When it comes to women’s midlife health, movement is medicine, but for those living with arthritis, hip and knee issues, or chronic joint pain, exercise can often feel out of reach. Dr Anne H. Light has dedicated her career to breaking down those barriers. A Harvard-trained physician with decades of experience in both clinical care and system-wide health innovation, Dr Light now serves as Medical Director of AbilityFix, an aquatherapy platform designed to make safe, effective therapy accessible to anyone with an internet connection. In this conversation, Dr Light shares her vision for empowering women in midlife to stay active, protect their joints, and rediscover the strength and vitality that comes from moving with confidence.

You helm AbilityFix, a clinic known for helping movement, function, and recovery. How do you approach exercise prescription differently when working with midlife women grappling with arthritis, hip, or knee pain?

AbilityFix is an application that brings professional aquatherapy instruction to your phone. With dedicated instructional videos for more than 250 exercises, users can create their own playlists to target healing exactly where they need it.

When working with individuals with joint pain and injury, the most important first step is to identify their current limitations and pain points and work around those. Within the AbilityFix platform, all exercises have five levels of increasing mobility and challenge so that users with pain or injury limitations can start where they are and build up strength and flexibility within the platform over time.

What are the “red flags” in joint pain that women should pay attention to, signals that something is more serious than normal wear and tear?

As a physician, I would say all joint pain should be evaluated by a medical professional. That could be as simple as mentioning it to your primary care physician at your annual physical, or it might warrant a separate visit. For new, mild aches and pains without an obvious mechanism of injury (such as a fall), you may be able to rest, elevate, and ice the affected area for a few days to see if the pain goes away. If it doesn’t, seek medical attention.

When designing strength or resistance work for someone with joint sensitivity, how do you decide which movements to prioritise, modify, or avoid?

Every single person is different, and their strengths and limitations should determine their exercise regimen. That is why the onboarding process at AbilityFix includes questions about each user’s joint movement, as well as their overall fitness level. Once the program analyses each user’s strengths and challenges, it will assign specific exercises to safely rehabilitate that user. For example, after a recent hip replacement, you might have severe limitations and mobility challenges and start at Ability Level 1 within our HipHipHooray protocol, designed specifically to build function in the hip joint. If you are struggling with minor arthritis of the knee, you may start at Level 4 or 5 of the KneeHab program instead.

Many women in midlife feel stuck between wanting to stay active and fearing that movement will worsen joint pain. What’s your framework for helping them test movement safely without overdoing it?

Joint health is a complex matrix, and different injuries have different physical and biochemical components. Some may require medication or surgery, but all will benefit from improving the local strength and architecture of the joint. Think of the muscles, tendons, and ligaments around your knee as providing a sort of ‘knee brace’ to stabilise and support the joint within.

Aquatherapy is the best way to build this local architecture due to three key properties of water:

• Buoyancy: Water’s buoyancy decreases the downward pressure on your joints by more than 50%, easing the stress on older or achy joints and decreasing the risk of a fall. These properties provide a safe environment to push yourself without fear of injury or overuse, leading to maximum benefit over time with fewer setbacks.
• Hydrostatic pressure: The pressure that water exerts on your legs and arms works wonders for your vascular system. At five feet down, your lower legs will experience a pressure of 2.7 psi—four times more than prescription-strength recovery tights or massagers, and all without the risk of chafing or sores if the fit isn’t right. Why does this compression matter? Supporting sagging veins allows your body to bring nutrients and growth factors to your tissues more easily while also getting rid of toxins and metabolic by-products. Think of it as borrowing a Gen Z circulatory system during your workout, without the Halloween overtones.
• Resistance: Water supports you where you are weak, but it also resists fast and hard motions. That means you can work your muscles more effectively, building more strength and flexibility than a similar routine would on land.

What role do mobility, neuromuscular activation, and joint preparatory work (warm-ups, soft tissue, etc.) play in your protocols before heavier loading?

In aquatherapy, warm-up exercises get blood flowing and slowly ease into range-of-motion exercises, gently initiating neuronal and muscular activity. Because the therapy is in water, it provides vascular support and improves circulation before the workout begins. After the main workout, targeted stretching helps ease muscles and gradually cool them down. During the session itself, muscular load is determined largely by the user, with more forceful movements creating more load, while slower movements will require less.

