Aquatic Exercise Benefits for Hip Osteoarthritis (Part 1)
The following posts(Part 1 and 2) have been adapted from the articles, “Hip Osteoarthritis: Aquatic exercise for healthy living on land” by Mary E. Sanders, PhD, FACSM, RCEP, and Cathy Maloney-Hills, RPT and “Shallow-water Hip energy workouts,” in the July/August issue of The Journal on Active Aging.
For hundreds, even millions of people, hip pain is something they encounter on a daily basis. Hip pain is caused by a wide variety of problems. Some attribute their pain from ‘long hours of sitting at a desk, a hard workout, repetitive activity, an injury, bursitis or arthritis.” However the location of the pain must be determined in order to proceed with any treatment or solutions.
As the article states, there are numerous reasons and causes for hip pain, however, authors Sander and Maloney-Hills, focus this article on osteoarthritis.
More the 151 million people worldwide are thought to live with osteoarthritis (reports from World Health Organization). This condition wears away the smooth, cushioning cartilage in the joints. This disease can affect millions of people and often results in great pain and limited mobility. However depending on the stage of osteoarthritis, simple physical activity can help! Some recommendations include aerobics, muscle-strengthening and water-based exercise.
Research has shown that aquatic workouts provide a safe form of exercise for adults with osteoarthritis. A study was conducted with 38 men and women, mean age 66 years old, who have osteoarthritis of the hip or knee. They were randomly assigned to either a 12-week shallow-water exercise program or a non-exercise control group.
The exercise program was conducted 3 days per week for 50 minutes in the pool. The results spoke for themselves after the 12 week study:
- Muscle strength improved for knee extension and flexion (18%,12%)
- hip flexion (12%)
- abduction (25%)
- adduction (13%).
Another study was conducted where 71 participants, mean age 62 years, took part in a 6 week aquatic or no aquatic exercise program. The participants exercised in shallow warm water and compared to the control groups, the program participants reported 72% less pain. In addition, the reports showed a 75% decrease in joint stiffness, greatly due to their aquatic exercise in the warm water pools. And a third study was conducted, of similar fashion, and results showed improved balance and confidence to perform activities on land.
For the trainers and physical therapists, prior to having your patient begin their aquatic therapy program, this article offers a few things to note:
Before exercise screening tips:
- Observe participant’s difficulty getting in and out of the pool
- Advise participants to wear water exercise shoes for greater stability
- Check for cardiovascular disorders
- Check the water temperature of the pool. ‘Studies show that temperatures as low as 86 degrees may be appropriate, but other may be more comfortable in warmer temperatures 90-93 degrees
- Adjust the depth of the water for your patient. Participants’ feet should be grounded on the pool bottom, or individuals should wear a buoyancy belt and perform deep-water exercises.
- Teach abdominal and gluteal muscle-activation skills for trunk stabilization
- Strengthening the gluteals, hip abductors, quadriceps and hamstring and abdominals
- For flexibility, focus on joint range-of-motions at the hip and target specific stretching exercises for the quadriceps, hamstrings, hip adductors, gluteals, hip rotators and low back
- Include cardiovascular conditioning and ADL (activities of dialing living) exercises
As far as structuring and scheduling your aquatic program, the article suggests breaking the program into phases to allow for improvements. ‘Progress a program gradually starting with movement control, and then add balance, posture, ADL exercises and cardio endurance.’
Hip Health for healthy living
As noted previously, hip osteoarthritis can inhibit daily activities because of the cartilage break down in the hip joint. In the early stages of this condition, physical activity, such as walking and water-based exercise, can help relieve pain and enhance mobility. Aquatic workouts for hip osteoarthritis concentrate on several areas, including lengthening and strengthening muscles in the hip region for better movement control. The ultimate goal for aquatic therapy: to support healthy living on land!
For additional information, research and videos about treating osteoarthritis, hip arthritis and knee arthritis, click here! Stayed tuned for part two, which features an aquatic therapy workout routine specifically for patients with hip osteoarthritis.