocol will show a change in the normal population before testing a specialized population (i.e., athletes). Women were not included in this study because of the variation of hormone levels that takes place as part of the menstrual cycle, which may have interfered with the study such as altering glucose levels. Untrained participants underwent baseline anthropometric, performance, and metabolic measurements followed by an eccentric muscle damaging protocol of the knee extensors and flexors. It is well established that unaccustomed eccentric exercise elicits DOMS (4,6,25). The muscle damaging protocol and the assessment of torque were conducted using the same device to increase the specificity of testing (36). Isometric strength testing occurred over the 3 days of in laboratory testing throughout both protocols to validate the outcome of the muscle damaging protocol. Blood lactate, blood glucose, and heart rate were measured before any testing, after the muscle damage protocol, and after the treatments to determine the effect of either the seated control or the flotation REST treatments. To gauge metabolic strain and recovery from the muscle damaging protocol, glucose and lactate were measured. Furthermore, high accumulation of lactate is associated with muscle fatigue (2). Therefore, decreases in the amount of lactate may be indicative of better recovery and better performance as previous research has observed improvements in resistance exercise performance associated with lower lactate levels (1,9). OMNI-rating of perceived exertion for resistance exercise (OMNI-RPE) (28), perceived pain scale (8), and a 100-mm Visual Analog Scale (VAS) to measure DOMS were used to determine the effect the treatments had on the individual's perceptions of effort and soreness.

Participants completed a detailed medical health history form to screen for any health issues that may prevent them from safely partaking in the study. Twenty-four healthy men (23.29 2.1 years, 184.17 6.85 cm, 85.16 11.54 kg) from a large Midwestern University participated in this study. Participants were explained all procedures and were given time to ask questions regarding the study. Participants were college-aged students who were screened for exercise habits and deemed untrained if they performed resistance exercises less than 3 dwk1 (17). Men who had a body mass index (BMI) greater than 29.9 were excluded as those with a BMI of 30 and higher are categorized as obese and are at a significantly greater risk of cardiovascular disease, hypertension, poor cholesterol ratio, and mortality (10). Individuals were also excluded if they have had recent surgery, a history of any knee pathologies (i.e., ligament tears), or medical condition in regards to the knee (i.e., chronic hyperextension of the knee, surgical alteration, or injury). Individuals who had a history of claustrophobia were also unable to participate because of the conditions of the experimental environment. Participants provided written informed consent after reading an informed consent document and having all questions answered regarding the study. This study was approved by the institutional review board.

After receiving details of the study, participants signed an informed consent, completed a physical activity questionnaire, and completed an extensive medical health history questionnaire. Participants were familiarized with testing for all dependent variables: maximal isometric strength, heart rate, blood lactate, blood glucose, blood pressure, OMNI-RPE (28), and perceived pain. Both experimental and control testing sessions took place on 3 consecutive days. Participants returned 1 week after completing the first 3-day session for the second 3-day testing phase. Day 1 of the experimental and control sessions were completed in 2 hours, whereas the visits on days 2 and 3 were 30 minutes in duration. Participants were instructed to refrain from any physical activity 3 days before any testing, during the duration of the study, and to maintain routine diet and sleep patterns. A 7-day physical activity recall questionnaire was completed before beginning the study to determine if previous strenuous activity may hinder their muscular performance (30). Participants were also instructed to refrain from eating 2 hours before testing, including caffeine, and for the duration of the first day's testing session (2 hours). Before testing, standing height (Seca 220 Telescopic Height Rod; Seca Corporations, Hamburg, Germany), body weight (T500E Athletic Scale; A&A Scales LLC, Prospect Park, NJ, USA), heart rate (Polar Vantage XL; Polar Electro Inc., Lake Success, NY, USA), blood pressure (Omron Health Care, Inc, Bannockburn, IL, USA), and simultaneous measurements of blood glucose and blood lactate (YSI 2300 Stat Plus Glucose/L-Lactate Analyzer; YSI Inc., Yellow Springs, OH, USA) took place for baseline data.

Participants performed a 5-minute warm-up on a cycle ergometer at 50 rpm before any muscular strength measurements. Initial isometric strength assessment took place to determine maximal force production of the knee extensor and flexor muscles of the nondominant leg. All testing took place using the Humac Norm Testing and Rehabilitation System (CSMi, Stoughton, MA, USA). The machine was calibrated according to the CSMi's user manual before each day of testing. The participants sat with the back angle of the chair set at 90 during the isometric knee extension and flexion strength assessment, and during the maximal eccentric knee extension and flexion exercise (27). The maximal isometric knee extension and flexion strength assessment was performed 3 times with the knee flexed at 60 for both the knee extensors and flexors and held for 5 seconds to measure maximal isometric force of the extensors and flexors (20,22,24,37). Participants were asked OMNI-RPE and perceived pain. The participants were given a 3-minute rest period after the initial strength assessment before performing a maximal eccentric knee extension and flexion exercise protocol (50 repetitions at60s1) (4). Blood glucose, blood lactate, and heart rate were measured after exercise. All participants were given water ad libitum immediately after the maximal eccentric knee extension and flexion exercise. Either the 1-hour seated passive recovery control or the 1-hour flotation REST session took place followed by an assessment of strength, measurements of blood glucose, blood lactate, heart rate, OMNI-RPE, and perceived pain. During the seated control, participants were asked to remain seated in the Neuromuscular Laboratory under the supervision of the researcher and were allowed to use cellular devices, complete homework, or use a personal computer. Participants returned after 2 days for isometric strength testing and measurements of OMNI-RPE, perceived pain, and DOMS using a 100-mm VAS.

