Man exercising in the pool

Water Exercise Therapy: An Introduction to the New Wave


Basic definitions of water therapy

Water fitness has grown largely as a result of one fundamental demographic trend – our aging population. Water is seen as a more gentle medium. Therefore, water programs were initially developed for special populations, such as seniors, who were considered too out of shape to participate in the more strenuous land-based exercise programs. Water conditioning was thought of only for the weak or injured, those to whom land workouts might potentially create more problems than they solve. Though it is now changing, this limited view of water exercise is still prevalent among fitness professionals and the fitness public. Understanding vertical water exercise and the tremendous potential it represents for the betterment of the human condition is what this manual is all about. Aqua training allows the instructor to expand their horizons for their own continuing education (learning about the water), and applying fitness principles to water training.

It will help students and instructors to understand that water is more than doing laps, or just having fun. It may become one of the most widely used forms of exercise by the end of this decade. Some important reasons are listed below:

Table 1: Water Exercise Components

1) Reduces impact forces while exercising

2) “Unweights” the body, buoyant medium

3) Provides three dimensional resistance

4) Provides mainly concentric muscular contractions

5) Allows the joints to move along a natural path

6) Helps control core body temperature

7) Provides accommodating resistance

8) Human cardiovascular system works more efficiently
in the water

9) Allows for a full range of motion

10) Provides a positive psychological environment

11) Time efficient

One thing should be understood concerning the relative buoyancy of water. It has nothing to do with how heavy a person is on land. It only has to do with how densely constructed that person is. Fat floats and muscle does not. Many aquatic professionals believe they must get a larger size water running belt or vest for an obese person than for a smaller, trimmer person. Usually just the opposite is true. Though an obese person may weight 250 pounds or more on land, in the water they are very buoyant and float quite easily. Thin persons, especially people who are muscular with little body fat are often negatively buoyant. In other words, they will sink in water. A 170 lb. athlete with 8% body fat needs a more buoyant flotation belt than a 300 lb. person with more than 30% body fat. One of the most attractive attributes of aquatic exercise is that its participants stay cooler than their land-based counterparts. Water facilities thermal exchange. A water temperature of 80 degrees Fahrenheit will cool the body several times faster than air at the same temperature. Because cool water dissipates heat so effectively, exercise can be done at a much more vigorous pace without the aquaciser becoming overheated.

When using water for a full line exercise program, the temperature of the water should be on the cool side of what the aquaciser thinks is comfortable. Normally, a pool temperature of 79o Fahrenheit (F) to 85o F is recommended. Though the pool may seem a little uncomfortable upon entering, within a few moments the aquacisers will appreciate the cooling effects of the water as they heat up.

Water temperature above 90o F will actually prevent the aquacisers from cooling off and cause an increase in their core body temperature. When submerged in water, sweat does not evaporate as it does in the air. It is this evaporation mechanism which cools the body as we sweat. Being submerged in water subverts this important cooling process. Therefore, water temperature should be maintained in a range that is several degrees cooler than skin surface temperature in order to cool the body. Skin temperature is around 93.5o F, which is why the cooling effects of water to the body ceases above 90o F, at least during exercise.

One of the properties of water is its effects on acceleration of the body. Since water is more dense than air, it has more resistance and it is harder for the body to accelerate through it. One of the factors modifying acceleration is drag – which is a force resisting the body’s movement in water. Components of drag include small waves (called eddys) that ripple along side the body as it moves through water. the faster the movement, the larger the eddy, and the more resistance occurs. The second component is friction of the water to the skin, which adheres to skin by virtue of it being in the water. Again, as movement increases, friction increases. The third component is tail suction, which describes the inability of water to not fill in behind body parts that are not aqua-dynamic enough, thus the body must “pull along” a certain amount of water as it moves – adding to the resistance. Water surrounds the body and resistance is provided equally in all directions. The 3-D freedom of movement afforded in the aquatic medium allows the joints to move in a manner which is most natural for them. This means that water is not only non-injurious to the joints but when used properly, water exercise can potentially be therapeutic to the joints.

