PILATES CONDITIONING FOR SCUBA DIVING A methodical exercise & fitness program for the middle-aged male diver

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1 PILATES CONDITIONING FOR SCUBA DIVING A methodical exercise & fitness program for the middle-aged male diver Anna Maria de Freitas October 13, 2017 Foundation Apparatus Program Standard (Modules 1-6), Tacoma, WA Comprehensive Global Program (Modules 7-12), Vancouver, WA 2016

2 Abstract Scuba diving is a dynamic sport which places many demands on the mind and body. Many participants do not realize scuba diving requires conditioning. Muscles and joints are taxed while carrying tanks and heavy equipment to and from the shore, entering and exiting a boat in rough seas, and from swimming neutrally buoyant for long periods of time in a hyperlordotic position. Many requirements for a safe scuba diver are inherent to the Pilates method: balance, flexibility, endurance, efficiency- aspects which are often overlooked in traditional fitness regimes. Many scuba divers, even those whom regularly participate in traditional exercise programs, pay little attention to the specific conditioning required to dive safely as they age. This paper develops a methodical set of exercises based on the Pilates method for the aging male diver. Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 2

3 Table of Contents Abstract... 2 Table of Contents... 3 Anatomical Description... 4 Introduction... 6 Scuba Diving Basics...6 The Risks of Scuba Diving...6 Diving Research and Accidents...7 Case Study... 8 Fitness Requirements and Physical Demands for Scuba Diving...8 The Fitness Program and Selection of Exercises...9 Case Study Findings Conclusion About the Author References Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 3

4 Anatomical Description The human spine is a complex structure comprised of approximately 33 bones or vertebrae. The focus of this paper is the lumbar spine. The lower back or lumbar curves inward toward the abdomen. There are 5 vertebrae that connect to the sacral spine. The Lumbar derived from the Latin word lumbus means lion. The lumbar spine is built for power and flexibility lifting, twisting and bending. The sacral region is at the bottom of the spine and lies between the fifth segment of the lumbar spine and the coccyx. The sacrum is a triangular-shaped bone that consists of five segments that are fused together. The thoracic spine and its 12 vertebrae are located above the lumbar spine. The cervical spine that begins at the base of the occipital bone and ends at the base of the neck, comprised of 7 vertebrae makes up the very top of the spine. Low back pain is often associated with an injury to the muscles and ligaments of the lumbar spine due to lifting, bending or twisting injuries. Many lumbar conditions are interrelated. Lumbar stenosis occurs when nerves in the lower back are compressed leading to sciatica or leg pain. Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 4

5 Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 5

6 Introduction Scuba Diving Basics To the untrained eye, scuba diving is an effortless and relaxing sport. Divers float underwater amongst schools of colorful fish and sprawling coral reefs. Unlike scuba diving s outward appearance of total relaxation, there are many demands on the body: physical demands on the joints, circulatory system, and muscles and psychological demands that affect mental acuity. We are land-based creatures. To sustain ourselves underwater for longer than a single breath, we need a variety of equipment and training. Breathing underwater with a SCUBA (Self- Contained Underwater Breathing Apparatus) requires the diver to acclimatize one s self to breathe only from the mouth while wearing a mask and a regulator. This is not trivial - think about how awkward it feels when you have a cold and you can t breathe from your nose. Then add the unexpected stressors of navigating and swimming with limited visibility or against strong currents, cold water, or equipment failure. The Risks of Scuba Diving The demographic for scuba diving has been trending towards a graying population over the past 10 years with younger folks taking up more extreme sports instead. 1 This older population has many health risks associated with aging including excess weight, high blood pressure, and heart problems. Many of these health risks are contraindications to diving. Unlike a pilot s or driver s license that requires regular medical recertification, a diver s certification card is valid for life. These health risks are exasperated when traveling to remote sites where divers are multiple days travel away from a full service medical facility or decompression chamber. Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 6

