How to Fall Safely

More than one out of every four people 65 or older falls each year. One out of five falls causes a serious injury such as broken bones or a head injury. Over 800,000 patients a year are hospitalized because of a fall injury. Each year at least 300,000 older people are hospitalized for hip fractures. These statistics from the Centers for Disease Control and Prevention are a concern for many of my water exercise class participants and for me. When I came across some articles on How to Fall Safely, I decided the information was worth passing on.

I found articles from several sources, including AARP, physical therapist blogs and wikiHow. The pictures in this Blog post come from wikiHow. The co-author of the post was Chris M. Matsko, MD.

Protect your head. Head injuries can be very serious. Make sure you prioritize protecting your head. Tuck your chin down to lower your head. If falling face first turn your head to the side. Use your arms for additional protection. Put them in front of your head if falling forwards or behind your head if falling backwards.

Turn as you fall. If you are falling either straight forward or straight backwards, try to turn your body so you land on your side. This reduces the risk of injuring your head, face, arms or back.

Keep arms and legs bent. It may be tempting to try and catch yourself with your arms. However, landing with your arms straight out can break your wrists and/or your arms.

Stay loose. Tensing up increases the chance of sustaining an injury. The tense parts of the body are more likely to break. Try breathing out as you fall to help keep your body relaxed.

Spread out the force of the fall. A big part of falling safely is to spread out the force of the impact over a large area of your body. This reduces the risk of a serious injury to a single part of the body.

Another suggestion is to roll out of the fall. This is difficult to do unless you have practiced beforehand. If you wish to learn the technique, you can ask a physical therapist to show you how, or practice falling and rolling in a gym with padded and cushioned floors.

Just as important as knowing how to fall is taking steps to prevent falls in the first place. Wear shoes with slip resistant soles. Pay attention when you walk. Be aware of uneven areas on the ground, curbs and stairs. Hold the hand rail when taking stairs. In the home, close drawers after you are done with them. Don’t leave cords in walkways. Keep the area well lit. Use non-slip bath mats. Remove small throw rugs.

Another way to reduce your risk of falling is to improve your strength and balance with exercise. The pool is the perfect place to work on both strength and balance. Because the water’s buoyancy and resistance helps support the body, exercises can be done without fear of falling. Options include the following:

Gait training. Gait training is walking practice. The goal is to lengthen the stride and improve confidence while walking.

Core Strength Training. Core strength training is training for the postural muscles of the trunk. This includes the Trapezius and Rhomboids, the Latissimus dorsi and the Erector spinae. Exercises to try are rowing, bowstring pull, and lat pull-down using the water’s resistance or drag equipment. Walking backward strengthens the Erector spinae.

Deep-Water Exercise. Deep-water exercise is performed, while wearing a flotation device, in water in which a person can remain vertical without the feet touching the floor. Exercisers must aggressively engage the stabilizing muscles of the core to remain upright.

Balance Challenges. Balance challenges are exercises performed with a narrow base of support, such as the feet together, one foot in front of the other, or standing on one foot. Slow movements are more challenging than fast ones.

Falling is scary, but learning how to fall and taking steps to prevent falls in the first place are things we can all do now to reduce the risk.

See you in the pool!

Chris Alexander


Why is good posture important in water exercise?

I suppose my classes sometimes get tired of hearing all my cues for good posture, good alignment, good form. After all, the main thing is that they are moving, right? Well, yes and no. Moving is definitely better than being sedentary. But the quality of movement is important too. The terms good posture, good alignment and good form all mean that the spine is aligned in its natural curves.

When the spine is aligned, the bones are evenly spaced and the discs between the bones are not pinched in any way. Our spines are designed to be able to bend forward (forward flexion) or to the side (lateral flexion), but during exercise it is important to have the spine in alignment. This places the least amount of strain on the supporting muscles and ligaments. It allows us to use our muscles correctly so that we can increase intensity without risking an injury. Good form prevents muscle strain, overuse disorders and back pain. Keeping the bones and joints in correct alignment decreases the abnormal wearing of joint surfaces that could result in degenerative arthritis and joint pain.

