According to the Arthritis Foundation, the warmth of water relieves pain and stiffness, buoyancy makes water exercises safe and easy on joints, and the resistance of the water strengthens muscles. You should perform aquatic exercises on your core, hips and legs to help decrease symptoms, increase strength and improve function of osteoarthritic knees. Consult a physician prior to starting aquatic exercises.
Locomotive
Locomotive exercises involve moving from one place to another in the pool. Swimming and water walking are common locomotive exercises. According to Rana S. Hinman and colleagues in a 2007 article in the journal "Physical Therapy," aquatic exercises including walking improved physical function. Other locomotive exercises include lateral or side-to-side movements, marching and walking backward. The duration of locomotive exercises varies and depends on your level of physical fitness.
Core
The core helps stabilize the body and lower extremities during everyday activities, which might prevent further irritation of the knees. To perform side bends, bend sideways at the waist, alternating sides. To do another core exercise, put your back against the wall of the pool while tucking your hips down and back. If done correctly, your low back will touch the wall. Perform one to three sets of 10 to 15 repetitions for each exercise or as directed.
Hips
Increasing the strength of hip muscles such as the abductors and gluteus maximus can reduce the force placed on knees. While holding onto the pool edge or a rail, perform leg extensions or kickbacks alternating legs, which strengthens the gluteus maximus. For the abductors perform side leg lifts alternating legs while still holding onto the rail. Perform one to three sets of 10 to 15 repetitions for each exercise or as directed.
Legs
The hamstrings and quadriceps stabilize the knee joint. Holding onto the rail and facing sideways, lift the outside hip and knee to 90-degree angles. Then kick the leg or knee forward, contracting the quadriceps or thigh muscles. Perform hamstring or knee curls holding onto and facing the rail while curling one knee back, alternating sides. Perform one to three sets of 10 to 15 repetitions for each exercise and leg.
Other Considerations
According to the Arthritis Foundation, the pool water temperature should be between 83 and 88 degrees. The water can be between hip and shoulder deep, unless directed otherwise. Progress gradually into aquatic exercises to avoid aggravating the knees. The Arthritis Foundation recommends participating in aquatic classes or exercises two to three times a week for 45 to 60 minutes a session.
References
- The Cochrane Collaboration: Aquatic exercise for the treatment of knee and hip osteoarthritis
- Physical Therapy: Aquatic Physical Therapy for Hip and Knee Osteoarthritis
- Ohio State University Medical Center: Aquatic Exercises
- University of Washington Medicine: Water Exercises
- Arthritis Foundation: Water Exercise
