Is swimming good for joints: benefits and limitations

Yes, for most people, swimming and other aquatic exercises can be beneficial for joints. Water reduces the impact of body weight on weight-bearing joints, making movement often easier to tolerate than walking or exercising on land. For knee and hip osteoarthritis, aquatic exercises can reduce pain and stiffness and improve physical function. Current guidelines consider exercise a fundamental treatment for osteoarthritis, and aquatic exercise an acceptable option alongside walking, strength training, and other forms of exercise. [1]

It's useful to distinguish between swimming and therapeutic aquatic exercise. Much research on joint disorders has examined pool walking, squats, leg movements, balance exercises, and water resistance, rather than crawl or breaststroke. Therefore, it's more accurate to say that the evidence particularly supports aquatic physical activity in general, rather than the existence of any single "therapeutic swimming style." [2]

Swimming isn't entirely "weight-free." Water reduces the effects of gravity, but it also creates resistance. If you move quickly or use fins or other means of additional resistance, muscle and joint strain can increase significantly. This is why swimming is generally gentle on the knees and hips, but with improper technique or excessive training, it can overload, for example, the shoulders or knees. [3]

Why are joints easier to move in water?

The main advantage of water is its buoyant force, which counteracts gravity. When a body is immersed in water, part of its weight is supported by the water. Therefore, when walking, bending a knee, or doing hip exercises, the legs do not have to bear the same load as during similar movements on land. [4]

This is especially beneficial for people who find regular walking painful. On land, each step requires shifting body weight through the hips, knees, and ankles. In a pool, the same person can walk, lunge, or lift legs with less body weight, allowing for more movement. The U.S. Centers for Disease Control and Prevention notes that people with arthritis are often able to exercise longer in water without increasing joint and muscle pain. [5]

However, the term "unloading" does not imply a complete absence of load. A direct study of patients with telemetric knee and hip prostheses showed that during chest-deep water exercises, joint forces were, on average, lower than during similar movements on land, but the magnitude of the load depended greatly on the type and speed of movement. Fast movements and the additional resistance of water could significantly increase the effort. [6]

It is this property that makes water convenient for rehabilitation: the load can be adjusted not only by the weight of the dumbbell, but also by the depth of the water, the speed of movement, the area of the moving limb, and the use of special resistance devices.

Water not only relieves the joint, it also loads the muscles.

The paradox of water training is that water simultaneously reduces the axial load of body weight and creates resistance to movement.

When slowly lifting a leg on dry land, the resistance is relatively small. In water, the same limb must overcome the viscosity and resistance of the environment. The faster the movement, the greater this resistance becomes. Therefore, exercises in water allow you to train your muscles while placing relatively little stress on the supporting joints. [7]

This is important in osteoarthritis. Weakness of the muscles around the affected joint impairs function and can further limit movement, so current recommendations include not only general aerobic activity but also strengthening exercises. The 2024 European guidelines call for individualized exercise selection, including strength, aerobic, flexibility, and coordination exercises; the format can be either land-based or aquatic. [8]

Therefore, the pool is especially convenient not because it allows you to “not load anything”, but because it allows you to load the body in a different way.

What do studies show about knee osteoarthritis?

The evidence for the benefits of aquatic exercise has been best studied in the context of knee osteoarthritis.

A meta-analysis of 22 randomized trials involving 1,394 people with knee osteoarthritis found that, compared with no exercise, aquatic exercise improved scores on pain, stiffness, and physical function immediately after the training course. However, there was no significant difference in pain, stiffness, or function between aquatic and land-based exercise. [9]

This is an important result. It does not mean:

"swimming is better than all other exercises"

Or rather:

"Exercising in water is one of the effective ways to get the necessary physical exercise."

This option becomes especially attractive when a person finds it difficult to train normally on dry land due to pain, large body mass, fear of falling, or severe stiffness.

