Legendary Swimmers

Man performing a supported knee-bend movement in a swimming pool during aquatic exercise for osteoarthritis.

Aquatic Exercise for Osteoarthritis: What the Research Says

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Aquatic exercise for osteoarthritis may offer a lower-impact way to stay active while working on strength, mobility, balance, and everyday movement. Osteoarthritis commonly affects weight-bearing joints such as the knees and hips. It can involve pain, stiffness, reduced mobility, and changes in how comfortable daily activities feel. For many people, movement is still an important part of maintaining function and quality of life. But the type of movement, intensity, range of motion, and pace need to be appropriate for the individual. This is one reason water exercise is often explored. The water can support part of the body’s weight while still providing resistance for controlled movement. Why Water Can Be a Supportive Exercise Environment On land, walking, squatting, stepping, and balance exercises require the body to manage its full weight against gravity. In the water, buoyancy can reduce weight-bearing load on the lower body. At the same time, the resistance of the water provides a challenge when you walk, move your legs, press your arms, or change direction. This may allow some people to practice movement with less joint impact while still working on important fitness qualities, including: Lower-body strength Balance and coordination Mobility Cardiovascular fitness Confidence in everyday movement Water exercise is not automatically easy. A controlled movement can still be challenging, especially when speed, range of motion, surface area, or resistance equipment are increased. The difference is that water offers another way to adjust the challenge. Related Reading: Protect Your Joints While Building Strength in the Water What Does Research Say About Aquatic Exercise for Osteoarthritis? A 2022 systematic review and meta-analysis examined 20 studies on aquatic exercise for people with osteoarthritis. The review found that aquatic exercise was associated with improvements in pain, joint dysfunction, and quality of life when compared with control groups. Many of the studies focused on people with knee and hip osteoarthritis. A second systematic review and meta-analysis focused on knee osteoarthritis. It found that aquatic physical therapy had positive effects on pain, physical function, knee-extension strength, and walking ability across the studies included. These findings are encouraging, but they should be interpreted carefully. Research programs vary. Participants, pool temperature, exercise selection, session length, supervision, and comparison groups were not identical across the studies. Not every outcome improved consistently, and water exercise is not a cure for osteoarthritis. Still, the evidence supports aquatic exercise as one possible movement option for people who want a more joint-friendly way to stay active. Research links: Effects of Aquatic Exercises for Patients with Osteoarthritis: Systematic Review with Meta-Analysis Overall Treatment Effects of Aquatic Physical Therapy in Knee Osteoarthritis: Systematic Review and Meta-Analysis Building Strength Around the Joints When someone has osteoarthritis, it can feel tempting to avoid movement completely. But avoiding all movement can make it harder to maintain strength, mobility, and confidence over time. Appropriate strengthening does not mean forcing a