Arthritis & Aquatic Exercise – Keep Moving to Keep Healthy

The Facts About Arthritis

Adapted from the Arthritis Foundation website http://www.arthritis.org

• 2005 – 66 million (nearly 1 in 3 adults) in the US have been diagnosed with arthritis or live with chronic joint symptoms.
• Arthritis is one of the most prevalent chronic health problems and the nation’s leading cause of disability among Americans over age 15.
• Arthritis is second only to heart disease as a cause of work disability.
• Arthritis limits everyday activities such as walking, dressing and bathing for more than 7 million Americans.
• Arthritis affects people in all age groups including nearly 300,000 children.
• Arthritis strikes women more often than men.
• Arthritis refers to more than 100 different diseases that affect areas in or around the joints. The disease also can affect other parts of the body. Arthritis causes pain, loss of movement and sometimes swelling.

Why Exercise?

Many people mistakenly believe that exercise and arthritis are not compatible. For years it was promoted by event the medical community that you should not exercise if you had arthritis because it would damage your joints. Luckily, research has shown that exercise is an essential tool in managing arthritis and living a healthy and full life.  Individuals with arthritis can benefit from regular exercise, as increases in strength and endurance will improve quality of life and enhance performance of activities of daily living (ADL). 

Regular activity increases energy, helps you sleep better, aids in weight control, decreases depression and enhances self-esteem. Furthermore, exercise can help stave off other health problems such as osteoporosis and heart disease.

Generally, low to moderate exercise is recommended and adjustments must be made during acute joint inflammation (arthritis ‘flare ups’).  Although exercise may be tedious when managing arthritis, physical inactivity leads to poor health and may make the disease even harder to manage.  Water exercise – water walking, low impact aerobics, Ai Chi, Yoga, deep water training, etc – is highly promoted by health professionals and medical professionals.  The Arthritis Foundation encourages water exercise as one of the best activities for individuals of all ages who have arthritis symptoms.  From their website comes the following, Why Water Exercise?

·                   The soothing warmth and buoyancy of warm water make it a safe, ideal environment for relieving arthritis pain and stiffness. 

·                   Immersing in warm water raises your body temperature, causing your blood vessels to dilate and increasing circulation. 

·                   Water exercise is a gentle way to exercise joints and muscles. 

·                   Water supports joints to encourage free movement, and may also act as resistance to help build muscle strength.

Aquatic Programming Guidelines

The pool provides a comfortable exercise environment because the buoyancy reduces impact to the joints, lessens stress and strain on the submerged joints, allows for greater pain-free movement and it is FUN!

Some general exercise guidelines for the pool are listed below, but keep in mind that some variations will be acceptable depending upon the individual and the type and severity of arthritis symptoms.

·                   Water Depth – submerge the joints being moved; alter approximately chest to shoulder depth usually appropriate.  Submerging the joint reduces stress caused by gravity.  Pain-free range of motion (ROM) is usually enhanced when the joint is submerged.

·                   Water Temperature – ATRI suggests 84-96 F (29-35.5 C); AF/YMCA suggests 84-88 F (29-31 C).

·                   Additional Equipment – only with medical approval; AF/YMCA recommend that NO resistance equipment be utilized, only equipment needed for stability or flotation.

·                   Duration of Exercise – build up to 20-40 minutes per session; adjust based upon the 2-hour Pain Rule.

·                   Mode of Exercise – Activities such as water walking, muscle conditioning, deep water, stretching and fine motor skills are generally tolerated.  A longer warm up is suggested.  Most bouncing/bounding movements should be eliminated – focus on low impact options.

·                   Change activities and body positions frequently to avoid excessive joint strain from too many repetitions.

·                   Wear Shoes in the Pool – protect feet and joints.

·                   Frequency of Exercise – build up to 3-5 days per week.

·                   Exercise with a Friend – it is not recommended to exercise alone in the pool!  Join a class or hire a personal trainer.

Helpful Hints

Medicine House website, http://www.medicinehouse.com/arthritis.html

Some helpful hints to prevent arthritis or limit the symptoms:

1. Practice good joint protection.
2. If you are overweight, you need to lose weight to reduce the stress on your joints. For every ten pounds you lose, you save 200 pounds of stress on your joints.
3. Correct posture is important. Use a firm mattress or bed board while you sleep or rest in bed. Whenever possible sit in straight back chairs that have armrests and try not to slump.
4. Follow the 2-hour pain rule. If exercise induced pain lasts longer than 2 hours, cut back on exercises but do not stop. Do not exercise a joint that is inflamed or "hot". However you should gently move the joint through the full range of motion twice a day.
5. Pace yourself throughout the day so you do not get too tired.
6. Learn to relax.

REFERENCES:

Aquatic After Care Trainer Manual, 2^nd Edition, The Personal Health Trac, Inc.  Florida.  2005.

Aquatic Fitness Professional Manual, 5^th Edition.  World Aquatic Coalition/Aquatic Exercise Association. Nokomis, FL. 2006.

Arthritis Foundation website, http://www.arthritis.org

Accessed January 15, 2006

Introduction to Aquatic Therapy and Rehab, Ruth Sova Editor, DSL, Ltd. Port Washington, WI.  2004.

Medicine House website, http://www.medicinehouse.com/arthritis.html

Accessed January 15, 2006.

JULIE SEE, President of the Aquatic Exercise Association (AEA) and co-founder of Innovative Aquatics, has been active in the fitness industry for over 25 years specializing in innovative programming for both land and water.   She has produced over 50 educational videos/DVDs and instructional CDs for the general population and fitness professionals.