Here is the final part on everything you need to know about pool based training.
Water Workouts - A Complete Guide to Pool Based Training for Training and Rehabilitation - Part II
Water Workouts
Now for the fun stuff. In the following sections I'm going to run through the various types of training that you can complete in the pool. These training methods will improve your fitness, help you recover from training and prevent and rehabilitate injuries.
Cardiovascular Training (aerobic and anaerobic)
Deep water running is a viable alternative to pounding the streets day after day (4,9). In a joint study, researchers from England and Tasmania compared the effectiveness of deep water running and road running in improving maximum oxygen uptake in a group of 20 untrained young women. Both training programmes produced similar and substantial improvements in VO2max, and the researchers concluded that deep water running, in common with other aerobic activities, offers significant cardiovascular benefits when performed at the appropriate frequency (3-5 days per week), intensity (60-75% of maximum heart rate) and duration (20-60 minutes) (3).
A common argument I get from coaches and athletes is that standard aqua running is too easy and doesn't provide an adequate workout. Athletes that I work with don't perform standard aqua running - and they know the session is as tough as anything they will experience on dry land. The main reason we don't perform standard aqua running is linked to fluid dynamics. Normal aqua running doesn't really create a lot of disruption to the flow, the purpose of the CV training is to involve the whole body and make sure the intensity of the workout is appropriate - intensity can be increased by causing disruption to the flow. I favour the following techniques that were shown to me by one of my colleagues over normal aqua running. Give them a try and you will realise why they are far superior to anything else. The intensity of drills described below can be altered by using fins (feet mostly), using a 2:1 ratio of feet to hands (2 leg drives for 1 arm drive) or hands to feet (2 arm drives for 1 leg drive), using floats on arms or legs (watch for excessive build up of lactate) or using bungees attached to the side f the pool which will allow you to add some variety to your workout (go to full extension and hold - go to full extension then drift and repeat - go to extension drift back to edge of pool and go out again).
Flexed Running Position (45 degree)
This is a full body exercise similar to running. Unlike aqua jogging, when performing this drill your body will be almost horizontal. Keep trunk 'tight' when performing the drill. This position requires the athlete to be in a heavily flexed position at the pelvis, with a forward lean from the pelvis of about 45 degrees (This technique is particularly useful for games players who adopt a flexed position - hockey, rugby etc). You will get increased activation around the gluteal, hip flexor, and hamstring groups. Once in the water lower you hips so you are working at a slight angle. Reach straight forward to full extension with one arm, pull palm back and then pull arm back so the elbow bends to approx 90° then continue to pull straight through and back to your hip. Bring your opposite knee forward toward your chest (keep toes pulled up) and, at the same time, push the other leg straight back until it is fully extended (only push toes out at the bottom of the leg drive). Maintain hip, knee and ankle alignment (avoid using a 'breast-stroke' type leg movement, especially when fatigue starts to set in).
Upright Running Position
This is a full body exercise similar to running. Like aqua running you will be almost upright and should adopt a slight forward lean from the pelvis in (5-10 degrees). Keep trunk 'tight' when performing the drill. This form of aqua running is predominantly used for recovery specific to upright running musculature, cadence development and maximal resistance work. It also helps improve flexibility and ROM, which has particular benefits for slow runners that just shuffle along with a short stride length. We've also found that our horizontal jumpers returning from injury liked this technique because of the large ROM, which help to prevent them from 'tightening up' during the course of their rehabilitation. Reach straight forward to full extension with one arm, pull palm back and then pull arm back so the elbow bends to approx 90° then continue to pull straight through and back to your hip. Bring your opposite knee forward toward your chest (keep toes pulled up), and then extend the leg forward (shin out), once the leg is fully extended in front of the body pull the leg straight back through the water (pushing the toes out at the bottom of the leg drive). Maintain hip, knee and ankle alignment
Cross Country Skiing Running Position
This position requires the athletes to be in a near vertical position. They will have a slight forward élan from the pelvis (5-10 degrees). Where this technique differs from upright running is that the legs remain straight throughout the movement and the major ROM comes from the pelvis (not the knee), which in turn creates a much greater gluteal contraction. This is a great drill for warming up and provides increased gluteal function, pelvic control and for lower limb recovery.