Participants entered a 844.15-L galvanized water tank that measured 2.13 m long, 0.76 m wide, and 0.61 m deep (Freeland Industries Inc., Portage, WI, USA). The galvanized water tank was filled with 529.96 L of water and mixed with 254.01 kg of Epsom salt (San Francisco Bath Salts Co., San Francisco, CA, USA). After the first 10 uses of the tank, an additional 22.68 kg of salt was added to maintain the proper salinity of tank because of salt being lost when participants exit the tank as it adheres to the body and hair. Brief showers were required before and after treatments.

The room in which the tank was held was dark during treatment and in level of the building to keep noise to a minimum. A Green Ecology Home (model GW 302) 3-stage ultraviolet lighttreated filtration system (SunSun Industry Co., Ltd, China) was used to aid in sanitation of the sterile Epsom salt and water solution, whereas an 800-W True Temp heating system with digital controller (JBJ USA Aquarium Products, Inglewood, CA, USA) created a water temperature of 3435 C. The heating system was removed during all flotation sessions so that the participants did not burn themselves on the titanium heating rod. Average water temperature was 34.8 C.

Two space heaters, the Sunbeam Compact Heater (model SFH111-wm; Jarden Corp., Rye, NY, USA) and the Patton Milkhouse Utility Heater (model POH-680; Jarden Corp.), were used to heat the room to 26.6 C to help to maintain. The temperature of the room was measured using the Davis Perception II Weather Station (Davis Instruments Corp., Hayward, CA, USA). The lights in the flotation and adjacent room were turned off during each session, with a small light in the corner of the flotation room for the participant in case they needed to exit the tank early. A researcher was in an adjacent room during the flotation session to provide privacy for the participant while still supervising the experiment using the MobiCam AV (model 70060) infant monitor equipped with night vision (Mobi Technologies, Inc., Culver City, CA, USA). Before entering a tank, each participant read a script giving them instructions and informing them of video monitoring before their 1-hour flotation REST session.

The statistical analysis consisted of a multivariate analysis of covariance (MANCOVA) to determine if there were any statistically reliable mean differences between the independent variables for multiple dependent variables using baseline measurements as covariates. Dependent variables included muscle strength (in Newton meter), blood glucose (in milligrams per deciliter), blood lactate (in millimoles per liter), heart rate (in beats per minute), pain intensity, and OMNI-RPE. Each variable was analyzed during specific time periods (e.g., postexercise, posttreatment, 24 hours, 48 hours). A multivariate analysis of variance (MANOVA) was used to determine if any significant differences of DOMS occurred between the 2 categorical independent groups. Statistical significance was set at p < 0.05 for all analyses. Statistical analyses were completed using SPSS Statistics 19.0 Premium (SPSS Inc., Chicago, IL, USA).

Baseline values for muscle strength, OMNI-RPE, and perceived pain were calculated as the average of 6 measurements taken on 2 separate days separated by 1 week. The baseline values for blood glucose and blood lactate are averages of 4 measurements taken on 2 separate days separated by 1 week. Heart rate values are averages of 2 measurements taken before exercise on 2 separate days separated by 1 week (see Table 1).

The MANCOVA did not reveal a significant main effect for treatment with either the knee extension or the flexion measures. A follow-up univariate analysis of variance (ANOVA) revealed a significant main effect for the posttreatment knee extension (F1,45 = 4.629, p = 0.037, 2 = 0.093). Power to detect the effect was 0.558. No statistical significance was observed at any of the subsequent time intervals. The mean torque elicited by the knee extensors was greater during the control than the flotation treatment at the posttreatment interval (19.12 Nm; control 242.12 65.46 vs. float 223 58.03) and the 24-hour interval (10.58 Nm; control 239.26 55.74 vs. float 228.68 54.45). The 48-hour interval showed a greater mean torque value for the flotation treatment (7.88 Nm; float 236.93 71.32 vs. control 229.05 56.98) (see Table 2). No statistical significance was observed for any of the knee flexion measures during follow-up ANOVA tests (Figures 1 and 2).

