If you live with knee, hip or spinal joint pain, you’ve likely asked yourself this question:

Should I exercise on land… or in water?

For many people with osteoarthritis, post-surgical joints, rheumatoid arthritis, fibromyalgia or age-related stiffness, exercise feels confusing — even risky. You may worry that moving more will make things worse.

The truth?
The right type of exercise is one of the most powerful treatments for joint pain.

At Mercy Physio, we offer both land-based physiotherapy and warm-water hydrotherapy programmes, so you don’t have to choose blindly. Let’s break down the differences, the science, and how to decide what’s right for you.

Why exercise matters when you have joint pain

One of the biggest myths about arthritis and joint pain is that you should “rest it.”

While short-term rest can calm a flare, long-term avoidance leads to:

  • Muscle weakness
  • Joint stiffness
  • Reduced balance
  • Loss of confidence
  • Increased pain sensitivity

Appropriate exercise helps by:

  • Strengthening the muscles that support your joints
  • Improving mobility and lubrication within the joint
  • Enhancing circulation and tissue healing
  • Supporting bone density
  • Reducing pain over time

The key isn’t whether you exercise — it’s choosing the right type of exercise for your current pain levels and goals.

Understanding water-based exercise (hydrotherapy and aqua therapy)

Water-based exercise includes:

  • Supervised hydrotherapy sessions with a physiotherapist
  • Structured aqua classes
  • Independent pool-based exercise programmes

Hydrotherapy is typically performed in warm water (around 34°C), which is significantly warmer than a standard swimming pool. This warmth plays an important therapeutic role.

At Mercy Physio, our hydrotherapy and aqua programmes are specifically designed for people with joint pain, stiffness, post-operative recovery needs, and chronic pain conditions — not just general fitness.

The science behind hydrotherapy: Why water helps joint pain

When we talk about hydrotherapy benefits for joint pain, we’re referring to four key physiological effects of water.

1. Buoyancy reduces weight-bearing stress

Water supports your body weight.

Depending on water depth, buoyancy can reduce joint loading by up to 50–90%. That means:

  • Less pressure through painful knees and hips
  • Easier walking and squatting movements
  • Greater confidence moving without fear

Many people who struggle to walk comfortably on land find they can move freely in water.

2. Resistance strengthens without impact

Water provides gentle, multidirectional resistance.

Unlike lifting heavy weights, resistance in water:

  • Is evenly distributed
  • Has no impact loading
  • Can be adjusted simply by changing speed

This allows you to build strength safely — without aggravating sensitive joints.

3. Warmth relaxes muscles and improves circulation

Warm water increases blood flow to muscles and joints.

This can:

  • Reduce stiffness
  • Decrease muscle guarding
  • Improve range of motion
  • Provide natural pain relief

For people with morning stiffness or chronic inflammatory conditions, the warmth alone can feel transformative.

4. Hydrostatic pressure reduces swelling

Water exerts gentle, even pressure around your body.

This hydrostatic pressure can:

  • Support venous return
  • Reduce mild swelling
  • Improve circulation
  • Decrease joint oedema

This makes hydrotherapy particularly useful after joint replacement or arthroscopic surgery.

Curious whether hydrotherapy could help your joints?
You can explore our hydrotherapy options here:
👉 Learn more about hydrotherapy sessions at Mercy Physio

Or book an Initial Consult with one of our expert musculoskeletal physiotherapists HERE.

Benefits of land-based exercise for joint pain

Water isn’t the only answer — and it’s important to say that clearly.

Land-based exercise also plays a crucial role in joint health.

Functional movements

Land exercise mimics real-life tasks:

  • Sit-to-stand
  • Stair climbing
  • Lifting
  • Carrying

These movements build strength that directly transfers to daily life.

Bone density support

Weight-bearing exercise is essential for maintaining bone density — particularly important for post-menopausal women and older adults at risk of osteoporosis.

Water reduces load (which is great for pain) — but some weight-bearing stress is necessary for bone strength.

Balance and coordination

While water supports you, land challenges your balance systems more directly — helping reduce fall risk.

Accessibility and variety

Land-based exercise:

  • Requires no pool access
  • Offers more equipment options
  • Can be progressed in load more easily

For some people, convenience and preference are important factors.

Comparing effectiveness: What does the research say?

Research consistently shows that both water-based and land-based exercise reduce pain and improve function in people with osteoarthritis and chronic joint conditions.

Key findings from clinical studies include:

  • Water-based exercise is often better tolerated in those with moderate to severe pain
  • Land-based strength training improves long-term functional capacity
  • Both approaches reduce pain and stiffness
  • A combination approach often produces the best outcomes

There isn’t a single “best” option — there’s a best option for you, right now.

Which exercise type is right for you?

Water-based exercise may be ideal if you:

  • Have moderate to severe joint pain limiting land exercise
  • Are recovering from joint replacement or surgery
  • Have multiple painful joints
  • Struggle with balance or fear of falling
  • Want to move but find land exercise too painful

Land-based exercise may be ideal if you:

  • Have mild to moderate pain manageable during activity
  • Need functional strength for daily tasks
  • Are training for specific activity goals
  • Prefer not to use pool facilities
  • Are focused on improving bone density

The combined approach: Best of both worlds

In reality, many of our most successful joint pain programmes use both.

For example:

  • Start with hydrotherapy to reduce pain and restore movement
  • Progress to land-based strengthening as symptoms improve
  • Use water sessions during flare-ups
  • Maintain strength on land long-term

Some people even prefer seasonal variation — hydrotherapy in winter for stiffness, outdoor walking in summer.

Exercise is not all-or-nothing. It evolves as your body improves.

Mercy Physio’s hydrotherapy and aqua programmes

What makes Mercy Physio different is that we offer both options under one roof — allowing seamless progression between water and land-based treatment.

Our services include:

  • Warm water hydrotherapy pool on-site
  • One-on-one supervised hydrotherapy with a physiotherapist
  • Group classes – Osteo Aqua Class
  • Independent hydrotherapy access for maintenance
  • Combined land and water-based physiotherapy plans

Our Osteo Aqua Class is specifically designed for people with osteoarthritis and joint stiffness.

👉 Explore our Osteo Aqua classes
👉 Book a joint pain physiotherapy assessment to find the right exercise plan for you

Getting started: What to expect

When you begin at Mercy Physio, we don’t simply put you into a class.

We start with an assessment that looks at:

  • Your pain levels
  • Your mobility and strength
  • Your medical history
  • Your goals and preferences
  • Your confidence with movement

From there, we design a gradual, monitored programme that progresses as you improve.

You’ll also receive education on:

  • Managing flare-ups
  • Pacing activity
  • Safe progression
  • Long-term joint care

Our aim is not just short-term relief — but sustainable joint health.

Move better with the right exercise for your joints

Both water-based and land-based exercise have strong evidence behind them.

Both can reduce pain.
Both can improve mobility.
Both can strengthen your joints.

The difference lies in:

  • Your current pain level
  • Your stage of recovery
  • Your goals
  • Your confidence

You don’t have to figure it out alone.

At Mercy Physio, we help you choose the right starting point — and evolve your programme as your body improves.

If you’ve been avoiding exercise because it hurts, hydrotherapy may be the safe and supported entry point you need.

If you’re ready to build functional strength, we can guide your land-based progression too.

👉 Book a joint pain assessment today
👉 Try a hydrotherapy session at Mercy Physio
👉 Osteo Aqua classes

Call our friendly team on (08) 9271 9422 to find out more.

Your joints were designed to move — sometimes they just need the right environment to begin again.