Quick answer: Water-based exercise suits arthritis because the water supports your weight, warm water eases stiffness and moving against water gently builds strength. Options include water walking, aqua classes, swimming and physiotherapist-led hydrotherapy. Start with 15 to 20 minutes in the shallow end, two or three times a week, and build up gradually. You do not need to be able to swim.
Exercising in water is one of the most comfortable ways for many people with arthritis to get moving. The water takes some of your body weight off painful joints, warmth helps loosen stiff muscles, and pushing against the water gently builds strength. Water-based exercise is much more than swimming lengths: you can walk, march, stretch and do strengthening exercises in the shallow end, join an aqua class, or have physiotherapist-led hydrotherapy. This guide explains the options, gives you a 30-minute pool routine and an 8-week plan, and covers safety, practical tips and when to get help.
Why water helps arthritic joints
- Buoyancy. Water supports part of your body weight. The deeper you stand, the less weight goes through your hips, knees and feet, so movements that hurt on land can feel easier.
- Resistance. Water resists movement in every direction, so walking and arm movements gently work your muscles. Moving faster increases the resistance; moving slowly reduces it.
- Warmth. Warm water can ease stiffness and muscle tension. Hydrotherapy pools are usually kept warmer than ordinary swimming pools.
- Support and confidence. The water slows movement down and reduces the fear of falling while you practise balance.
- Whole-body fitness. Water exercise can raise your heart rate and count towards the UK target of 150 minutes of moderate activity a week.
NICE guideline NG226 recommends therapeutic exercise, including muscle strengthening and general aerobic fitness, for everyone with osteoarthritis. Water-based exercise is one way to do both, particularly if land-based exercise is painful. Many people use it as a stepping stone to land exercise, or alongside it.
Your options compared
| Option | What it involves | Best for | How to access |
|---|---|---|---|
| Water walking and pool exercises on your own | Walking, marching and simple exercises in the shallow end | Most people, including non-swimmers | Public pools, often during quieter or adult-only sessions |
| Aqua aerobics or aqua fit classes | Instructor-led group exercise to music | Fitness, motivation and company | Leisure centres and gyms; look for gentle or low-impact classes |
| Swimming | Swimming lengths or widths | Fitness, if you can swim comfortably | Public pools and lane sessions |
| Arthritis or condition-specific water classes | Gentle sessions in warmer water | People with arthritis or other long-term conditions | Some leisure centres, charities and community groups |
| Hydrotherapy (aquatic physiotherapy) | Exercises tailored and supervised by a physiotherapist, usually in a warm pool | Severe pain, after surgery, or when land exercise is very difficult | Usually by referral from an NHS physiotherapist or rheumatology team; availability varies |
Our guide to hydrotherapy for arthritis explains NHS access and what to expect at sessions, and our guide to hydrotherapy pools covers how to find one.
Before you start
Most people with arthritis can start water exercise safely. Check with your GP or physiotherapist first if you have heart or lung problems, very high or low blood pressure, epilepsy that is not well controlled, have had recent surgery or have an open wound, or a skin infection. Do not go in the pool if you have an infection, diarrhoea or a high temperature.
- Choose your session: quieter, adult-only or "lane and shallow" sessions are easier. Ask your pool about water temperature and the depth of the shallow end.
- Waist to chest depth is a good level for most exercises. Deeper water takes more weight off joints; shallower water gives more stability.
- Pool shoes give grip on the pool floor and on wet changing room floors.
- Use the steps or a hoist rather than jumping or climbing in. Many pools have handrails, ramps or a hoist; ask staff.
- Drink water before and after. You still sweat in a pool.
A 30-minute shallow-end routine
Stand in waist- to chest-deep water near the side so you can hold the rail if needed. Move slowly and smoothly. Start with 5 to 8 repetitions of each exercise and build to 10 to 15.
Warm-up (5 minutes)
- Water walking: walk forwards across the pool, swinging your arms, then walk backwards. Take normal-sized steps and land heel first when walking forwards.
- Side stepping: step sideways along the pool wall, then back the other way.
- Shoulder rolls and arm circles under the water.
Legs and hips (10 minutes)
- Marching: holding the rail, lift each knee towards hip height in turn. 10 to 15 each leg.
