Water Exercises.

Figure 1 - Forward arm reach

Figure 2 - Sideways arm reach

Figure 3 - Arm circles

Figure 4 - Elbow bend

Figure 6 - Wrist turn

Figure 7 - Wrist bend

Figure 8 - Finger hold

Figure 9 - Finger curl

Figure 10 - Thumb circles

Figure 11 - Ankle bend

Figure 12 - Toe curl

Figure 13 - Ankle circles

Figure 14 - Knee bend

Figure 15 - Knee to chest

Figure 16 - Spread eagle hip

Figure 17 - Leg swing

Figure 18 - Knee lift

Figure 19

Figure 20 - Side leg lift

Figure 21 - Walking

Figure 22 - Side bend

Warm water exercises

General guidelines

When first entering a spa or pool, relax and enjoy the soothing water. When your muscles and joints feel more comfortable and relaxed, slowly begin your exercise routine. Allow enough time after exercising to again relax muscles before getting out of the water.

The Arthritis Foundation recommends the following guidelines when doing water exercises:

• Submerge body part being exercised.
• Move the body part slowly and gently.
• Begin and end with easy exercises.
• Follow through complete joint range of motion if possible, but do not force movement. Stop if you experience any sudden or increased pain.
• Do three to eight repetitions as tolerated.
• Pain that lasts for more than one to two hours after exercise may indicate overuse. Cut back next time.
• Remember the weakening effects of heat when exercising in warm water.
• Start slowly and don't overdo.
• Any individuals who have severe joint damage or joint replacement should check with their doctor or surgeon before doing any of the following exercises.

The following illustrations of exercises can be done while sitting in a spa or while sitting or standing in a pool. Consult your doctor or physical therapist to determine which exercises are appropriate for you.

Shoulder

Forward arm reach (flexion):

Raise one or both arms forward and upward as high as possible. If one arm is very weak, you can help it with the other arm. See figure 1.

Slowly raise both arms out to the side, keeping the palms down. Raise only to shoulder (water) level. Then lower arms. See figure 2.

Arm circles (combined motions):

Raise both arms forward until they are a few inches below water level. Keep both elbows straight. Make small circles (about the size of a softball) with the arms. Gradually increase circle size (until the size of a basketball). Then decrease. First make inward, then outward circles. Do not raise your arms out of the water or let them cross. See figure 3.

Elbow

Elbow bend (flexion/extension):

Bend the elbows and the thumbs to the shoulders. You do not have to touch. Relax elbows and straighten down along side of you. See figure 4.

Turn the arms until the palms face forward. Bend the elbows until the fingertips touch the shoulders. Relax and straighten your elbows, leading down with your palms. See figure 5.

Wrist and fingers

Wrist turn (supination/pronation):

Turn the palms toward the ceiling, then turn them down to face the bottom of the spa or pool. See figure 6.

Bend the wrists backward and then forward. See figure 7.

Hand and fingers

Finger hold (thumb opposition):

Touch the tip of the left thumb to the tips of the other fingers, one at a time, to form a round letter "O". Repeat with right thumb. (May move both thumbs at the same time.) See figure 8.

Curl the fingers into the palm (making a loose fist) and then straighten them out. See figure 9.

Move the thumb in a large circle. See figure 10.

Ankle and toes

Ankle bend:

Sit with back supported and slowly straighten your knee. While holding the knee straight, bend the ankle and point the toes. Then reverse to point them toward the ceiling. See figure 11.

Curl right toes down and then straighten them out. Repeat with left foot. See figure 12.

Sit with back supported and slowly straighten your knee. While holding the knee straight, make large inward circles with the foot, moving from the ankle. Then repeat circles in the opposite direction. Repeat with other foot. See figure 13.

Hip and knee

Knee bend (flexion/extension):

Slowly raise one foot up to straighten out your knee. old straight 3 seconds. See figure 14.

Sit erect. Lift one knee and hug towards chest, hands under the thighs or over the knee to assist with the stretch. See figure 15.

Sitting on the edge of the seat, straighten one knee. While holding it straight, slowly move it out to the side, hold 3 seconds, then bring it back to the center. Repeat with other leg. See figure 16.

Stand with left side to pool wall holding wall with left hand for balance. Keep knees straight. Lift right leg slowly forward to a comfortable height. If possible, hold leg for a count of 5 second, then slowly swing leg backward. Motion should only occur in hip (not waist or neck). Keep upper body straight at all times. Repeat with left leg--right side to wall. See figure 17.

Stand with back or left side against pool wall. Bend right knee, bringing thigh parallel to water surface. Straighten the knee; then bend it again. Lower leg, keeping knee bent. Repeat on left. See figure 18.

Stand with left side to wall, holding wall with left hand for balance. Stand straight with legs slightly apart and left leg forward of right. Keeping body straight, lean forward, slowly letting left knee bend. Keep right knee straight and heel on bottom. Court 5. Return to starting position. Repeat with right leg forward, right side to pool. See figure 19.

Stand with left side to pool wall, holding wall with left hand for balance, knees relaxed. Swing right leg out toward center of pool and back to midline. Do not cross in front of left leg. Repeat with left leg--right side to wall. See figure 20.

Walk normally across or in a circle in the pool. Swing your arms as you walk. See figure 21.

Trunk

Side bend (flexion):

Place hands on hips and, without moving your feet, bend slowly toward the right; then return to starting position and bend to the left. Do not twist or turn the trunk. Arms may hang at the side, if preferred, and as you lean to the right, let the right hand slide down the thigh. Repeat on the left. See figure 22.

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