If we exercise with poor posture we create muscle memory that makes poor posture feel normal and good posture becomes harder to achieve. No one intentionally wants to train for poor posture! Let’s take a look at some examples of common mistakes in alignment during water exercise.

This is the classic image of good form/bad form in deep-water running. The runner on the right (with the big red X) is leaning forward, streamlining his body so that the water hits his chest and slides down his abdomen. He can travel faster than the runner on the left who presents a larger surface area to the water’s resistance, which is probably why so many people adopt this form. But the front part of the discs in his spine are compressed and he is causing abnormal wear of his joint surfaces. The runner on the left is able to work harder, run with more power, without risk of an injury.

High knee jog

In this photo I am demonstrating another common running mistake, bringing the knees up too high. People who adopt this form are usually trying to increase intensity. But the spine is out of neutral and the high knees risk aggravating the sciatic nerve. Bring the upper leg up no higher than parallel to the floor. Another running mistake is bobbing from side to side. It may feel like you are working harder because there is so much movement going on, but you are compressing the sides of the discs. The best way to increase intensity is to maintain the entire trunk in neutral alignment and add power to the movement of the arms and legs.

High kick

Another mistake is trying to get the leg up too high in a high kick. You are aiming for your full range of motion in this exercise, but you do not want to push it beyond normal. If you try to get your toes out of the water you end up arching your back and taking your spine out of neutral.

Rocking horse

Another exercise that is often performed with an arched back is the rocking horse in shallow water. The exerciser should rock from the back foot to the front foot without taking the spine out of neutral alignment. Arching the back is not a safe way to increase intensity.

Inner thigh lift

Mistakes are often made while performing the inner thigh lift and hopscotch. The exerciser tries to touch the ankle during the first exercise and the heel during the second one. If you can do that while maintaining neutral alignment, great! But if you have to bend forward to reach the ankle or lean to the side to reach the heel, then you are straining the muscles of the back. It is more important to keep the shoulders level. The purpose of the inner thigh lift is to work on hip flexibility and the purpose of the hopscotch is to work the hamstrings, and both objectives can be achieved without touching the ankle or the heel.

These are pictures of what not to do. For photos of the correct way to perform the exercises, see my books, Water Fitness Lesson Plans and Choreography and Water Fitness Progressions. 

See you in the pool!

Chris Alexander

Holiday Ideas for Your Class


There is a lot to do during the holiday season: shopping, wrapping presents, decorating, baking, holiday parties and more. You know your water fitness class participants need to maintain their exercise routine to help them manage the holiday stress, but sometimes exercise moves near the bottom of their priority list. Try some of the following ideas to make your water fitness class more festive and encourage everyone to keep coming:

Holiday Music. Break out some holiday music to get everyone in a festive mood. All the fitness music companies have Christmas music playlists for sale. Check out:

(1) Super Happy Xmas Step (128-130 BPM) and Xmas Buzz (135 BPM) at Yes Fitness Music

(2) Tis The Season – Best of Christmas Hits Remixed (130 BPM) and Christmas Hits Remixed (135 BPM) at Power Music

(3) Core Christmas Volume 2 (128 BPM) and Christmas in Motion 3 (135 BPM) at Muscle Mixes

Holiday Themed Games and Activities. Add fun activities at the end of your fitness routine to have everyone laughing and looking forward to the next class. Here are two ideas:

(1) Holiday Obstacle Course – Create an obstacle course with the pool equipment you have on hand, giving it a holiday theme. Station One: Have a participant begin by cross-country skiing to the North Pole, using either drag equipment or foam dumbbells. Station Two: Tie 3 noodles in a triangle to serve as a Christmas tree and have a bucket of small balls nearby. The participant throws the balls into the triangle to “decorate the tree.” Station Three: The participant picks up a paddle or a foam dumbbell and uses it to “stir up the Christmas cookie dough.” Station Four: The participant runs to 3 “elves” who are holding 3 balls. The participant helps in the toy shop by tossing the balls a set number of times back and forth to each elf. Station Five: The participant picks up 2 noodles and puts the ends of each noodle under an arm with the opposite ends sticking out in back. “Santa grabs the free ends and takes a seated position. The participant now takes the place of Rudolph the Red-Nosed Reindeer and pulls Santa’s sleigh to the finish line. If your class is large, half of the participants can man the stations while the other half runs through the obstacle course; then the two groups
change places. If your class is small, have all your participants (but one) man the stations while the “contestant” runs the course. Then that person will take the place of another participant who will take a turn running the course.