For women who can’t tolerate traditional squats or lunges because of knee, hip, or back discomfort, what go-to modifications or alternative movements do you find most reliable and effective?

I don’t recommend land squats or lunges for most women with joint discomfort; the risk versus reward is just not there. As for aquatic modifications, it all depends on the user and needs to be tailored according to their limitations and injury, hence the onboarding quiz we utilise before choosing the right exercise for each user. In addition, many users will find themselves improving over time, so regularly revisiting their capabilities and adjusting within the app will allow them to tailor their exercises over time.

Consistency is one of the biggest struggles, especially when flare-ups happen. How do you coach women to stay on track while honouring necessary rest and recovery?

Not overloading the joints and providing good circulation during exercise is key to avoiding injury while building muscular strength. As for frequency, I recommend that anyone start a new program slowly, aquatherapy included. While the eventual goal may be three times per week, you may want to start with once per week and work up slowly over the course of a month.

In your experience, how much joint resilience can be regained in midlife? Do you believe women can meaningfully improve mobility, reduce pain, and protect joints long-term, and what examples have you seen?

Absolutely! One of the coolest statistics in biology is that you make one billion new cells every hour. One billion! And they selectively settle down and multiply wherever you use them. So if you spend that hour doing an aquatherapy workout, most of the weight will go to the joint that you are exercising. Over time, these cells will help build new and healthier joints that work better both in and out of the pool.

In studies, 93% of people doing aquatherapy routines had reduced knee pain at eight weeks, compared to just 33% doing comparable land-based physical therapy. In addition, aquatherapy participants saw twice the improvement on walking, quality of life, and mental health scales.

So why isn’t aquatherapy more widespread? The cost of building and maintaining a pool can be prohibitive for many physical therapy centres, making in-person aquatic therapy hard to find. That’s why we created AbilityFix: to enable everyone to benefit from the exercises proven to give the best results, with the least amount of risk.

For a midlife woman reading this and saying, “I can’t even walk without pain,” what is one gentle movement or mindset shift she could begin today that would help rebuild trust in her body?

First of all, show yourself grace. Talk to your physician for ways to improve your pain, and remember that big improvements can come slowly, day by day.

When you can, get into water. Water’s buoyancy decreases the load on your leg joints by more than half, often making water walking much less painful or even pain-free. In that setting, you can build musculature, improve circulation, and decrease swelling, all of which will set you up for less pain on land over time.

If you need to start smaller, that’s okay, too. Just do what you can. As someone who struggled to get out of a wheelchair due to serious arthritis, I know that not every day is a good one. But with the right medical care and the power of aquatic rehabilitation in your pocket, you can get there.

Bonus: How to find a pool for aquatherapy

• A. What to look for: Many people find a zero-entry, chest-height heated pool the most comfortable for aquatic therapy. However, even small spaces like a hot tub can provide the space you need to move around, and cooler pools may be perfectly comfortable for you. If your local pool is too chilly, consider thermal or neoprene swimwear to make yourself more comfortable. Just be sure to check the buoyancy factor so you can stay grounded and not float away.
• B. How to find a pool near you: Reach out to your local city or county council for information on pools open to the public. Check Yelp or Google for local locations with pool access, including schools and gyms that may have open swim times.
• Utilise targeted resources, such as Places 2 Swim, for a comprehensive list of all pools in your area.

DISCLAIMER: All patients should consult their doctor before starting any new exercise program, especially if they have an existing injury or illness.

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Dr Light’s work is a powerful reminder that midlife fitness doesn’t have to mean “pushing through pain.” With the right support, safe approaches, and innovative tools, women cannot only protect their joints but also thrive with strength, balance, and freedom of movement. AbilityFix isn’t just about exercise; it’s about restoring possibility, independence, and hope. I hope this conversation leaves you inspired to explore new ways of caring for your body, and reassured that even with challenges, movement can be both safe and deeply life-giving.

Get 3 months free at Abilityfix.com with code ‘FREE90’

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