Healing shoulders in the water

Swimming coach Nicola Butler offers her guide to pool-based rehabilitation for your shoulders

Shoulder injuries, especially those involving the rotator cuff, impingement syndromes, or swimmer’s shoulder are common among athletes and active individuals. The repetitive overhead motion in swimming can aggravate these conditions but, paradoxically, the pool can also be one of the best places to heal them. During winter, the body may benefit from warmer environments like an indoor heated pool. This can also help prevent further injuries by allowing the muscles and joints to warm up effectively and work safely under pressure in warmer conditions.

Swimming pools can be powerful allies in shoulder injury recovery. With the right approach, swimming offers a low-impact, high-reward environment to rebuild strength, mobility, and confidence.

Why the pool works for shoulder rehab

• Water provides a unique therapeutic environment due to its buoyancy, resistance, and warmth
• Water resistance offers gentle strengthening without weights
• Buoyancy reduces joint loading, allowing pain-free movement
• Hydrostatic pressure helps reduce swelling and improve circulation
• Warm water promotes muscle relaxation and joint mobility

Aquatic therapy isn’t just for recovery, it’s a proactive tool for long-term shoulder health. Whether you’re a competitive swimmer or a weekend warrior, the pool can be your partner in healing and performance.

Best practices for pool rehab

• Start slowly: Avoid aggressive strokes early on – freestyle and butterfly are especially demanding
• Focus on form: Poor technique can worsen impingement. Emphasise scapular control and core engagement
• Use tools wisely: Kickboards, pull buoys, and paddles can help or hinder – use under guidance
• Monitor pain: Mild discomfort is okay, but sharp or lingering pain signals a need to scale back

Example swimming set

Focus: Activate rotator cuff, build scapular control, endurance and coordination.

Warm up:

• Resistance band external rotations: Anchor band poolside, rotate arm outward keeping elbow tucked – 5 mins alternating
• Sculling drills: Elbows bent at 90°, forearms in water – move hands in figure-eight motions – 5 mins

Main set:

• Water walking with arm swings: Walk forward and backward while swinging arms gently – 5–10 mins
• Push-pull with kickboard: Hold kickboard underwater and push/pull gently to engage shoulder stabilizers – 5 mins
• Modified swim strokes: Use fins or snorkel to reduce shoulder load; focus on technique – 5 mins
• Interval drills: Swim 25m using breaststroke or backstroke (less shoulder strain), rest 20s, repeat x 6-8
• Water treading with shoulder emphasis: Use arms in circular motions to stay afloat – fins optional – 5 mins. Follow up with a sauna or warm shower

Remember, technique matters! Poor form could be the reason for shoulder problems, too. For example, entering the water thumb-first can increase internal rotation and stress on the shoulder. It’s important to try and focus on a neutral hand entry without crossing over the midline during strokes and engaging your core muscles to reduce shoulder load.

Top tip – get sculling!

Sculling increases your sensitivity to the pressure of the water on your palms and forearms. This heightened awareness helps you to instinctively find the best hand position to create propulsion. For example, sculling drills can train muscle memory for the crucial high-elbow position during the catch phase, preventing the elbow from dropping plus a greater propulsive force with each stroke.

Kit corner: kickboards

Kickboards are designed to strengthen legs, improve kicking technique, and help with body alignment. Popular models from brands like Arena, Speedo, TYR and FINIS offer features such as ergonomic shapes, durable foam, and specific designs like the Finis alignment board which promotes better body position. The choice of kickboard depends on specific training goals, but many professional models are built to provide stability and maximise benefits for advanced swimmers. The Finis model ticks all boxes and retails between £20-28 from Amazon or Pro Swimwear.