Swimming for recovery from joint surgery

If you are an athlete recovering from surgery on one of your joints, or if you are simply an active person recovering from a sports injury and can’t exercise in other ways, swimming is a highly effective means of staying fit and protecting your joint health.

We speak with Mr Robert Lewis Carter, a consultant orthopaedic surgeon at Ross Hall Hospital, and Elaine Farquharson, a physiotherapist at The Winterbourne Hospital, to explore the topic in more detail.

While swimming is an amazing way of helping improve strength and stability in your joints, it cannot replace treatment such as physiotherapy and surgery for joint injuries such as fractures, or joint pain conditions such as arthritis. But it can be incorporated into your recovery programme for the best possible results. We recommend that anyone looking to incorporate swimming into their recovery gets advice from a doctor or physiotherapist first.

Swimming is currently one of the most popular sports in the UK. Why do you think it is popular?

Mr Robert Carter: Swimming is a great low impact sport that anyone of any age, size or fitness level can do. Recent success of British swimmers in the Olympics and World Championships has raised the profile of swimming. In addition, there has been an increase in the number of private gyms and fitness studios with swimming pools, so you don't have to rely only on your local pool. Essentially, it’s a very accessible form of exercise for all age groups.

Elaine Farquharson: Swimming or water-based movement is accessible for everyone of all ages and abilities – you have to admit, there’s nothing more fun than splashing around in the water.

How does swimming help people recover from joint injuries?

Mr Robert Carter: Swimming helps to maintain and restore your muscle bulk, build your strength, and improve your flexibility. Regular swimming following surgery to your joint can help you progress through the stages of rehabilitative physiotherapy more quickly. It allows you to improve the flexibility of your joints while the water takes the weight and load off them.

As your flexibility returns, you can build up the length of time you swim for, or your speed, to help strengthen the muscles throughout your body – swimming can improve lower limb strength, upper limb strength, and even cardiovascular (heart and lung) fitness.

Elaine Farquharson: Swimming allows a full body workout in a supported, weightless environment. It cushions and assists your joints through the buoyancy of the water. It helps to relieve anxiety and stress because it is a relaxing, sensory experience. For people who are struggling with swelling across their joints, swimming can help by improving the circulation through hydrostatic pressures on your muscles. It also is a method of improving your fitness and cardiorespiratory system when you are not able to exercise in other ways.

Does swimming benefit some joints more than others?

Mr Robert Carter: Swimming is generally good for all your joints.

In the water your body weight and the load on your joints is relieved as you float, so your joints are ready for recovery at an earlier stage than they are on the ground. Many of the elite professional sports clubs use AlterG® Anti-Gravity Treadmill® running machines over traditional running activities to get their players back to fitness. This uses the same theories as pool-based activities.

Elaine Farquharson: Swimming can benefit all joints but most importantly can be used to target specific regions to improve your mobility, or to add resistance to strengthen your muscle power. Also, the turbulence of the water can be useful to increase the positional sense of your joints, which improves balance and precision of movement.

If I am not ready to swim the full length of a pool, what pool exercises can I do?

Mr Robert Carter: Stretching, walking, and running in the shallow end of the pool all offer fantastic exercise – even if you’re not able to swim the full length of the pool. You can start off by carrying out a stretching programme in the water and then progress to walking with floats. After you have progressed to this stage, you can try walking across the shallow end of the pool and increasing the number of widths. Pushing against the water, walking with high knees, and also jogging in the water are good and safe exercises even if you can't swim confidently.

Elaine Farquharson: If you are a non-swimmer, you can use the water to practise walking and balance, gentle upper limb movements or spinal mobility. There are lots of guided aqua-aerobic classes or hydrotherapy groups that help with this, so you will feel safe in the water.

For those patients that are carrying a minor injury, swimming can be used as cross training and adapting the stroke with drills or floats can completely avoid exercising the injured limb whilst still giving you a challenge. For patients suffering with neck or back pain or for those patients that are unsure of going in this environment alone then a physiotherapist will be able to offer you guidance or design a training plan.

I haven’t had my surgery yet, is it wise for me to go swimming?

Mr Robert Carter: Yes, it’s a great idea. There is evidence that improving your cardiovascular fitness in addition to general muscle fitness improves the quality and speed of recovery after surgery. If you train before the surgery, you will find it easier and more enjoyable to recover and rehabilitate.

How soon after my surgery can I go swimming?

Mr Robert Carter: As a rule, you can swim around one to two weeks following lower limb surgery. It may be possible to start earlier with specific waterproof dressing. The operating surgeon and physiotherapist can advise you specifically regarding your operation.

Elaine Farquharson: It obviously depends on the extent of your surgery and whether you are medically fit and well, but for all post-ops we would like the wound to be completely healed before you go to a public pool environment.

Some physiotherapy-led hydrotherapy pools can take you earlier so long as they assess your wound and protect it with waterproof dressings. This early hydrotherapy can be particularly beneficial for people who are on protected weight bearing as it gives you the freedom to move in a weightless environment. But again, this is best assessed by a physiotherapist first.

How many times per week should I be getting into the pool?

Mr Robert Carter: Three to four times is ideal but even once a week is likely to significantly help. The more you carry out your rehabilitation both in the pool and on land the stronger and quicker you will recover and improve your function.

What other therapy would be beneficial in my recovery?

Mr Robert Carter: Guidance from your surgeon and physiotherapist will be provided regarding your surgery, but as a rule, regular walking is a good exercise throughout your lower limb surgery recovery. All the low impact activities are easier to return to and will help push on recovery at an earlier stage. Once good healing and recovery has taken place your surgeon and physiotherapist will guide you on returning to running and other medium- and high-impact activities.

Elaine Farquharson: Improving your biomechanics through coaching and exercise, massage, manual therapy, taping and in some cases electrotherapy or acupuncture are all useful therapies to aid in your recovery. Also, for those with large swollen limbs, lymphatic drainage can be helpful for relieving this.

Recover from joint pain surgery with Circle Health Group

At Circle Health Group we offer tailored treatment, including surgery, for many joint pain problems. We also have bespoke aftercare programmes to help you recover from surgery as soon as possible. Many of our hospitals have bespoke physiotherapy appointments equipped with specialist equipment such as AlterG running machines.

If you want to know more about our treatment options, give us a call today.