A MANCOVA revealed a significant multivariate main effect for treatment on blood lactate (Wilks' = 0.768, F5,42 = 2.479, p = 0.023, 2 = 0.232). Power to detect the effect was 0.776. Therefore, the hypothesis concerning lactate is confirmed. A follow-up univariate ANOVA revealed that the treatment had a statistically significant effect on blood lactate levels immediately after the treatment (F1,45 = 10.356, p = 0.002, 2 = 0.187). Power to detect the effect was 0.883. No other statistical significance was observed. Mean blood lactate immediately after the flotation treatment was 0.66 mmolL1 lower than that of the seated control (float 1.11 0.27 vs. control 1.77 0.98), but blood lactate was found to be higher than the control treatment 24 hours (0.2 mmolL1; float 1.62 0.55 vs. control 1.42 0.52) and 48 hours (0.12 mmolL1; float 1.44 0.64 vs. control 1.32 0.36) after flotation treatment (see Table 3). The MANCOVAs performed on blood glucose and heart rate did not show a significant main effect for treatment, but statistical significance when performing a follow-up ANOVA was observed for 24 hours posttreatment heart rate (F1,45 = 4.361, p = 0.042, 2 = 0.088). Power to detect the effect was 0.533.

The MANCOVAs performed on OMNI-RPE did not reveal any significant effect for either the knee extension or the knee flexion variables. A follow-up ANOVA revealed a significant effect on pain perception during knee extension at the posttreatment interval (F1,45 = 7.004, p = 0.011, 2 = 0.135) with a power of 0.736. Mean pain level during knee extension after flotation was lower by 0.57 (float 0.46 0.72 vs. control 1.03 1.42) on the 010 scale. Conditions were not significantly different at any other time point. The MANOVA revealed no significance regarding DOMS between treatments.

The purpose of this study was to determine the effects of flotation REST after an acute bout of strenuous eccentric knee extensions and flexions. We measured knee extension and flexion, blood lactate, heart rate, perceived exertion, and perceived pain. Researchers hypothesized a reduction in extensors and flexors with greater alleviation of DOMS after a 1-hour flotation REST condition compared with the seated passive recovery period. Delayed onset muscle soreness was measured over 6 days after the muscle fatigue protocol, whereas other variables were assessed after the immediate 1-hour recovery period.

Statistical analyses found significance between the type of treatment and the immediate posttreatment mean values for knee extension force production (in Newton meter). The mean force production elicited by the knee extensors was greater during the control than the flotation treatment by 8% and was deemed significant during the immediate posttreatment. It appears from this study that force production of the knee extensors is somehow compromised after a 1-hour flotation REST session. This may be because of an increased state of relaxation stemming from floating with minimal environmental stimulation (11,13,16,35). Indeed, the reduction in environmental stimuli that is experienced during flotation REST has been used as a stress management tool with the primary goal of increased muscle relaxation (11).

The metabolic variable blood lactate shows a response similar to those seen in previous research (31) and expected physiological responses. Mean blood lactate was significantly different at the posttreatment time point. It seemed that blood lactate had a steady decrease throughout the control treatment. Lowered blood lactate after flotation REST is consistent with previous research (31) where a 25% decrease in blood lactate was observed after a 1-hour flotation session without exercise before flotation.

Blood glucose had an average decrease of 11.33 mgdL1 from baseline when measured after the flotation session compared with 7.84 mgdL1 mean change after the seated control. The difference, while not significant, may be explained by the lack of sympathetic nervous system stimulation (11). Specifically, the lack of arousal in the sympathetic nervous system may hinder epinephrine secretion, which stimulates glucose production. Therefore, the liver may not be able to readily produce and release glucose into the blood stream. Another potential consideration is the increased need of glucose by the brain, as it has been suggested that increased oxygen and glucose could be available to the brain during flotation REST allowing for the increased state of relaxation and enhanced mood (31). Glucose metabolism of the brain during rapid eye movement stage of sleep, a state similar to the profound relation achieved during flotation REST, is similar to that of wakefulness (21). Fourteen of the 24 (58.3%) subjects fell asleep during the hour-long flotation session, whereas all were awake during the control. The quality of sleep was not determined but is be an interest for further exploration. Coupled with the decrease in sympathetic nervous activity, it may be possible that cerebral glucose utilization further augments the decrement in blood glucose.

It is likely that a lack of sensory stimuli in the flotation REST treatment dampens arousal of the central nervous system thus leading to an increased state of relaxation (31). Although this is ideal for an individual trying to achieve this rested state, it does have the consequence of dampening the one's sense of proprioception, which provides information about the body's physical position and motion and is essential to athletic performance (26). Proprioception is a function of the somatosensory system, which allows stimuli to travel to the central nervous system to be processed (26). As proprioception is likely compromised during flotation REST, it is possible that those being treated with this procedure may not be able to produce large amounts of force in the immediate posttreatment period. Indeed, this is what was observed in the current study for the knee extensors and may also be true for the knee flexors, although no significance was seen between treatments. In short, the combined effects of decreased proprioception and impaired motor control from a lack of stimuli to the central nervous system (31) may explain the significantly lower mean value of the knee extensors and knee flexors during the posttreatment measurements.

The mean rate of perceived exertion values were not deemed significant, but it is noted that the mean rates of perceived exertion seem to be slightly lower for the knee extension and knee flexion during the flotation treatment. This may be attributed to enhanced feelings of relaxation that were witnessed in previous literature (16,31). Pain intensity values were statistically significant treatments at the posttreatment measurement. The reduction in muscle pain is congruent with other studies that have shown reductions in pain for several hours after REST treatment in patients with chronic whiplash disorders (12,35).

