Knee Pain? Work Out in Water

Even simple exercises done in the water can have added benefits for people with painful arthritis.


If you have arthritis in the knees and other joints in the lower body, simple movements of daily life can be painful, leading you to do less and less. But this can make matters even worse. “Moving joints helps to keep them lubricated, which helps to maintain function,” says aquatic expert Christine Schulte, PT, MBA, Director of Rehabilitation and Sports Therapy at Cleveland Clinic.

If exercising is problematic, try doing it in a pool. “The buoyancy of the water decreases compressive forces within the joints,” says Schulte. “The deeper in the pool you go, the more these forces decrease.”

When you stand in water up to your hips, you’re bearing about 50 percent of your weight. In water up to your chest, you bear about 25 percent, and in water up to your neck, it’s only 10 percent. “If you’re in severe pain, move deeper into the water to take more pressure off your joints,” says Schulte. Be cautious, as the deeper you go in the pool the more buoyant your body will become.

Benefits of Water

Pool exercise

Illustration by Alayna Paquette

Just being in the water has benefits. In water, the pressure at your feet is greater than the force at the surface. This hydrostatic pressure assists blood flowing from the limbs back to the heart. The improved circulation allows you to exercise more effectively without the soreness you get on land. It also helps alleviate swelling in ankles and knees that can restrict movement.

When you exercise on land you’re working against gravity. “If I sit in a chair and lift my leg up, there’s resistance as I bring it up and resistance as I bring it down,” says Schulte. “With a similar motion in the pool, I have the assistance of buoyancy in the upward movement and resistance with the downward movement.”

This means different muscle groups are worked—the muscles on the front of the thigh (quadriceps) plus the muscles on the back of the thigh (hamstrings) in the pool as opposed to just the quadriceps on land. “By changing muscle groups there is less fatigue,” says Schulte.

Just Move

You can do lots of exercises in water, but it can be as simple as multidirectional movement. Take five steps forward and five steps backward. Then step to the side. The water creates resistance when you change direction.

You don’t need a large pool. In fact, a smaller pool may be better. Take a few quick steps, stop and change direction. The water will rebound on you, which makes you contract your core and extensor muscles, and stabilize your hips. “You can make this more fun by doing a little dancing in the pool,” says Schulte. Or play catch, which requires you to make unanticipated movements. Having other people in the pool at the same time also helps because the extra turbulence in the water creates more resistance.

These activities help build strength to allow you to function better on land. “When you work in the kitchen, for example, and you go from the refrigerator to the stove and to the sink, you’re moving in a multidirectional way,” says Schulte.

Multidirectional movements in water have the added benefit of improving reaction time, which can help prevent falls. “The water sloshing against the side of the pool and then coming back at you forces you to contract your core and stabilize,” says Schulte.


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