(2) Sleigh Races – Have your class members partner up. One partner can be Rudolph and the other Santa. Rudolph then pulls the sleigh as in the obstacle course above, racing with all the other sleighs in the class. After one team wins the race, Rudolph will take a turn being Santa, and Santa will become Rudolph, and the teams race again.

Costumes. This is the perfect time to wear your red swim suit, a Santa hat, a Frosty the Snowman top hat, a red nose or a hat with reindeer antlers.

Holiday Gifts. Show your appreciation for your class by giving them each a small gift. If you are an H20 Wear AquaPRO, you can get coupons for your participants worth 10% off their first purchase of a swim suit. Contact them at to request coupons or to become an AquaPRO member. Some other gift ideas include a Clementine tangerine, a tree ornament, a peppermint candy cane, a Christmas cookie, a package of hot cocoa mix or some kind of homemade goodie. Here is an easy recipe if you would like to make your own treats:

Peppermint Crunch Puppy Chow

Ingredients: 5 cups Rice Chex, 10 ounces melting white chocolate, 1 cup crushed candy canes, 1 cup confectioners’ sugar

Pour the cereal into a large bowl. Melt white chocolate according to the package directions. Pour melted chocolate over cereal, stirring and folding until the cereal is completely covered. Fold in crushed candy canes.

Pour the confectioners’ sugar into a zipped-top bag. Pour the cereal mix in next. Seal the bag and shake until all the cereal is coated with the confectioners’ sugar. Discard excess powdered sugar.

Divide the puppy chow into individual bags and tie with a ribbon.

Merry Christmas!


Chris Alexander

What’s Wrong with This Picture?

Dumbbells up clip art

Here we have a clip art picture of three smiling people in the water holding dumbbells in the air. What better way could there be to promote water exercise? First of all they are happy and second they are using equipment, suggesting that they are serious about improving their fitness. So what could be wrong with that?

The problem is that the dumbbells used in water fitness are made of foam. They are designed to use the buoyancy of the water for resistance. Weights which are used on land use gravity for resistance. Foam dumbbells are pushed down underwater to work the muscles of the upper body. Weights used in strength training on land are lifted up to work the muscles of the upper body. The two kinds of equipment are used in opposite ways. These happy women are lifting foam dumbbells which weigh a few ounces into the air as if they were weights. This is a misrepresentation of water exercise.

Okay, this is just one little clip art picture. But if you Google “pictures of water exercise” you will find dozens of photos of smiling people holding foam dumbbells in the air.

Maybe it makes a better photo to wave foam dumbbells in the air where the camera can see them as opposed to photos of people using the equipment underwater as intended. But it makes water fitness instructors and participants look like they don’t know what they are doing, at least to those of us who actually participate in water fitness.

Although waving foam dumbbells in the air is the most commonly seen problem with photos of water exercise, it’s not the only one. There are also photos of people doing contraindicated exercises, exercises that risk injuring the person performing them. You can find photos of people suspended from dumbbells held to the sides, for example.

The shoulder joint is like a golf ball (the head of the humerus) sitting on a tee (the glenoid cavity). This allows the shoulder to be extremely mobile, but the shoulders are not designed to be weight bearing. The rotator cuff is a group of 4 muscles that stabilize the shoulder joint. Impingement is the pinching of the tendons of the rotator cuff in the shoulder area. Impingement occurs when you hang from foam dumbbells with the arms abducted to the sides, as in the above photos. Repeated impingement injures the rotator cuff.

