Many different injuries are seen in returning veterans of modern warfare. Since the invasion of Iraq and Afghanistan, 50,420 United States service members have been wounded in action (Kozen, 2010). Injuries range from chronic lower back pain to multiple limb amputations due to the large forces of present day weapons. Cognitive impairments, such as Post Traumatic Stress Disorder (PTSD), can make a veteran’s return difficult as well. These injuries and mental disorders can be managed using aquatic therapy and exercise programs… but are there enough nationwide?
The Wounded Warrior program gives aid to any soldier physically or mentally injured on or after September 11, 2012. The mission of the Wounded Warriors program is to honor and empower injured veterans and ease the transition back to a normal civilian life. Warriors team up with specialized sports providers to rehab from injury and maintain a high level of physical fitness. Many types of rehabilitation are used to reach the warrior’s desired goal, including aquatic therapy and exercise.
Dr. Mary Wykle is an aquatics and fitness professional who works with these wounded warriors. Wykle founded the Aquatic Warrior Exercise Program (AWEP) to give injured soldiers another option of healing. “The pool accommodates the large variety of injuries by allowing everyone to work at their own pace. No matter the stage of recovery, all participants could benefit,” says Wykle (Tucker, 2010). The AWEP was to start as therapy and rehab, then transition into a more vigorous exercise program. Fort Belvoir and Fort Eustis in Virginia, along with Fort Lewis in Washington, were the first three facilities that participated in the aquatics program. Data from the workouts was obtained from 250-500 wounded soldiers, or Warrior Transition Units (WTUs). Officials are now reviewing and comparing the aquatic therapy to land-based-only therapy
Many different types of injuries arise that can be rehabilitated in the water. Amputations, surgeries, and PTSD are just a few of the complications, with back, shoulder, and knee problems being the most common musculoskeletal injuries (Kozen, 2010). The goal is to reteach the warrior to use his/her body effectively after injury. Some WTUs have assistive equipment, such as prosthetic limbs, with which they need to learn to function. The aquatic medium is a great place to start because all aspects of fitness can be improved in water while easing the entry into an exercise program.
Reduced gravity provided by the buoyant force of water can assist with balance, while the decreased weight bearing can relieve joint pain (Tucker, 2010). Hydrostatic pressure also enhances blood circulation while reducing swelling and the sensation of pain (Hannan, 2010). Many activities can be completed in the pool that a warrior may not be able to initially perform on land. The pool allows individuals to go at his/her own pace while still improving ROM, strength, endurance, flexibility, and balance, regardless of the injury. Group classes offer moral support, which may boost cognitive functioning (Tucker, 2010).
If an individual has impaired walking ability, his/her activities of daily living and quality of life will be negatively altered. For this reason, regaining the ability to ambulate is imperative. Gait exercises in the pool can improve walking ability, balance, and coordination. The force of the water challenges posture when moving, which recruits other muscles to counteract the turbulent forces (Hannan, 2010). Paddles and gloves can also be used with walking to add drag to any movement, further improving muscular strength. Resistance can be adjusted by increasing or decreasing surface area or length of the paddle (Tucker, 2010). For more aerobic activities, floatation devices, like noodles and belts, can be used for weightless endurance workouts. Deep water running with a belt and or bicycle kicks while sitting on a noodle are both good cardio workouts that minimize repetitive pounding on injured joints (Mooneyham, 2012). The freedom of the pool allows for an optimal workout environment, no matter the desired exercise or physical impairment.
More relaxing forms of therapy can also be used to speed up recovery. Active and passive Bad Ragaz ring method can help with lower back problems, bringing increased ROM and core strength (Mooneyham, 2012). Other more stationary activities, such as suspended traction in deep water, can reduce chronic pain and improve lower back ROM as well (Ray, 2010). Ai Chi classes are also a relaxing option that can be utilized in rehab. The soothing breathing exercises may alleviate cognitive symptoms of warriors with PTSD (Mooneyham, 2012; Hannan, 2010). These tranquil activities, along with basic aquatic exercises, can improve all areas of fitness and give the WTUs confidence to progress towards more dynamic physical tasks.
Many warriors continue with the aquatic exercises in union with land exercises after therapy is complete. Returning to active duty or mastering occupational tasks is the main goal of this group; however, some take their training to the next level. The Warrior Games is held annually to showcase wounded warriors in athletic events including basketball, track and field, and swimming.
Providing the best possible rehab methods to these injured soldiers should be a priority across the country. A small piece of the 682 billion dollar military budget could be used to provide funding (Ray, 2010). Warm pools for therapy and cool pools for exercising should be available in all Wounded Warrior programs, helping rehabilitate all veterans who have risked their lives for our freedom.
Hannan, M. (2011). New Aquatic Therapy Options for Wounded Warriors: Pilot programs offer injured soldiers water-based rehabilitation. Parks and Recreation, 46, 2.
Kozen, K. (2010). Aquatic Therapy is the U.S. Army’s Newest Recruit. Aquatics International, 2010.
Mooneyham, D. J. MAEd, LRT/CTRS. (2012). I’m Back, I’m Wounded, Now what? The NeuroDevelopmental Treatment Association, 19, 6-8.
Ray, T. (2010). Program aims to improve lives of Fort Bragg wounded warriors. Paraglide, 2010.
Tucker, L. (2010). Wounded warriors dive into healing waters of aquatic therapy. 633d Air Base Wing Public Affairs, 2010.
Will Corley is an undergraduate in the Exercise Physiology program at West Virginia University. He swam competitively for 14 years and currently works as a lifeguard at the WVU Recreation Center. After finishing his aquatic therapy emphasis and obtaining his DPT, he plans on using his knowledge of the water in union with land-based rehabilitation through the Wounded Warrior Program.