Strength and Power
I've been a long time proponent of pool based plyometrics for strength and power development and I've had some interesting conversations (arguments) with coaches that don't believe you can develop power in the pool. Well my experience as a coach suggests otherwise and we even have some research to back me up.
Back in 2001 researchers investigating the efficacy of water-based plyometric training drills found that improvements in vertical jump performance following a pool based plyometrics programme were still possible and that there were no significant differences between land and water-based training methods (12). More recently in 2005 researchers based in America showed that pool based plyometrics can produce significant increases in vertical jump scores and provides similar benefits to land based plyometrics (11). This is great news for anyone looking for a low-risk power-based training tool for themselves or their healthy athletes.
I've also used this with a great deal of success with athletes that are returning from injury. Pool based plyometrics allows them to slot back into the training programme as soon as possible? Most 'high intensity', land-based plyometric drills are out-of-bounds for athletes returning to fitness, but what if they do the drills in the pool? The Ohio-based team found that many healthcare professionals are using the pool during the rehabilitation of injuries and several publications are expounding the virtues of pool-based plyometics in sports injury rehab (12). Here are the benefits. Remember what we said about buoyancy earlier on.
Research has shown that on dry land the musculoskeletal system is subjected to minimum impact forces of between 3-5 times bodyweight as a result of landing during plyometric drills such as depth jumps. Take a typical male weighing 70kg and perform the same land-based drill in a pool and you will have immediately reduced the impact forces associated with the exercise from between 210-350kg to just 35-57kg. Not bad if your knees are a bit on the dodgy side! You can change the intensity level simply by changing the level of the water. Water provides support for the athlete's body as it moves downwards and resistance as the athlete explodes upwards.
The water will also add resistance to lateral movements, thus increasing their work intensity, with the potential benefit of improved strength levels (a massive benefit for athletes attempting to get back to full fitness following an enforced layoff due to injury). Athletes and individuals immersed in water have a higher pain threshold and patients with lower-limb arthritis have shown significant improvements in proprioception and balance (12).
OK, an athlete returning from surgery may not necessarily react in the same way as an arthritic patient, but it is not inconceivable that the benefits experienced in one group could be replicated in another. Athletes suffering from ACL injuries, a common problem associated with participation in jumping sports (especially for females) may find pool-based plyometric sessions to be a viable alternative. Research has found reduced joint swelling, increased strength levels and range of movement when athletes took part in pool-based rehab sessions.
So where should you begin when putting your programme together? Well, this training method is still in its infancy so there don't appear to be any hard and fast rules. The team based at Ohio University suggests you adopt the same training principles as those on dry land (volume, intensity, jump height, frequency). For a sample programme and more detailed explanation of the training principles check out Plyometrics in the Pool (SIB 2002 summer time I think)
Speed
If you thought I was mad to suggest your could train strength and power in the pool then you will definitely think I'm crazy for suggesting that you can train speed in the pool. Why do I believe you can train speed - because I've used it successfully with a number of athletes recovering from injury. When I talk about speed development in the pool, it's all about the cadence element. This is the aspect that can be effectively developed and maintained. I firmly believe that you can improve or maintain the rate of leg turnover in the pool. OK, I agree you won't get the same level of development as you would on dry land (there's constant resistance from the water in the pool and there's not going to be any ground contact) but aqua running that focuses on high cadence techniques may enhance speed or minimise loss in an athlete recovering from injury. Once again it's a simple case of taking the land based speed conditioning drills and adapting them for use in the pool.
Control, Stability and Balance.
The pool is a great environment for developing and maintaining control, stability and balance and is particularly useful during the initial stages of rehabilitation. A general guideline is that deep-water work will involve open kinetic chain movements and shallow water training will involve predominantly closed kinetic chain movements (although a combination could be used). You can develop control, stability and balance in a number of ways. The key is to use your imagination and think about the methods you use on dry land and see if they can be adapted to work in the water. Here are some ideas to get the brain ticking.