Hanging from walls also puts the shoulder joint under extreme stress. It puts stress on the elbows and wrist as well.

Holding on to the wall in a prone position causes hyperextension of the low back and the neck, risking an injury to those areas.

I look for photos of water exercise often and I would love to see a collection of pictures of smiling people performing safe and reasonable exercises in the water online. But until that happens, it is important to use good judgment when selecting photos to promote water fitness. If you are not sure whether a photo shows a safe and reasonable exercise, you might want to check out Do No Harm, a notebook and DVD by Pauline Ivens, MS and Catherine Holder, PT which can be purchased at for $125. It is a comprehensive guide to exercises that might hurt water fitness participants.

My books, Water Fitness Lesson Plans and Choreography and Water Fitness Progressions contain many pages of safe and reasonable exercises. The books can be ordered from Human Kinetics (the publisher) (just click on the name of the book you wish to order) or from

Water Fitness Lesson Plans   Chris Book Cover    IMG_4509

See you in the pool!

Chris Alexander

Aquatic Step

Aquatic Step

Aquatic steps are not available at every facility, but if yours has them, then you have the opportunity to spice up your classes with some new exercises. Think “outside the box” and rather than just transferring the gym’s step aerobics class to the pool, use some water specific exercises instead. My thanks to Julie Twynham whose MAAP workshop in 2006 provided me with a lot of ideas for using aquatic steps.

                                                                                              Chris Step Water at Elbows

Aquatic steps have rubber on the edges of the bottom to help keep them from sliding around too much. Ideally the water should be deep enough so that when you stand on the step, the water comes up to your elbows, as in the picture to the right. Some aquatic exercises to try are:


Chris Step Rocking Horse 1   Chris Step Rocking Horse 2

Rocking horse with the front foot landing on the step and the back foot landing on the floor.

Chris Step Skateboard 1   Chris Step Skateboard 2

Stand on the step with one foot and skateboard with the other. Bend your standing knee to get a deeper sweep with the pedaling foot.

Chris Step Kick & Lunge 1   Chris Step Kick & Lunge 2

Stand on the step with one foot; kick and lunge to the floor with the other.

Chris Step CC Ski 2   Chris Step CC Ski 1

Cross-country-ski with the front foot landing on the step and the back foot landing on the floor.

Chris Step Squat 2   Chris Step Squat

Try some squats, with both feet on the step, or with one foot on the step and one foot on the floor. When you squat on a step, less of your body weight is supported by the water’s buoyancy.

Chris Step Log Jump 3   Chris Step Log Jump 2   Chris Step Log Jump 1

Log jump to one side of the step, tuck above the step, and log jump to the other side.

Chris Step CC Ski Suspended 2   Chris Step CC Ski Suspended 1

Cross-country ski, suspended, above the step.

Chris Step Tuck Pike Land Down 1   Chris Step Tuck Pike Land Down 2   Chris Step Tuck Pike Land Down 3   Chris Step Tuck Pike Land Down 4

Hop up on the step, pike, tuck and land on the step, then hop down to the floor.

Chris Step Fall Sideways   Chris Step Fall Sideways Tuck   Chris Step CC Ski Side-lying

Fall sideways off the step, tuck, extend the legs to the side, and cross-country ski side-lying back to the step.

Chris Step Chest Stretch 3   Chris Step Hamstring Stretch

You can even use the aquatic step for stretching. For example, walk around the step dragging your arm behind you for a chest stretch. Put one heel on the step to stretch your hamstrings.

You can create an entire class with the aquatic steps or use a few of these exercises in a circuit class. You might also want to use them for some games at the end of class. Set some aquatic steps up around the shallow end of the pool and play follow the leader around them and over them, pausing on top for some squats or Yoga tree poses or anything else you can think of. For more ideas on incorporating aquatic steps in a lesson plan, see my book Water Fitness Progressions. The book can be ordered from Human Kinetics (the publisher) or from Just click on whichever source you wish to order from and the link will take you there.

Chris Book Cover    IMG_4509

See you in the pool!

Chris Alexander