Contraindications and Concerns

1. Hyperextension - straightening a joint past it's normal position
   • Do not lock joints - keep slightly flexed - soft joints
     1. hips
     2. knees
     3. elbows
   • Do not hyper extend (arch) lower back
     1. Maintain dynamic lumbar stabilization
     2. Do not over-extend leg in raised rear position
     3. Avoid back circling and back bends
   • Do not hyper extend neck (looking upward)
     1. Keep range of motion and head movements slow and controlled.
     2. Avoid neck circles
2. Hyper flexion - bending a joint more than normal
   • Always support extremity under the joint.
   • Do not restrict joint movement by holding in the knee or elbow, such as hugging the joint and pulling it to the body with the arms or hands.
3. Repeatedly rising on the toes and heels may weaken the long arches of the feet.
4. Staying on toes - press heels to the floor to prevent shin splints.
5. Isometric exercises should not be performed by those with high blood pressure or heart trouble. If done for stabilization of the trunk, BE SURE you breathe.
6. Avoid hyperventilation - Over breathing - forced, rapid, or deep breathing
7. Dehydration - excessive loss of water from the body, usually through one of the following:
   • Evaporation
   • Urination - caffeine/diuretic induced fluid loss
   • Perspiration - sweat from exercise
   • To avoid, do not restrict water during exercise
     1. Replenish fluids before, during, and after exercise.
     2. Encourage water bottles poolside.
8. Avoid moving arms/legs rapidly from water to air or vice versa. An exercise should keep arms in the water or keep arms out of the water for that exercise.