underwater digital arthritis foundation’s 10 tips

Zorc7390    April 17, 2023    Comment   

Let’s get this little misconception out of the way: Water exercise is not just for senior citizens with joint pain. Water exercise for people with arthritis is for all ages at all levels of ability and disability, says Julie Mulcahy, DPT, physical therapist with McLaren Health Management Group, a Michigan-based organization that provides home health care.

From water walking to water aerobics, and even water Zumba, aquatic exercise programs can be modified to any fitness need — from a gentle range-of-motion and floating routine to high-level intensity workouts for athletes.

For people with arthritis, recent research has shown that water exercise can be a safe and effective exercise option. One study published in the

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Found women with rheumatoid arthritis (RA) who did water-based exercises three times a week for sixteen weeks saw significant improvements in disease activity, pain, and functional capacity compared to those who did land-based exercises. And in a recent

Of 13 trials that included 1, 190 patients with knee or hip osteoarthritis (OA), researchers found aquatic exercise may help improve pain and function.

Think of the pool as “nature’s body weight support system.” It can unload up to almost 90 percent of your body weight, according to experts at the American Physical Therapy Association. That buoyancy makes moving in the water easier on the joints. “It allows you to perform movement with an arthritic joint that would be painful on land, which then helps improve strength and flexibility in that joint, ” explains Dr. Mulcahy, who also works with Physera, an app-based platform for physical therapy. For example, it may be tough to perform a squat on land with knee OA, but in the water, the squat is more doable.

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“Exercise in the water removes the impact stress of ground reaction force, ” explains Lauren Shroyer, MS, senior director of product development at the American Council on Exercise. The impact of stepping on the pool floor is significantly less than stepping on dry land. “When joints are inflamed and painful during weight-bearing exercise, working out in the water allows you to experience the advantages of movement without the negative consequence of impact, ” she explains.

It takes more effort to walk from one side of the pool to the other in the water than it does out of the water. That’s because water provides greater resistance than air — up to 12 times more, says Dr. Mulcahy. That resistance to your movements not only helps strengthen muscles, but also burns more calories to help you lose weight faster. The faster you move, the higher the resistance.

Water exercise works your whole body in multiple directions and promotes smooth movements (instead of quick, jerky motions), says Dr. Mulcahy. It also allows you to work at a higher level that you could tolerate on land, which helps improve mobility and strengthen cardiovascular endurance. “Patients with chronic joint conditions often say they feel free from their disability when in the water, ” she adds.

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Not exactly. One big difference is the water temperature, says Dr. Mulcahy. “Many arthritis water exercise programs are conducted in hotter water, which is meant for low-intensity exercise and more soothing for arthritic joints, ” she explains. Pool temps for a water exercise classes for people with arthritis range from 92 to 98 degrees F.

Lap swimming, on the other hand, is a moderate intensity exercise that requires a cooler pool, with a water temperature between 83 and 88 degrees F, says Dr. Mulcahy. “Swimming laps in water that’s too warm, such as 90 degrees F or greater, can lead to exhaustion and overheating, ” she says.

Lap swimming, however, is also great exercise for people with arthritis. It has little impact on joints, lengthens muscles, and improves cardiovascular fitness.

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Regular exercise is an important part of your arthritis treatment plan, and your doctor will recommend it — whether you have osteoarthritis or an autoimmune, inflammatory form such as rheumatoid arthritis. But before you try any water exercise program, talk to your doctor or physical therapist to make sure pool exercises are right for you.

Consider your gear. Water shoes will give you extra traction on the pool floor. If you are exercising in deeper water, use a Styrofoam noodle or flotation vest to keep you afloat. You can also use Styrofoam weights or a kickboard for increased resistance.

Stop if anything hurts. “Listen to the pain, ” says Shroyer. Take a break when your joint starts to ache. If you feel any new joint pain, it’s time to stop. Talk to your doctor about what pain is normal and when it’s a sign of something more serious.

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Many aquatic centers, YMCAs, and community pools have water exercise classes designed for people with arthritis. The following water exercises were recommended by Shroyer at ACE and Dr. Mulcahy, and are inspired by some of the exercises here and here.

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How Hydrotherapy Can Improve Arthritis Pain And Symptoms

Poor Sleep May Make Vaccines Less Effective — Here’s How to Get More As a Rheumatoid Arthritis Patient Kelsey Kloss Read MoreA dip in a nice, warm pool probably sounds pretty relaxing and restorative right now. Add in underwater exercises and you’re now performing hydrotherapy, a beneficial treatment for those with many kinds of arthritis, including osteoarthritis and inflammatory types, such as rheumatoid arthritis.

“When we talk about hydrotherapy or aquatic therapy, we’re referring to exercises performed in a pool where the level of the water has to be at least waist, chest, or shoulder height, ” says Soo Yeon Kim, MD, medical director of musculoskeletal medicine and assistant professor of physical medicine and rehabilitation at Johns Hopkins Medicine in Lutherville, Maryland.

That’s one thing that differentiates hydrotherapy from a spa therapy where you might float or sit in a pool and simply relax. Traditional hydrotherapy is not just soaking in warm water; it requires you to put in some work.

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In this treatment, you would see a physical therapist who has a specialized pool that contains exercise equipment, such as an exercise bike or treadmill. There may be bars you can hold to perform resistance exercises.

You can also take underwater aerobic exercise classes at your local community center or gym. These are usually not run by a physical therapist but a certified personal trainer or group fitness instructor. Learn more here about water exercises for arthritis.

Both can be effective, though randomized controlled trials examining hydrotherapy have been done in a physical therapy setting. Dr. Kim says that anecdotally, patients also respond well to aquatic classes in a community pool.

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If you’ve ever tried to walk underwater, you know it’s a tougher task than walking on land. “Water creates resistance, which is what builds strength in muscles, ” says Dr. Kim. The big plus, though, is the elimination of gravity. “Underwater, patients feel better. They have less pain and engage muscles more. They can activate muscles that they don’t typically use when doing land therapy, ” she says.

A wealth of research shows that regular exercise is very beneficial for people with arthritis. Regular physical activity improves joint functioning, reduces symptoms like fatigue, leads to a lower risk of being hospitalized, and decreases the likelihood of developing chronic disease associated with inflammatory arthritis, like heart disease, according to a review in Best Practice & Research Clinical Rheumatology.

However, many arthritis patients may skip exercise entirely, either out of the belief that certain types of movement will worsen symptoms or because workouts feel terrible. “We have a lot of evidence that land therapy is important for managing symptoms. But the problem is that patients say that their joints hurt, so exercise isn’t fun. It can almost be torture for them, ” says Dr. Kim.

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That analyzed six studies, RA patients who performed hydrotherapy felt less pain and joint tenderness, improved their mood, and reported liking the workout, too. Here are more details on why hydrotherapy is good for arthritis:

“Hydrotherapy affects disease activity in RA. Studies have found that certain inflammatory markers decrease with aquatic therapy, ” says Dr. Kim. Exactly why isn’t well understood, however.

Then, there’s the mental uplift from spending time free of pain. “Research shows that a sense of well-being — an ability to move the body as you want without pain — increases your quality of life. That is one of the most motivating factors for encouraging aquatic therapy, ” says Dr. Kim.

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Talk to your rheumatologist about what water therapy option might be best for you. If you’re grappling with a greater level of pain and need more supervision (or worry that you could hurt yourself if you attempt these exercises on your own), then a referral to a physical therapist who offers pool therapy is right for you. If you’re more functional and your disease activity is well