Anyone with almost any kind of chronic pain should seriously consider spending more time in the pool (doing almost anything, but aquajogging is a particularly good choice). This includes many patients who may not normally think of pool therapy.
Aquatic therapy can be great for almost any kind of stubborn pain. Immersion and floatation have curiously potent benefits, particularly partial relief from gravity, that most relentless of all physical stresses; this is valuable both as actual mechanical security and to make movement feel easy, cushioned, and safe — and feeling safer with movement can be a critical stepping stone in all kinds of rehabilitation and pain management. Modern pain science has makes it extremely clear that pain is an expression of perceived danger to the system.1 Pools are one of the few places where we can both be more active while also actually feeling safer. That’s a precious combination. There are some other helpful biological effects of immersion, too: the human nervous system really seems to like it.
The pool isn’t for everyone, and there are some downsides. Getting chilly is the most obvious, and a deal-breaker for some chronic pain patients. However, it is well worth taking a shot at it and making the effort to make it work for you.2
The simplest aquatic therapy is to just float. There are two main kinds of floatation therapy:
All of the above is potentially terrific for injury rehabilitation and chronic pain in many ways.
Aquajogging and water aerobics combine the benefits of vertical (deep) immersion with “the closest thing there is to a miracle cure,”8 … exercise.
Aquajogging works a lot better with the help of a simple accessory, a buoyancy belt like the AquaJogger or the WaterGym Water Float Belt (and many others, sometimes called a water aerobics belt). I recently encountered a fellow who was wearing one of these at the pool, and he claimed he’d had his for more than a decade: a good investment!
Oddly enough, I’d never heard of aquajogging until quite recently. Reader Jared Updike introduced me to it in 2016. He’s a persuasive evangelist for it:
I would love for more people to know about aquajogging. It is a weirdly convenient form of swimming where you trade several pieces of equipment (goggles, hair cap, ear plugs, etc.) for a single strange piece of equipment (flotation belt) and in exchange your hair and eyes and ears stay dry and you can wear a hat and sunglasses while you slowly pull yourself across the pool. And it scales up or down for different fitness levels or pain-level fluctuations. It’s the closest thing to a silver bullet I have found for my pain and fatigue.
Or you could just, you know, swim! Swimming itself is, of course, great exercise. If your body will tolerate it, it’s one of the best workouts you can do. But for chronic pain patients, the vertical immersion of aquajogging really is ideal.
The popularity of yoga is almost oppressive. People feel that they “should” try yoga and may even feel guilty for not trying it (or not liking it). For people on the fence, a little water yoga might be more fun and easier to mess around with. 😃
I use a pool regularly for “yoga” rather than for swimming — a casual and unstructured yoga, but yoga nevertheless. Using the buoyancy of water to aid rehabilitation is a well-known and excellent idea, but the potential for your pool to be an excellent place to breathe and stretch is less widely appreciated. Here are five examples of exercises that make good use of the water:
Yoga and stretching are not everything they are cracked up to be, and they probably fail to achieve much of what people are hoping for — such as preventing muscle soreness,15 or curing low back pain.16 But I am not anti-stretching: it feels great, and not only is that sufficient reason in itself, it probably does mean it’s doing something valuable for us biologically, even if it’s surprisingly unclear exactly what. Here’s an interesting clue: a 2011 study showed that a program of static stretching alone — just pulling on muscles — had a clear benefit for heart rate regulation, a common way of measuring fitness.17 Bodies probably need constant sensory feedback for optimum function — use it or lose it — and this evidence is probably a nice demonstration of that principle.
I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.
— Added a footnote with some tips about how to cope with getting chilly in pools.
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The big four “proximate” causes of preventable ill-health are: smoking, poor nutrition, lack of physical activity and alcohol excess. Of these, the importance of regular exercise is the least well-known. Relatively low levels of increased activity can make a huge difference. All the evidence suggests small amounts of regular exercise (five times a week for 30 minutes each time for adults) brings dramatic benefits. The exercise should be moderate – enough to get a person slightly out of breath and/or sweaty, and with an increased heart rate. This report is a thorough review of that evidence.
Regular exercise can prevent dementia, type 2 diabetes, some cancers, depression, heart disease and other common serious conditions — reducing the risk of each by at least 30%. This is better than many drugs.
This study of stretching found that
multiple-set flexibility training sessions enhanced the vagal modulation and sympathovagal balance [that’s good] in the acute postexercise recovery, at least in subjects with low flexibility levels. … stretching routines may contribute to a favorable autonomic activity change in untrained subjects.
This seems like a fairly straightforward bit of good-news science about stretching. It’s not a surprising idea that movement would have some systemic regulatory effects (motion is lotion, use it or lose it), but it’s nice to see some corroboration of that common sensical notion, and it’s also nice to know that perhaps just stretching did this (to the extent we can learn anything from a single study). If true, it makes for nice evidence to support a general stretching habit, yoga, mobilizations, really any kind of “massaging with movement,” and probably even massage itself.BACK TO TEXT