Floatation Devices
Floatation devices are designed to do one thing.....float! If you place a float under a limb they will place upward pressure on the limb, which provides a controllable proprioceptive challenge, which can be increased by changing the size and shape of the floatation device.
Current
By making the athlete work against a current, the proprioceptive challenge to the joint and the need to control and stabilise the body is increased. You can also increase the turbulence in the water to place even more demands on their ability to remain stable.
Depth
By increasing or decreasing the depth of immersion in the water you will increase or decrease the proprioceptive demands on the athlete. The deeper the body is immersed in the water the greater the stability, with relationship to being on the land
Surface Area
You can increase the surface area of the feet and hands using fins and mitts, which will in turn increase the proprioceptive demands placed upon the proximal joints.
Recovery and Regeneration
Angela Calder recommends completing a 20-minute pool based recovery session the day after a heavy training session or competition (2). This is something that we used regularly with the England Netball team and it's something that I've successfully used with a number of the athletes and sports that I currently work with. Pools provide an excellent environment in which to conduct a recovery session. The buoyancy and resistance properties allow you to complete training with minimal impact on the body. The water temperature should be between 20-28 degree celsius and the session should last between 10-20 mins. The content of the session can be similar to that used for a land based recovery session, the intensity should be light to moderate and drills could include walking (forward/backward), side steps, basic swimming strokes and aqua jogging, stretching (static and dynamic).
Below is just one example of how to put together a recovery pool session. The main thing to remember is that the session should be a 'recovery session' and should not turn into a full on training session! 
Take Home Messages
The pool is a fantastic training environment and as you have seen it is extremely versatile. Traditionally people have only turned to the pool to supplement their training when they have sustained an injury but this article has shown you that the pool has far more to offer than simply being a place to skulk off to when you've tweaked your hamstring.
The ability for athletes training and competing in high impact sports (running, basketball, football, rugby, netball etc) to train in a non-impact or low-impact environment is really important. The applications are endless and I urge you to get down to you local pool and let your imagination loose - there's a lot of great work that ca be completed in the pool. By using the pool as part of your athletes ongoing training you will allow them to adapt and recover quicker, which will allow them to undertake higher intensity land based training.
Everyone is a winner!
References
Butts, N. K., Tucker, M., & Greening, C. (1991). Physiologic responses to maximal treadmill and deep water running in men and women. The American Journal of Sports Medicine, 19: 612-614.
Calder, A. Revive, Survive and Prosper In: Castella, R, and Clews W, ed. Smart Sport - The Ultimate Reference Manual for Sports People (1996) pp 7-1 - 7-17.
Davidson, K. (2000) Deep Water Running Training and Road Running Training Improve V02 max in Untrained Women. Journal of Strength and Conditioning Research. 14 (2): 191-195
Dowzer, CN & Reilly, T. (1998) Deep Water Running. Sports Exercise and Injury. 4: 56-61
Grimshaw, P & Burden, A. Instant Notes in Sport and Exercise Biomechanics (2006)
Hall, S, J. Basic Biomechanics (4th Ed) (2004)
Harrison RA, Bulstrode S. Percentage weight bearing during partial immersion in the hydrotherapy pool. Physiotherapy Practice 1987;3:60-63.
Huey L & Forster, R. The Complete Waterpower Workout Book Periodisation (1993)
Loupias, JP, & Golding, LA. Deep Water running: A Conditioning Alternative (2004). (ACSM's Health and Fitness Journal. 8 (5) 5-7 10.
Svedenhag, J & Seger, J (1992) Running on land and in water: comparative exercise physiology. Medicine & Science in Sports & Exercise. 24: 1155-1160
Martel, GF, Harmer, ML, Logan, JM & Parker, CB. (2005) Aquatic Plyometric Training Increases Vertical Jump in Female Volleyball Players. Medicine and Science in Sports and Exercise. 37(10): 1814-1819
Miller, M.G., Berry, D.C., Gilders, R. & Bullard, S. (2001) Recommendations for implementing an aquatic plyometric programme. Strength and Conditioning Journal. 23 (6): 28-35.