The pool offers a unique and effective environment for shoulder rehabilitation and maintaining shoulder function. The buoyancy, resistance, and hydrostatic pressure of water create a low-impact setting that promotes healing while minimizing strain on the joint. By submerging the shoulder and incorporating specific movement patterns, clients can improve mobility, reduce pain, and strengthen key stabilizing muscles. Here are three overall ideas that may help you.
Submerge the Shoulder Joint
Submerging the shoulder in the water immediately reduces gravitational load, which decreases joint compression and allows for easier, less painful motion. To do this the client can move to deeper water or bend the hips/knees/ankles while maintaining good alignment. The hydrostatic pressure helps reduce swelling and inflammation, improving circulation to the joint. If the shoulder is out of the water, many painful issues can occur from exercise or movement.
Scapular Depression
Many shoulder issues stem from poor scapular positioning. In my workshops, I ask attendees to move their shoulder blades up … just the shoulder blades, not the shoulders. There’s not much movement. Then I ask them to press the shoulder blade (not the shoulders) down, and they’ll feel a lot of movement. It’s because all of us have elevated shoulder blades, which can lead to pain and injury. After submerging the joint, practice scapular depression.
Teaching scapular depression, the intentional downward movement of the shoulder blades, can re-establish correct shoulder mechanics and postural alignment. Reinforcing this movement during exercise re-engages lower trapezius and latissimus dorsi muscles, which are crucial for shoulder stability.
Externally Rotate
External rotation exercises target the rotator cuff, particularly the infraspinatus and teres minor, which are muscles essential for joint stabilization and functional movement. With shoulders submerged (and shoulder blades lightly depressed) and elbows bent at 90 degrees, clients can perform slow outward rotations of the forearms against the natural resistance of the water.
Try this: hold your arms, hands and elbows as if you’re jogging. Now turn your palms up and you will probably feel the shoulders externally rotate. That’s what we need: the external shoulder rotation implemented into regular exercises. Turning your palm up or, if your elbows are extended, turning your palm forward externally rotates the shoulder joint.
Now let’s go back to “With shoulders submerged (and shoulder blades lightly depressed) and elbows bent at 90 degrees, clients can perform slow outward rotations of the forearms against the natural resistance of the water.” and experiment do this with thumbs up and then palms up. We can incorporate this external rotation into a myriad of exercises.
Summary
These are critical not only for restoring function but also for preventing future injury:
* Submerge the shoulder
* Depress the shoulder blades
* Externally rotate the shoulders
Whether recovering from rotator cuff surgery, impingement, or chronic instability, these three concepts offer a multidimensional, effective path toward healing while promoting joint mobility, muscular re-education, and long-term strength.
Written By Ruth Sova
Known as the Queen of Aqua Fitness, Ruth Sova has been a trailblazer in the industry for nearly three decades. She first presented at FitnessFest almost 27 years ago and has been inspiring aqua fitness professionals ever since. Ruth is celebrated for her deep knowledge, generosity, and dedication to helping others succeed. Passionate about sharing her expertise, she provides incredible free resources to the fitness community. As she says of herself, “My name is Ruth Sova, MS – Credentials: Old, so I know a lot!”