Delayed onset muscle soreness, as measured by the VAS, was greater during all the control treatment measurements except for the 48 hours postmeasurement. The strenuous resistance exercise protocol had the expected effect on soreness as DOMS peaked 48 hours after both treatments and began to subside in the remaining days. However, no significant difference between treatments was observed for DOMS, but soreness was evidently lower for many of the participants. On returning to the laboratory after the flotation treatment, participants stated (unprompted) that they felt less sore in the days after the flotation than during the seated control. As stated above, flotation REST has been effectively used as a pain control technique and to treat those with chronic pain (16,35). It is conceivable that such reductions in pain are related to enhanced relaxation experienced during flotation REST. Although this experiment was not designed for pain control, the added analgesic effect of flotation REST may provide additional rationale for the use of this technique. Although no research has been found regarding flotation and perceived soreness with elite athletes, according to various web pages (i.e.,,, professional athletes have claimed use of flotation to enhance recovery and improve performance.

This study provides novel data on the physiological and psychological responses to flotation REST; however, the data are not without limitations. The primary limitation of this study was the small sample size, which resulted in low statistical power. Also, it was not within the scope of this study to control participants' behavior outside of the laboratory (e.g., food consumption, overall activity, and amount of sleep), which may have impacted study results. It should be noted that strength data were not collected for the postexercise period, alternatively, the time frame before the commencement of either the seated or flotation treatments. Lastly, potential apprehension of participants before entering the flotation tank may have caused interference with the accuracy of data collected. Every participant was inexperienced with flotation REST before this study.

Results of this study indicate that flotation REST seems to have a significant effect on blood lactate. We found a decrease in blood lactate after a 1-hour flotation REST session compared with a 1-hour seated condition, which potentially allows for enhanced muscle recovery. Lowered torque production of the knee extensor muscles was observed after flotation, which may be explained by the lack of sensory stimuli and perhaps concomitant decline in proprioception and decreased motor control. Our data also suggest that individuals suffering from lingering muscle pain may also benefit from flotation REST. Based on this study, DOMS was not alleviated at a quicker rate after flotation. However, the inflammatory response causing pain during DOMS (7) possibly may have been dampened by the absorption of magnesium sulfate (MgSO4) across the skin. Therefore, it appears from this study that flotation REST may be used for acute recovery from strenuous exercise but does not have any significant effect on alleviating DOMS.

Flotation REST may be used as an alternative method of recovery after strenuous and exhaustive exercise of the knee extensors and flexors by enhancing muscle recovery by decreasing high levels of lactate. Athletes who have experienced micro-injury and who are in an increased state of pain may also find pain alleviation after flotation REST, which was observed in the current study and in several previous studies (12,16,29). The perception of pain may be decreased for several hours after a 1-hour flotation condition or even several months when administered on a consistent basis (29), which may give an athlete the confidence to play in the upcoming game or event. Although it is not recommended to play through a serious injury, which unfortunately is observed on a regular basis in collegiate and professional sport, flotation REST may provide a less risky alternative than other interventions. However, this method of pain relief as a preexercise, or precompetition, agent has not yet been studied and needs to be further investigated as our data suggest that force production immediately after REST treatment may be dampened. Recent literature has also displayed how chronic stress negatively impacts many physiological mechanisms involved in the recovery process (32). Athletes and the normal population may be able to use flotation REST after sustaining musculoskeletal injury to aide in the alleviation of pain and perhaps enhance recovery. This new literature may warrant further investigation regarding the utilization of various relaxation, or stress relieving methods, on the psychological and physiological mechanisms associated with the recovery phase.

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water exercise for osteoarthritis patients

water exercise for osteoarthritis patients

Water exercise (also called aquatic exercise, pool therapy, or hydrotherapy) can include aerobic or endurance activities, stretching and strengthening exercises, and range-of-motion exercises performed in warm water.

According to Johns Hopkins University, a good temperature range for most pool exercise is 82 F to 86 F. Therapeutic pools, usually heated from 92 F to 98 F, are appropriate for gentle range-of-motion exercise.

The buoyancy of water supports the body's weight. In waist-deep water, you bear about 50% of your weight. In chest-deep water, you subtract another 25% of your body weight. For osteoarthritis patients who struggle to stand and walk on weight-bearing joints, like the hip and knee, there is less stress on the joints in water. An exercise program performed in water is still an effective workout -- water provides 12 times the resistance of air. Walking in water allows the arthritis patient to build and strengthen muscle. Exercises that are painful on land are much less painful in water for people with arthritis.

People with knee osteoarthritis and hip osteoarthritis who perform exercises in warm water get some benefit. According to a Cochrane Review published on October 17, 2007, researchers assessed 6 trials that included 800 osteoarthritis patients. Four of the 6 studies included patients with osteoarthritis of either the knee or hip. One study had patients with only hip osteoarthritis and the other had only knee osteoarthritis patients. In the studies, patients did water exercise for various lengths of time and various sessions. Other patients exercised on land or not at all. Most patients were assessed after 3 months.

