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Water Works Aquatic Activity: A Painless Way to Stay Fit

Sally Marshall was trying her best to stay fit and active. But with arthritis in her right ankle and nerve damage in her feet, the retired fashion illustrator was finding workouts difficult.

“I landed hard on one foot while exercising one day, and then I couldn’t even walk right,” she says.

So taking the advice of her son, an Indiana University professor of kinesiology (the study of movement) and an expert on the physical and mental benefits of exercise, the 81-year-old turned to the water, enrolling in twice-weekly aquatic aerobic classes at a community pool near her Lincoln, Neb., home.

“It has done wonders,” says Marshall. “I’ve gotten stronger because of the water’s resistance. I can control my movements and balance because of its buoyancy. I’m walking just fine now, and my arthritis is now under control.”

That’s no surprise to Marilyn Regueira, the instructor of Marshall’s water exercise class. “One man in my class had hip surgery and because of complications in his recovery, he was confined to a wheelchair,” she says. “But after our classes—he would wheel himself into the pool—he is now walking again.”

Such stories are not uncommon, says John A. Hardin, M.D., chief scientific officer of the Arthritis Foundation. “Although exercise is beneficial—whether done on land or in water—it’s very possible that water activity helps because it takes weight off the muscles and joints. So it’s able to improve arthritis and other conditions that cannot be helped with land exercise.”

Increasingly, researchers are finding that because of water’s buoyancy, resistance and temperature, aquatic workouts may go further than similar land-based activities in relieving the pain of age-related conditions such as arthritis and fibromyalgia; in boosting range of motion, balance and everyday functioning; and in improving heart health and possibly even brain function.

“If you are over 50, the American College of Sports Medicine recommends moderately intense aerobic exercise for 30 minutes a day, four times a week, plus resistance strength training, plus balance and flexibility training,” says Mary E. Sanders, a researcher at the University of Nevada, Reno, and founder of Golden Waves, a functional aquatic exercise program for older Americans. “A swimming pool provides the one place where you can do all of that at the same time without the need for a lot of machines—at your own pace and more comfortably.”

What are some of water’s health benefits? Its hydrostatic pressure “pushes” against your chest and body, lowering the heart rate and helping blood circulate more efficiently. Its resistance makes any movement harder than on land, resulting in faster development of muscle strength, endurance and flexibility. Its buoyancy makes your body “weight” in waist-deep water 50 percent lighter than your land load, reducing joint impact for less pain and providing better balance. And in a cool pool, you can exercise longer and more comfortably.

Those properties make water welcoming to people who have trouble exercising on land—those who are elderly, obese, arthritic or osteoporotic. But even able-bodied folks benefit.

In one study, published in Medicine & Science in Sports & Exercise in May 2007, Sanders found that older women who regularly participated in a water-based exercise program improved their on-land walking speed by 16 percent, their agility by 20 percent and their ability to climb stairs by more than 22 percent, compared with others who did the same routines on land. She is now conducting a five-year study on Japanese women between ages 50 and 80. “What we are finding is that when they have an event such as stroke, their recovery rate is much faster if they have participated in water-based exercise.”

Pool exercise also speeds recovery after knee-replacement surgery, according to a study by Richard McAvoy, a physical therapist and certified strength and conditioning specialist in New Hampshire. He presented his research at the 2007 World Aquatic Health Conference on the rehabilitation of 30 patients who’d had knee replacement, among the fastest-growing surgeries in the United States. Half of the patients combined 30 minutes of water-based exercises with 30 minutes of traditional land exercises; the others did their rehab on land only.

“We found there was significant improvement in flexibility of the knee joint in those who used both water and land exercises,” he says. “What’s more, they reported on their outcomes survey less joint clicking, grinding, swelling and difficulties with stiffness, compared to the land exercisers.”

The reason: “In the water, you can do multidirectional exercises that you cannot do on land—such as walking backwards at different speeds,” explains McAvoy. “When you sit on an exercise machine, you usually can only move one way and in one direction.”

Pool time also seems to improve mood and mental health. “We already know that exercise makes you feel better,” says exercise researcher Jack Raglin, Sally Marshall’s son. Although the feel-good results of exercise are often attributed to the release of endorphins—beneficial hormones that produce the so-called runner’s high—only intense, strenuous exercise triggers that biochemical response. “It’s clear that even milder forms of exercise can result in psychological benefits,” he says.

Raglin's theory is based on studies he has published in 15 medical journals: Just being in water improves mental health and prompts a positive outlook. Other studies, meanwhile, suggest that a positive outlook aids in preventing and battling disease.

“When you’re in warm water, the body heats up more quickly than on dry land, which relaxes muscles and eases tension,” says Raglin. “But it also releases hormones to ease stress and mental fatigue and invigorate the psyche.” Some research also suggests that because movement is harder in the water, that may also promote chemical changes in the brain important in maintaining thinking and memory.

And there’s that other mental advantage: “Water tends to be a more social environment,” says Raglin. “The simple fact that you are in an environment you enjoy, away from work and stress, may be a diversion that promotes mental health. And let’s face it … just about everybody enjoys being in water.”

Sid Kirchheimer is a freelance writer who lives near Philadelphia.