Tuesday, July 02 2019

From infancy we are doomed to a life of flexion - walking forward, reaching forward, bending forward, holding in front, typing in front, driving in front, sitting in front – pretty much everything with shoulders and hips flexed.  A life of flexion takes a serious toll on the human body.  Traditional exercises, even those in the pool, can actually make matters worse.  Learning how to design an aqua fitness workout with an emphasis on extension can help reduce pain and promote better living.  

Guess what?  There is a video for that!  Aquatic Therapy & Rehab Institute (ATRI) President, Ruth Sova, makes her debut on Fitmotivation with the video, Extension for Function, a movement tutorial designed to educate the importance of extension. Take away strategies for adding extension-focused movement into all aspects of program design from the warm-up to the cool down. 

Cradling babies, sitting at a desk, typing on a keyboard, talking on a phone, driving a car, walking up stairs, hugging, handshaking and reaching forward for E.V.E.R.Y.T.H.I.N.G means flexion, flexion and more flexion.  Exercising to keep ourselves in better shape means walking, jogging, stepping, catching, shooting jumping, skiing, punching, kicking.  You guessed it – flexion, flexion and more flexion.  And that causes a problem because joints are meant to flex AND extend.   All this flexion leads to muscle imbalances.  Classic symptoms of muscle imbalances are usually pain associated with the affected joint. 

The musculoskeletal aches and pains increase as we age and joint instability becomes more pronounced.   As movement becomes limited, activities of daily living we once took for granted start becoming arduous.  Health issues caused by forward flexion also include more serious ailments such as breathing issues, gastrointestinal upsets and decreased organ function due to a perpetually slouched torso and rib cage.  Falls become more prevalent when posterior muscles are weakened. 

People often give in and just accept that pain comes with age.  Wrong. The musculoskeletal system doesn’t have an expiration date when all hell breaks loose and it falls to crap.  Corrective exercises that focus on extension can help reverse the imbalances caused by too much flexion.  Fitness professionals should be committed to educating themselves and understanding how to design fitness routines with an emphasis on extension.  


Segment 1:  Extension Warm-up
Walking, marching and jogging are commonly used in an aquatic fitness warm-up.  Simple cues such as foot placement an inch further back and heels pressing all the way down can create a great deal of transference from the hip flexors to the gluteals in these common exercises.  Nearly a century ago, Joseph Pilates began teaching movement strategies for eliminating the over-worked hip flexors as a movement producer.  He favored external hip rotation (feet pointed out) as a method for transferring the workload from anterior muscles to posterior, medial or lateral musculature.  In this segment, Ruth applies both external and internal (feet pointing in) corrective strategies for walking.   

Segment 2:  Extension with Lateral Travel
Lateral movement is good because it typically involves moving sideways rather than forward, which is a reprieve on the hip flexors.  However, lateral travel can sometimes morph into flexion in some traditional lateral exercises.  In this segment, Ruth explores the crossover jog, which is typically taught with crossing in front.  A simple corrective solution to enhance extension is to cross the jog behind instead. This corrective crossover jog is then paired with other backwards-focused moves to create choreography that targets extension.

Segment 3:  Extension with Diagonal Travel
Instead of forward travel, consider adding more diagonal travel into your class programming.  Traveling diagonally in a forward direction will create a more favorable scenario for leading with a lateral movement of the hip rather than a forward flexed movement.  In this segment, Ruth once again builds a choreographed combination of movements with corrective cues and techniques that discourage flexion and encourage extension. 

Segment 4:  Extension with Stationary Movement
In this segment, corrective exercise techniques designed to enhance extension are offered for a variety of aquatic fitness base moves, including jumping jacks, cross country skis, rocking horse, kicks and more.  Cues to straighten, pull back, press down and lift rib cage are offered.  Techniques such as a momentary pause or removing arms are also utilized to encourage the extension phase of the movement. 

Segment 5:  Extension Cool Down
Explore various walking patterns as effective warm-down activities that also encourage extension.  Once again, Ruth explores various techniques to remove forward flexion, such as striding with circumduction and abduction, along with walking on tip toes and on heels. 

Since I got to be the student in this video I can relate first-hand how amazing it was that such simple cues and small adjustments could make such a difference in muscle transference from the hip flexors to the gluteals, hamstrings, adductors and abductors.  I will for sure be using these cues and techniques in my class designs going forward. 

Extension for Function primarily focuses on lower body movements, but extension can be enhanced in the upper body by encouraging downward and backward movement of the arms, as well retraction and depression of the shoulder girdle.  Ruth also notes that cues for straightening elbows, wrists and fingers can be helpful as they are rarely straightened.   

Stay tuned for more information as Ruth is currently working on an article regarding extension.  Prior to founding ATRI, Ruth was the founder of the Aquatic Exercise Association (AEA), which launched operations in 1986.  Angie Proctor and Julie See later took over AEA in 1994 when Ruth moved on to ATRI.  At the 2017 International Aquatic Fitness Conference (IAFC), Ruth was honored with the Elizabeth Burg Global Award for Lifetime Achievement. 

In honor of IAFC’s 30th anniversary, I had the privilege of interviewing Ruth about her past 40 years in fitness and the milestones she has achieved.  The full article was printed in the 2017 June/July issue of AKWA Magazine but you can read it here.  Fitmotivation would like to extend a big THANK YOU to Ruth Sova for taking the time out of her busy schedule to film this important topic for subscribers.  Visit to see a full listing of ATRI events dedicated to aquatic therapy education.





Author: Mark Grevelding is the founder of Fitmotivation. He is also a training specialist and consultant with the Aquatic Exercise Association’s (AEA). Mark has been active in the fitness industry for 22 years as a group fitness instructor, personal trainer, international presenter and a continuing education provider for AEA, AFAA & ACE.