painful or overly difficult workout. It means choosing movements that are manageable and progressing gradually. In the pool, lower-body movements may include: Water walking Supported knee bends Controlled squats within a comfortable range Side steps Gentle leg lifts Heel raises Slow marching Supported balance practice The best starting point depends on the person, their symptoms, joint location, mobility, and medical guidance. Smaller, controlled movements are often more useful than large, rushed movements. Related Reading: Benefits of Pool Walking: Why Water Walking Is Great for Your Health Pacing Matters With osteoarthritis, some discomfort may be part of daily life, but a workout should not leave you feeling as though you need to push through sharp pain, significant swelling, instability, or symptoms that continue to worsen. Pacing can help make movement more sustainable. That may mean: Starting with a shorter session Choosing a comfortable water depth Taking rest breaks Reducing range of motion Using the pool wall for support Moving more slowly Avoiding exercises that cause symptoms to worsen Building gradually over time Your body’s response during and after movement matters. What feels appropriate on one day may not feel appropriate on another. A healthcare professional can help you understand what is suitable for your condition and health history. Aquatic Exercise Is One Option—Not the Only Option Water exercise does not need to replace every other form of movement. Land-based exercise can also be valuable for many people with osteoarthritis. The best approach depends on what you enjoy, what feels manageable, what is accessible to you, and what your healthcare team recommends. For some people, the pool may be the place where they can begin moving with more confidence. For others, it may complement walking, strength training, physical therapy, or other forms of activity. The most meaningful routine is often the one you can safely continue. Related Reading: How to Progress in Water Aerobics: From Beginner Movements to More Challenging Workouts Begin With Controlled, Joint-Friendly Movement If you have been cleared for exercise and would like to try a guided, low-impact pool workout, explore our free 15-minute aqua fitness workout. Choose movements, speed, and range of motion that feel appropriate for your body. Pause, reduce the movement, or choose an alternative whenever needed. Try the Free 15-Minute Aqua Fitness Workout This article is for general educational purposes only and is not medical advice, diagnosis, or treatment. It does not replace guidance from your physician, physical therapist, or other qualified healthcare professional. Consult a healthcare professional before beginning or changing an exercise routine, especially if you have osteoarthritis, another medical condition, an injury, or concerns about exercising safely. References Song J-A, Oh JW. Effects of Aquatic Exercises for Patients with Osteoarthritis: Systematic Review with Meta-Analysis.Healthcare. 2022;10(3):560.Read the full study Dong R, Wu Y, Xu S, et al. Overall Treatment Effects of Aquatic Physical Therapy in Knee Osteoarthritis: A Systematic Review and Meta-Analysis. BMC Musculoskeletal Disorders. 2022.Read the full study The broad osteoarthritis review included 20 studies and reported improvements in pain, joint dysfunction, and quality of life relative to control groups; the knee-focused review found improvements in pain and physical function but not every measured outcome.

