Hydrotherapy & Aquatic Equipment for Knee Pain

Overview of Knee Pain

Frequent knee pain affects approximately 25% of adults, limits function and mobility, and impairs quality of life.   According to Knee Pain Australia, knee pain is the second most cause of musculoskeletal pain complaints in Australia, with a significant number of people having suffered from knee pain at some point in their lives.

Knees are the joints that allow free movement of your legs, and these joints enable you to walk, run, sit and bend down. However, they are also the joints that bear the most pressure when performing land-based activities. They are also the shock absorbers that help your body absorb pressure and impact when performing many activities.

Knee pain is a widespread pain complaint and is often categorised as pain that displays from the lower part of the thigh to the upper part of the shin. People who suffer from knee pain can feel the pain either in the anterior or posterior of the knee or indeed on the inner or the outer of the knee.  There are, of course, people who will feel the pain that radiates all over the knee area in all of the positions mentioned here.

The pain that is felt in the knee can range from:

• A small niggle

• Nerve pain

• A dull ache

• A cramping sensation

• Burning pain

• A pulling pain

• Pain that severely restricts movement.

There is sometimes no reason why someone suffers from knee pain, which can be infinitely frustrating if there is no explanation for the pain experienced. However, there can be many mechanisms of injury that can influence knee pain, such as:

• Age-related degeneration

• Direct damage to the affected area

• A muscle strain or unusual movement

• Constant repetitive bending/squatting

• Immobile

• Overweight

These are just a selection of the physical aspects that can be potential influences of knee pain. There can, of course, be other factors, such as Arthritic conditions such as osteoarthritis, knee surgeries, and disease.

What is Knee Pain?

Knee pain is a prevalent pain complaint and is often categorised as pain that displays from the lower part of the thigh to the upper part of the shin. People who suffer from knee pain can feel the pain either in the anterior or posterior of the knee or indeed on the inner or the outer of the knee.

Knee pain can range widely in severity from a slight ache or pull that may go away over a short period on their own accord, but more often than not, someone who suffers from knee pain will have more of a long-term issue or find that the knee pain is recurrent.

The pain that is felt in the knee can affect many other aspects of daily life, including:

• Walking

• Sitting

• Standing

• Driving

• Sleeping

• Concentration

So it is crucial to manage knee pain as effectively as possible to reduce pain and reduce the effect the pain may have on other areas of your life.

Who is more likely to suffer from Knee Pain?

Knee pain does not differentiate between genders and may appear at any time in life, but it is said to be more prevalent in those between 45 and 65 years of age as age takes its toll on load-bearing joints and starts to weaken.

There are specific careers that can cause or indeed exacerbate knee pain, and these can include:

Retail workers- Those who stand up for extended periods can cause or exacerbate knee pain by putting prolonged pressure on the knees

Manual workers- Those who have manual jobs can find that they are more predisposed to knee pain due to the nature of their career, especially those who do a lot of repetitive movements such as bending and twisting. Lifting puts pressure on the knees 1 kg lifted is 4x the impact on the knees.

Those with mobility impairments- Having something that causes someone to be immobile or in the same position for extended periods, such as those who use wheelchairs or in Covid isolation, can actually drive and exacerbate knee pain. The lack of mobility works towards having weak knees, which can cause pain and discomfort. Lack of mobility is normally also associated with weight gain, putting further pressure on the knee joint.

Professional therapists and healthcare workers- Indeed, professional therapists and healthcare workers, such as Physiotherapists, Occupational Therapists, and nurses whose job involves a lot of standing, walking, and leaning movements can affect the knees, causing pain and discomfort.

Regardless of how knee pain occurs, most people who suffer from it will say that it reduces their quality of life by restricting certain areas of life or movement, either through the feeling of discomfort or physically being restricted from the pain.

Symptoms of Knee Pain

Knee pain is often diagnosed through a person's account of how the knee pain feels to them.

While diagnosis can be difficult and takes on many considerations and several factors, such as:

• Severity of pain

• Mechanism of pain

• Any direct injuries

• Any infection markers (such as inflammation or bursitis)

• Age

• Career

It is recommended to see an orthopedic expert to ascertain the cause and severity of the underlying problem behind the knee pain. 

