Water Aerobics: A Safe Exercise for Many Patients 

water aerobics

Angela Ridgel, PhD, an exercise physiologist at Kent State University, usually helps patients exercise at the gym, while studying how it might improve their cognition and brain health. But many exercise routines on land, such as aerobic or stretching ones, for example, can be challenging for people with multiple sclerosis (MS), she says. “When you’re doing exercise [on] land, which is what we mostly do in my lab, that would have a tendency to make MS patients overheat and then exacerbate their symptoms,” she adds.

So she teamed up with a doctor who specializes in working with MS patients to see if water aerobics might be a better choice for you than a workout in the gym. 

However, you don’t have to have MS to benefit from a workout in water. Studies have shown that the regimens can contribute to overall fitness in healthy participants, healing from injuries and improving lower-back pain. It can be a safe choice for people managing a variety of conditions, from MS to breast cancer.

Water Aerobics for General Fitness 

Water aerobics can be a fun, sociable workout for anyone and is especially popular among people who want to minimize impact on their joints. The water’s buoyancy reduces stress on joints, while also providing resistance to strengthen muscles.

One study of 80 adults over 55 without pre-existing conditions showed that exercising in the water four times per week or who alternated between aquatic and land-based exercises experienced the same vascular benefits as those who exercised in the gym only.

This means people can choose a form of exercise that causes less pain,

stress or strain on joints, but will still benefit their heart health. This may be especially good news for people who may be more frail, or for those who are afraid of handling gym equipment,” the study’s author wrote in The Conversation.

Water Aerobics for Lower-Back Pain

Water-based exercises can help reduce lower-back pain, including that caused by pregnancy, according to a 2018 review study. A more recent trial published in January 2022 found that three months of biweekly water-aerobics classes was even more effective at reducing pain and improving sleep, quality of life and mental state than traditional physical therapy for patients with chronic lower-back pain. The patients continued to report that they felt better even 12 months after the trial.

Multiple Sclerosis 

People with MS often show limited blood flow in the brain, which can harm their cognition.

Exercise is known to help patients with MS, says Ridgel, but it’s difficult for them to do an intense workout as it can raise their body temperature and worsen symptoms.

Still, when it’s possible, patients with neurological diseases like MS “seem to get better benefits for the higher intensity versus just doing something long and slow.” She wondered if exercising in water would allow patients to reach higher intensities, and thus more effectively ease symptoms.

Her study lasted only one week. At the start, scientists measured blood flow in the brains of 31 participants. Then, every day for seven days, 17 patients completed a high-intensity hour-long water aerobics workout that raised their heart rate. The remaining 14 patients served as controls, maintaining their normal levels of activity. Before and after the seven days, researchers tested blood flow to the patients’ brains during a cognitive test. After the seven days of aerobics, the exercisers showed increased blood flow to their brains, while the 14 controls did not, suggesting that water aerobics may be a safe way for people with MS to exercise intensely and limit cognitive symptoms.

Breast Cancer

For decades, clinicians had advised cancer patients and survivors to emphasize rest instead of exercise. After thousands of studies, the American College of Sports Medicine released updated guidelines in 2019, suggesting that the organization change its tune by announcing that exercise was not only safe, but also beneficial for most cancer patients and survivors. It can even help mitigate treatment-related side effects,such as peripheral neuropathy and cardiovascular symptoms.

Still, patients and survivors have to be on the lookout for lymphedema, a dangerous buildup of fluid that happens when the lymph system is damaged or blocked. Amanda Salacinski, PhD, who studies movement science at Westfield State University, set out to test whether a patient participating in water aerobics for 12 weeks increased the risk of this complication for breast cancer patients. She also tested their overall fitness and muscle growth.

Her pilot study only included 10 patients, and they didn’t show substantial increases in strength, but they also had no higher risk of lymphedema, suggesting that the exercise was safe. Even more important than the physical gains, Salacinski hoped that the exercise routine could return some autonomy to the patients. Giving them a workout that they can control “in a world that is completely out of their control. That was one of the most important factors for me,” she says. 

She adds that  a small soon-to-be published study suggests that water aerobics does improve self-reported quality of life.

How to Start Water Aerobics

You can try some exercises on your own, but if you’re not familiar with water aerobics, find a class at your local public pool or YMCA. If you’re hoping it’ll help with a medical condition, ask your physician first. Patients should “make sure their doctor is comfortable with them cardiovascular-wise,” and that it’s safe for them to do an intense workout, says Ridgel.

It’s also helpful to meet with the instructor before classes begin and ask these questions:

  1. How much experience do you have working with people with my condition?
  2. Describe what happens in the first class
  3. How should I prepare and what equipment or clothing and accessories should I bring? 


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