7 There are other inherent risks improper or irregular training. Diving, like Pilates, is a life-long journey. An introductory scuba diving course takes six weeks to learn the basics. To fully master the sport, experts recommend that one complete at least 50 dives a year. This will ensure a diver s comfort in a foreign underwater environment and ability to perform life-saving skills in the event of equipment failure, the onset of nitrogen narcosis, or decompression sickness (DCS). There are environmental challenges. Often there is limited visibility and rapidly changing currents. Cold water diving requires additional equipment and thermal protection - stressors that often lead to claustrophobia and increased air consumption. Diving Research and Accidents Divers Alert Network (DAN), located in Durham, North Carolina, is the diving industry s foremost association dedicated to scuba diving research and diver safety. DAN research statistics shows that the majority of diver fatalities are a result of drowning. In many cases this is brought on by a heart attack, improper physical conditioning due to obesity or old age, or judgement errors. The research director at DAN summarizes the diver fatalities statistics, saying that while each accident is different most accidents can be represented as a chain of multiple events that lead to a deadly outcome. Removing any link from the chain may change the outcome. 2 This paper provides a physical fitness protocol using Pilates to support the middle-aged male diver become physically fit. In addition, this fitness program builds a solid foundation to address the subject s chronic lower back pain and build body awareness to prevent against new back injuries often caused by the physical demands of diving. In the unfortunate event of an accident, Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 7

8 his strengthened mental and physical capacity will hopefully eliminate one link of the chain to overcome a potentially life-threatening situation. Case Study The research subject, David, is a 55-year old male who regularly participates in weekend activities including bike rides, hikes and ski trips. In the past, he attended mat and group Pilates equipment classes. Unfortunately, his limited patience to methodically learn the fundamentals of the Pilates exercise method caused him to advance exercises prematurely. He suffered lower back pain, sciatica, and other injuries due to improper regular conditioning and trying the advanced repertoire too quickly. These injuries set him back several months while he focused on healing. During his recovery period, he stopped all exercise. This study occurred after his recovery period when he wanted to resume an exercise routine. Fitness Program The following Pilates exercise program was designed to address the fitness requirements and ease the physical demands of scuba diving for David with a particular focus to the lumbar spine. The exercises chosen targeted the following physical attributes for scuba diving including: 1. Spinal flexibility and mobility, strong back stabilizer muscles, and a strong transverse abdominis reduce the stress on the skeletal and muscular systems carrying the scuba equipment on their back and to reduce recurrence of subject s chronic lower back pain. Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 8

9 2. Shoulder flexibility to avoid injury getting in and out of snug fitting exposure suites with tight seals and to avoid accidents by being able to reach valves or hoses during emergency situations Increased muscle density so that the diver is less buoyant and requires less weight. A typical diver carries upwards of 55 pounds of gear for warm water diving and 70 pounds for cold water. Divers with less muscle density carry more weight to be properly weighted Core strength and balance to enter and exit a moving boat or navigate an unstable rocky shoreline with heavy equipment on their back. 5. Ankle mobility and strength (dorsi and planter flexion), strength in calves and hamstrings to reduce the possibility of foot and leg cramps when swimming with fins and to swim more easily against strong current and climb ladders for boat re-entry. 6. Hip flexor stretching (psoas muscles) to correct the hyperlordotic diving posture that often leads to lower back strain or injury. The Fitness Program and Selection of Exercises This exercise program was developed as a life-long fitness program to mentally and physically prepare the subject for diving taking a holistic approach to his lumbar back and recurring injuries. Pilates is a great option for conditioning the body during travel and dive decompression. Mat in particular is ideal as it requires no special equipment, can be performed virtually anywhere, and will not put a diver at risk for decompression sickness if performed after or between dives. 5 Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 9

