INSTRUCTOR SAFETY

Excerpt from AQUATICS: The Complete Reference Guide for Aquatic Fitness Professionals by Ruth Sova.  The book is available at www.aeawave.com.

The majority of instructor injuries associated with exercise are a result of overuse. Too much bouncing, incorrect body mechanics and alignment, improper footwear, and inappropriate water depth can all cause aquatic exercise injuries. Environmental conditions can also take their toll.

Posture

Maintaining good alignment allows the muscles of the body to work without strain and will assist in preventing injury recurrence. Good alignment allows the safe transfer of body weight and enables the joints and spine to absorb shock efficiently. Think about “standing tall” when teaching.  The knees and hips should bend each time jumping or bouncing or landing occurs.

Overuse

Biomechanical overuse injuries include shinsplints (medial tibial stress syndrome), stress fractures, tendonitis, bursitis, plantarfascitis, chondromalacia patella, lower-back pain, neuroma, and metatarsalgia. With the exception of stress fractures, these overuse injuries occur in soft tissues and are unlikely to

show up on x-rays. Instructors may ignore or deny the injury and attempt to continue teaching in spite of the symptoms. This can result in an increased injury and other injuries brought on by an altered gait.

Soft-tissue injuries should be recognized as they develop. Specific signals or symptoms will assist the instructor in recognizing injuries. Localized pain–tenderness or pain on or around a bony area or joint is an indication of injury. Radiating pain involving nerves and tingling sensations, is another sign of injury. Swelling or inflammation can indicate tissue damage also. The swelling may occur after the overuse injury, since it takes time for the inflammation to occur. Discoloration of the skin and movement impairment are also warning signs of injuries.

Overuse injuries can often be treated with the following three-step plan:

   1. Reduce or stop the stress that is causing the injury.

   2. Reduce inflammation.

   3. Correct any factors that may cause an injury to reoccur.

Shoes

Because of the number of classes instructors teach and the possibility of working on the deck, instructors should review and follow injury prevention guidelines. Instructors who work on the deck should protect themselves further from injuries by using well-cushioned shoes, using low-impact moves while asking students to add the impact, and possibly using a dense mat. The concrete and tile found on pool decks is the most unforgiving of exercise surfaces. Changes in foot structure can occur without any overt symptoms of injury.

Good shoes, specifically designed for the type of aquatic exercise being performed, are essential for injury prevention and will assist in keeping injuries from recurring. The shoes should fit the shape of the foot, have adequate cushioning in the heel and forefoot to absorb shock, and be well-padded in the arch. The shoes should also have good stability for forward, backward, and lateral movement, and the heel box should be firm for heel stability. Shoes should also have good flexibility to move with the foot. The flexion should be near the toes, not at the arch. The sole of the shoe should have adequate gripping power to hold on the slipperiest of pool bottoms. Comfort, fit, cushioning, stability, flexibility, and gripping are the characteristics of a good aquatic shoe.

Overexertion

Instructors should avoid overexertion. The symptoms of overexertion are breathlessness, extreme fatigue, dizziness, an extremely red face, nausea, and poor heartrate response. The heartrate response could indicate either a very high heartrate or a very poor recovery rate. A poor recovery rate would be indicated by a high heartrate even 5 or 10 minutes after the cooldown.

By monitoring the heartrate and following the progressive overload principle, instructors can gradually increase the aerobic intensity with clients while maintaining his/her own safety.  The instructors should listen to their bodies.

Overexertion can be avoided by gradually warming up, monitoring intensity during the aerobic section, and adequately cooling down. The aerobic heartrate or perceived exertion level should be monitored several times during the class.

An inadequate cooldown may lead to light-headedness and fainting. A proper cooldown will allow the heartrate to slow gradually and will prevent pooling of blood in the extremities.

Overtraining

Instructors who try to teach too much, for too long a time, or just too frequently—may experience symptoms of over-training. Overtraining occurs when the concept of progressive overload is ignored.

While a basic musculoskeletal injury may not occur, an instructor should watch for these signs and symptoms of overexercising:

   1. persistent muscle aches and soreness

   2. energy loss

   3. depression

   4.  insomnia

   5. irritability

   6. elevated resting heartrate

The instructor should modify his/her workout by decreasing frequency, intensity, or duration if these symptoms occur.