A meta-analysis of lower extremity osteoarthritis studies also found short-term improvements in pain, function, and stiffness after aquatic exercise. However, the long-term effect was less convincing, highlighting the importance of regular physical activity rather than a one-time course of exercise. [10]

In a 2025 systematic review of people over 60 years of age with osteoarthritis, aquatic exercise also improved pain, stiffness, balance, and walking ability compared with no exercise.[11]

And specifically, swimming, and not aqua aerobics, was researched?

Yes, but there are significantly fewer such studies.

In one randomized trial, 48 sedentary middle-aged and older adults with osteoarthritis were assigned to either swimming or stationary cycling for 12 weeks. The sessions were conducted three times a week for 45 minutes. Both groups experienced reductions in pain and stiffness and improvements in physical function and quality of life; no significant differences were found between swimming and cycling.[12]

This is direct evidence that regular swimming training may be a suitable form of aerobic exercise for osteoarthritis.

But the study was small, so it can't be used to draw a universal pattern:

"Everyone with arthrosis needs to swim exactly 45 minutes three times a week."

Most of the evidence, however, relates to a variety of aquatic exercise programs. Therefore, for someone with technical difficulties in swimming, walking and pool aerobics may be equally sensible choices.

What do current guidelines say?

Today, physical activity is not considered an optional adjunct to the treatment of osteoarthritis.

The UK's National Institute for Health and Care Excellence recommends individually tailored therapeutic exercise programs, including muscle strengthening and aerobic exercise, for all people with osteoarthritis. Patients are also advised that pain may temporarily increase at the beginning of exercise, but that regular, appropriate exercise typically reduces pain and improves function and quality of life. [13]

The European Alliance of Rheumatology Associations, in its guidelines for hip and knee osteoarthritis, states that exercise formats should be chosen based on the individual's capabilities and preferences. Land-based and aquatic exercise are considered as variants of a single therapeutic approach, rather than competing methods, one of which is necessarily superior. [14]

The American College of Rheumatology also strongly recommends exercise for knee and hip osteoarthritis and specifically includes aquatic exercise as an acceptable option along with walking, strengthening, and neuromuscular training.[15]

In April 2026, an update to the European guidelines on physical activity in inflammatory arthritis and osteoarthritis was published. They again consider physical activity as part of standard care throughout the disease, with individualized volume and load adjustment. [16]

Can swimming wear down your joints?

Routine therapeutic exercise does not appear to be a cause of accelerated cartilage destruction in osteoarthritis.

Fear of movement is very common: it seems logical that if the cartilage is already damaged, any additional movement should "wear it down" faster. But a joint isn't a mechanical bearing that wears out strictly proportionally to the amount of movement.

A systematic review of randomized trials that assessed cartilage using magnetic resonance imaging found no compelling evidence of damaging effects of therapeutic exercise on articular cartilage in people with knee osteoarthritis or at increased risk for the disease. The quality of this structural evidence was limited, but it does not support the notion that recommended exercises "wear down cartilage." [17]

A 2025 review specifically addressing this misconception came to the same conclusion: available systematic reviews do not show damage to cartilage structure or quality following exercise therapy for knee osteoarthritis.[18]

However, the opposite conclusion cannot be drawn from this:

"Swimming restores damaged cartilage."

This claim is not supported by evidence. Furthermore, in the classic Cochrane review of aquatic exercise for osteoarthritis, not a single included study assessed radiographic joint restoration. The benefits were primarily symptomatic and functional—less pain, easier movement, and a somewhat improved quality of life. [19]

Why is swimming especially convenient for those with a large body mass?

For people who are overweight or obese, it can sometimes be difficult to begin with long walks: each step places significant strain on the knee and hip joint.

In a pool, the buoyant force of the water partially supports the body, making exercise easier. This allows for simultaneous work on aerobic endurance, mobility, and muscle strength without the same level of bodyweight stress. [20]

A 2026 meta-analysis, including 12 randomized trials and 1,057 overweight or obese adults with knee and/or hip osteoarthritis, found modest improvements in pain and physical function with aquatic exercise. The authors described their analyses of optimal duration and frequency as exploratory only and did not recommend using them as a proven exercise prescription. [21]

Therefore, a pool may indeed be a particularly convenient entry point into regular physical activity, but weight loss where appropriate and muscle training remain important parts of overall osteoarthritis treatment.[22]

Swimming for rheumatoid arthritis

In rheumatoid arthritis, physical activity is also recommended, but it does not replace antirheumatic drug treatment.