Researchers concluded that in people with osteoarthritis of the hip or knee, pain may decrease by one more point on a scale ranging from 0 to 20 with water exercise, and function may improve by 3 points on a 0 to 68 scale. Small to moderate improvement was observed for function and quality of life, with a minor effect on pain level.

No effect was observed on walking ability or stiffness immediately after water exercise. Researchers believe water exercise has beneficial short-term effects on hip and knee osteoarthritis. No long-term effects have yet been determined. More long-term studies are needed.

Before trying any type of exercise, discuss it with your doctor. While water exercise seems like a good thing, be certain that for you, the benefits outweigh the risks (such as overusing damaged joints).

Most arthritis patients have such a difficult time sticking with an exercise program because exercise can exacerbate pain in the short term. In the long term, exercise can actually reduce pain by strengthening muscles that surround the joints. It's tricky to know how much exercise is appropriate before crossing over into too much exercise or overdoing it.

Water walking is becoming popular. Water walking is considered easy on the joints, according to the Arthritis Foundation. You can walk in the shallow end of the pool or walk in the deep end with a flotation belt. You can walk backward and sideways, as well as frontwards in the pool, to tone different muscles. Sitting along the pool edge and doing kicks or squats also enhance your water workout.

the 7 best inflatable life vests of 2021 | in smooth waters

the 7 best inflatable life vests of 2021 | in smooth waters

If youre like most people, you probably recognize that life jackets are essential to staying safe. However, there are many details regarding the right inflatable life vest to use for your needs. When youre looking for the best inflatable life vest, youll need to be an informed consumer if you want to keep your head above water.

In this article, well review seven of the best inflatable personal flotation devices on the market, explain which features to look for when you want to buy an inflatable life jacket, and teach you how to avoid picking weaker personal flotation devices.

If youre interested in learning more about why inflatable life vests are critical safety tools, our website has an interactive resource depicting US drowning statistics as well as worldwide drowning statistics and drowning prevention.

Onyx A/M-24 personal flotation device is an industry-leading product thanks to its lightweight and minimalistic design. With the A/M-24, youll get a certified type V life jacket with Type III performance for open and calm waters.

The only downside of this Onyx inflatable life vest is that its a bit uncomfortable to wear on exposed skin. The fabric on the exterior edge of the vest is rough on your inner arms flesh, and the nylon belt can cut into your torso.

This means that if you prefer to wear your life vest without anything on underneath, you might want to look elsewhere. On the other hand, if you plan on wearing your life vest with light clothing on, this vest wont cause you to overheat, making it a great choice for fishing.

Bluestorm Gears Cirrus 26 inflatable personal flotation device is a slim and comfortable vest thats ready for kayaking or fishing expeditions. Unlike other personal flotation devices, the Cirrus 26 has a small pocket for sunglasses, chapstick, and anything else you might want to keep nearby.

The Cirrus 26 is also notable for its comfort. The rear harness fits naturally for most body types, and you wont need to worry about having broad shoulders. The only downside to the Cirrus 26 is that its buckle is directly in the middle of the stomach region at the bottom of the vest.

While it isnt technically a life vest, Faxpots inflatable snorkeling jacket fulfills many of the same functions. The Faxpot jacket is easy to store, extremely lightweight, and it doesnt require any CO2 cylinders or other pressurized gas canisters to inflate.

With this vest, youll have a high amount of buoyancy in an attractive cyan-colored package. You should be aware that this vest is designed to be used while wearing a wetsuit, however. If you plan on using this vest for fishing or kayaking, you may find that it isnt the best fit for your needs.

Youll need to manually inflate the Faxpot vest if you want it to provide any buoyancy. If youre on the open water, you should inflate the vest before you expect to need it, meaning that youll need to grow accustomed to its bulkiness.

The Belt Pack isnt a perfect life jacket, however. While it is worn about the waist like a fanny pack, you wont be able to wear any other pockets or packs at the same time, and the Belt Pack has no storage space of its own.

Bluestorms Gear Stratus 35 life vest is an excellent choice for anyone who wants a highly-buoyant flotation device that they can rely on in turbulent waters. The Stratus 35 has wide straps and a wider-than-average harness loop, meaning that its weight is distributed over a larger surface area.

This means that while the Stratus 35 appears to be larger than many other life vests, you wont notice the weight as much. When inflated, the Stratus 35 offers 35 lbs of buoyancy, meaning that its more buoyant than most of the rapidly inflating personal flotation devices on the market.

The Stratus 35 also has a roomy gear pocket so that you wont lose track of your stuff. The only issue with the Stratus 35 is that it works best for people whose shoulders are broader than average. If youre slim in the shoulders, the vest may seem comically large on you.

Eysons inflatable life jacket is a great all-around choice thanks to its highly adjustable design. With this vest, you can adjust the positioning of the back harness strap as well as the central belt strap, meaning that you wont have any issues if youre taller or shorter than average.

Likewise, the Eyson life vest is great for people who have more gear than average. There are several loops for hanging pouches or other pieces of equipment, and the jacket rides high enough so that they wont get in the way.

Unfortunately, the adjustable straps on the Eyson jacket might make it uncomfortable for some people. The rear harness strap can dig into your back, and the odd design of the front buckle may be hard for some people to secure properly.

