Frozen shoulder (adhesive capsulitis) is a painful condition that severely limits shoulder joint range of motion. The primary concern is finding safe and effective ways to restore mobility without causing further injury. Swimming is often recommended for joint issues, but the mechanics of swimming may pose a risk to the recovering shoulder. The answer depends entirely on the specific phase of the condition and the type of movement performed.
Understanding Frozen Shoulder
Frozen shoulder is characterized by inflammation and thickening of the shoulder capsule, the connective tissue surrounding the glenohumeral joint. This thickening forms adhesions, causing the capsule to contract and restrict both active and passive arm movement. The condition progresses through three phases: freezing, frozen, and thawing. The initial “freezing” phase involves increasing pain and gradual loss of motion over several months. The “frozen” phase features persistent stiffness, while the “thawing” phase involves a slow, spontaneous return of mobility.
The Role of Water Therapy in Joint Recovery
The physical properties of water create an environment suited for gentle joint mobilization and rehabilitation. Buoyancy provides an upward force that counteracts gravity, significantly reducing the load and pressure on joints like the shoulder. This reduced pressure allows individuals to perform exercises and achieve a range of motion that would be difficult on land. Water’s hydrostatic pressure, exerted by the fluid, helps reduce swelling and improve circulation in the affected limb. Additionally, the warmth of a heated pool, commonly used for hydrotherapy, helps relax tight muscles and soothe sore joints, contributing to pain relief and increased flexibility.
Safe Movement and Recommended Strokes
General Movement
In the later “thawing” phase, when pain has subsided, controlled water movements can help regain lost range of motion. The goal of exercise should be to encourage gentle, pain-free movement, utilizing the water’s resistance. Simple pool walking with a gentle arm swing is an effective way to introduce motion without overstressing the joint. Any movement should be performed slowly, stopping immediately if any sharp or increasing pain is felt.
Specific Water Exercises
Passive range-of-motion exercises, such as pendulum swings or using a flotation device to allow the arm to drift gently, utilize buoyancy to assist movement. When considering strokes, a modified dog paddle is often the safest option because it avoids the rotation and overhead reaching required by others. This modified movement involves keeping the elbow bent and the hand near the body, limiting the movement to a comfortable, pain-free arc. Using a kickboard for stabilization while focusing solely on kicking is another recommended activity, allowing for a cardiovascular workout without engaging the shoulder joint.
Movements to Avoid During Rehabilitation
Traditional swimming strokes must be avoided, especially during the painful “freezing” and “frozen” phases, as they demand a range of motion the affected joint cannot provide. The freestyle, backstroke, and butterfly require significant overhead reaching and rotation of the shoulder. These repetitive motions can easily aggravate the inflamed joint capsule, potentially worsening the condition. Even the breaststroke can be problematic due to the forward extension and inward pull required. Any activity that forces the shoulder beyond its current pain-free limit should be temporarily eliminated.