By Land or By Sea: Why water may not be the best for all rehab needs.

Water-based exercise or therapy has many benefits, including easing of stiff joints and muscles, improving endurance, reducing pain, and possibly enhancing your sense of well-being, mood and sleep quality.

But is it the answer when strengthening is required to recover from an illness or injury?  A recent review and analysis of numerous studies on the effectiveness of aquatic-based exercises in improving lower limb strength in people with musculoskeletal conditions indicates that it may not yield the results at the same rate it is being practiced currently.

The review studies indicated that there was no difference in the strength of the studied lower limb muscle groups between aquatic exercise and no exercise.  The analysis concluded that there is inadequate application of resistance in water exercise which likely leads to minimal to no strength gains.  More research is needed to help determine if using methods of greater resistance in the water along with appropriate resistance training principles can be more effective at improving muscle strength.

The take-away message from this may be that if your physical therapist or doctor feels your condition needs strengthening to improve, your best bet may be land-based therapy or a combination of land and water-based treatment.

Thank you for reading.  Stay active and give us a call today to see if we can help.

Stephany Primrose, PT

Reference: Effectiveness of Aquatic Exercise in Improving Lower Limb Strength in Musculoskeletal Conditions: A Systematic Review and Meta-Analysis 2016

Cycling for Fun and Fitness

Cycling is a popular and fun way to spend time enjoying the outdoors now that the summer weather has arrived.  The benefits to our cardiovascular (heart and lungs) and musculoskeletal systems are numerous and include muscle strength and flexibility, increased blood flow to muscles, improved heart function, strengthened bones and improved mood, to name just a few.  There are some things to keep in mind when beginning your cycling program since it is a new activity for your body’s muscles, joints and, in particular your sit area, to adjust to if you are new to it or have not been riding all winter.

Begin slowly, gradually increase distance to your ride each week.  Progress from flat terrain to more hilly terrain.  Take extra caution if it has been awhile since you have ridden a bike.  Choose low traffic roads and ALWAYS wear a helmet.

Proper bike fit is essential to preventing soreness and injury and the overall enjoyment of your ride.  There are numerous resources on the web, such as , to properly fit your bike.  However, a trip to your local bike shop to allow the professionals there to make the adjustmens or offer necessary safety or fit accessories, may be a great place to start.  Paula Hoffmann, PT, MPT, MS here at Advanced Physical Therapy and Fitness (717-790-9994) is also able to assist you with fit, especially if you are having muscle, joint or spine pains.

Try out some of the local rails to trails ( )to enjoy vehicle free trails and the company of other riders.  Get outdoors…stay active…be safe…and have fun!

Pilates and Lower Back Pain

Back pain is a major health issue in our country.  It is estimated that 60-80% of adults will experience low back pain (LBP) at some point in their lives and low back pain accounts for millions of dollars in health care costs.  According to research studies, core stabilization programs have been shown to significantly reduce chronic LBP by 39-76% and muscular strengthening programs can reduce it by 61.6%.  According to recent research studies, Pilates was found to significantly improve back pain, as well as hamstring and low back flexibility for patients diagnosed with non-specific chronic low back pain. 

The Pilates method of exercise was developed by Joseph Pilates in the early 1900's when he was interned in England.  He named his exercise "Contrology" and defined it as "complete coordination of body, mind and spirit."  The focus of his exercises was on developing the core stabilizing muscles of the abdomen, which then provided the rest of the body the ability to move freely and with increased ease and flexibility. 

Today, Pilates exercises are taught in a variety of settings including; private studios, gyms and even physical therapy facilities.  

Benefits of Pilates:

  • Mind-body workout
  • Development of a strong core
  • Improves overall flexibility
  • Increases postural awareness
  • Creates a more balanced and efficient body through the use of whole body activation
  • Gentle, low impact activity which can be modified for all different individuals

 Pilates exercises emphasize core stabilization training and proper recruitment of the transversus abdominis, oblique muscles, multifidus, and pelvic floor muscles.  The transversus abdominis and internal oblique muscles attach to the thoracolumbar fascia and help to increase the stiffness of the tissue, which helps to enhance core stability.  These muscles also help the spine to resist various stresses which aides in reducing low back pain.  Pilates exercises also stress proper breathing techniques, as well as, correct spinal and pelvic alignment by teaching the client a neutral spine position and improving postural awareness.  Exercises are performed with a strong emphasis on the quality of the movement, proper control and coordination of whole body movements. 

As with any exercise program, before starting it is best to ensure that the instructor is certified in the Pilates exercise method and has an understanding of specific back problems.  It is also best to start with several one-on-one sessions, in order to learn proper form and technique for the exercises. 

Talk to your PT today about whether Pilates is right for you!

Jennifer Buono, PT, DPT and certified Pilates instructor


Siler, Brooke.  Your Ultimate Pilates Body Challenge. New York, 2006. : A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain (2016).


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  Disclaimer:  The information in this medical library is intended for informational and educational purposes only and in no way should be taken to be the provision or practice of physical therapy, medical, or professional healthcare advice or services. The information should not be considered complete or exhaustive and should not be used for diagnostic or treatment purposes without first consulting with your physical therapist, physician or other healthcare provider. The owners of this website accept no responsibility for the misuse of information contained within this website.