Many people suffering from Knee Pain say that they have at least some, if not all, of these symptoms:

• Deep, achy joint pain

• Muscle spasms

• Reduced range of motion

• Stiffness during rest periods

• Tenderness in the knee area

• Loss of flexibility

• Grating sensation

• Nerve or shooting pains

• Swelling

• Inability to "get going" straight away

Risk Factors

Risk factors for Lower back pain include:

• Age  

• Overweight 

• Direct trauma  

• Indirect trauma to surrounding areas

• Reduced levels of mobility

• Muscle weakness  

• Repetitive body movements 

• Infection  

• Muscle and tendon damage or atrophy

• Previous knee pain

• Underlying deformities of the knee

• Bone disorders 

• Surgical interventions such as knee replacements and surgeries

Water Therapy & Knee pain

Those people who have knee joint pain may find that traditional exercise is too painful and puts too much exertion on their knees. Pain may cause a person to shy away from activity or avoid it altogether due to the amount of pain and discomfort it brings with it. This adds to weight gain putting even more pressure on the knees and the situation can escalate quickly.

Gravity inadvertently puts pressure on the knee area during most exercises that include weight-bearing on your feet. The buoyancy of water and the support it gives during exercise may relieve a lot of this pressure simply by providing a different action to gravity, one that supports the body to reduce some of the pressure points and stress areas of the body when in motion. 

Water exercises, particularly aqua cycling, are recommended for those who suffer from knee pain. It is a way of performing activities they could not ordinarily achieve on land without feeling varying degrees of pain and discomfort.

Deep and achy joint pain:This is a common complaint in people who suffer from knee pain.

Water helps provide an ideal environment for patients to exercise due to the buoyant force that acts as a counteraction to the downward pull of gravity, therefore reducing the overall weight placed on the knee joints. 

Previous studies around hydrotherapy have shown that around half of the body's weight is supported when in waist-deep water. In contrast, a massive 90% of a person's weight is supported if the submersion is neck-deep. 

Patients who suffer from knee pain can often not perform traditional land-based exercises due to increased pain created by the impact. 

In a wholly supportive medium such as water, patients can perform similar strengthening or endurance exercises with the benefit of gentle resistance and a reduction in pain on exertion. 

Reduced range of movement:This can be both a cause and a symptom of knee pain.

The water will physically support you and help prevent excess stress on the muscles and the knee joint, which can make exercise easier to achieve without the fear that the pain is too much to bear. 

Hydrotherapy helps increase the ranges of motion that you can achieve while in the water and improves your overall mobility. 

Stiffness:Stiffness during rest, especially if you have been static for an extended period, can occur in the knees.

Many people who suffer daily from knee pain will say they feel stiff when they have been static in the same place for too long.

This is generally reported in the area affected directly and the neighbouring regions such as the legs and lower back. 

Exercising in water is an excellent form of physical therapy as it allows the muscles and stiff joints to relax and release stiffness, therefore potentially easing pain.

Joint pain:The pain of someone who suffers from knee pain may range from a slight ache to a burning or shooting pain. 

The buoyancy that comes as part of working out in water helps support the surrounding muscles while strengthening them for support, making it easier to balance and hold a good posture that otherwise may be too painful to achieve on land. 

Tenderness:When applying light pressure on or around the affected area, your knee joints may feel delicate and tender, especially when attempting land-based exercise. 

The element of the water physically surrounding and supporting you as you exercise physically prevents stress on the affected area and will help you mobilise easier than if you were on land, increasing confidence in your movements.

Loss of flexibility:By carrying out a workout when submerged in water, you will have the ability to improve your flexibility and range of movement because of the pressure and support created when the water is surrounding you.

Swelling:Swelling and inflammation is a symptom of knee pain likely caused by soft tissue inflammation around the joint, which is a natural response the body has to protect the damaged area.

To assist in mild swelling, water therapy can help reduce the swelling by adjusting the temperature of the water. 

For instance, hydrotherapists may introduce cold water to help reduce inflammation, while therapists may also use warm water to aid better circulation.

Tender points:These points are areas of tenderness in the affected areas of the body. Preventing excess stress on these tender points as you move in the water will help you be more confident in moving around and may reduce the pain you feel.

Water Therapy Equipment & Knee Pain

An Aqua Bike is an excellent piece of aquatic equipment that can help alleviate the problematic symptoms of knee pain and enables exercise with minimal pain as it can:  

• Reduce stiffness in the knee joints

• Reduce inflammation

• Reduce joint pain when mobilising

• Relieve tenderness in the joints and muscles in the knee

• Build strength in the support structures of the painful knee, quads, glutes, other knee, hips and ankles

• Improve the range of mobility

• Enable a challenging workout without impact on the knee joint 

• Help to avoid after workout pain

• Provide physical relief for any continual pain

An Aqua Treadmill is also an excellent option for runners to help relieve the symptoms of knee pain and enables running with minimal discomfort as it: 

• Removes impact-related pain

• Improve flexibility and reduce stiffness in the legs

• Reduce overall body fatigue

• Increases muscle function for strength

• Relaxes the tense muscles surrounding the knee

• It soothes tired muscles and tendons and allows more pain-free movement

Note: Please seek medical advice before exercising & always train under the advice your medical specialist.