Water Aerobics Exercises for Arthritic Patients

Water aerobics may be a more exacting exercise than "land" aerobics. The weight of water presses against movement to an isometric effect. For example, walking in water is 12 times more exacting than regular walking. Knee bends and bicep curls can be more demanding than using light weights. But, how do arthritic patients fare in the water?

Doctors and The Arthritis Foundation recommend water aerobics because they are, in general, lower in stress and impact. The Livestrong Foundation values the aerobics as a way to manage pain. Specialists in rheumatoid and osteoarthritis refer patients who need to improve flexibility and strength, to improve coordination and range of motion, and to forestall additional joint damage and manage pain. The classes also seem to improve self-esteem, enhance moods, and create social contacts.

Caution: As with all such exercise, discuss your plans with your doctor. Patients who have undergone hip and knee replacement, for example, may not be good candidates, or they may be advised to participate selectively in certain exercises and not others.

Finding a Water Aerobics Class

Water Aerobics Classes are offered at most Y's, senior citizen complexes, and at many fitness clubs. Such sponsoring locations usually provide certified water aerobics instructors. The Y organization holds regular continuing training specifically for its arthritis class instructors.

The class should be conducted in a pool where the water temperature is in the 84ºF (28.9ºC) to 88ºF (31ºC) range. Warm water is soothing to primary and tangential pain. It raises the body temperature modestly and increases blood circulation. The buoyant water supports the patient and promotes freedom of motion despite the fact that it is also presenting isometric resistance. Most participants do not realize they have had a workout until later in the day.

Caution: A water temperature over 98ºF (36.7ºC) is not recommended. The water should sooth, not shock, the system. Very hot water will provoke inflammation which is what you are trying to reduce. Even if patients seek comfort in a hot tub or spa at this temperature, they should not stay longer than 10 minutes.

Now, if there is no certified class near you, or if you cannot afford a membership, but you still have a pool or community pool available to you, you can follow the aerobics regimen yourself.

Caution: Do not exercise in the water alone. You need a buddy system. Remember, some people react differently; some get light-headed or nauseous. And, see your doctor if the stiffness and pain increase.

Most participants get into the water ahead of their start, just to warm and loosen up. (In classes, this is a great opportunity to chat and gossip.) But, at a specific time, begin slowly to do some warm-up exercises to increase their heart rate and respiration. Be sure you are in water that is chest deep for maximum impact.

Warm-Up Exercises: (Most of these steps are repeated 4 to 5 times)

• · Walk back and forth across the pool.
• · Add a march step lifting knee to a right angle with the body.
• · Switch to raising foot sharply behind you to stretch hamstring muscles.
• · Return to walk step making breast stroke motions with arms.
• · Continue this step, but walk backwards doing the breast stroke motion.
• · Walk forward with stiff arms and legs like a robot.
• · Walk with giant steps stretch legs forward.
• · Walk sideways while crossing legs in front of each other as you go.
• · Step sideways, raising your knee high before setting it down, as if you were stepping over a log.

Stretching Exercises: (Most of these exercises are repeated 8 to 10 times while walking in place between exercises)

• · With hands at waist, turn your torso as far left as you can and, then, turn right.
• · With hands at waist, lean your torso from the waist to the left as you can and, then, lean right. (You, then, combine these exercises, turning right and left and leaning right and left in sequence.
• · Stretch your arms forward with palms down. Press hands down to thighs and back up to shoulders. (You can loosen up here by stretching into the air or out the sides, but the emphasis is on the full stretch.)
• · With hands at waist, rotate hips in a hula hoop motion right and, then, left.
• · With hands at waist and feet planted, thrust pelvis forward and, then, backward.
• · With hands at waist, lift right leg up to the right as far as is comfortable. Raise and lower leg repeatedly.
• · With hands at waist, raise the right leg forward and lean forward as if to touch right toe with left hand. Lift left leg to the rear while leaning forward with right hand. Then, combine these movements, lifting legs to side and, then, to front and back.
• · Form fists with your hands and throw short punches (in the water) forward from the elbow. Switch to upper cut punches and, then, to long punches stretching forward the entire arm, alternating right and left.
• · With hands at waist, repeat the sequence of leg lifts in the previous exercise starting, this time, with the left leg.

Wall Exercises: (Exercises for toes, ankles, knees, and hips are performed with one arm leaning on edge of swimming pool; everything listed here is repeated for each side of the body.)

• · Stretch and curl toes repeatedly.
• · Flap the foot up and down from the ankle.
• · Turn the foot left and right from the ankle.
• · Turn the foot in circles from the ankle and, then, repeat count in the opposite direction.
• · Roll the foot in and out, as if you were looking for something on the bottom of your shoe.
• · Raise and lower knee.
• · Raise knee and kick out in the front; bring leg back from kick and lower it to floor.
• · Raise knee and kick out in the front; lower leg back to floor with a straight leg.
• · Raise knee and, with hand on knee, turn the knee out to the side to open the pelvis.
• · Raise knee and, with hand on knee, swing knee right and left, back and forward.
• · Raise foot to buttocks and hold for count in sequence up to 10.
• · Raise leg to the front without changing posture.
• · Raise leg to the back without changing posture.
• · Swing leg forward and back as far as you can without changing posture.
• · Make circles with whole leg from the hip.
• · Raise leg to the side and make circles from the hip.
• · Swing leg like a pendulum across your body.
• · With arm extended, move hips to wall of pool and, then, swing arm over head, so hips move away from the wall.

Balance Exercises: (These exercises might be performed between the change in the Wall Exercises from left side to right.)

• · Stand on toes and stretch arms well above head where you rotate thumbs.
• · While standing on toes, raise and lower arms at sides.
• · Lower toes and stand on heels only.
• · Move a few steps to right and left on heels only.
• · Hop a few steps while standing on your heels.
• · Standing on one leg and, then, the other, close your eyes for 15 to 30 seconds.

Wind-Down Exercises: (These exercises are the least stressful and bring class to a soothing finish.)

• · Extend arms and stretch fingers as is you were playing piano.
• · Roll fingers in and out of a fist, one joint at a time.
• · Touch the tip of each finger with the thumb of the same hand one at a time.
• · Touch the pads of each finger with the thumb of the same hand one at a time.
• · With hands in a prayer position, bend wrists one way and the other.
• · Extend hands in a prayer position forward in a stretching movement; return the hands to your chest and, without breaking the prayer position, raise them high above your head.
• · Stretch arms to the sides and, bending slightly forward, form and X with your hands in front of your thighs; standing up, bend slightly backward and form an X with your hands behind your back.
• · Settling deeper into the water, turn your head right and left as far as you can.
• · Breathing and exhaling deeply, let your head roll forward and, then, left and right.
• · Raise your hands high above your head and lace fingers together, then, lean to right and left.
• · Extend arms as far back as you can and, then, move them forward and around yourself in hug.

Strange as it sounds, you want to keep yourself hydrated during exercise, so have a bottle of water at the pool's edge. You also want to commit to regular performance. Consider an hour 3 or 4 days a week. If you are able to alternate the water aerobics with some other strength building exercises, you will be proud of yourself - and a little less stressed by inflammation and pain.