The current European guidelines for 2026 extend support for regular physical activity to both osteoarthritis and inflammatory arthritis. Exercise should be adapted to the individual's condition, disease activity, physical fitness, and associated limitations. [23]

A systematic review of aquatic exercise for inflammatory arthritis found potential benefits in rheumatoid arthritis and spondyloarthritis, but the number of studies and quality of evidence was significantly lower than for knee and hip osteoarthritis.[24]

Therefore, a person with rheumatoid arthritis may consider swimming or exercising in a pool as a convenient form of physical activity, but the phrase:

"Swimming cures joint inflammation"

It would be wrong.

Control of the inflammatory activity of the disease remains a separate task of drug therapy.

Swimming for spinal arthritis

For axial spondyloarthritis, regular exercise is an important non-drug part of treatment because it helps maintain mobility, physical function, and overall endurance.

Research on aquatic programs for this condition exists, but it is significantly less numerous than studies on land-based exercise. Systematic reviews generally support physical activity, but do not support the assertion that swimming specifically offers a unique advantage over other appropriately selected exercises. [25]

For some people, swimming is particularly comfortable due to the ease of core movement and pain relief. Others benefit from combining swimming with targeted exercises for posture, spinal mobility, and strength.

Swimming and hip joints

The hip joint experiences significant stress when walking and bearing body weight, so water exercises are often well tolerated by those with hip osteoarthritis.

A Cochrane review of 13 studies with 1190 participants with knee and/or hip osteoarthritis found small short-term improvements in pain, functional limitations, and quality of life after aquatic training compared with control groups.[26]

Modern European recommendations do not single out water therapy as mandatory or superior to land therapy, but explicitly allow it as a way to implement an individually selected program. [27]

For someone who finds long walks painful, this can be a very significant benefit: water can be used to maintain activity while strength and functional training gradually increases one's abilities on land.

Is swimming good for your knees?

For most people with knee osteoarthritis, yes, as long as the movements chosen do not cause persistent pain.

Systematic reviews show improvements in pain, function, and stiffness after aquatic exercise training, and few serious adverse events directly related to it have been reported in studies.[28]

However, the saying "swimming is easy on the knees" does not mean that every swimming style is suitable for every sore knee.

The breaststroke deserves special attention.

Breaststroke can irritate a sore knee.

During breaststroke, the legs perform a characteristic wide, whip-like thrust with knee movement and shin rotation. With high training volumes, this mechanism has long been associated with so-called breaststroke knee, typically manifesting as pain on the inside of the knee. [29]

Most of this data is from competitive swimmers who perform thousands of repetitions of the movement, so it is not directly transferable to an older person swimming a few laps comfortably twice a week.

However, the practical principle remains sound: if breaststroke kicking reproducibly causes knee pain, don't continue despite the pain. You can try a different stroke, swimming primarily with straight-line kicks, or switching to walking and aquatic aerobics, especially until the cause of the pain is determined.

There is no universal scientifically proven “best style for knee osteoarthritis.”

Is rabbit healthier?

Crawl is often easy on the knees because the legs make relatively small alternating movements without the characteristic wide movement of breaststroke.

But the freestyle stroke has another potential overload area—the shoulder joint. Swimmers repeatedly raise their arm overhead, and with high training volume, this can lead to overload of the soft tissues of the shoulder. Systematic reviews confirm that the shoulder is a primary site of pain and injury in competitive swimmers. [30]

Therefore, it is better to choose a style not based on a universal rating, but based on which joint is the problematic one.

If your shoulder joints hurt

Here the common phrase “swimming is good for your joints” requires a particularly important caveat.