As any weight lifter or strength coach knows, there are two types of resistance, positive and negative. Positive resistance is described when the muscle contracts and overcomes the weight, lifting it off the floor. A negative resistance is described when the weight overcomes the contractual force of the muscle and the weight is lowered back down.

Negative resistance has certain advantages and disadvantages from a training perspective. “Negatives” as they are often called, play a major role in increasing the size of the muscle and tendons. The major disadvantage negatives present is that they also cause minute tears in the connective tissue which often result in delayed onset muscle soreness (DOMS) and the possible development of adhesions over time. Soft tissue swelling and a restriction of blood flow to the affected area are also a result of negative resistance.

Positive resistance has none of these disadvantages. When using positive only resistance, the next day soreness is greatly reduced or eliminated. Swelling and adhesions are much less likely to occur. From a safety standpoint, positive only resistance is vastly superior since the danger of a falling weight or rubber band recoiling is non-existent. These factors or comfort and safety, along with the increase in blood flow resulting from positive only resistance exercise, make it the preferred form of resistance for most forms of physical therapy and as well as general population conditioning.

Water is a positive only resistance medium. When moving an object through water, once the muscle ceases to contract, the water does not apply force against the muscle to force it back. Water merely resists movement. This makes it a passive resistance medium. As such, it allows the exerciser to be maximally aggressive. This liberation from the need to protect against the injurious potential associated with negative resistance, can be a very dynamic training tool for elite and professional athletes.

Sample Exercises

Basic Water Movements- Warm-up

  • Power Walk
  • Deep Water Running

Basic Arm Movements

  • Lateral Arms
  • Lateral Raise/behind

Chest/Upper Back Exercises

  • Pectoral Flys
  • Horizontal Circles

Basic Leg Exercises

  • Leg Extension/Flexion
  • Leg Kicks

Water IS the training tool in the evolution of exercise. Its application to decondtioned and medical participants is almost universal. As more and more people become aware of water programs, and more of these programs become part of the health care contiuum of treatment, their use will expand even more.


1. Beasley, RL. Aquatic Exercise. Sports Medicine Digest. pp. 1-3, Jan. 1989.

2. Bishop, PA, Frazier, S. Smith, J. Physiologic responses to treadmill and water running. Physician and Sportsmedicine. 17:87-94, 1989.

3. Chappell, M. Therapy: The aquatic solution. Aquatics. pp. 24-29, Nov. 1989.

4. Cole, A.J. Moschetti, M., Eagleston, R.E. Getting backs into swim. Rehab Management. Aug./Sept. pg. 63-71, 1992.

5. Cole, A.J. Spine pain: aquatic rehabilitation strategies. Journal of Back and Musculoskeletal Rehabilitation. 4:4:273-86, Oct. 1994.

6. Koxzuta, LE, From sweats to swimsuits: Is water exercise the wave of the future? Physician and Sportsmedicine. 17;4:203-206, 1989.

7. Knopf, K., Fleck, L., Martin, MM. Water Workouts. 2nd edition. Hunter Books, San Jose, 1992.

8. McWaters, G. Deep water exercise during pregnancy. AKWA Letter. 1;2:3, 1987.

9. Mitchell, T. The use of props in water exercise for muscle conditioning. AKWA Letter. 3;1:6, 1989.

10. Sova, R. Heart rates in aquatic exercise. IDEA Today. pg. 9, 1990.

11. Sova, R. Aquatics Activities Handbook. Jones and Bartlett Publishers, Boston. 1993.

12. Triggs, M. Orthopedic aquatic therapy. Clinical Management. 11;30-31, 1991.

13. Vickery, S.R., Cureton, K.J., Langstaff, J.L. Heart rate and energy expenditure during aqua dynamics. Physician and Sports Medicine. 11;3:67-72, 1983.

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Written by Eric P. Durak MSc

Explore Wellness in 2021