We are at the height of summer. All around the country, rising temperatures are pushing people towards a dip in the water. If you have arthritis, this may be the perfect time of year to try water exercise to improve the health of your joints.
Exercise in general is good for your joints. It can increase flexibility and boost muscle strength around stiff and swollen joints.
It is absolutely fine to do dry exercises. But you must be especially careful when exercising on land, as you can easily strain your joints.
There are many benefits to water exercise for arthritis patients. Water supports the joints, allowing for a greater range of movement. For those who need it, the water also can provide a soothing warmth that relieves stiffness.
Whether you need to take stress off your joints or just want escape the summer heat, it may be time to take your arthritis exercises to the water.
Why Exercise in Water?
Water adds a couple elements to arthritis management that you cannot get through exercising on land: buoyancy (support) and warmth.
Joint Movement and Support
Staying physically active is a crucial part of managing your arthritis. If you do not use your joints, they can lose range of motion and weaken over time. Regular exercise helps keep your joints flexible and strong, which protects them from becoming more damaged.
With healthier joints, you can improve your ability to do daily tasks like walking or typing. In addition, regular exercise - even easy walking - can boost your mood and self-esteem.
The buoyancy of water allows you to safely and gently exercise your joints. Water gives support which lowers stress on your joints. Water also encourages freer movement, and can even serve as resistance to help build muscle strength.
Warm water has been shown to relieve arthritis symptoms. While heat is not recommended for every person with arthritis, some patients find that warm water relaxes their muscles and eases joint pain and stiffness. This relief can make it easier to do exercises and daily tasks.
Soaking in warm water can distribute heat throughout your body, soothing all of your affected joints. Soaking in warm water also raises your overall body temperature, which can cause your blood vessels to widen and increase your circulation.
Be careful not to soak in water that is too hot. Extremely hot water can be unsafe.
Generally, water temperatures between 83 and 88 degrees Fahrenheit is comfortable for exercising. If you are just soaking or doing light motions, you can probably handle higher temperatures.
The amount of time you soak in warm water will depend on the water temperature and how well you handle the heat. Do not do anything you cannot tolerate. If the water is too hot, turn down the temperature or get out. When you are starting out, try short soaking times. In general, it is best not to soak much longer than 15 minutes in water between 98 and 104 degrees Fahrenheit.
In some cases, people with arthritis are told to soak in warm water in the morning before their day starts. The morning is often the time of day when joint pain and stiffness are at their worst.
Other patients find it most soothing to soak in the afternoon, when a day full of activity has made the joints tense. Some patients like to soak to loosen their muscles before exercising. Soaking in warm water also can relax the joints and muscles for a good night's rest.
If you have access to a hot tub, you not only get the benefit of warmth, but also the benefit of massage. The jets in a hot tub spit out warm water and air, which can massage tight muscles and relieve stiffness.
General Tips for Water Exercise
As you get into a hot tub or pool, the first thing to do is enjoy yourself. Enjoy the water and let your muscles and joints relax. Once you feel comfortable, begin your exercises.
When doing water exercises, remember to:
- put the body part being exercised fully underwater
- move the body part slowly and gently; do not overexert yourself
- start and end your exercise routine with easy exercises
- move your joints through their complete range of motion without forcing movement
- stop a motion or exercise if you feel sudden or increased pain
- begin slowly
- avoid overuse
When exercising in warm water, remember that heat can make you weaker.
It is also important to be aware of pain that lasts for more than a couple hours after exercise. Extended pain may be a sign of overuse.
If you are planning on exercising in a pool or soaking in warm water, follow these safety tips:
- Have someone nearby to assist you if needed, as you may need help getting in and out of the water.
- Talk to your doctor before using or buying a pool or hot tub, especially if you have other health problems like lung disease, heart disease, circulatory problems, high or low blood pressure, diabetes, multiple sclerosis (MS), skin irritations or other serious conditions.
- Check the water temperature with a thermometer before getting into a pool or hot tub.
- Heat affects everyone differently. If you start to feel weak or dizzy, get out of the water.
- There is no reason to soak or do water exercises if it is not helping. If you experience more joint swelling, pain or stiffness, stop using heat and exercising and talk to your doctor.
- Do not drink alcohol or use drugs before getting in a pool or hot tub.
- If you are pregnant, talk to your doctor before entering a hot tub.
Types of Water Exercise
The types of exercises you will do in the water depends on the joints affected by arthritis.
