For Improved Movement, Just Add Water

Written by Dr. Rick McAvoy FMS

Water is a buoyant, three-dimensional, holistic, non-momentum prone environment that is the opposite of the weighted, one-dimensional, momentum-prone environment found on land.  The properties of water make it a unique environment for movement and, more specifically, physical training. 

Though aquatic training often has a stigma of being reserved for senior citizens, it's commonly incorporated in training and recovery across high-performance sports.  Water is almost 800 times denser than air and, therefore, it requires significantly more effort to move in water than on land.  Additionally, the greater density decreases impact on the ground, limiting pounding on joints. 

I have been incorporating the water into my client's training programs for a number of years. In addition to using aquatic training sessions to challenge my clients physically, I've found that using the water to screen movement is very beneficial and have tried to do it in almost every aquatic training session I perform. 

People tend to be very patterned individuals because of the influence of gravity and momentum. In water, both gravity and momentum are diminished.  Movement tends to be "slower" and dysfunctional patterns can be more apparent.  The water also provides three-dimensional resistance.  When people move in the water, they are subjected to the forces of buoyancy, viscosity, and drag. These factors tend to turn most people (at least initially) into very uncoordinated individuals. Even the simplest movements - such as walking forward or backward with proper reciprocal arm swing - can frustrate the most elite athletes.

For movement correction, the water’s hydrostatic pressure acts as what I call a “second pair of hands” and assists with increased proprioceptive and kinesthetic feedback so the client is able to improve his or her body awareness and motor patterning relatively quickly. 

I was speaking with a colleague one day about how I utilize the water for cleaning up movement issues and the great results I was having. He asked if I had ever used the FMS to validate the results that I get with clients in the water.  We discussed how using the FMS as a screening tool could offer insights into how the effectiveness of training in water would  compare to training on land in terms of improving movement. 

I am very fortunate to be adjunct faculty at two universities and educate PT’s and ATC students on the benefits of the water. I also have great colleagues around the globe who are very passionate about helping to validate the benefits of water as well. 

I was able to recruit one of the universities that I teach at as well as a colleague of mine in the UK to help perform this testing. 

We were able to set up an acute bout study comparing the FMS Active SLR test with both water and land based participants.
2 groups: 25 water and 25 land participants
Age Ranges: 18-77 years old. 

Protocols are listed below: 

Land Protocol: (Right)

Test: Supine Active Straight Leg Raise via FMS and document Light Warm up: (2 minutes of walking or light jogging)




Perform: Core Activation with tubing and active straight leg raise. 45 seconds each leg

Verbal cues: technique, alignment and posture.

Retest: via FMS and Document 



Water Protocol (82 degree pool): no more than 2 participants at a time so can cue effectively (right) 


Test: VerActive Straight Leg Raise via FMS at the pool and document
Light Warm up: (2 minutes quick jogging to get acclimated to water) 


Apply: 1 flotation cuff applied to moving leg then switch cuff to opposite leg after.
Perform: Vertical 3 position active straight leg raise.45 seconds each exercise. (45 forward, 45 seconds out, 45 seconds in). Repeat opposite leg (can gently hold side of pool for assistance if needed) 


Verbal cues: technique ,alignment and posture.

Retest: via FMS at pool and Document 

Results: Without performing a formal statistical analysis - but rather averaging the results - it was noted that each group had very similar outcomes. The only difference that was noted was that the older participants (over 65 years) responded a little more favorably in the water group. 

Though this was only a general data collection program, it was very promising to note the similarities between each group. A big take away from his project was that water can produce just as effective results as land based training on an acute bout basis.

Obviously a more formalized study with greater numbers will be needed, but this project is the first that I am aware of that looks at the FMS incorporating an aquatic setting. It would be great to look at how integrating both water and land together would possibly accelerate better movement 

I am sometimes asked,  if we live on the land why train in the water?  I feel that by integrating aquatic training into our programs then we can have much faster results. Water training does not work well unless it is combined with land based training. This land integration helps to strengthen whatever was gained in the water with a gravitational influence, this helps with proper motor patterning. 

I always like to compare water and land to Peanut Butter and Jelly. Separate they are good but when they are combined they are great! And who doesn't love Peanut Butter and Jelly. 

Dr. McAvoy,has specialized in Aquatic Physical Therapy and Sports Performance for over 25 years. Rick is a published author and researcher in the field of Aquatic Therapy and Fitness as well as Sports Performance. He trains and consults with numerous athletes and sports teams from professional sports, collegiate and high school teams, along with fitness and healthcare institutions. Rick is sought after Master Instructor in the Burdenko Method, a specialized form of dynamic aquatic and land-based techniques. Rick lectures nationally and internationally throughout the year teaching the benefits of Aquatic Therapy and Fitness and Sports Performance to health clubs, athletic institutions and health care practices. Rick is an adjunct faculty member at both The University of New Hampshire in the Department of Kinesiology and Franklin Pierce University in the Doctoral of Physical Therapy program.

Contact Rick at

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