Every day over 46 million Americans experience the aches and pains of arthritis; the nation’s most common source of disability. (Arthritis Foundation 2008) There are over 100 forms of arthritis, but the most common type is osteoarthritis (OA), which is a condition characterized by the breakdown of the joint’s cartilage. (Arthritis Foundation 2008) Stiffness, pain, and loss of movement in the joint are all effects of osteoarthritis. (Arthritis Foundation 2008) Getting involved and being active in aquatic exercise activities such as Tai-Chi, Ai Chi, Arthritis Foundation YMCA Aquatic Program, as well as strength and flexibility exercises may help reduce the stiffness and pain that is associated with this debilitating disease.
Tai-Chi was developed as a martial art movement paired with a breathing pattern that exercises all joints and major muscle groups while circulating internal energy, or “chi”. Tai-Chi is performed slowly, evenly, and thoughtfully while emphasizing the continuity of movement. (Tai Chi Academy 2002) Breathing is through the nose, slowly and evenly; inhaling during contractions and exhaling during expansion of the form. Tai-Chi is completely non-impact, but involves the entire body thus promoting strength stamina and flexibility. (Tai Chi Academy 2002) Although not developed to be performed in the aquatic setting, performing Tai-Chi in the water provides individuals with an ideal environment to allow for complete non-impact, joint-friendly exercise. Studies have shown that Tai-Chi has provided significant improvements in function and pain in individuals with OA. (Arthritis Foundation 2008)
Much like Tai-Chi, Ai Chi is a water-based, total-body strengthening and relaxation program. It consists of 16 progressions that utilize deep breathing with slow, broad movements of the arms, legs, and torso in shoulder depth water. Ai Chi was created by combining Tai-Chi with Shiatsu and Watsu techniques. (TBTUI 2009) It is a perfect program for individuals with OA because it also allows for a complete non-impact, joint friendly exercise session. Some of the benefits of Ai Chi include pain management, relaxation, increased range of motion and flexibility, as well as increased trunk strength.
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The Arthritis Foundation YMCA Aquatic Program is a recreational exercise program designed to accommodate the abilities of individuals with arthritis and other related diseases. (Arthritis Foundation Aquatic Program 2005) Arthritis Foundation YMCA Aquatic Program includes exercises to improve overall function and performance of daily tasks, mobility, gait, independence, flexibility, balance, and coordination. The components of the program are warm up, joint range of motion for flexibility and strength, cool down, and also optional games and activities. (Arthritis Foundation Aquatic Program 2005) Individuals work all major joints of their body including the neck, shoulders, elbows, wrists, fingers, hips, knees, ankles, and toes. This program provides individuals with joint specific exercises in which variety and appropriate exercise intensity are included.
Strength and flexibility exercises are great for individuals with OA, but can be painful when performed on land. Taking those exercises into the water makes them more doable and effective for the individual. When performing exercises in the water, the majority of the weight that the joints have to bear is taken away, pain is reduced, and flexibility increases. The water acts to support your body, thus making these exercises more successful.
A variety of studies reviewed, specific to OA, indicate that aquatic exercise improves pain and physical function in individuals with the disease. Tai-Chi has also shown improvements in pain, self-reported physical function, and even increased stair climbing ability. Aquatic therapy denotes decreases in pain and joint stiffness, increases in greater physical function, quality of life, and hip and muscle strength, when compared to land therapy. This establishes that while performing strengthening exercises in the water participants can be subjected to a more enjoyable, less painful, and more functional exercise experience. Performing an exercise program with all or a portion of these exercises listed would be ideal for an individual with osteoarthritis.
Lori B. Dingess is a senior undergraduate student at West Virginia University currently studying Exercise Physiology with an emphasis in Aquatic Therapy. She is a proud three year member of the Exercise Physiology Club at West Virginia University. Lori has a primary interest in Physical Therapy and is planning on attending a Physical Therapy graduate program after graduation in May 2010.