Thursday, September 16, 2010

The Vital Dip


There are many facets to his healing, his touch, his therapy. I explore the avenues, one at a time…and an extremely successful arm of treatment is aquatherapy which has been the backbone of the Pugazhendi “ stay healthy regime”.
The indoor pool is warm, sparkling and inviting. It is a “women only” morning. Women arrive with walkers, canes and crutches. Some limp along holding a friend, terrified of falling on the water drenched floor outside of the pool. They are helped into the pool and those for whom it is a terrifying experience, are encouraged to hold the supports by the side of the pool and just walk slowly till they gain confidence. Priya the physiotherapist stands at the edge of the pool guiding her patients. She teaches them how to walk, to march, do various kick exercises and squats. I revisit the scene after four weeks. The progress is incredibly encouraging. Most of the women are able to walk on their own and the ones who can’t have made at least 30% progress.

As an eminent sports medicine doctor who treats injuries and restores normalcy of movement in patients as well as establishing maximum mobility, what made him turn to water?

It began with the training of R. Natarajan national sprinter who was diagnosed as having two stress fractures on his shin bone as he was preparing for the selection trials for the Asian Games in 1994. Dr.Kannan Pugazhendi designed the mode of training and the exercises to be done in water to maintain flexibility, muscle tone and explosive strength without causing pain. “High knee action and stretches in water resulted in a speedy recovery without a vestige of pain. I broke my own national record at the Asian Games in the 100 mts and 200 mts ….”. says Natarajan.

Recently diagnosed with a tear in his right Achilles tendon Natarajan sought Pugazhendi's guidance though various specialists had suggested surgery as the only way out.Three weeks of aquatherapy which consisted of walking in water, ankle and toe movements,etc. completed the healing process without the ordeal of undergoing surgery.

Who are the patients ideal for aqua therapy? Almost everyone. Dr Kannan has treated patients with acute knee pain, persons who find surgery inaffordable, those suffering from osteo arthritis, Bharata Natyam dancers, osteoporotic patients, rheumatoid arthritis patients, and post surgical cases. There are patients who are not suitable for this kind of treatment. Those suffering from cardiac problems need to get an all clear from their cardiologists. The coolness of the water (even in a place like Chennai) chills the body and the heart has to pump harder to even out the circulation. The heart should not go into shock at this effort. For any person not used to swimming or water, it is advisable to start aqua therapy for five minutes and increase it slowly to one hour sessions. At least initially all exercises need to be done under medical supervision, or by trained physiotherapists.

Anuska, cine artist swears by aquatherapy which she claims removed her knee pain totally in a few weeks time strengthening her muscles without straining her knee.
Surupa Sen,dancer describes that Dr Kannan motivated her recovery through a positive perspective having suffered from back pain and knee pain which many dancers suffer from. “ the aqua therapy enabled a greater range of exercise and movement which sustained my fitness over a longer period of time. That was by far the most beneficial treatment which helped me keep myself flexible and strong throughout the recovery period” she says.
The body weight is reduced by 90% in water and the buoyancy makes even the more difficult exercises doable. For instance persons with knee problems are generally advised not to do squat exercises. In water, one can do all this and more without discomfort or injury. Even jogging is permissible. The exercises are very specific to each person and and each person needs to work out under an exercise prescription. You don’t need to know swimming to undergo aquatherapy. Watching persons in the thick of it, I am convinced the experience is very enjoyable. “The initial problem which we surmounted was getting the women to shed their inhibitions and get into water…” says Dr Kannan. The reluctance stemmed from having to wear a swimsuit under the public eye. The resourceful doctor got permission from the concerned authorities to allow the women to wear clean salwar kameezes or tights if they so chose, and half the battle was won.

What are the benefits of aquatherapy? Due to the water buoyancy, exercises are easier. It is almost “a return to the womb” feeling, and a snugness and confidence once patients get used to the water. You carry only 10% of the body weight, so doing exercises are much easier. There is uniform omnipotent pressure in the water, and the full weight bearing joints are faced with minimum loading.. The muscle mass is improved and with regular workouts, the gait is improved.

The ideal candidates for aqua therapy are the geriatric population. Those with ataxia, who lose balance and fall easily, find that their limbs are strengthened and they are steadier on their feet during normal walking. Those with respiratory problems are greatly benefitted as compressed water exists exhalation. Muscle tone is improved for those with hypertrophy. It is indeed a mega treatment even for those who have undergone bypass surgery, with the consent of the cardiologist, of course.

The exercises seem gentle and easy, but the after effect is mind boggling. You begin with a warm up as in any exercise regime, then begin exercises. Half an hour of aquatherapy is equal to an hour of walking or workouts in the gym. According to Pugazhendi, after the initial healing takes place in the case of a limb fracture, aqua therapy restores, maintains function, and enhances mobility. “Of course where nothing else works, surgery is the ultimate answer, in certain cases, and I don’t rule this out entirely,” says Dr Kannan.

Any new developments in aqua therapy? “ I am constantly devising new methods which might prove to be beneficial,” says Dr Pugazhendi. I am trying out yoga pilates in water which will improve the entire muscular skeletal system. This will help to strengthen bone mass. Kalari in water is the next experiment, and pranayama in water should be really beneficial in assisting the mental and physical progress of the individual.”

If this as the good doctor says, improves the quality of life, swimming pools should be easily accessible to the populace. And if pools can be reserved for women, the response will be greater, most Indian women cannot come to terms in sharing a pool with men. Though it is wishful thinking, an indoor pool will attract the female patients further, as the fear of getting exposed to sun is dormant in them!

Any non-formal method of healing which eliminates the trauma of surgery will always be welcome to patients and fitness freaks to whom wellness is a big factor in good living.

Sabita Radhakrishna
Chennai based free lance writer and author
She may be contacted at