In my last post, I talked about how pool exercise/aquatic physical therapy has been so central to my recovery– both in getting me to the point I’m at now, and also helping me to maintain my recovery.
The really great thing about water exercise, and why I believe it is superior to pretty much any other form of exercise for the SI joint, is that it allows you to strengthen the muscles that support the SIJ without putting additional strain on your ligaments.
As if that wasn’t enough, the pool offers additional benefits you can’t get from any other form of exercise.
The most important move I do in the pool is to let my legs hang beneath me in the deep end.
Basically, you want to use some sort of a flotation device to support your upper body. For our purposes here, it doesn’t matter so much what you use: the point is that your upper body is being held up, and your legs are free to hang down beneath you.
I usually use a noodle, as physical therapist Dr. Jo does in this video:
But you can use anything that helps keep your upper body at the surface of the water, while your legs are free to hang beneath you. (You could also consider an Aqua Jogger vest).
What this does is allow gravity to pull your legs and your lower body down, while the buoyancy of the water combined with the flotation device gently holds your upper body up.
These opposing forces create what is known as traction on your spine.
Healthy joints have a little bit of space between them.
However, due to injury or just the normal process of aging, sometimes our joints can become compressed. (This is definitely a factor in SI joint dysfunction, but can happen in other joints as well, particularly within the spine).
When joints are compressed, they do not function optimally. Normally our joints have a bit of fluid in them, to keep things lubricated and provide nutrients for healing. When a joint is compressed, the flow of this fluid is restricted, meaning we may not heal as quickly or may have pain.
The point of traction is to re-create space in a joint that has become compressed.
You may be familiar with the concept of traction from land-based physical therapy.
Basically, traction is a form of treatment in which you are attempting to create space in a joint, by gently applying forces to pull each side of the joint in different directions.
There are ways for a physical therapist or chiropractor to apply traction manually, with their hands (I’ve had them gently apply traction to my neck, which felt great. Basically, it just feels like they are pulling on my neck to create space between the vertebrae, but there is obviously a lot of skill involved).
And there are also traction machines, which you can use in a PT’s office or even buy to use at home:
Now, I don’t know a ton about the various forms of traction treatments. I have never tried a traction machine myself, and knowing how sensitive my body is to any sort of dramatic intervention, I wouldn’t really be interested at this point in time.
(This seems like a great time to note that I have recently added a “Disclaimer” section to my sites, reminding you I am not a licensed medical professional– I am simply a patient sharing what she has learned. Please consult your doctor with any questions!).
With all that being said:
I personally think that the kind of traction you can get in a pool is probably one of the best things you can do for your SI joints, or for back pain in general.
To me, it seems way more gentle than many of these land-based treatments, and it’s something you can easily control yourself.
When you let your legs hang beneath you, you are letting gravity gently pull you down, creating the same traction forces that you would get from a hands-on treatment or from a machine.
But again, it’s a lot less invasive, it’s something you can control yourself, and it doesn’t cost anything extra. Instead, it’s something you can incorporate into your overall workout without very much effort.
In her video above, you will see that Dr. Jo is using ankle weights during her exercises. This is something that some aquatic PT’s will recommend– it intensifies the effects of gravity pulling you down, meaning you get a stronger traction effect.
I personally do not use weights, and I’ve never tried them. Again, I know that my SIJ’s are very sensitive to any sort of dramatic intervention, and I still feel the benefits of traction when I don’t use them. So I stick with what works for me.
(But please– consult your doctor or qualified physical therapist before making the decision for yourself!).
For more ideas:
Here is another great video that I really appreciate. It shows an aquatic therapy session for a patient with multiple sclerosis:
If you fast forward to the 2:30 mark, you will see the part where she is using multiple noodles as well as hand “floats” to give herself more stability than you’d get with just one noodle. You can experiment with different noodle/float configurations to figure out what works best for you.
So, that’s all for this post. I hope it was helpful for you. Please let me know if you have any questions!