Aquatic Exercise and Cancer


Aquatic Exercise and Cancer

Aquatic exercise offers a ton of physical and psychological benefits for cancer survivors – and it’s fun!

Dale Ischia, CSEP, Accredited Exercise Physiologist, specializes in exercise rehabilitation for cancer survivors, including patients at InspireHealth and Back on Track Fitness. InspireHealth is a nonprofit integrative cancer care organization helping Canadians since 1997; it’s partially funded by the BC Ministry of Health.

Summer is full on, and the sunshine and long evenings are truly amazing. You may have already enjoyed a swim or looked longingly at a sparkling, outdoor pool and wondered if swimming is really the right exercise for you. But swimming laps is not the only thing you can do in a pool.

Aquatic exercise includes a broad range of activities and exercise that can be done in water, such as

  • walking
  • deep water running
  • jumping
  • squatting
  • stretching
  • pushing floats and paddles around for increased resistance
  • cycling while lying on a noodle
  • stomping on a noodle
  • attaching a float to your ankle and performing standing stability exercises
  • breast stroke
  • back stroke
  • kicking with flippers, and so on. The list is endless!

In addition to being lots of fun and providing you with much needed vitamin D if you are in an outdoor pool, aquatic exercise can provide many benefits.

Joint and muscle benefits

If joint aches and pains are limiting your ability to exercise on land, the water is an excellent medium to try instead. The resistance provided by water allows you to work as hard or as gently as you want. The buoyancy reduces impact on the joints and may reduce or eliminate joint pain while you are exercising in the water. That experience can possibly break the pain cycle. In addition, the exercises will improve joint range of movement and increase the strength of the surrounding muscles.

Strength, flexibility, and cardiovascular benefits

Swimming and other aquatic exercises use many large muscle groups throughout the body while also working out the cardiovascular system. Health benefits of cardiovascular exercise include

  • weight reduction/control
  • reduced blood pressure
  • increased good (HDL) cholesterol
  • reduced bad (LDL) cholesterol
  • a reduction in cancer-related fatigue
  • improved circulation of oxygen around your body, and
  • improved blood sugar control.

Using floats, flippers, buoys, paddles, and kickboards in a variety of ways can create an entire body workout. You can use floats to assist a stretch or to push down on the water to increase resistance.

When using paddles, the slower you move them through the water, the easier the resistance. The faster you move them, the harder the resistance.

Psychological benefits

Many people find they achieve a psychological boost from swimming and aquatic exercise. With your head in the water, you are alone with your thoughts or even no thoughts. The repetitive movement and sound can be meditative. Combined with the endorphins released from this full body workout, the end result can be energizing and satisfying. A sense of accomplishment can contribute to positive feelings that last far beyond the time you spend in the water.

Help with cancer-related fatigue

A randomized control trial conducted in Spain in 2013 investigated the effectiveness of aquatic exercises on breast cancer survivors. After performing aquatic exercises three times a week for eight weeks, the participants showed significant improvements in strength and reduced cancer-related fatigue.

A reduction in breast symptoms

Another trial conducted in Spain in 2013 compared water-based exercise and land-based exercise with usual cancer care. Researchers found that land-based exercise produced a greater decrease in body fat and an increase in lean muscle mass, whereas the water-based exercise was better for reducing the breast symptoms often experienced by cancer survivors: pain, swelling, sensitivity, and skin problems.


There are a few issues to consider when it comes to aquatic exercise and cancer.


The chlorine used by many public pools irritates the skin during chemotherapy and radiation treatments due to the skin’s increased sensitivity. If you have no residual sensitivity, this may not be an issue for you. More and more pools are using different cleaning systems such as salt and ozone, which is much less irritating to the skin. This is not a concern if you are exercising in a lake or an ocean.


Cancer treatment can reduce your body’s ability to fight infection by compromising the immune system. There is an increased risk of infection in water. This is especially true in public swimming pools. In a private pool the risk is reduced, provided the pool is kept clean and chemicals are regulated well.

Water temperature

The temperature of the pool also needs to be considered. If the pool is kept too warm (over 31 C) and you are swimming laps, deep water running, or performing other vigorous activity, you may experience more fatigue. As an alternative in a warmer pool, try some gentle stretches and relaxation, but keep the vigorous activity to a minimum to avoid temperature-induced fatigue. For swimming laps, the ideal temperature is between 27 to 29 C.

Cardiovascular stress

Another consideration is your heart. When you are submerged in water your blood pressure increases due to the pressure on your body (hydrostatic pressure). The temperature of the water also affects your blood pressure. If the water is cold, your blood vessels constrict and your blood pressure goes up. If the water is hot, your heart rate will increase initially, then after a few minutes the blood vessels dilate and lower the blood pressure.

Heart conditions can be a side effect of cancer treatment, thus it is advisable to get a medical clearance from your treating medical practitioner prior to commencing an exercise program.

Aquatic exercise is great to use in conjunction with land-based exercise. It can offer a great all-round workout while giving the weight-bearing joints some recovery time. Summer is the perfect time to hit the pool, ocean, or lake and try some aquatic exercise!


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