Aquatic PT

(Oh my goodness I just read this...all this rambling will be fixed once I can put a few coherent thoughts together. Wow I'm spent!)

Elena is super excited to have Aquatic PT! We are in a 2x/week program for 12 weeks. I pursued this because I didn't feel like Elena was ready for swim lessons. This past summer, we were able to get E independent in the water with her swim vest (the summer definitely did not start out this way--even while wearing her swim vest, it took a while for E to be able to right herself).

We considered group swim lessons...but the pool is still a very dangerous place for Elena, mainly b/c of the edge. Obviously, standing and walking along the edge is dangerous for her--but also entering the water from a seated position along the edge, b/c frequently she just *barely* clears it--if she enters "toothpick-style", her head misses the edge of the pool by a sliver. At this moment, I think she would need more attention than is offered in a group lesson, and I wasn't ready for private lessons, as I figured she might need a different sort of swimming introduction than they typically offer (not to mention the cost).

I LOVE E's swim lessons with Emily, one of her old PTs (from her post-SDR days). The therapy pool depth ranges from 2 feet to 4 feet. They warm up walking/running in the 2ft end, and have Elena try to stop on her own in the water (great practice, as E has trouble doing this anyway). Then they'll try to have E put her head under the water (she LOVES this, especially since we got her some goggles that fit!) and retrieve items off the pool entrance steps. The object here is two-fold; one, for her to be comfortable with her head under the water, and two, to try to keep her feet under her (core strength, limb coordination). If her feet float up (which they do often), she can stay under the water to pick up the item. Emily expects this lesson to be learned pretty quickly.

Staying Grounded


Emily also wants Elena to learn to swim with her head in or under the water. There are many reasons for this, but the biggest two are being confident in the water and saving her energy for swimming. Heads are heavy, so it will fatigue her (and the rest of us) if she tries to swim too long with her head out of the water. Note, that at present, her legs move like they are crawling. It is the expectation that her leg movement will lengthen as she is more comfortable moving in the water, with the hope that she'll be able to "kick from the hip" eventually. The good news here is her arms look great--the are much farther away from her body than they used to be!

Swimming


When E looks underwater, she ends up arching her back to place her head under the water. She also tends to stop moving her arms and legs. Emily is encouraging E to keep moving while looking underwater. To pick her head up, she has to "push" her arms down into the water--she is doing a GREAT job with this, and her fingers are staying together better (we call them "fish hands") rather than being far apart, which makes it easier for her to bring her head up.

Looking underwater


E also wears little swim fins on her feet. This isn't really to help her swim (well, not yet, anyway). Mostly it is to make her aware of her feet, and to work on raising her knees and flexing her ankles to move and stand. Great dorsiflexion work!



I was worried she would be too tired to do ANYTHING after a full day of school and a swim lesson. After our second lesson, Elena not only was walking around the house barefoot (great confidence!) but she also went down the entire flight of steps after her bath--barefoot, with no assistance, using only one hand on the banister. That almost never happens, and certainly never at nighttime! Her energy is decent, her movements look great, and she is enjoying herself. YES!