The use of water in the forms of spas, hot springs has been used to treat arthritis for centuries. More recently it has been discovered that specific exercises done in a pool can help patients with arthritis improve their range of motion and strength. Exercising in a pool is non-impact, so there is no shock to the joints. Also, the buoyancy of the water eliminates the risk of falling. Studies have demonstrated better quality of life scores in arthritis patients who participated in a water-based exercise program.
One of my patients was seen at Johns Hopkins and she brought back an outline of some great hydrotherapy exercises.
Here are a few exercises to consider:
High step: Stand in chest deep water. Walk back and forth across the pool lifting your knees high. Do 2 sets of 4 laps to start.
Lumbar rotation: prop your arms up on the pool ledge with your back to the wall. Bend your knees and bring them up to your chest. Rotate your legs from right to left. Then return your legs to the center and straighten them with your feet pointed down. Repeat while rotating your legs from left to right. Do 2 sets of 4 repetitions.
Knee flex/extend: Prop your arms on the pool ledge with your back to the wall. Bend and straighten your knees fully (extending). Repeat while alternating legs. Do 2 sets of 10 repetitions for each knee.
Quad stretch: Sit on the pool steps at the shallow end of the pool. Put your right foot on the next step down with your foot flat. Put your left foot straight out and rest it on the step below your right foot or the floor of the pool, whichever is next. Gently slide your hips forward until you feel a stretch across the top of the right thigh. Hold it for 20 seconds. Relax and repeat the stretch with your left foot. Do 2 repetitions each foot.
Knee squat: Stand in chest deep water with your feet shoulder-width apart. Slowly and gently squat while keeping your heels flat on the floor of the pool. Stand back up. Do 2 sets of 4 repetitions.
Calf raises: Stand in chest deep water with your hands resting on the pool ledge for support. Stand up on your tip toes, then lower your heels until your feet are flat on the pool bottom. Repeat. Do 2 sets of 15 repetitions.
Hip and leg figure 8′s: Stand in waist deep water. Spread your arms apart and hold onto the pool ledge with the hand closest to the edge. With your knees straight, move your right leg in a clockwise figure 8 motion. Then reverse, moving your leg in a counterclockwise figure 8. Repeat with your left leg. Do 2 sets of 4 repetitions each leg.
Shoulder towards: Stand in shoulder deep water with your left arm out and down at a 45 degree angle to your side. Move your arm up and in across your body toward the surface of the water. Return your arm to the starting position and repeat. Do 2 sets of 9 repetitions. Then do the same with the right arm.
Shoulder away: Stand in shoulder deep water with your left arm across the body and placed down at the opposite hip. Move your arm up and out away from your body to the surface of the water. Return to the starting position and repeat. Do 2 sets of 9 repetitions. Repeat with your right arm.
Side bends: Stand in waist deep water with your legs shoulder width apart. Raise your right arm over your head. Lean at the waist to the left and hold for 10 seconds. Return to the starting position and repeat. Do 2 sets of 5 repetitions. Do the same with the left arm up leaning to the right.
As with any exercise program, get clearance from your rheumatologist and primary care physician before embarking on a program like this.