Heat Stress

Instructors who teach from the deck need to protect themselves from the air temperature and humidity conditions commonly encountered in indoor pool areas. With an average humidity of 60% and air temperature of 85 degrees, instructors are in the “dangerous exercise condition” segment of the Institute for Aerobic Research guidelines for exercise in heat and humidity.  Instructors should use low-impact and small movements; drink plenty of fluids before, during, and after class; and splash their faces with water from the pool or jump into the pool occasionally to cool off.

Heat Exhaustion

Heat exhaustion occurs when the brain and muscles need increased bloodflow due to the workout intensity at the same time the skin needs increased bloodflow to dissipate heat. Pale, clammy skin; weakness; faintness; dizziness; nausea; vomiting; and fainting can all be acute symptoms, along with profuse sweating, a weak and rapid pulse, a throbbing pressure in the temples, and a cold sensation over the trunk. Body temperature is usually normal or slightly elevated. Headaches and loss of appetite are chronic (delayed-onset) symptoms. Immediate treatment includes sips of water; applying cool, damp cloths to the body; gently pumping the legs to promote circulation; and lying down with feet elevated. Fluid and electrolyte replacement and rest from exercise are long-term treatments.

Vocal Cord Injury

The acoustical factors in a pool setting increase the likelihood of instructor vocal cord injury. The water, glass, cement, and concrete typically found around a pool make it the worst possible situation to try to teach in. Add to that the noise from filter systems, blowers, splashing, and people, it is very challenging to be heard in a pool. The strain on the instructor’s voice can be great.

The aquatic instructor can injure the vocal cords in several different ways:

   1. talking constantly

   2. shouting over the music or singing with the music

   3. teaching two or three classes in a row

   4. clearing the throat excessively

   5. changing the voice pitch or volume suddenly

   6. talking with the neck in an unnatural position (such as looking straight down at the students in the pool)

   7. inhaling or exhaling inadequately while talking

   8. inhaling the chlorine gases that hang above the water level

Symptoms of vocal cord injury include throat or neck pain, dry mouth or throat, hoarseness, temporary voice loss, temporary vocal change of pitch, habitual use of lower pitch, pitch breaks or voice cracking, vocal fatigue, vocal nodules, and the need to continually clear the throat. If the instructor experiences any of these early warning symptoms, the professional assistance of an otolaryngologist or a speech pathologist should be sought. An article put out by the Institute for Aerobics Research, reported that 88% of aerobic instructors have experienced symptoms of voice injury. Aquatic exercise instructors are at greater risk due to the poor pool acoustics and the chemical make up of the air.

Vocal cord injury can be prevented if the proper precautions are taken, including the following:

   1. Gradually warming up the voice, building to the volume and frequency needed to teach class in the pool area.

   2. Keep directional or step-change cues short and to the point. Correctional and motivational cues should be included but minimized.

   3. Eliminate unnecessary talking, unless it can be done in a conversational tone.

   4. Use a lower volume of music.

   5. Drink water before, during, and after class to keep the vocal cords hydrated.

   6. Avoid talking with the neck in an unnatural   position.

   7. Use a microphone and speak normally into it.

   8. Use simplified routines.

   9. Use precued tapes with incorporated verbal cues of heartrate checks, intensity checks, or new moves.

10. Use nonverbal cues, with physical demonstration instead of verbal cues and hand and body signals to signify changes.

Skin Lesions

Aquatic exercise instructors who work in outdoor pools can be prime candidates for skin cancer. Repeated exposure to the sun’s ultraviolet rays can do serious damage to the skin, sometimes causing different types of skin cancer. Aquatic instructors are at an unusually high risk because exposure is both to direct sunlight and ultraviolet reflections off the water surface. Additional factors that affect the likelihood of developing skin cancer and the extent of its damage are: heredity, age, skin type, the length of exposure each day, and what precautions are taken to protect the skin.

The skin is the largest organ of the body. It functions to regulate body temperature, excrete waste, prevent the loss of too much water, and protect structures underneath from injury. It is a sense organ for touch, pressure, cold, heat, and pain.  Protect it.