Swimming and water exercise

Is swimming good if you have sore joints?

Water exercise can help sore joints, though the benefit is usually small. In knee and hip osteoarthritis, it tends to give a small, short-term improvement in pain and everyday difficulty¹. In knee osteoarthritis it also tends to ease stiffness². The pain benefit may still be there three months later, but gains in stiffness and everyday function may not last².

Water exercise isn't clearly better than the same exercise on land. For adults with long-term muscle and joint conditions, improvements in pain, everyday function and quality of life are about the same either way⁵.

Its main value may be as a comfortable way to start. Water is thought to take load off weight-bearing joints and make movement easier, which can help if land exercise has been hard to stick with¹. For adults with fibromyalgia who have been inactive, exercise in warm water may be a way to begin without making pain worse⁶.

The benefits above come from water exercise such as classes and walking, so you don't need to swim lengths. Water walking or a gentle class in the shallow end is a low-effort way to try it. Start with short sessions and build up slowly. Choose a pool or class with a lifeguard or instructor, and tell them about any sore joints before you start.

If a movement makes a joint hurt more than mild effort would, stop that movement and ease off. See a doctor or physio if the pain persists or gets worse.

What is aqua aerobics like?

Aqua aerobics is an exercise class in a pool, usually led by an instructor. It mixes cardio, strength and flexibility exercises, and you go at your own pace using the support and resistance of the water⁷.

Classes vary:

• Gentle classes. A low to medium intensity class for beginners, seniors and people recovering from injury may use equipment to work on core stability, coordination, strength and flexibility³.
• Higher-energy classes. Some combine cardio intervals with strength exercises, often using noodles and dumbbells for resistance⁷.
• Deep-water classes. You wear a flotation belt and move without touching the floor. They are described as no impact but still challenging³. The buoyancy of the water reduces stress on joints⁷.

Water-based training is an effective way to improve health and fitness, both in healthy adults and in adults with long-term health conditions⁸.

For your first visit:

• Look for a class described as beginner, senior or low-impact.
• Ask whether you can watch or try a session first.
• Go at your own pace. If you're building up, you could begin with around 20 minutes and add time over several weeks¹.
• Tell the instructor about any health conditions or concerns before the class.

Do you need to swim well to exercise in water?

No. Some aqua classes are described as a great option for non-swimmers³. In a standard class you can keep one or both feet on the pool floor and stay close to the side⁴. Once you're in, the water holds you up, and you don't put your head under the water⁴.

If you're nervous about getting in, you can use a walking aid up to the pool steps, and many other people feel the same way⁴. In deep-water classes, a flotation belt supports you and no swimming skills are needed³. One council offers noodles for people who want to try the class before committing to a belt⁷.

To get used to the water:

• Ask the venue which classes suit non-swimmers, and say you can't swim when you book.
• Enter and exit at the shallow end, and walk up and down its width a few times to get used to the depth and temperature⁹.
• Stay near the side at first, with a foot on the floor.

Swimming alone or without supervision is linked with a higher risk of drowning, so a pool with a lifeguard and a supervised class is a sensible choice¹⁰. Leisure centres usually have a lifeguard⁴.

When to check with a health professional

If you're starting exercise after a long break, it's always a good idea to see your doctor first.

For an injury or a health condition, see a health professional, such as your doctor or a physio.

Being in water puts extra load on the heart, even before you start exercising. If you have a heart condition, talk to your doctor or heart rehabilitation team before trying water exercise, as it may not suit you¹¹.

If you feel sick, sweaty, unwell, dizzy or breathless in or after the water, get out and rest. If it has settled, see a doctor soon. A sore muscle or joint, or soreness a day or two later, is a reason to ease off, and to see a doctor or physio if it persists or gets worse. Don't exercise when you're unwell.

Cough, coughing up blood or shortness of breath soon after getting into the water can be a sign of immersion pulmonary edema, which has been linked to water immersion combined with cold and exercise. Get out of the water, and if you're coughing up blood or very short of breath, call your local emergency number¹².

Call your local emergency number for chest pain or pressure (or pain spreading to the arm, neck, jaw or back, especially with sweating or feeling sick), severe breathlessness, fainting or collapse, signs of a stroke, a serious injury, or someone who isn't safe.