Regular swimming itself puts stress on the shoulders. Freestyle, butterfly, and backstroke involve a lot of repetitive overhead arm movements. Swimmers have reported rotator cuff strain, scapular control issues, instability, and other sources of pain. [31]

This is particularly true for athletic volumes. A systematic review of training loads found an association between high swimming volume and shoulder pain in some groups of competitive swimmers, although a precise safe threshold could not be established.[32]

If a person already has shoulder pain when raising their arm, lap swimming may be less suitable than water treadmills, leg exercises, or individual therapeutic exercises.

In this case, water remains a beneficial environment, but the swimming motion itself may need to be modified.

What about backstroke?

Swimming on your back eliminates the need to turn your neck to breathe and is subjectively more comfortable for some people.

However, the shoulders still perform repetitive overhead movements. Therefore, backstroke swimming cannot be automatically considered therapeutic or safe for those with shoulder joint problems.

If a particular style doesn't cause pain during exercise and doesn't lead to persistent deterioration afterward, it may be acceptable. If pain recurrs, it's wiser to reduce the volume, reconsider technique, or choose a different type of aquatic activity.

There are not enough studies to rank crawl, backstroke, and breaststroke based on safety for various types of arthritis.

What's better for joints: swimming or walking?

There is no clear winner.

With osteoarthritis, the primary goal is to move regularly and strengthen the body in a way that is sustainable over time. Current guidelines do not establish a hierarchy in which swimming is always superior to land-based exercises. [33]

Water exercises have obvious benefits if:

• when walking, significant joint pain occurs;
• difficulty bearing body weight for a long time;
• there is pronounced obesity;
• the person is afraid of falling;
• The ground load is still poorly tolerated.

Walking, in turn, has a different practical value: it's on land that a person needs to get up every day, walk around the house, climb stairs, and maintain balance. Therefore, improving swimming ability doesn't completely replace training for terrestrial function.

For many, the optimal choice is not:

"either a pool or land"

And a combination of both options.

Swimming is not a substitute for strength training.

This is one of the most important practical nuances.

Swimming provides aerobic exercise and water resistance, and pool exercises can strengthen muscles. However, a person with osteoarthritis typically needs a targeted strength program, while older adults also need balance and functional movement. [34]

The World Health Organization recommends that adults perform exercises for major muscle groups at least two days a week, and that older adults additionally include multi-component strength and balance exercises. [35]

Therefore the regime:

"I swim three times a week without any problems, so I don't need to do anything else for my joints and muscles."

Not always optimal.

Swimming can be a great aerobic workout, and exercises on land or in a pool can complement it with strength and functional training.

How much do you need to swim?

There is no separate proven swimming norm specifically “for joints”.

Studies of aquatic therapy have used widely varying programs—the duration of sessions, the number of sessions per week, the depth and temperature of the water, the exercises, and the overall duration of the course. This is one reason why it is impossible to prescribe a universal regimen for osteoarthritis. [36]

One of the few direct experiments with regular swimming used 45-minute sessions three times a week for 12 weeks and found improvements in pain and function, but this regimen is a specific study protocol and not a mandatory clinical recommendation.[37]

For general health, the World Health Organization recommends that adults get 150-300 minutes of moderate-intensity aerobic activity per week, or 75-150 minutes of vigorous-intensity activity, or a combination of both. These minutes don't have to come from swimming alone. [38]

If a person hasn't exercised for a long time or their joints are painful, it's much more important to start with a tolerable volume and increase it gradually than to try to complete the full weekly requirement from day one.

How to know if the intensity is right

During moderate aerobic exercise, breathing quickens, but a person is usually still able to speak in short sentences. In water, subjectively assessing exertion is sometimes more difficult, as cooling and buoyancy alter the usual sensations.

For sore joints, another useful guideline is the condition not only during but also after exercise.

Minor temporary discomfort after unaccustomed exercise is possible. NICE specifically recommends warning people with osteoarthritis that pain sometimes increases at the beginning of a program and that this does not necessarily indicate harm to the joint. [39]

But if after each session severe pain appears, which is significantly stronger than the initial one and persists, swelling increases, or function deteriorates, the load should be reconsidered.

