Water Exercise for Osteoarthritis: Water Aerobics and More


Last one in the water is a … Remember this challenge from your childhood? For today’s fitness-conscious adults, it has new meaning. Don’t be the last person to discover the new wave of water workouts — for strength and cardio training, flexibility, relaxation, rehabilitation, and weight management.

“We’re seeing growth in both ends of the spectrum [of aquatic workouts], from high-intensity exercises like kickboxing and circuit training to mind/body workouts like ai chi, which combines tai chi and shiatsu massage,” says Julie See, president of the Aquatic Exercise Association (AEA) in Nokomis, Fla. “We’re working against a perception that aquatic exercise is just for old people, not the young and fit. With younger people coming into the water, we’re starting to see a lot of sport-specific training and one-on-one personal training.”

“If it’s been a decade or more since you had a water fitness class, you’ll see many changes,” says Jane Katz, EdD, associate professor of health and physical education, City College of New York, and author of Aquafit: Water Workouts for Total Fitness. “Back then it would have been traditional skills of breathing, floating and swimming, which are still taught today, but with the addition of stretching and vertical exercises” done in a standing position.

Another difference, she says, is the abundance of exercise equipment. A lot of landlubber gear has made its way to the pool: handheld weights, rubber tubing, even bicycles and treadmills. Plus, the old aquatic stand-bys like fins and kickboards are no longer “one-size-fits all.” They’re engineered in a host of styles to suit specific applications.

Who Can Benefit From Water Exercise?

Water exercise can benefit virtually everyone, says Katz. A former Olympian, she teaches fitness and swimming to New York City firefighters and police officers and also has a special fondness for a class for women in their 60s, 70s, and 80s. Athletes use water to rehabilitate after injury or to cross-train. People with arthritis or other disabilities that can’t perform land exercise use water to improve fitness and range of motion and to relieve pain and stiffness.

Age and physical condition aren’t issues in the water. Kids love to play in water without realizing it’s good for them. Seniors who rely on a walker or wheelchair on land can stand in water with the help of flotation belts and water’s buoyancy. Water exercises provide less stress on the bodies of pregnant women.

Also not at issue is the ability to swim: Most water workouts consist of exercise done in a vertical position (with the bonus of keeping your dry).

Water’s buoyancy accommodates both the fit and unfit. Water cushions stiff and painful joints or fragile bones that might be injured by the impact of land exercises. When immersed to the waist, your body bears just 50% of its weight; immersed to the chest, it’s 25%-35%; and to the neck, 10%. In addition, says See, the lower gravity promotes the return of blood to the from the extremities.

While water significantly reduces exercise’s impact to the back and joints, running and other vertical shallow-water exercises do cause some impact. That’s one reason experts advise wearing shoes. “>exercise program.” For starters, she suggests lightweight sneakers such as Keds. “Once you get hooked on water, which usually takes a couple of weeks, invest in a better shoe.”

Water provides at least 12 times greater resistance than air, and in every direction. “No matter which way you move, it challenges you,” says Katz. “You don’t need equipment, you don’t need an Olympic-sized pool. All you need is your body.”

Water cools your body and prevents overheating. See points out that even in 80- to 85-degree water, the recommended temperature for exercise, you should warm up in the water before your workout to prevent injury. Just as with a land workout, you will sweat during water exercises, so it’s important to drink water.

Intimidation may not be the first thing you think of when you consider the differences between land and water exercise. But it’s important, because concern about appearance or proper technique prevents many people from being physically active.

“Water is democratic,” says See. “Once you’re in the pool, we’re all the same. There’s less intimidation than walking into an aerobics studio surrounded by mirrors. You don’t have to wear a swimsuit. If you’re more comfortable, wear Lycra pants and a T-shirt. And it doesn’t matter if you’re on the wrong foot. As long as you’re moving, you’re getting the benefit.”

Can It Help Me Lose Weight?

There’s debate as to how efficiently water exercise burns calories. Katz says there’s some evidence that water exercise isn’t as effective as land exercise for losing body fat. One reason is that the big muscles in the legs and buttocks don’t have to work as hard in water.

Nevertheless, she says, water exercise can contribute to weight management. Strenuous exercise curbs appetite and promotes relaxation, factors in controlling compulsive eating.

Also, studies of water walking have showed that the number of calories burned increases with the depth of the water. Katz says a half-hour of deep-water running burns 300 calories, compared with 200-250 for running on land, 150 for tennis, and 150-200 for aerobics. Also, a 150-pound person swimming at his or her target heart rate burns about 600 calories per hour.

Choosing a Water Exercise Program

Here’s a roundup of some popular types of water workouts:

  • Aerobics. Water aerobics classes feature vertical exercises that often mimic land exercises, like dancing, walking, running, jumping jacks, and kickboxing. While swimming is a horizontal exercise performed on the top of the water, vertical exercises increase the workload because they’re done below the surface where drag is greater. If you’re just beginning an exercise program, start slowly by walking in shallow water. Gradually increase the intensity of your workout by moving to waist-high, then chest-high water, and adding movements that use both arms and legs. Always do a five-minute warm-up and cool-down.
  • Deep-water exercise. Deep water provides a no-impact workout and has long been associated with rehabilitation, but it’s also a great place to get a high-intensity athletic workout while preventing overuse injuries. Using flotation belts, you can jog, run, do sit-ups, and more.
  • Swimming laps. Katz says many people think swimming laps is boring, but there are ways to vary routines: learning different strokes, practicing dives and turns, and adding equipment such as kickboards, foam noodles, and fins. Even if you do land exercises before entering the water, always begin your session with a warm-up, which can be a few laps of very relaxed swimming, to raise your core body temperature and put your body in the groove for swimming. A beginner — someone who can swim 10-25 yards without stopping — should plan a 30-minute workout that includes a 10-minute warm-up, 15-minute main set, and five-minute cooldown. Katz advocates a progressive program that takes swimmers from a total distance of 100 yards up to two miles. As your speed and endurance improve, you’ll want to add strokes to your repertoire, time yourself on the different strokes, and test your endurance.
  • Holistic workout. Take your favorite yoga, Pilates, and tai chi exercises to the water or join a class to learn these popular mind/body movements. Some exercises offer multiple benefits. For example, the yoga “warrior” position performed in waist-high water provides relaxation, relieves stiffness in the waist and rib areas, stretches the entire body, and strengthens arms and legs. Water’s support and the fluid movements of these exercises make them ideal during pregnancy and rehabilitation. Katz recommends 30-minute routines that include five minutes each of warm-up and cool-down. The workouts can focus on relaxation, strength and toning, cardiovascular and aerobic exercise, or flexibility.
  • Sport-specific workouts. Katz says water workouts add variety to sports conditioning, offer relief in hot weather, and enable training to continue after an injury. In addition, you can isolate certain moves and reinforce them in the water. For example, a golfer, tennis player, or baseball player could stand in chest-deep water and practice their swings, paying close attention to proper technique. Resistance devices, such as paddles, can be used to make the workout more challenging. For variety, do an aquatic circuit-training workout that incorporates exercises such as boxing punches, soccer kicks, and cross-country skiing movements.
  • Prescriptive workouts. For the past 25 years, water exercise has been “prescribed” for people with arthritis. It improves range of motion and flexibility and relieves joint pain and stiffness. Lesser-known but equally important are workouts that target other health conditions, including , obesity, pregnancy, back problems and more. Experts advise consulting with your doctor before beginning a program.

Many gyms now offer a variety of aquatic exercise programs. But if you don’t have access to a water exercise class, don’t despair. Books and videos are excellent ways to learn proper techniques and create your own program.