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This Rheumatoid Arthritis Awareness Week, one of our physiotherapists, Ruth Ashton discusses how hydrotherapy can benefit patients with rheumatoid arthritis.

About Ruth Ashton

Ruth operates a split post working both in management and covering a clinical caseload. She has a special interest in tendinopathies, running related injuries and post-surgical rehabilitation. She completed an MSc in Sports and Exercise Medicine and has post graduate training in acupuncture, Pilates, manipulative therapy, women’s health and aquatic therapy.
View Ruth Ashton’s full profile

About Ruth Ashton

Ruth has over 15 years of experience working at various NHS trusts in and around London and in the private sector. Ruth enjoys treating lower limb injuries and spinal and pelvic girdle pain.
View Ruth Ashton’s full profile

Close-up of an old man's hands


Rheumatoid Arthritis Awareness Week runs from 18 - 24 June. This condition affects approximately 1 per cent of the population in the UK, which is more than 400,000 people. Women are roughly three times more likely than men to be affected and it typically develops between the ages of 40 and 60, or a bit older for men. 

Rheumatoid arthritis is different to osteoarthritis, which is a degenerative joint condition. rheumatoid arthritis is a long-term autoimmune disorder, meaning that the body’s immune system becomes too active and incorrectly attacks the body.

In rheumatoid arthritis the immune system attacks the synovial lining of the joints, which leads to inflammation and symptoms such as pain, swelling, stiffness and fatigue. 

Rheumatoid arthritis tends to affect the small joints of the hands and feet first usually on both sides of the body in a similar pattern.  It can also affect organs such as the lungs, heart and eyes.

Rheumatoid arthritis treatment  

These days the medication on offer to control the progression of rheumatoid arthritis is generally very effective, enabling people diagnosed to lead full and active lives.

People who have been diagnosed with rheumatoid arthritis may find it difficult to participate in regular exercise due to pain, stiffness and fatigue. This in turn can lead to worsening joint stiffness, muscular weakness and ultimately loss of function. Physiotherapists can help people with this condition to learn how to protect their joints while continuing to exercise and keep joints moving.

Aquatic therapy

One option for people with rheumatoid arthritis is aquatic therapy (also known as hydrotherapy). 

Hydrotherapy patient in the pool

Aquatic therapy is exercise in warm water.  It is a very effective way to exercise for people diagnosed with rheumatoid arthritis.  At The London Clinic we have a light and airy state-of-the-art aquatic therapy pool with specialist aquatic therapy trained physiotherapists who can teach people with rheumatoid arthritis how to exercise safely.

The properties of water are particularly beneficial to people diagnosed with rheumatoid arthritis (and other joint related problems):

  • Warmth (35 - 36 degrees)
    The warmth of the water can help to relax and ease muscle spasm and reduce pain and increase circulation. 
  • Hydrostatic pressure
    The pressure from the water is evenly exerted on the body at any given depth, this is known as hydrostatic pressure. The amount of pressure increases as the depth of water increases. This effect of hydrostatic pressure can be used to reduce joint swelling and improve general circulation. It also provides resistance to the chest wall allowing a training effect to be had by the respiratory (breathing) muscles.
  • Buoyancy
    Buoyancy refers to the upward pressure of the water. This has the effect of reducing the load on painful joints and can allow people with stiff joints and weak muscles to move more easily. Your physiotherapist may ask you to use equipment to help increase the effect of buoyancy – this can enable you to work your muscles against gentle resistance.  
  • Viscosity
    Viscosity is the friction created by cohesive forces between molecules of liquid. This cohesive force provides resistance that can be used to strengthen muscles and improve cardiovascular fitness.  It can also help to improve joint stability. Joints severely affected by rheumatoid arthritis may become unstable, as the ligaments and joint capsule become stretched by chronic swelling.
  • Drag
    Drag refers to the resistance created by the water. Every movement performed under the water will encounter resistance. This means that several muscle groups can work simultaneously. The resistance created by the water also reduces the speed of movements, which in turn reduces the likelihood of jerky movements. This effect protects joints from potential injury while exercising.

Ultimately exercising in the water can allow people with rheumatoid arthritis to move more freely, work several muscle groups at the same time all while being performed with reduced pain and pressure on joints. This can enhance self-confidence and improve general wellbeing.

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