- Leg swings forward and back: side-on to the wall, swing one leg forward and back from the hip, keeping your body upright. 10 each leg.
- Leg swings out to the side: facing the wall, lift one leg out to the side and back. 10 each leg.
- Mini squats: holding the rail, bend your knees slightly and straighten. 10 times.
- Heel raises: rise up onto your toes and lower slowly. 10 to 15 times.
- Knee bends: holding the rail, bend one knee to bring your heel towards your bottom, then lower. 10 each leg.
Upper body and core (7 minutes)
- Arm sweeps: with arms just under the surface, sweep them forwards and back, palms facing the direction of movement. 10 to 15 times.
- Arm openings: bring your arms together in front of you, then open them wide to the sides, keeping them under the water. 10 to 15 times.
- Wall press-up: hands on the pool edge, bend your elbows to bring your chest towards the wall, then push back. 8 to 12 times.
- Standing twist: with feet steady and arms in front, gently turn your upper body side to side. 10 each way.
Balance and cool-down (8 minutes)
- Single-leg stand: holding the rail lightly, stand on one leg for up to 30 seconds, then swap. Let go for a few seconds if you feel steady.
- Heel-to-toe walking along the wall.
- Slow water walking for 2 to 3 minutes.
- Gentle stretches: calf stretch against the wall, thigh stretch holding your ankle (or a towel round it), and a chest stretch with hands on the rail behind you. Hold each for 15 to 20 seconds.
Making it easier or harder
| To make it easier | To make it harder |
|---|---|
| Move more slowly | Move faster to increase resistance |
| Stand in deeper water to reduce weight on joints | Stand in shallower water for more load |
| Keep arm movements small and close to the body | Use cupped hands, gloves or a float to push against |
| Hold the rail with both hands | Hold on lightly, then not at all |
| Fewer repetitions | More repetitions or a second round |
An 8-week plan
| Weeks | Sessions | Length | Focus |
|---|---|---|---|
| 1–2 | 1–2 a week | 15–20 minutes | Get used to the pool; warm-up, legs and cool-down |
| 3–4 | 2 a week | 20–25 minutes | Add upper body exercises |
| 5–6 | 2–3 a week | 25–30 minutes | Full routine; try an aqua class or a few widths of swimming |
| 7–8 | 2–3 a week | 30–40 minutes | Move faster in parts; add balance challenges |
Combine pool sessions with some land-based strength exercises and walking where you can, because these help bones and everyday function in ways water exercise alone may not.
Tips for your main joint
| Joint | Most helpful in water | Take care with |
|---|---|---|
| Knee | Water walking, marching, mini squats, knee bends, gentle kicking holding the rail | Breaststroke kick and pushing off hard from the wall |
| Hip | Leg swings forward, back and to the side, water walking, side stepping | Wide breaststroke kick; after hip replacement, positions your surgical team has advised against |
| Back | Water walking, gentle twists, floating on your back with a float | Head-up breaststroke, which arches the neck and lower back |
| Shoulder | Arm sweeps and openings under the water, wall press-ups | Front crawl and backstroke arm movements if overhead reaching is painful |
| Hands and wrists | Slow opening and closing of the hands under water, wrist circles | Gripping floats tightly for long periods |
| Feet and ankles | Heel raises, ankle circles, water walking in pool shoes | Rough pool floors without shoes |
Water exercise with inflammatory arthritis and during flares
Many people with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis find warm water especially comfortable, and NICE guideline NG100 says adults with rheumatoid arthritis should have access to specialist physiotherapy to improve fitness and learn exercises for flexibility and strength. During a mild flare, a short, gentle session of slow walking and stretching in warm water can help stiffness, but skip the pool if a joint is very hot and swollen, or if you feel unwell or feverish. If you take medicines that affect your immune system, such as methotrexate or biologics, keep cuts covered with waterproof dressings and avoid swimming if you have an infection.
Cost and concessions
Prices vary widely between pools. Many councils and leisure trusts offer reduced-price or concession memberships for older adults, people on certain benefits and disabled people, and some offer free or reduced sessions through exercise referral schemes from a GP or practice nurse. Carers may be able to go in free with the person they support. Ask your local pool what is available, and whether there are off-peak, adult-only or condition-specific sessions.