The goal of the exercise is to gradually expand capabilities, rather than regularly provoke a noticeable exacerbation of symptoms.

Do you need warm water?

Warm water is often subjectively reported to facilitate movement in cases of stiffness and is used in therapeutic pools.

The mechanical effects of water training are primarily generated by buoyancy, hydrostatic pressure, and environmental resistance. Heat can also facilitate muscle relaxation and pain perception, but this doesn't mean a regular pool isn't beneficial. [40]

Many studies of therapeutic water exercise have used warm water, but it is impossible to determine a single optimal temperature for all joint conditions.

If the normal pool temperature is comfortable and does not provoke symptoms, there is no need to look for an exclusively warm therapeutic pool.

Is it possible to swim when the pain worsens?

The decision depends on the cause and severity of the exacerbation.

In osteoarthritis, a moderate, temporary increase in pain does not necessarily require a complete cessation of all movement. Guidelines support maintaining individually adapted physical activity and gradually increasing the load. [41]

In practice, it is possible to reduce:

• duration;
• speed;
• amplitude of painful movement;
• resistance;
• number of tracks.

Sometimes, instead of swimming, it makes sense to temporarily switch to calm walking in the water.

But a suddenly swollen, hot joint, a new significant injury, severe instability, or severe unexplained pain require first identifying the cause. In such a situation, the phrase "you need to exercise the joint through the pain" can be dangerous.

Swimming after a joint injury

The pool is often used in rehabilitation, but the start time depends on the specific injury and stage of healing.

Water allows you to perform some movements sooner or more comfortably because it reduces the load from body weight. However, ligaments, tendons, bones, or surgically repaired structures have their own healing timelines, which water does not alter.

Therefore, after a fracture, ligament repair, meniscus surgery, or other orthopedic procedure, permission to exercise in the pool depends on the type of intervention and the rehabilitation plan.

You can’t rely solely on the principle:

“There’s almost no weight in water, so after the surgery you can do anything there.”

The resistance of water during rapid movements can create significant force. [42]

Swimming after knee or hip replacement

After hip replacement, swimming is generally considered an appropriate low-impact activity, but pool entry is not permitted until the surgical wound has healed and the surgeon has cleared diving.

The UK's National Health Service recommends avoiding immersing a surgical wound in a pool, bath, or other water until it has completely healed or until a doctor has given the go-ahead. This is primarily due to the risk of infection. [43]

Specific timeframes vary among orthopedic centers. Some post-knee replacement programs allow swimming after approximately six weeks, once the wound has fully healed. Others simply say "after complete healing," so the surgeon's individual instructions take precedence. [44]

Recommendations for breaststroke after hip replacement vary greatly: some centers allow all strokes after the wound has healed, while others advise avoiding breaststroke kicks for the first few weeks. This depends on the surgery, surgical approach, soft tissue condition, and local protocol. [45]

Therefore, after endoprosthetics, the correct question is not:

"Is it even possible to swim with a prosthesis?"

A:

"At what stage of my rehabilitation is the pool and specific style allowed?"

What to choose: swimming or water exercises

For a person with a sore joint, exercising in water is sometimes even more convenient than classic swimming.

Target	What is more suitable?
Reduce the load when walking	walking in water
Gently increase mobility	flexion and extension exercises in water
Work on your leg muscles	squats, leg raises, water steps
Improve aerobic endurance	swimming, water walking, aqua aerobics
Severe pain in the shoulders	More lower body exercises instead of multiple rows
Knee pain when breaststroke	a different style or exercises without the "whip-like" movement of the legs
Fear of falling on land	controlled pool exercises with safe entry and exit

This is not a therapeutic prescription, but a principle for selecting a load. Modern recommendations for osteoarthritis suggest choosing an exercise format based on function, preference, and accessibility, rather than prescribing a single training regimen for everyone. [46]

Can a swimming pool improve balance?