Non-inflating devices have several advantages. First, they dont require any CO2 cylinders or breath-based assistance to provide buoyancy. This means that they are less expensive to use throughout multiple periods in the water.

However, non-inflating devices are always bulkier than their inflatable cousins. This makes them significantly less comfortable to wear for the majority of the time that you arent in the water.(You might be interested in reading the Best Non-Swimmer Life Jackets)

Inflatable devices are made with deflated air pockets that are enclosed in fabric. When the user inflates the vest, or the vest inflates automatically, the air pockets are filled with either CO2 or the ambient air. Then, the air pockets provide buoyancy.

Inflatable devices are more comfortable to wear when outside of the water because they are nearly always much smaller and more lightweight than non-inflatable flotation devices. Theyre also typically just as comfortable as their non-inflatable counterparts once youre in the water.

As far as buoyancy, theres no meaningful distinction to make between inflatable devices and non-inflatable devices for consumer-grade products. In other words, your inflatable life vest can be just as buoyant as a non-inflatable vest.

The biggest disadvantage of inflatable life vests is that they frequently require CO2 cylinders to inflate. Once you inflate the vest once, you will need to purchase another cylinder before the vest can go through another cycle of inflation.

Of course, if you dont have a spare CO2 cylinder, you can also continue to use the inflated device as a life vest so long as it still has air in its pockets, making it more like a non-inflatable device.

There are a handful of inflatable life jacket features you should know about because they have a large impact on the comfort and the utility of the flotation device. These features include the strap configuration, manual or automatic inflation, and the vests buoyancy.

The configuration of life vest straps varies from jacket to jacket. Most jackets have a belt section and a harness that reaches around the wearers back. The belt section is connected with a buckle either at the center or off to one of the users sides.

Some personal flotation devices have more unique strap configurations, with straps reaching between the wearers legs, under their arms, or across their chest. In most cases, these alternative configurations are less comfortable than the standard, so plan accordingly.

Likewise, the width of the life jackets straps can make a big difference in terms of comfort. Most people will find that wider straps made of softer and more elastic materials will be easier to wear for long periods, especially when worn over bare skin.

Some inflatable life vests are inflated manually with the pull of a cord. When pulled, the cord triggers the CO2 cylinder to inflate the vests air pockets and provide buoyancy. Most inflatable life jackets have a pull-cord as a backup whether or not they are automatic.

Alternatively, other manual inflatable life jackets require the user to breathe into the jacket to inflate the air pockets. Many inflatable life jackets also have a manual inflation tube as a backup whether or not they are automatic.

Automatically inflating life vests have systems which detect when the user has fallen into the water and then inflate the life vest accordingly. These systems can range from saltwater-sensitive fabrics to dissolving pills that uncap the CO2 canister when they are finished dissolving.

Importantly, automatically inflating life vests have a handful of backup methods to manually inflate the vest if the automatic systems fail. This means that automatically inflating vests tend to be safer overall than manually-inflating vests.

In other words, if you fall into knee-height water while wearing an automatically inflating life jacket, the jacket will probably inflate, spending the CO2 cylinder within. This means that automatically inflating vests can be a nuisance to keep uninflated leading up to the period when you need them to work.

Life jackets rate their buoyancy in terms of pounds. Many also provide helpful indicators for the maximum weight of the wearer. More buoyancy doesnt always mean that one jacket is better than another.

In general, the harsher and larger the waters you need your life jacket to work in, you will need more buoyancy. Likewise, the heavier you are, including all of your clothes and equipment, the more buoyancy youll need to be safe.

These benefits mean that automatic inflatable life jackets are great for everything from sailing to deep-sea fishing. In situations where you wont be in contact with the water until youre genuinely in danger, automatic inflatable life jackets provide peace of mind.

While it may be tempting to brush off the fact that automatic inflatable life vests work even when youre unconscious, for sailing, its an important feature. If you get hit in the head and knocked into the water by an unexpectedly traversing boom, an automatic vest will still save you, but a manual vest wont.

If you plan on using your inflatable life jacket in a situation where youll be in contact with the water frequently, even when you arent in danger, an automatic vest will be a significant annoyance.

CO2 cylinders arent expensive to replace, but it does take a minute or two to remove a spent bottle, deflate the vest, and re-attach a new cylinder after accidental inflation. If you want to rely on your automatic inflatable life vest, youll need to keep a supply of extra cylinders on hand.

On the other hand, if you plan to be on a boat or somewhere else where youre more likely to be completely dry until the moment you fall into the water and are subsequently in danger, automatic inflatable life jackets are a better choice than manual jackets.(If you want to purchase vests just for boating, you should read: Best Boating Life Vests)

First, make sure that the life vest is firmly secured using all of the provided straps and buckles. There shouldnt be anything extra dangling from your vest that is not attached or cinched to make a close fit.

While it may seem annoying to cinch the vest tightly and secure all of the straps and buckles, the vest needs you to do these things to ensure that it works correctly if you are knocked into the water.

