Hydrotherapy Shoulder Exercises – Progression from Mobility to Stability

Hydrotherapy can play an important role in shoulder rehabilitation. Because of the buoyancy of the water, there is less load, allowing for shoulder activity to start earlier than exercises on land. Warm water also allows for increased circulation and can be effective in reducing pain during shoulder rehabilitation.

These hydrotherapy shoulder exercises highlight the progression from mobility to stability for patients with shoulder issues.

Note: people recovering from injury or surgery should consult their health professional before undertaking a physical exercise regime.

Addressing mobility deficits

In the video below, we show hydrotherapy exercises that can help address mobility deficits. We illustrate how changing the movements, the speed of movement, the depth of water, and the presence or absence of the current allow patients to work on movement quality and quantity. By thinking creatively, therapists can manipulate the environment to address patient limitations.

Providing biofeedback

In the video below, we illustrate the unique characteristics of the aquatic environment for providing biofeedback to improve movement quality. By using the patient’s ability to feel the water’s surface during movement, the therapist can address scapulohumeral rhythm. Additionally, the sensory feedback provided by movement in the water can improve the patient’s awareness of movement and direction. The feedback facilitates better fundamental movement mechanics.

Improving eccentric strength and control

Improving eccentric strength and control are key to treating shoulder injuries, including tendonitis and instability. In the video below, the current is used to isolate the eccentric component of various shoulder movements. We illustrate how eccentric shoulder internal rotation or eccentric horizontal adduction can be isolated. The patient can develop smooth control of these movements. Therapists can control the resistance by modifying the speed of the current or by using external devices.

Using resistance current

Because of the uniformity of the current, hydrotherapy shoulder exercises using SwimEx pools offer an extraordinary range of methods for strengthening the shoulder. The patient’s position in the pool can address specific muscle groups, such as the rotator cuff or serratus anterior. Hydrotherapy addresses functional movement patterns with great efficiency. The resistance level can be well controlled by the speed of the current or by selecting different strengthening tools. The patient can be positioned so that the core must also be engaged to produce the desired action. The patient’s position can be further manipulated to change the functional demands of the exercise.

Shoulder stability

In the later stages of shoulder rehabilitation, stability often becomes the focus of treatment. In the video below, we share several examples of the options available to therapists when using SwimEx pools to assist in the training of shoulder stability. The smooth water resistance is a natural way to work on rhythmic stabilization activities. Apply the current to engage dynamic stability of the shoulder during isolated shoulder motions or more functional motions. The ability to view the patient from above as well as below the water level is ideal for identifying compensatory movement patterns and to further focus treatment.

Shoulder injuries are common, and these hydrotherapy shoulder exercises will help produce positive outcomes.

~ Authored by Thomas J Marston, who is a Physical Therapist in Bristol, RI. Thomas graduated with honors from Boston University College of Health and Rehabilitation Sciences in 1994, with a Master’s degree in Physical Therapy. He received his Doctorate of Physical Therapy from SUNY Upstate in 2010. He has more than 29 years of experience, with special focus on the shoulder.

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