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Occupational Therapy: The Basics

Therapy SwimmingBefore we start something new we tend to picture what it will be like. Will it be easy? Will it come naturally? Will it be difficult or painful? Will I enjoy it? Will it benefit my life? We tend to hope for the best, setting high expectations on ourselves before we even begin. Thus it is important to remember to start with the basics.

For swimming, the basic elements include safety and technique. These two elements are also the basis for any occupational therapy session. The number one priority is client safety – for One with the Water, our client is the swimmer. We want to teach each person knowledge and skills that will enable him or her to complete tasks as independently as possible.

In the occupational therapy world that often means reminding people to take rest breaks -in the pool that means floating on your back or resting at the side. Then, in between the breaks we work on proper ways to complete the task to produce the best outcomes over time. It can be a slow process because we have to work on building our activity tolerance up step by step or stroke by stroke. To highlight this, let me compare a hospital therapy session after spinal surgery to a One with the Water swim session.

Occupational Therapy Sessions

I’ve worked with many individuals the day after having spinal surgery who are getting up out of bed for the first time since surgery. Walking to the bathroom 5 yards away should be easy, right? They may think to themselves, “I have done this before, it can’t be that hard” or “I am very strong, I can do this.” The truth is, sometimes we don’t even make it a few feet. Instead, we have to start with the basics.

This means taking time to work on safe techniques to get ourselves seated at the edge of the bed so we do not hurt the surgery site. If we make it to standing up, it then becomes critical to be monitoring the patient and have safety precautions in place, like a nearby chair to pull up fast if a knee gives out. Initially practicing how to safely get to the restroom with the OT is good because the therapist can point out safe ways to do things.

We benefit from the help identifying when we are tired and need to rest or someone to quickly pull a chair over when our knees begins to give out. However, therapists are not always present throughout the day, just as swim instructors are not present every time you are in the water. Patients and swimmers alike need to be educated on recognizing their current activity tolerance on their own and have strategies put into place for their safety and success. Therefore, education is key.

In The Pool

All of the tools used for a client after spinal surgery are the same tools we use in the pool. We may spend a good chunk of time working on back floating or rolling over from front to back because we want our swimmers to be safe. We want to allow opportunities for them to recognize that they need to make an adjustment so they are safe and can make it to the side of the pool. If they get too tired, we want them to think, “What are safe things I can do or find to help me instead of panicking?”

We want to allow them the chance to critically think of what a rest break may look like to them based on the skills we are teaching them. While doing this, we may not cover large distances, and that’s okay because they are learning the foundations to safety while building up their activity tolerance.

In addition, the shorter distances allow us to look at the technique used before we reach the exhaustion point. It is important to have good technique, not only for effectiveness but also for short term and long term safety reasons. If a client has swum before, but their technique needs improvement, we will focus on that instead of the yardage. This way, we are helping our swimmer be able to optimize energy spent versus distance completed.

We can also positively impact the longevity of their joints and muscles. We all know swimming is wonderful because it decreases impact on our musculoskeletal system. However, improper movements repeated over time can lead to muscular imbalances and added stress on the body. Meaning, sometimes we have to slow down and focus on our technique before we can safely progress. Just as the patient after spinal surgery had to stop and learn a safe way to get out of bed even though they’ve gotten out of bed countless times before. So be patient, and continue to work on the basics. I promise they will add up and you will see progress.

Lastly, I want to say, you are never simply a passive participant in the activities you are a part of. You started a program, or signed your child up, with a goal in mind. Share with us what you envision this experience to be. We want to teach you safety and technique, so we can help you reach your goals. I will admit, five minutes into the first session will probably not meet your expectations, but we will work with you to reach your goals.

Just like our spinal surgery patient – their goal is to get back to their daily routine but initially, it can be overwhelming because there are so many choices to pick from. So we start with the basics that are important to them (i.e. getting out of bed, getting dressed, bathing, etc.). We begin with techniques and progress toward task completion with maximum independence.

Set Goals

It’s the same for swimming. Set your goals strategically, assessing the basics to set yourself up for success. Set measurable short term goals that help build your technique and safety in the water, then, continue to track your progress.  Then, set long-term goals that can be obtained by successfully compiling all of the short term goals.

These goals can be as simple as, getting my arms out of the water 90% with fingers together 80% of the time to increase the effectiveness of my stroke for 15 yards. Then a long term goal can be, complete freestyle for 50 yards with my arms out of the water with fingers together for 95% of the time. Your short term goals allow for refinement and time to increase your activity tolerance. Believe me, you will be shocked that you did not have to stop and touch the bottom of the pool during a 50 yard freestyle after several lessons. Why?  Because you were completing all of your small goals prior, resulting in long-term success.

So what are you waiting for? Start setting goals and figuring out what basics can help you reach your vision of becoming one with the water!

And remember – as a non-profit, we accept grants and donations from community organizations, local businesses, and private donors! We offer need-based scholarships to persons with mental or physical challenges, including Service-Disabled Veterans, as well as to families struggling financially. If you want to give the gift of better health and increased self-confidence, consider donating to the One with the Water Foundation. You can be a hero today!

Become a Hero

Have you already experienced what swimming can do? Partner with us today to teach economically disadvantaged children, special needs children and Service-Disabled Veterans to become One with the Water! Be a hero today, and when you donate now, you can help reduce the risk of drowning for children by up to 88%! Be a hero and help us save the life of a child.


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