Second, you shouldnt tamper with the reflective strips, inflation cylinder, or any other part of the life vest. You may be tempted to remove the reflective strips or replace them, but there isnt any advantage to doing so.

Third, check your life vest for any perforations before putting it on. If the air pockets of your life vest are damaged, theres a chance it wont be able to inflate at all. Likewise, if the straps are fraying, they may rip when you inflate the vest.

Most inflatable life jackets dont need much maintenance, but there are a few best practices. In general, your inflatable life jacket will maintain itself so long as you keep it stored in a dry and dark place.

You should also make sure that your inflatable life jacket is not wet when you collapse it for storage. If you pack up your life jacket while it is wet, it may grow mold, and the fabric may become damaged.

In the same vein, you should avoid leaving your inflatable life vest submerged in saltwater for long periods. Saltwater is harsh on most materials, and with extended exposure, it may cause the fabric of your vest to deteriorate. The same goes for any chemicals like gasoline or grease.

Aside from these tips, you should also test your inflatable life vest buoyancy relative to your weight in a controlled setting. This means that you should inflate your jacket and submerge yourself in the water. If your head stays above water as a result of the buoyancy of the vest, your vest is a good fit.

On the other hand, if your personal flotation device doesnt keep your head above calm waters during your test, youll need to find a different one with more buoyancy. Remember, in rougher waters, youll need a higher amount of buoyancy to stay comfortable if you fall in.

On that note, you should also ensure that your personal flotation device is balanced such that it keeps your head facing above the water even if the vest is inflated when your head is facing down into the water.

Most inflatable life vests are balanced so that you can right yourself very quickly once the vest is inflated. If you find that during your test, it is difficult to right yourself from a face-down swimming position when the vest is inflated, you should find another vest or adjust your vest.

The point of the self-righting balance of inflatable personal flotation devices is that it will keep your head above the water even when you are unconscious. So, if the vest isnt balanced correctly, you cant count on it to keep you safe.

That concludes our review of the seven best inflatable personal flotation devices. We hope youve learned something about the features to look for in a life jacket and the major differences between automatic and manually-inflating life vests.

Remember to make your life jacket choice carefully. If you pick the right life vest, you could be saving your life down the road. On the other hand, if you choose the wrong PFD for your needs, it could let you down when you need it the most.

physical therapy exercises to do after total knee replacement

physical therapy exercises to do after total knee replacement

If youve had knee replacement surgery, chances are very high that youll feel far less pain and can move around much better than before. Physical therapy (PT) is an important part of that recovery. Rehab exercises will help you walk, climb stairs, and return to other normal activities more quickly.

This may surprise you, but you can expect to start PT within a day of your operation. If you're not in too much pain, you may start the day of the operation. At first, you'll sit up on the edge of the bed, and maybe stand and walk a few steps with some help.

A physical therapist will come to your hospital room and show you exercises you should start doing right away. For instance, they may ask you to pump your ankles or tense and relax your thighs. Youll have fresh stitches and a brand-new body part. Trust that the moves are safe, though. Theyre designed to:

Most people spend 1 to 3 nights in the hospital. After youre discharged, you might check into a rehab facility. There, youll usually get physical therapy 6 days a week for a couple of weeks. One advantage of a rehab clinic is that you will have help and youre sure to do your exercises every day.

A third way is to do your PT at an outpatient rehab clinic. Some people have even the knee surgery itself as an outpatient, without an overnight stay. Your doctor will decide the best option for you based on your age and health.

Eat right. Even if you dont have an appetite after the operation, make sure to eat nutritious foods. Your doctor may also suggest an iron supplement or fiber-rich foods to lower possible problems with medications.

The therapist also will help you with bedside exercises. An example is to tighten your thigh muscles, hold for 5-10 seconds, release, and repeat 10 times. Youll also pump your ankles by moving your foot up and down to tighten your shin and calf muscles.

Day 2: Youll keep doing exercises to strengthen the muscles that support your knee. You will practice bending and straightening your knees, as well as flexing and relaxing your thigh muscles. Youll also walk farther, either with a walker or crutches.

You'll gradually add more strengthening exercises as you build up your endurance. You should exercise 20 to 30 minutes two or three times every day -- or as much as your doctor suggests. Walking several times a day may also help. Start with only 5 minutes, and work your way up to 20-30 minutes several times a day. Use a cane if you need it.

In 3-6 weeks, you could shop for groceries, get up from a chair, and do other things that were difficult before the surgery. Just remember that you might not be 100% pain-free. Let you doctor know about any pain that bothers you.

aquatic therapy in the rehabilitation of athletic injuries - sciencedirect

aquatic therapy in the rehabilitation of athletic injuries - sciencedirect

Increasing interest in aquatic physical therapy can be attributed in part to its evolution from the limited confines of spas and Hubbard tanks, to the larger venues of swimming pools. These larger exercising areas accommodate a greater variety of exercises, including those that require sustained propulsive movements.

