Why Doctors Recommend Water Running

This article originally appeared in the Fall 2011 issue of USA Triathlon Magazine.
The benefits of pool running — a form of cross training when your joints need a break or you are sidelined by injury. Now, learn why doctors recommend this method of training and quick tips to help you excel.

1. Athletes are truly unloaded, allowing a workout without the impact

2. Water running is closely biomechanically specific to running. Done correctly, it uses muscle groups in a very similar fashion as running on land.

3. Usefulness is backed by science. Studies have documented that athletes can reach necessary metabolic levels for training effect and that this can transfer to improved fitness for land-based running as demonstrated by improvements in both land-based VO2 and performance.

4. Not just for injured: great for a low-impact, high-turnover workout or for a low-stress form of active recovery.

5. Temperature-safe environment. One can get a hard workout in on bad weather days that normally disrupt training.

6. Most injured runners and triathletes can continue water running even when injured to minimize the effects of missed training.

Quick Tips

1. Pattern your form as closely to running as possible. The following guidelines for maintaining proper form are an excerpt from the “Textbook of Running Medicine” by Francis G. O’Connor and Robert P. Wilder:
•The water line should be at the shoulder level. The mouth should be comfortably out of the water. The head should be looking straight ahead, with the neck unflexed.
•The body should assume a position slightly forward of the vertical, with the spine maintained in a neutral position.
•Arm motion is identical to that used on land, with primary motion at the shoulder. Hands are held lightly clenched.
•Hip flexion should reach 60 to 80 degrees. As the hip is being flexed, the leg is extended at the knee (from the flexed position). When end hip flexion is reached, the lower leg should be perpendicular to the horizontal. The hip and knee are then extended together, the knee reaching full extension when the hip is in a neutral position (0 degrees flexion). As the hip is extended, the knee is flexed. These movements are repeated, and throughout the cycle the foot undergoes dorsiflexion and plantarflexion at the ankle. The ankle is in a position of dorsiflexion when the hip is in a neutral position and the leg extended at the knee. Plantarflexion is assumed as the hip is extended and the leg is flexed. Dorsiflexion is reassumed as the hip is flexed and the leg is extended. Underwater viewing demonstrates that inversion and eversion accompany dorsiflexion and plantarflexion, similar to land-based running.

2. Pattern workouts as closely to land workouts as possible (long runs, tempo runs, intervals…same time, same intensity: use perceived exertion to guide intensity)

3. Monitor heart rate: expect about 10 beats per minute less in water than on land (note lower heart rates in water actually correspond to higher VO2 so 10 beats per minute lower than land value is a good ballpark). If trouble getting heart rate up: check form: make sure you are bringing leg muscles into it.

4. Strength in numbers: cajole friends into joining you for a workout. The company will pass the time faster, just as with any training session and they will appreciate the introduction to a new option for their own training.

Robert P. Wilder, M.D., is the Harrison Distinguished Associate Professor and Chair of Physical Medicine and Rehabilitation