Jan 29, 2015
Treading Lightly

Speeding up rehab and preventing overtraining have never been easier, thanks to new ideas in using underwater treadmills.

By R.J. Anderson

R.J. Anderson is an Assistant Editor at Training & Conditioning. He can be reached at: [email protected].

At Iowa State University, athletes coming back from injuries often find them-selves up to their necks in rehab–that’s because they’re up to their necks in water. As is the trend at many collegiate and professional sports medicine facilities, underwater treadmills and aquatic therapy pools play a large role in getting injured athletes back in action at Iowa State.

One ISU success story took place in 2006, after a football player ruptured his Achilles tendon on March 31. “Before he could do any land-based exercises, he spent six weeks of rehab working in an aquatic therapy pool with a lot of time on the underwater treadmill,” says Head Athletic Trainer Mark Coberley, MS, LAT, ATC, CSCS, PES, CES. “Once he started working out on land, he progressed very quickly and was cleared to return to the team for two-a-days by Aug. 1–and he never had any problems after that.

“Aquatic therapy and the underwater treadmill are great tools for us,” Coberley continues. “We use them to enhance everything we do in rehab.”

Allen Hardin, PT, MS, SCS, ATC, LAT, CSCS, Co-Director of Sports Medicine at the University of Texas, has also seen great results from his three underwater treadmills. He says they have had the most impact on his rehabbing athletes’ functional progressions. He’s noticed that return-to-play times have decreased and athletes are in better shape when they do return. The results have also caught the attention of Longhorn athletes.

“After we installed a pool with an underwater treadmill at our basketball facility, we had demand from many athletes in other sports to use it,” says Hardin. “We quickly realized that our other existing pool [which didn’t have a treadmill] did not allow for the same rapid progressions.”

Ten years ago, underwater treadmills were an option for only the most elite athletic programs. But today, more and more athletic trainers are adding this modality to their rehab equipment lineup.


The main idea behind the use of underwater treadmills is to provide athletes with rehab workouts in an unweighted environment. They are also a great way to condition both injured and healthy athletes by greatly reducing foot-to-ground forces.

The most basic underwater treadmills mimic land-based models in appearance, with similar-sized belt options. These stand-alone units can be manually maneuvered into various aquatic therapy pools, and are offered in both motor-driven and pneumatic models.

Coberley has a portable self-powered underwater treadmill that he uses in an aquatic therapy pool. And although he’s currently designing a new sports medicine facility that will include a larger aquatic therapy pool with an integrated motorized underwater treadmill, he’ll keep the self-powered unit even after the new facility is built, since he believes there are advantages to both styles. “There are benefits to propelling yourself and benefits to being propelled,” he says.

“Our current treadmill is used as a resistance device that builds leg strength in a partial-weight bearing environment,” continues Coberley, adding that the treadmill is inclined. “The athlete provides the power to push the belt, so we’re able to build leg strength from the feet up to the hips.”

With the self-powered treadmill, the aquatic therapy pool’s adjustable current provides additional resistance. “We do everything from general gait training with full resistance to high speed sprinting activities using the current,” says Coberley. “Not only are the athletes driving the treadmill with their own power, they’r


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