10 This program required twelve weeks of participation. Each week the subject spent three days per week in a combination of mat and private and/or group equipment Pilates classes (See Table 1) and two days per week doing thirty minutes of non-impact aerobic activity including walking, rowing or swimming. The exercises were rotated within each block and between apparatuses so the subject learned the repertoire and built a solid base. The choice of exercises focused on building a solid foundation for fitness and increasing core strength and balance. Pilates mat focuses on the depth of the breath and the fundamentals of the Pilates practice without the distraction of apparatus. As Rael Isacowitz, BASI s founder preaches, the mat is the foundation of the Pilates repertoire and it is important to be mat strong. 6 All the footwork, no matter the apparatus, was chosen to increase dorsi and planter flexion, ankle stability and calf strength. The back extension block improves flexibility for the upper and middle back. Several of the back extension exercises (swan prep, prone 1 and 2 and the wunda chair back extension exercises) target shoulder flexibility. Shoulder stretch prone, the pole series and ladder barrel stretches were chosen to improve shoulder flexibility. To improve cardiovascular health and lung capacity, two days of low-impact aerobic exercise were incorporated each week in addition to the Pilates conditioning. The reformer jump board series was rotated throughout the twelve week session to add cardio conditioning. The abdominal equipment and mat block targets the lower back and transverse abdominals and work toward building core strength. We choose several exercises to isolate lumbar flexion including pike standing (wunda) and cat on the chair and cadillac. Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 10

11 The exercises specified in the matrix also target quad, gluteals and hamstrings, in particular the magic circle prone and sitting series, jumping series on the reformer, cadillac squats and the wunda chair hamstring curl and leg press. Exercises were also chosen to reduce the onset of exercise-associated muscle cramps (EAMC). Both clinical studies and practical experience agree that overuse of the muscle, dehydration, or mineral depletion are often the cause of EAMC. To prevent them you need to delay the onset of acute muscle fatigue that triggers them. 7-9 The conditioning program incorporated functionally similar exercises to diving to build up the back of the leg and calf muscles to help delay the onset of muscle fatigue during a dive. The exercise program includes stretching the calf muscle to help reduce the resistance of the muscle to movement. Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 11

12 Table 1. Pilates Exercise Grid Block Mat Exercises Reformer Cadillac Wunda Chair & Other Warm Up Roll down Roll down Roll down Roll down Foot Work Abdominal Work Fundamental Warm Up Pelvic Curl Spine Twist Supine Chest Lift Chest Lift with Rotation Leg Changes Intermediate Warm Up Roll-up Spine Twist Supine Double Leg Stretch Single Leg Stretch Criss Cross Hundred Prep Hundred Roll Up Leg Circles Rolling Like a Ball Double Leg Stretch Single Leg Stretch Teaser Prep Hamstring Pull 1-3 Fundamental Warm Up Pelvic Curl Spine Twist Supine Chest Lift Chest Lift with Rotation Leg Changes Foot Work Parallel Heels Parallel Toes V Position Toes Open V Heels Open V Toes Calf Raises Prances Single Leg Heel Single Leg Toes Hundred Prep Short box series Round Back Flat Back, Tilt Twist Round About Climb-A-Tree Intermediate Warm Up Roll-up Spine Twist Supine Double Leg Stretch Single Leg Stretch Criss Cross Foot Work Parallel Heels Parallel Toes V Position Toes Open V Heels Open V Toes Calf Raises Prances Single Leg Heel Single Leg Toes Warm Up Series Roll Up with Roll Up Bar Mini Roll-Ups Mini Roll-Ups Oblique Roll-Up Top Intermediate Warm Up Roll-up Spine Twist Supine Double Leg Stretch Single Leg Stretch Criss Cross Foot Work Parallel Heels Parallel Toes V Position Toes Open V Heels Open V Toes Calf Raises Single Leg Heel Single Leg Toes Step Barrel Chest Lift Reach Overhead Stretch Teaser Prep Wunda Chair Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 12

13 Loaded Cat Standing Pike Standing Pike Reverse Cat Hip Work Spinal Articulation Spine Stretch Rolling Like a Ball Seal Puppy Open Leg Rocker Supine Leg Series Frog Circles Down Circles Up Openings Bottom Lift Short Spine Basic Leg Springs Frog Circles (Down, Up) Walking Bicycle Monkey Tower Prep Hip Opener Pelvic Curl Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 13