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Woman water walking in an indoor pool during a gentle aquatic exercise session for fibromyalgia.

Aquatic Exercise for Fibromyalgia: Research & Gentle Movement

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Aquatic exercise for fibromyalgia is one option many people explore when they are looking for movement that feels more manageable, lower impact, and easier to adapt to their individual energy and comfort levels. Fibromyalgia can involve widespread pain, fatigue, stiffness, sleep concerns, and changes in how the body responds to physical activity. Because symptoms and daily capacity can vary greatly from person to person, there is no one “best” workout for everyone. However, research suggests that supervised aquatic exercise may be a helpful form of movement support for some people with fibromyalgia, particularly when the program is individualized, paced appropriately, and included as part of a broader care plan. Why the Water May Feel Different Water can create a unique exercise environment. Buoyancy may reduce the loading and impact associated with some land-based movements. At the same time, water provides resistance as you push, pull, sweep, walk, or change direction. That combination can make it possible to work on movement, mobility, balance, and fitness without relying only on higher-impact exercise. For someone living with fibromyalgia, this does not mean the water automatically makes exercise easy. Symptoms, fatigue, pain levels, pool temperature, confidence in the water, and the intensity of the movement can all affect how a session feels. The goal is not to push through a difficult day. It is to find an appropriate level of movement that your body can recover from and return to consistently. Related Reading: Why Water Exercise Feels Easier Than Land Exercise—But Still Builds Strength What Does Research Say About Aquatic Exercise for Fibromyalgia? A 2024 systematic review examined recent clinical trials on aquatic exercise in physical-therapy treatment for fibromyalgia. The review found positive results related to pain and quality of life, while emphasizing that programs should be adapted to each person’s needs. A larger Cochrane review of aquatic exercise training included 16 studies and 881 participants with fibromyalgia. Compared with control groups, the review found low-to-moderate quality evidence of benefits across areas such as wellness, symptoms, and physical fitness. Importantly, the research does not show that aquatic exercise is a cure for fibromyalgia. It also does not show that water exercise is automatically better than all land-based exercise for every person. Instead, the research supports aquatic exercise as one possible movement option, particularly for people who find the water more comfortable, enjoyable, or sustainable. Research links: Aquatic Exercise in Physical Therapy Treatment for Fibromyalgia: Systematic Review Aquatic Exercise Training for Fibromyalgia: Cochrane Review Why Individual Pacing Matters With fibromyalgia, more exercise is not always better. A workout that feels manageable for one person may be too demanding for someone else. Even the same person may have different capacity from one day to the next. This is where pacing becomes especially important. Pacing means beginning with an appropriate amount of movement, monitoring how you feel during and after activity, and progressing gradually rather than trying to “make up” for time away or force a hard workout. A lower-intensity aquatic session might include: Slow water walking Controlled arm sweeps Gentle range-of-motion movements Easy side steps Supported balance work Light marching Rest breaks as needed Movements should remain controlled and within a comfortable range. For some people, a shorter session may be more appropriate than a longer workout. For others, breaking movement into smaller sessions throughout the week may feel more sustainable. Water Exercise Is Not One-Size-Fits-All Aquatic exercise can be adjusted in many ways, including: Water depth Exercise selection Movement speed Range of motion Number of repetitions Rest periods Session length Use of equipment Water temperature For example, increasing speed, adding larger arm movements, or using aquatic dumbbells can make a movement more challenging. Those options may be useful later for some people, but they are not necessary for everyone. A well-designed approach starts with what feels manageable today and progresses only when the body is responding well. Related Reading: How to Progress in Water Aerobics: From Beginner Movements to More Challenging Workouts Consider Professional Guidance If you are living with fibromyalgia, particularly if symptoms are new, worsening, or affecting daily life, it is important to speak with your healthcare professional before beginning or significantly changing an exercise routine. A physician, physical therapist, or other qualified healthcare professional can help you determine what type and amount of movement may be appropriate for your individual needs. A qualified aquatic physical therapist may be particularly helpful when someone needs individualized guidance related to pain, fatigue, mobility, balance, injury history, or symptom changes. This kind of guidance is not a limitation. It is a way to build a more appropriate, sustainable relationship with movement. Building Confidence in the Water For many people, the most valuable workout is the one they can return to. That may mean starting with five minutes of comfortable movement. It may mean using the pool wall for support, choosing simple movements, or taking more rest than you think you “should.” Consistency does not require perfection. It requires a realistic starting point. Water can offer a calm, adaptable space to practice moving with intention—whether your goal is to maintain mobility, build confidence, support fitness, or simply feel more comfortable being active. Related Reading: Low-Impact Water Aerobics: Boost Fitness with Aquatic Exercises Try a Guided Water Workout at Your Own Pace If you have been cleared for exercise and would like to experience a guided, low-impact water workout, explore our free 15-minute aqua fitness workout. It is designed to help you move with control and build confidence in the water. Choose a pace and range of motion that feel appropriate for you, and pause or modify whenever needed. Try the Free 15-Minute Aqua Fitness Workout This article is for general educational purposes only and is not medical advice, diagnosis, or treatment. It does not replace guidance from your physician, physical therapist, or other qualified healthcare professional. Consult a healthcare professional before beginning or changing an exercise routine, especially if you have fibromyalgia, another medical condition, an injury, or concerns about exercising safely. References Rodríguez-Huguet M, Ayala-Martínez

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Woman performing a controlled arm sweep in a swimming pool during an aquatic exercise workout for healthy aging.

