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Water Exercise Training for Painful Joints

Posted on April 17, 2018 at 9:55 AM

Photo by Yannis Papanastasopoulos on Unsplash

There may be affiliate links that I receive compensation or referall points in this post.

I've been certified by the Arthritis Foundation, the YMCA of the USA, and studied with the American Council on Exercise for water exercise instruction. The following comes from 18 years experience teaching and doing personal training in aquatics. 

When I began working in health and fitness, the first place I taught classes was in aquatics. I had the privilege of working with several people in the Arthritis Foundation water exercise classes and regular water aerobics who had various forms of arthritis. Although they were mostly older adults, many were younger. If you were to approach them about weight loss, they would laugh at you. Some of them were on medications like prednisone that cause weight gain coupled with limited movement made weight loss very challenging. They were just happy to move in the warm water of the pool on a pain-filled day. It was difficult for me to understand their pain and their perspective on health and fitness until I joined their ranks in my late 30's.

My own health issues benefit from working out in warm water pool (84-88 degrees Fahrenheit). Fibromyalgia and osteoarthritis have been my companion since my late 30’s. Fast forward to today, I find water exercise one of the best modes for me when mixed connective tissue disease causes some of my joints to swell from inflammation. I love to swim laps and do water aerobics, as well as cycling on bike trails, of course. What about you? Do you love to run, but your hips and knees don’t? Do your shoulders groan loudly when you try to do chest press in the weight room? Then water exercise might be the ticket for you.

The properties of the water are ideal for people with arthritis and chronic pain conditions.

Swimmers and water exercise enthusiasts are able to work the entire body without unbearable stress on their joints. The muscles of the working body parts can be strengthened with movements in different directions due to the variable resistance of the water. All of the muscle groups, ligaments, and tendons of working joints are strengthened synergistically. All movement is supported by the core muscles of the torso causing the body to work in a more efficient capacity in their full range of pain-free movement. 

Shoulders and arms are able to be strengthened with less stress because the water provides variable resistance. That means the speed and intensity changes how difficult or how easy it is to do different exercises like chest press, bicep curls, tricep extensions, and rows. As you move, you do eccentric/concentric movement, whether chest press and rows, bicep curls and tricep extension, etc. The stabilizing muscles are worked in coordination with the major muscle groups like the muscles of the rotator cuff are worked equally with the deltoids, pecs, biceps, lats, and rhomboids. Proper body form aids the movement’s effectiveness which protects the supportive muscles like the lower back or neck. It is important to use well-controlled movement to protect your elbows from hyperextension when working the arms and shoulders.

You can find warm water pools in your area with your local YMCA or Recreation Center.

Consider fitness swimming as a great water exercise form.

For swimmers, the entire body is lengthened and must be supported by buoyancy. The core supports all of the swimmer's movement. As the swimmer kicks, it increases the work on the abdominal and back muscles as well as the legs strengthening them without undue stress. If joints are painful, other swim strokes and kicks may be used to avoid pain. If there are damaged joints of the feet, ankles, knees, hips, or back, caution should be used when using swim fins. Always check with your doctor before using swim equipment like fins, hand paddles, kickboards, or aqua gloves. Rotate through different swim strokes and swim drills to avoid overuse injuries. 

Water running is ideal for runners with arthritis.

For the runner, running in water chest high or in deep water with an aqua belt, his or her body weight has been reduced to 1/4-1/2. Bouyancy reduces impact on the lower body joints. It is imperative to wear well-fitted aqua shoes to reduce damage to feet. Proper body alignment is very important to protect the back and neck. Additional aerobic work can be done by wearing aqua gloves with an open fist or cupped hand. This makes for a nice change from running on the elliptical or treadmill.

Water exercise is low- to no- impact exercise meaning the lower body is well protected from impact damage. Runners can protect their joints in the off-season for outdoor running in deep water by wearing an aqua belt and aqua shoes to keep their endurance and cardio up while maintaining overall joint integrity. Some runners like to use tether cords made for chlorinated pools for additional resistance. Runners can build up the strength to support and protect the ankles, knees, hips, and back. When using proper body alignment in the water, the entire core is strengthened and balance is built up. Proper form is important to protect your joints in their full range of pain-free movement.

Water aerobics is a great alternative for land aerobic enthusiasts.

People who normally do aerobics on land will have a delightful surprise with water aerobics. First, you don't sweat as much, or at least, you don't feel it. Also, most land aerobics use the arms, but the arms are strengthened and used to increase the aerobic effect with the water's resistance. Third, your aerobic heart rate range is lower due to the hydrostatic pressure preventing the blood from pooling in your extremities, the blood is more evenly circulated. It is important to be immersed in water between waist and mid-chest high for reduced impact on your lower joints. A slimming effect happens for your core because the body Many of the same aerobic dance moves are used in water aerobics, but done more by time than in the aerobic count. No one should expect to keep up with everyone else in a water exercise class because the resistance of the water and turbulence caused by other class members affects everyone differently.

Wearing a well-fitted swimsuit that is chlorine resistant is very important. You would be moving in many directions including forward and back. I recommend a higher neckline and moderate leg cut without a skirt or shorts. Several companies like TYR and Speedo have  PBT  blends, and Dolphin, a less expensive brand, has polyester. Your suit should feel snug when it is dry, but it will stretch when it is wet. If you want more coverage, try light compression shorts or lycra leggings. I used to wear them when I taught on land for modesty. I could get in the water with the students to demonstrate movements in the water that were impossible on land without embarrassment. Wear aqua shoes to prevent ganglion cysts and arthritis in feet from impact with pool floor.

Living with arthritis and related conditions is all about health.

If your focus is on health, weight management will follow. You might not hit your original goal weight, but you can burn fat and build muscle to improve your body composition and lose some weight in the process. Eat nutritious foods that do not cause inflammation. Foods like processed meat, pre-prepared meals, and foods with preservatives, artificial flavors and colors, and high in sodium or sugar cause an overall inflammation of the body. For people with osteoarthritis and autoimmune diseases, this is especially important to reduce pain and damage of your joints. It improves your energy levels while aiding weight loss. High nutrition content can also help with low vitamin and mineral levels in some people. Ask your doctor for dietary recommendations for your health condition. Also, consult your physician before using supplements to avoid overdosing.


Plan your exercise for the week by your pain patterns, fatigue level, and flare-ups. If you aren’t feeling well, it may be best to either avoid your workout or simply walk in the shallow water. Wear proper swimwear that is chlorine-resistant (PBT or polyester), aqua shoes, and if you get cold easy, a rashguard shirt. If you are sensitive to the pool temperature, well-fitted leggings made from polyester or lycra (made to be worn in the chlorine water) will help hold your body heat in. Thermoregulation is important for some types of arthritis and Raynauds.


Water exrcise helps reduce blood pressure, aids weight loss, protects joints, and feels great! The benefits are amazing!  When done correctly with a healthy diet, you will see overall improvements in your health and energy. If you have questions, feel free to contact me or comment below.

Other resources to read:

Can the New Wave of Watery Exercise Help Your Arthritis? by WebMD

Water Walking 101 by Arthritis Foundation

Resources for Swimwear:

Swim Outlet


Swim and Sweat

Categories: exercise, special health conditions, fitness

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