14 Block Stretches Mat Exercises Reformer Cadillac Wunda Chair & Other Standing Lunge Shoulder Stretch Pole Series Prone Shoulder Stretch Kneeling Lunge Overhead Stretch Side Stretch Spine Twist Standing Arm Work FBI Arm Sitting Series Chest Expansion Biceps Rhomboids Hug a Tree Salute Elephant Shoulder Adduction Single & Double Arm Ladder Barrel Shoulder Stretch 1 Shoulder Stretch 2 Ped-A Pul Extension Abduction Circles Up Circles Down Triceps Leg Work Gluteals Side Lying Series Side Leg Lift Forward and Lift Forward with Drops Stomach Massage Jumping Series Parallel Position V-Position Single Leg Parallel Long Box Group Hamstring Curl Side Split Squats Hamstring Curl Leg Press Standing Magic Circles Prone Series Ankles Bent Knees Ankles Straight Knees Hamstrings Lateral Flexion / Rotation Side Lifts Spine Twist Saw Cork Screw Side Kick Side Over Box Mermaid Sitting Series Magic Circle Ankles Below Knees Above Knees Step Barrel Spine Twist Supine Side Lift Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 14

15 Back Extension Back Extension Single Leg Kick Double Leg Kick Swimming Swan Prep Breaststroke Prep Prone 1 & 2 Push Through Group Swan Basic Swan on Floor Back Extension Single Arm Case Study Findings This well-rounded program was implemented incrementally ensuring David had a solid knowledge of the fundamental repertoire before increasing the intensity of the work. Since the subject has been injured on several occasions by too quickly jumping back into a fitness regime, it was important to reign in advanced repertoire until he had developed a strong fitness base. The exercise program became one of functional fitness to train David how to translate what we did in the studio to every day movements and tasks. It took many sessions to build trust with this method. David had participated in traditional fitness exercises where progress was measured by the number of repetitions or amount of weight used. Now we were measuring success in terms of pelvic stability, increased balance and flexibility, anatomical symmetry, and more importantly freedom from pain. As David progressed through the program, he became more patient with the method and accomplished each exercise with an increased depth and precision. As we worked through the program, we spent a lot of our sessions on scapula stabilization to correct a winged scapula from a prior bicep nerve injury. The scapula winging Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 15

16 was further exacerbated by his old military style exercise approach to push-ups focusing on quantity versus quality. Conclusion After the 12 week session, the research subject had increased body awareness that will help prevent future injuries. The subject reported greater flexibility in his spine, hip flexors and hamstrings. His overall posture and balance also improved. During the research period, he never experienced any problems with lower back pain or sciatica. Immediately after the research period he went on an extended dive holiday. In the past, he usually sustained a back or shoulder injury diving. During this trip he remained injury free. About the Author Anna Maria de Freitas is a certified SSI and NAUI Advanced Open Water Instructor and SSI and Scuba Rangers Instructor. She has completed over 500 dives throughout the world in cold and warm water. Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 16

17 References 1 Davidson, Ben, How Many Divers are There?, undercurrent.org, May 2007, 2 Pollack, Neal W, Ph.D, Annual Diving Report 2016 Edition (2014 Diving Fatalities, Injuries and Incidents), Divers Alert Network, Durham, NC. 3 Martz, Cameron L., Fitness ror Divers, Chapter 16, Reaching Your Valves: Five Stretches for Shoulder Mobility, divefitness.com, Yeager, Selene, How to Get Fit for Diving, scubadiving.com, February Pollack, Neal W, Ph.D, Juggling Physical Exercise and Diving, Divers Alert Network, Durham, NC. 6 Isacowitz, Rael, Pilates 2 nd Edition, Human Kinetics, New York, Bently S: Exercise-induced muscle cramp. Proposed mechanisms and management. Sports Med Jun;21(6): Schwellnus MP: Skeletal muscle cramps during exercise. The Physician and Sportsmedicine 1999; 27(12) 9 Schwellnus MP, Derman EW, Noakes TD: Aetiology of skeletal muscle cramps during exercise: a novel hypothesis. J Sports Sci 1997;15(3): Pilates Conditioning for Scuba Diving Fitness: Anna Maria de Freitas Page 17

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