Using the water to regain lost mobility and strengthen weakened muscles has been described by a number of authors.9, 19, 20, 31, 35 The purpose of this article is to discuss the manner in which aquatic physical therapy is used for the treatment of common athletic injuries.

things that worsen knee osteoarthritis | everyday health

things that worsen knee osteoarthritis | everyday health

When you live with osteoarthritis the most common type of arthritis knee pain and stiffness can seem difficult to avoid. Your knees and other joints may feel swollen, especially after being active, and the symptoms can worsen over time. More than just wear and tear on your joints, osteoarthritis is a joint disease.

Some of the factors that can worsen knee osteoarthritis pain wont come as a surprise. For example, if youve had a long career working at a job that requires you to stand for extended periods of time, bend a lot, or lift heavy objects, this can impact your cartilage, or the connective tissue in the joints between bones. When cartilage wears away, this causes swelling, pain, and trouble moving the knee joint. Athletes who sustained injuries, even long ago, can also be at risk for faster cartilage breakdown and osteoarthritis.

As osteoarthritis progresses, the knee and other bones may break down and develop what are called spurs, which are growths around the bones edges. Little pieces of bone or cartilage can also break off and float around in the knee joint, according to the Arthritis Foundation. In the later stage of osteoarthritis, the cartilage between the knee bones wears away completely, causing bone to rub against bone, which can lead to even more pain as well as joint damage.

An important part of managing osteoarthritis knee pain is working with your doctor. Talk to your doctor about your symptoms and when you feel knee pain most often, such as first thing in the morning, or during or after being physically active. You will also want to speak up if your pain is worsening. Although there are medications and surgery available for osteoarthritis, the best treatment for you may be different than that of someone else with the condition.

Whats more, controlling pain from osteoarthritis of the knee may be easier than you think. In fact, it could be a simple as taking an honest look at your daily habits, some of which may be triggering your joint pain. People with osteoarthritis have a lot of control over behaviors that can help to reduce pain symptoms, says Matt Garver, PhD, an exercise physiologist and an assistant professor in the department of nutrition and kinesiology at the University of Central Missouri in Warrensburg. Often a mix of different approaches is most helpful for osteoarthritis.

It may seem counterintuitive to exercise if you have joint pain, but the Arthritis Foundation tells people to be active. The knee joint loves motion, says Brian Halpern, MD, a sports medicine physician with the Hospital for Special Surgery in New York City and author of The Knee Crisis Handbook. The challenge is to find the best types of activities for you. Dr. Halpern recommends bicycling, swimming, and elliptical trainers, as well as strengthening exercises that help muscles support the knee joint.

Although everyone with osteoarthritis is different, Halpern says that exercises that tend to aggravate knee osteoarthritis are deep squats, lunges, and any movement that pounds on the joint. Additionally, some people with osteoarthritis are simply too active, says Wayne Johnson, MD, an orthopedic surgeon in Lawton, Oklahoma. For example, runners might need to cut back on running, while people who do other active things like gardening, for example should spread out their activities instead of trying to do it all in one day. Talk to your doctor about what types of exercise are safe for you given the severity of your osteoarthritis and the amount of pain you experience.

The more you weigh, the more stress is placed on the knee joint, which can trigger an increase in pain, according to the American Academy of Orthopaedic Surgeons (AAOS). Whats more, a study published in August 2017 in the journal Radiologyfound that when overweight and obese adults lost weight over a two-year period, they significantly slowed down their rate of knee cartilage degeneration.

People with knee osteoarthritis often know that healthy lifestyle habits like exercise and weight control are recommended, but they arent implementing them, Dr. Garver says. His research, which was published in the October 2014 issue of The Journal of Rheumatology found that meeting with others who have osteoarthritis and sharing similar challenges can help motivate people to change their habits and add an exercise routine into their life.

People who eat more fruit, as well as those who are active and generally in good health, tend to have lower levels of osteoarthritis pain, according to the results of a survey of 197 adults published in September 2015 in the journal Pain Research & Management. Plus, eating healthier and being active can help reduce weight, which can also help reduce stress on the knee joint. In general, eat more fresh fruits and vegetables and lean meats, and avoid processed foods if you need to lose weight, says Dr. Johnson.

Depression, sleep problems, and osteoarthritis pain appear to be linked, according to a study published in March 2015 in the journal Arthritis Care & Research that assessed sleep, pain, and depression symptoms in 288 adults over the course of a year. The anxiety, stress, and worry that can go along with someone whos depressed may minimize their ability to cope with osteoarthritis, Johnson says. If you think you may be depressed, seek treatment immediately.

Vitamin D is crucial for bone health, as well as helping regulate the immune system. A study published in April 2014 in the journal Annals of the Rheumatic Diseases involving 769 adults with knee or hip pain revealed that a moderate level of vitamin D deficiency is correlated with increased pain levels. However, other studies suggest that taking vitamin D supplements may not be the answer to this issue: A June 2017 article published in the Orthopaedic Journal of Sports Medicine concluded that the effectiveness of vitamin D supplements for osteoarthritis was uncertain. It might be better to rely on other ways to get vitamin D besides taking supplements, such as eating foods specifically fortified with vitamin D like certain cereals, soy products, milk, and cheese; consuming fish; and even getting a bit of sunshine, which helps your body absorb vitamin D. Your doctor can test your vitamin D levels and make an appropriate recommendation.

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