Yes, properly designed exercises in water can train balance, although the skill still needs to be transferred to land.

Water resistance slows movement, and the body constantly reacts to small changes in flow direction. A systematic review in older adults found that aquatic programs can improve balance, and a 2025 review in older adults with osteoarthritis noted improvements in balance and walking ability. [47]

However, to prevent falls, a person must maintain balance in everyday settings—on the floor, outdoors, and stairs. Therefore, the World Health Organization recommends that older adults engage in a multi-component physical activity with targeted balance and strength exercises at least three days a week. [48]

The pool can be part of this system, but it does not always replace land-based training.

Swimming with osteoporosis: an important difference

Swimming is good for the heart, muscles and overall fitness, but its low axial loading means it is not an optimal single exercise for stimulating bone tissue.

This is especially important for people who choose swimming because of joint problems and are also at risk for osteoporosis. For musculoskeletal health, recommendations also include strength training and other appropriate forms of exercise on dry land. The World Health Organization recommends strength training at least twice a week, and for older adults, functional balance exercises are also recommended. [49]

Therefore the scheme is:

"My joints hurt, so I'll replace all physical activity with swimming."

May be suboptimal, especially in older age.

When Swimming May Not Be the Best Choice

A diagnosis of osteoarthritis itself is usually not a contraindication. However, the specific activity level should be reconsidered if swimming regularly causes severe pain in the joint that is actively used during this style.

This is particularly true in two situations: recurring shoulder pain with high stroke counts and pain on the inside of the knee during breaststroke. Sports literature has well documented overuse injuries to these areas in swimmers. [50]

After surgery, you cannot swim with an unhealed wound. [51]

If a person has severe cardiovascular or respiratory disease, their individual tolerance to diving and aerobic exercise should also be considered when choosing a training program. In such cases, the issue extends beyond the condition of a single joint.

When pain after swimming requires evaluation

A one-time, moderate muscle soreness after an unusual workout does not necessarily indicate injury.

A scheduled consultation is especially wise if:

• pain reproducibly appears with the same movement;
• the joint regularly swells after the pool;
• the range of motion gradually decreases;
• pain interferes with normal walking or sleep;
• instability, blocking, or a feeling of being stuck have occurred;
• I have to constantly cut back on my training because of the symptoms.

After a recent injury or surgery, treatment options depend on the specific injury and should be discussed with an orthopedist or physical therapist.

Sudden severe pain, severe deformity following an injury, inability to bear weight on the limb, or significant acute swelling require more rapid medical evaluation.

How to start swimming if your joints have been hurting for a long time

If a person has been sedentary for a long time, it's better to start with a small, well-tolerated volume rather than with the maximum distance. The World Health Organization recommends that inactive people begin with a small amount of physical activity and gradually increase the duration, frequency, and intensity. [52]

For example, the first goal might not be a kilometer of continuous swimming, but a calm combination of several short sections with walking in the water.

After a few lessons you can evaluate:

• What happens to pain when swimming?
• is the swelling increasing?
• how the joint feels later in the day;
• how he feels the next day;
• Which style is better tolerated?

If tolerance is good, the volume is gradually increased.

This kind of gradualism is much more rational than the rule:

"Since swimming is gentle, I'll swim for an hour straight away."

Do I need to warm up before going to the pool?

Warming up is especially useful for a person who enters the water with pronounced morning or evening stiffness.

A complex program isn't required. A few minutes of gentle walking in the water, gently moving your arms and legs, and gradually increasing the range of motion will allow you to transition from rest to exercise.

With arthritis, the main goal of a warm-up is not to “warm up the cartilage,” but to gradually prepare the muscles and joints for movement and assess current tolerance.

If even a very light warm-up causes acute local pain, trying to “work it out by force” is not a necessary condition for a useful workout.

Which swimming style is best for joints?

There is no universally established best style.

For a particular person, the choice is determined by which joints hurt and what movements provoke symptoms.