University of Washington Orthopaedics and Sports Medicine has outlined some water exercises for joints commonly affected by arthritis.
Start out with a forward arm reach, in which you raise one or both of your arms forward and upward as much as you can. If one of your arms feels weak, use the other arm to support it.
Next, try a sideways reach, in which you slowly lift both arms out to the side with the palms facing down. In a sideways reach, lift your arms only to water level (shoulder level).
Arm circles can also help shoulder arthritis. In arm circle exercises, you lift both arms forward with elbows straight until they rest a few inches below water level. Move your arms in small circles (about the size of a softball), gradually increasing into larger circles, then decreasing again.
To do an elbow bend, you bend both elbows and thumbs toward your shoulders. It is not necessary to touch your shoulders; just bend, then relax your elbows and straighten your arms along your side.
An elbow bend and turn combines two motions. First, turn your arms until your palms face forward. Then bend your elbows back until your fingers touch your shoulders. Relax and straighten your elbows.
To do a wrist turn, face your palms straight up then rotate them over to face the bottom of the pool or hot tub.
To do a wrist bend, pull your wrist backward then extend it forward.
Hand and finger exercises
To do a finger hold, touch the tip of your thumb to the tips of each finger one at a time. Every time your thumb and fingertips touch, you should be forming a round letter "O" with your fingers. Do this exercise on each hand, together or separately.
In a finger curl, your repeatedly curl your fingers towards the palm into a loose fist, then straighten the fingers out again.
Moving your thumbs through large circles (full range of motion) is also good for arthritis of the thumb.
Ankle and toe exercises
To do an ankle bend, sit down with your back supported and slowly straighten your knee. With your knee and leg straight, point your toes forward then back toward the ceiling.
Ankle circles are done in a similar position as an ankle bend. Sit with your back supported and your knee and leg straightened. Instead of pointing your toes, move your foot from the ankle in large circles. Do both inward and outward circles.
To do toe curls, simply curl your toes downward then straighten them out again. Do this exercise with both feet, at the same time or separately.
Hip and knee exercises
To do a knee bend, lift one foot up so that your knee becomes straight. Hold the straight position for about 3 seconds.
To do a knee-to-chest stretch, sit straight and bring your knee towards your chest. To help with the stretch, wrap your hands under your thighs or around your knees and pull towards your chest.
In a spread-eagle hip exercise, you sit on the edge of a seat and straighten your knee. While your knee is straight, move your leg out to the side. Hold the straight position for about 3 seconds, then bring it back to center.
To do a leg swing, stand with your right side to the wall of the pool. Grab the wall with your right hand while keeping your knees straight. Lift your left leg (outward leg) forward until it reaches a comfortable height. Try to hold your leg there for about 5 seconds, then let it swing slowly backward. Your leg should be moving only at the hip. Repeat this exercise with your right leg (the left side of your body towards the wall).
A knee lift involves standing with your back to the pool wall. Bend your knee while lifting your thigh parallel to the surface of the water. Now straighten your knee, then bend it back. Lower your leg while keeping your knee bent.
To do a calf stretch, stand straight with your left side to the wall and hold the wall with your left hand. Stand with your left leg slightly apart and forward of your right leg. Lean forward with your body straight, allowing your left knee to bend. Make sure your right heel stays on the ground with your right knee straight. Move back to your starting position. Repeat this process with your right side against the wall, stretching the left calf.
In a side leg lift, you stand with your left side to the wall while holding the wall with your left hand. Relax your knees. Swing your right leg outward, away from the wall. Bring your right leg back to the starting position. Do not cross your legs. Repeat this process with your right side to the wall.
Walking around the pool with the water's resistance is another good hip and knee exercise.
To do a side bend, put your hands on your hips. Bend slowly to the right, return to the starting position, then bend slowly to the left. Do this motion without moving your feet or twisting or turning your trunk. If you like, you can do this exercise with your arms hanging at your sides. With your arms hanging, let your hands slide down your thighs as you bend to either side.
Talk to your doctor before starting any exercise routine, whether it is in the water or on dry land. Your doctor can help you decide which types of exercises will help you the most and which ones should be avoided.
While exercising, stay aware of what your body is telling you. If you are feeling increased pain, maybe you should stop a particular exercise. If your joints seem to swell more after soaking in warm water, maybe you should avoid heat.
Keep working with your doctor and physical therapist to find an exercise plan specially tailored to your needs.