Aquatic Exercise for Healthy Aging: What the Research Says

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Aquatic exercise for healthy aging can be a powerful way to support strength, balance, cardiovascular fitness, and confidence in movement, without relying only on high-impact exercise. As we age, staying active becomes about much more than checking off a workout. It is about maintaining the strength to carry groceries, the balance to move confidently, and the cardiovascular fitness to keep up with daily life. That is one reason aquatic exercise can be such a valuable form of movement. The water can feel supportive on the body while still providing meaningful resistance, challenge, and opportunity to build fitness. Whether you are already active, returning to movement after time away, or looking for a lower-impact way to stay consistent, aquatic exercise may offer a practical place to begin. Why Healthy Aging Includes Strength, Balance, and Cardio Fitness Healthy aging does not mean avoiding challenge. It means choosing movement that helps you continue building and maintaining the physical abilities that matter in everyday life. Those abilities often include: Muscular strength for lifting, standing, climbing stairs, and getting up from a chair Balance and stability for moving with greater confidence Cardiovascular fitness for walking, traveling, playing with family, and completing daily tasks Mobility and flexibility for comfortable movement Confidence in your ability to stay active No single workout is perfect for every person. However, a balanced exercise routine can support many of these areas over time. For many adults, aquatic exercise for healthy aging offers a practical way to train strength, balance, and cardiovascular fitness in one environment. Aquatic exercise is especially interesting because it can be adjusted for many different fitness levels. A person can begin with controlled water walking, arm sweeps, gentle squats, or supported leg movements. As they become stronger, they may increase speed, range of motion, surface area, resistance equipment, or coordination demands. How Water Creates a Different Kind of Challenge Water is often described as “gentle,” but that does not mean it cannot be challenging. Buoyancy can reduce the impact and loading that occur when you move on land. At the same time, water creates resistance in every direction. When you push, pull, sweep, kick, or change direction, your body must move against that resistance. The challenge can increase when you: Move faster while maintaining control Use a larger range of motion Increase the surface area of your hands, arms, or legs Add aquatic dumbbells, resistance gloves, a noodle, or other equipment Move in more than one direction Perform balance or single-leg movements Work in deeper water This makes it possible to create water workouts that are both adaptable and progressive. You do not need to choose between movement that feels supportive and movement that helps you get stronger. Related Reading: The Science Behind Water Resistance Training: Why It Works What Does Research Say About Aquatic Exercise? A 2022 systematic review and meta-analysis examined 62 studies on water-based exercise in healthy adults and adults living with chronic conditions. Among healthy adults, the review found beneficial effects on: Strength Balance Cardiorespiratory fitness The researchers noted that programs lasting at least 12 weeks, performed two to three times per week, were associated with these benefits in the healthy-adult studies. This is important because strength, balance, and cardiovascular fitness are not separate goals. They work together to support the ability to move, remain active, and feel capable throughout life. The review also looked at adults with chronic conditions. It found promising results across several populations and health-related measures, including balance, physical fitness, pain, gait, and quality of life. However, research findings varied depending on the condition, the specific program, the person’s starting point, and the outcome being measured. That is why research-informed aquatic exercise should never be presented as a one-size-fits-all treatment plan. Read the systematic review: Benefits of aquatic exercise in adults with and without chronic disease Aquatic Exercise and Chronic Conditions: An Important Note Water movement can be a meaningful option for many people living with arthritis, osteoporosis, fibromyalgia, multiple sclerosis, injury history, or other health concerns. But “may be helpful” does not mean that every exercise, intensity, pool environment, or progression is appropriate for every person. Your needs may be influenced by factors such as: Your diagnosis and symptoms Current pain, fatigue, balance, or mobility level Medications and health history Whether you are recovering from an injury or procedure Guidance from your physician, physical therapist, or other qualified healthcare professional If you are managing a medical condition, returning from injury, or unsure where to begin, speak with your healthcare professional before starting or changing an exercise routine. A qualified aquatic physical therapist or other appropriately trained professional can help determine what is suitable for your individual needs. The goal is not to force your body through a workout. The goal is to find safe, appropriate movement you can return to consistently. How to Start Aquatic Exercise for Healthy Aging If you are new to aquatic exercise, begin with movements that feel manageable and controlled. A simple starting session may include: Water walking or light marching Controlled arm sweeps forward and backward Gentle shoulder movements within a comfortable range Supported squats or sit-to-stand-style movements Heel raises Slow knee raises Easy side steps Light balance practice while holding the pool wall if needed Start at a pace that allows you to maintain good posture, steady breathing, and control. You do not need to make every movement large or fast for it to be useful. Over time, you can progress by increasing your workout duration, adding repetitions, moving with slightly more speed, using equipment, or choosing more challenging variations. Consistency matters more than trying to do too much too soon. Related Reading: How Water Exercises Improve Stability, Coordination & Everyday Movement The Value of Finding Movement You Want to Continue One of the greatest benefits of water exercise may be that it gives people another way to stay active. For some, the water offers a place to move with less impact. For others, it provides resistance that makes exercise feel purposeful

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Older man smiling in a swimming pool while holding the pool ladder, representing swimming for healthy aging and confidence in the water.

Swimming for Healthy Aging: How Water Movement Supports Strength, Mobility, and Endurance

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Swimming is more than a workout. It is a low-impact form of water movement that can support strength, mobility, endurance, and confidence as you age. Learn how swimming and aqua fitness can work together to help you move better in the water.

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