With a problematic knee, breaststroke can sometimes be less comfortable due to the specific leg movement. With a problematic shoulder, crawl, backstroke, and butterfly can create a lot of repetitive overhead movement. [53]

Therefore, it is often more rational not to try to find the “medically best style”, but a combination of:

Technically comfortable swimming + exercises in water + targeted strength program.

If the goal is primarily rehabilitation, a consultation with a physical therapist may be more helpful than a maximum speed swimming lesson.

What is often misunderstood

"Swimming is beneficial because in water there is no stress on the joints at all."

No. Buoyancy reduces the load from body weight, but water resistance requires muscle work and creates joint forces. With rapid movements, these can be quite significant. [54]

"The deeper the water, the more therapeutic the exercise."

A greater depth provides greater support for the body, but the optimal depth depends on the task. Walking and weight-bearing training sometimes require a certain amount of load on the legs, so maximum load reduction isn't always the goal.

"Swimming restores cartilage"

There is no evidence for such an effect. Aquatic exercise primarily improves pain and function, and the classic Cochrane review did not include any studies with radiographic assessment of joint recovery. [55]

"With arthrosis, it's best not to put any strain on the joint at all."

Current recommendations state the opposite: individually tailored exercises are the main treatment for osteoarthritis. [56]

"Water is always better than exercising on land."

No. Meta-analyses generally do not find convincing superiority of aquatic exercise over a properly designed land-based program. The advantage of water is primarily its tolerability and the ability to train with a lower body weight load. [57]

"Any swimming is safe for any sore joint."

No. Repeated strokes can put stress on the shoulder, and intense breaststroke can put stress on the knee. [58]

"If you feel a little pain after an exercise, it means the joint is damaged."

Not necessarily. NICE warns that pain may temporarily increase at the start of a treatment program, whereas regular, appropriate exercise reduces pain and improves function in the long term. [59]

Practical choices in different situations

Situation	What role can a swimming pool play?	The main nuance
Osteoarthritis of the knee	a good option for aerobic and functional exercise	If you experience pain from breaststroke, change your style or exercises.
Osteoarthritis of the hip joint	allows you to move with less weight stress	combine with a strength program
Obesity + leg pain	allows you to start activities with better tolerance	Water does not replace general treatment and weight control.
Rheumatoid arthritis	a convenient option for physical activity	does not replace drug-based inflammation control
Shoulder pain	Classic swimming can irritate joints	consider exercises in water without multiple strokes
Old age and fear of falling	supportive environment for training	strength and balance on land are also needed
After endoprosthetics	often suitable during the recovery phase	only after the wound has healed and the surgeon has given permission
Recent injury	sometimes used in rehabilitation	the time frame is determined by the type of damage

Key points from experts

Anne-Kathrin Rausch Osthoff, PhD, is a physiotherapist, researcher, and lecturer at the Institute of Physiotherapy at the Zurich University of Applied Sciences. She is the head of the Physical Activity Research Unit in the Master's program in Physiotherapy. Her official profile confirms her specialization in promoting physical activity and her involvement in updating the guidelines of the European Alliance of Rheumatology Associations. [60] The updated 2026 guidelines, of which she is the first author, consider regular physical activity as part of standard care for people with inflammatory arthritis and osteoarthritis, with the program being tailored to the individual and their capabilities. [61]

Karin Niedermann Schneider, PhD, MPH, is a professor of physical therapy research and director of the Institute of Physical Therapy at the Zurich University of Applied Sciences. Her profile includes physical activity as a key research focus and project leadership for updating the guidelines for physical activity in osteoarthritis and inflammatory arthritis. [62] Current European guidelines do not limit physical activity to a single type of exercise: the principle is to provide sufficient dosage and individual adaptation of the load, rather than to search for a single “best” workout. [63]

Sharon L. Kolasinski, MD, is a clinical professor of medicine and a rheumatologist at Penn Medicine. Her credentials are recognized by her official Penn Medicine profile. [64] She chaired the U.S. Osteoarthritis Guidelines Task Force for the Hand, Knee, and Hip. These guidelines strongly recommend exercise, and for knee and hip osteoarthritis, walking, strength training, neuromuscular exercise, and aquatic exercise are explicitly listed as acceptable options, without establishing the superiority of any one type over the others. [65]

Frequently Asked Questions

Is it possible to swim if you have knee osteoarthritis?