Swimming with arthritis
If you enjoy swimming, it is a good way to build fitness. Choose strokes that feel comfortable: backstroke and front crawl are often easier on the neck and back than head-up breaststroke, while breaststroke kick can bother some knees and hips. Mixing strokes, using a float, and swimming widths before lengths all help. See our guides to swimming for arthritis and swimming exercises for hip osteoarthritis.
Tips for non-swimmers and nervous beginners
- You do not need to swim. All the exercises above are done standing in the shallow end.
- Tell the lifeguard or staff that you are new and have arthritis.
- Go with a friend for the first few sessions.
- Use a float or noodle for extra support.
- Ask about adult swimming lessons if you would like to learn.
Changing rooms and getting there
For many people, the hardest part is not the exercise but getting changed. Ask whether your pool has an accessible changing room, seats in cubicles, grab rails or a pool hoist. Wear clothes that are easy to take on and off, such as elasticated waists and slip-on shoes, and wear your costume under your clothes. A long-handled sponge or towel and a towelling robe make drying easier. Allow time to rest before you leave, as you may feel more tired than you expect after warm water.
After a session
It is normal to feel pleasantly tired. Some people find their joints ache a little later the same day. If pain is worse the next day, or lasts more than 24 hours, do less next time: a shorter session, slower movements or fewer repetitions.
When to get medical help
Get out of the water and rest if you feel dizzy, faint, sick, unusually breathless, or have chest discomfort or sharp joint pain. Tell the lifeguard.
- Call 999 for chest pain, severe breathlessness, or if someone collapses.
- Call NHS 111 or go to A&E if a joint suddenly becomes hot, red, swollen and very painful, especially with a high temperature or feeling unwell.
- See your GP or physiotherapist if water exercise consistently makes your pain worse, you would like hydrotherapy, or you are not improving after 8 to 12 weeks. In many areas you can refer yourself to NHS physiotherapy, and the physiotherapist can advise whether hydrotherapy is available and suitable for you.
Is water exercise good for arthritis?
Yes, for many people. The water supports your weight, warmth eases stiffness and moving against water builds strength gently. It is especially useful if exercise on land is painful, or if you have arthritis in several joints.
Is hydrotherapy the same as aqua aerobics?
No. Hydrotherapy (aquatic physiotherapy) is treatment planned and supervised by a physiotherapist, usually in a specially heated pool. Aqua aerobics is a general fitness class. Both can help, but hydrotherapy is tailored to your condition.
Can I get hydrotherapy on the NHS?
Sometimes. NHS hydrotherapy is usually accessed by referral from an NHS physiotherapist or rheumatology team, and availability varies across the UK. Ask your physiotherapist, or your GP, whether it is offered locally and suitable for you.
How often should I do water exercise?
Two or three sessions a week of 20 to 40 minutes is a good aim, once you have built up. Start with shorter, less frequent sessions and increase gradually.
Is warm water better for arthritis?
Many people with arthritis find warmer water more comfortable because it eases stiffness. Ordinary pools are cooler, so keep moving to stay warm, and ask your local pool about warmer sessions.
Will water exercise strengthen my bones?
Water exercise is excellent for joints and fitness, but because the water supports your weight it does less for bone strength than weight-bearing exercise. Combine it with walking or land-based strength exercises if you can.
Sources and further reading
- NICE NG226: Osteoarthritis in over 16s
- NICE NG100: Rheumatoid arthritis in adults
- NHS: Physical activity guidelines for adults aged 19 to 64
- NHS: Physiotherapy
- NHS: Physiotherapy – accessing
- Arthritis UK: Exercising with arthritis
Educational information for people in the United Kingdom — not a diagnosis or personal medical advice. Charity no. 1218461. Everyone's situation is different, so always follow the advice of your own GP, pharmacist or rheumatology team. If you feel very unwell, call 999 or go to A&E. For urgent advice, contact NHS 111.
Continue with related help
- Hydrotherapy for arthritis — NHS access and what to expect
- Swimming for arthritis — strokes and tips
- Swimming exercises for hip OA — pool moves for hips
- Hydrotherapy pools near you — finding a pool
- Exercise hub — more exercises