Water-Based Activities for Heart Health: A Guide for Cardiac Patients

Activity Specific Exercise | My Movement Medicine

Introduction

Swimming is a gentle, full-body exercise that offers exceptional benefits for people with heart conditions. As a low-impact aerobic activity, swimming helps build cardiovascular endurance, improve muscle tone, and enhance psychological wellbeing. With the right precautions and progression, swimming can be a valuable part of cardiac rehabilitation.

The Benefits of Swimming for Heart Health

• Low joint impact: Buoyancy in water reduces strain on joints, making swimming suitable for people with arthritis, joint pain, or reduced mobility.

• Improves aerobic capacity: Continuous movement in the water enhances heart and lung efficiency.

• Strengthens multiple muscle groups: Swimming engages the upper and lower body, improving muscular strength and endurance.

• Reduces stress and anxiety: Water’s calming effect, along with rhythmic breathing, can support mental health.

• Supports flexibility and coordination: Movements in the water encourage full-body mobility.

Research suggests aquatic exercise can reduce blood pressure, lower resting heart rate, and improve circulation in people with cardiovascular disease (Nakamura et al., 2019).

When Can You Start Swimming?

• After a heart attack or stent: Swimming is usually reintroduced during Phase 4 rehabilitation (maintenance phase) and only once wound healing is complete and clearance is given.

• After heart surgery: Avoid swimming until your sternum has fully healed—usually after 12 weeks. Check with your cardiac rehab team.

• With a pacemaker or ICD: Wait at least 6 weeks post-procedure. Shallow water walking or hydrotherapy may be a good first step.

Always seek medical advice before returning to water-based activities.

How to Get Started Safely

1. Begin with water walking or aqua aerobics: These activities offer cardiovascular benefits with less technical demand.

2. Try shallow-end lane swimming: Once confident, gradually increase time and distance.

3. Use swim aids: Float belts, pool noodles, and kickboards can improve confidence and technique.

4. Choose a supervised pool: Swim with a buddy or in a lifeguarded environment.

   
   
   
   

Additional Safety Tips:

• Avoid cold water, especially open water, as it can increase cardiovascular strain.

• Take prescribed medications beforehand.

• Don’t swim if feeling unwell, overly tired, or if you've recently eaten a large meal.

• Be aware of the pool depth, and avoid holding your breath for long periods (avoid prolonged underwater swimming).

• Use the poolside for support when resting.

Warm-Up and Cool-Down

• Warm-up: 5–10 minutes of light water walking, gentle strokes, or mobility exercises in the water.

• Main phase: 20–30 minutes of steady swimming or aquatic movement at a moderate pace (RPE 4–6/10).

• Cool-down: 5–10 minutes of floating, gentle strokes, and stretching in warm water if available.

Breathing should be steady and controlled—avoid holding your breath or racing through laps.

Safety Considerations

• Stop immediately if you feel dizzy, breathless, or experience chest pain or palpitations. Use GTN spray if prescribed.

  
  

• Use the talk test: You should be able to speak a short sentence without gasping.

  
  

• Avoid cold pools and unsupervised swimming.

  
  

• Consider a medical alert wristband or swimming cap with condition info if swimming unsupervised.

Sample Swimming Plans

Beginner (Weeks 1–4)

• Water walking or gentle swimming for 10–15 minutes, 2–3 times per week

• Use floats and stay in the shallow end

Intermediate (Weeks 5–8)

• Swim continuously for 20–25 minutes, 3–4 times per week

• Alternate strokes to vary intensity

• Practice controlled breathing and rhythm

Advanced (Weeks 9–12)

• 30–40 minutes of lap swimming, 4–5 times per week

• Incorporate drills, light intervals, or aqua aerobics classes

• Use apps like MySwimPro to track progress

Complementary Activities

• Strength training: Water offers resistance, but dryland strength exercises help improve bone density and upper body strength.

• Stretching and yoga: Supports flexibility and recovery after swimming.

• Walking or cycling: Great for cross-training and building aerobic fitness.

Train with My Movement Medicine

At My Movement Medicine, we support people with heart conditions through expert-led, heart-safe exercise programmes. Our online and in-person sessions offer tailored support to help you progress confidently—whether you're just getting started or looking to improve your swimming fitness.

With us, you'll receive:

• Supervision from a Clinical Exercise Physiologist

• Safe progression plans and flexibility for individual needs

• Access to cardio, mobility, and strength classes

• A motivating and understanding community

🔗 Book a free trial today at www.mymovementmedicine.co.uk or email us at mymovementmedicine@gmail.com.

We’ll help you stay afloat—and thrive—with every .

References:

• Nakamura Y, et al. (2019). Effects of Aquatic Exercise on Cardiovascular Health: A Systematic Review. Journal of Cardiology and Therapy.

• British Heart Foundation. (2022). Keeping active with heart disease.

• Association of Chartered Physiotherapists in Cardiovascular Rehabilitation (ACPICR). (2023). Guidance for Water-Based Activities. www.acpicr.com

This blog post was written by Jamie Pickett, Clinical Exercise Physiologist, with AI assistance.