Yes, it's usually possible, and it can reduce pain and improve function. Aquatic exercise is included in current physical activity guidelines for osteoarthritis. [66]

Is it possible to swim if you have hip arthrosis?

Yes. The evidence for aquatic exercise covers both knee and hip osteoarthritis, although the expected effect is generally modest and mainly concerns pain and function.[67]

What is better for your knees: swimming or cycling?

Both options may be beneficial. In a small randomized trial in people with osteoarthritis, swimming and cycling produced comparable improvements in pain, stiffness, and function. [68]

What style is best for sore knees?

There is no proven universal best stroke. If breaststroke causes pain on the inside of the knee, it is better to choose a different stroke, as breaststroke is most notorious for causing knee strain in swimmers. [69]

Is breaststroke good for knee arthrosis?

It may be tolerated normally, but it is neither necessary nor preferred. If the characteristic kicking motion increases pain, it is not recommended to continue despite the pain.

How to swim if your shoulders hurt?

Classic lap swimming can itself place significant repetitive stress on the shoulders. In this situation, walking, water aerobics, or individually adjusted technique may be more appropriate. [70]

How many times a week should you swim?

There is no specific universal norm for joints. For general health, the World Health Organization's guideline is 150-300 minutes of moderate aerobic activity per week plus strength training at least twice a week, but all of this activity does not have to be swimming. [71]

Is it possible to swim every day?

If the activity is well tolerated and doesn't cause persistent joint pain or shoulder strain, daily swimming itself is not prohibited. However, the intensity and volume should be appropriate to your fitness level, and it's best to increase them gradually.

Should you swim through pain?

Some discomfort is normal at the beginning of the program, but severe or increasing joint pain should not be ignored. Regularly painful exercise requires modification of technique, intensity, or type of exercise. [72]

Can swimming stop osteoarthritis?

There is no evidence that swimming reverses structural disease or restores lost cartilage. Its proven role is to improve symptoms, physical function, and activity maintenance. [73]

Is it possible to swim if you have rheumatoid arthritis?

Generally, yes: regular physical activity is also recommended for people with inflammatory arthritis. However, aquatic exercise is a complement to, not a replacement for, antirheumatic treatment. [74]

Can you swim after knee replacement?

Typically, this is possible after the appropriate stage of recovery, but not until the surgical wound has completely healed. The surgical team determines the specific timeframe; in many programs, the pool is returned after approximately six weeks. [75]

Can I swim after hip replacement surgery?

Yes, swimming is generally considered an acceptable low-impact activity after the wound has healed. It's best to consult your surgeon about the return time and acceptable strokes, as recommendations for early breaststroke vary. [76]

Is water aerobics more beneficial than regular swimming?

There's insufficient data to declare it superior overall. Its advantage is that the exercises are easier to target specific muscles, balance, and range of motion, whereas swimming is primarily an aerobic activity.

Main

Swimming can actually be beneficial for joints, especially if pain or excess body weight makes dryland exercise difficult. The buoyancy of the water reduces the load from body weight, and the water resistance allows muscles to work. For knee and hip osteoarthritis, aquatic exercise can reduce pain and stiffness and improve function. [77]

Swimming, however, does not possess a unique ability to "restore cartilage" and has not been proven to be more effective than properly selected exercises on land. Its main advantage is its portability: it is sometimes significantly easier for a person to complete a full workout in water. [78]

Another fundamental limitation: it's not the water itself that's beneficial, regardless of technique or volume. Breaststroke can irritate the knee, repeated strokes can strain the shoulders, and rapid movement in the water creates significant resistance. Therefore, the most successful program is one that allows for regular movement without a persistent worsening of symptoms and, if necessary, is combined with targeted strength and functional exercises. [79]