Aquatic Exercises for Amputees: Build Strength With Less Joint Stress

Written by Bryan Potok on August 14, 2026
Last updated on August 14, 2026

Reading Time: 7 minutes

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Summary:

Five low-impact pool exercises adapted for amputees of varied amputation levels.
Research found below-knee amputees up to 17 times more likely to develop knee osteoarthritis in the sound limb than non-amputees.
Another study found roughly 30% of upper-limb amputees report shoulder pain tied to compensatory sound-arm reliance.
Retired prostheses can be repurposed for pool use, but prosthetist sign-off is recommended.

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Are you looking for a sustainable workout that doesn’t put stress on your joints? Consider aquatic exercises. Water offers some resistance, which allows you to strengthen your muscles without equipment. This makes them ideal for people with limb loss of any level, whether you’re dealing with joint or shoulder pain, rebuilding strength after a prosthetic fitting, or simply wanting a low-impact workout that’s kinder to your body compared to land-based training.

Bilateral above-knee amputee preparing for aquatic exercise at an indoor swimming pool.

The Sound Side Can Benefit from Water-Based Exercises

Limb loss tends to shift extra work onto the sound side. For lower-limb amputees, that means the sound-side leg absorbs more weight-bearing and balance demand. Multiple studies indicate that individuals who have a single-leg amputation face a higher risk of developing osteoarthritis in the sound-side knee.

One frequently cited study found that below-knee amputees are roughly 17 times more likely to develop knee osteoarthritis in their sound limb than age-matched people without amputation.

For upper-limb amputees, the overuse pattern shows up differently: in the shoulders and neck. Individuals with upper-limb loss might face an increased risk of shoulder pain because they often rely on compensatory movements to use their prostheses and depend more heavily on their intact arm for daily activities.

A national study found that shoulder pain affected about 30% of participants, split between the residual limb side, the sound side, and both. It was more common among people using body-powered prostheses than externally powered ones. So, for people with limb loss, water-based exercise is one of the few ways to build strength in an overworked limb, sound-side or residual, without adding to the load it’s already carrying on land.

Getting Started

Most amputees exercise in the pool without their everyday prosthesis, since standard sockets, myoelectric components, and body-powered hardware generally aren’t built for water or chlorine exposure. But some readers have told us they keep an older or retired prosthesis around specifically to wear in the pool. If you’re considering that, check with your prosthetist first. This is because components and finishes vary in how well they tolerate repeated water exposure, which may affect how you move in the water.

Whether you decide to wear a prosthesis or not, look for a pool with rails, a lift, or zero-depth entry to make getting in and out easier. Also, bring water shoes for traction on the pool floor if you’re weight-bearing on a foot.

Water Walking

Start in waist-high water. Walk across the pool swinging your arms as you would on land, keeping your back straight and your abdominal muscles engaged so you don’t lean too far forward or to one side. If you’re walking without a prosthetic leg, use the pool wall or a rail for support rather than trying to balance unassisted, especially early on.

To work out your arms and shoulders, you can use hand webs—webbed gloves or a paddle that adds resistance as your arms move through the water. If you’re missing a hand or forearm, a single hand web on the sound side still adds resistance to that arm’s motion. Ask your physical therapist about strap or cuff options if you want added resistance on the residual side too.

And don’t forget to use water shoes to help keep your footing steady on the pool floor.

Deep-Water Walking

Once waist-high water feels manageable, move into deeper water and walk while swinging your arms, keeping the same straight-backed, engaged-core posture. Positioning a water noodle between your legs, with the back end angled higher than the front, helps you stay upright.

If you don’t swim, wear a flotation vest or float belt in deep water. Hand webs add resistance here, too. Once this feels comfortable, you can try jogging in deep water to further raise the intensity.

Arm Strengthening With Hand Webs

Hand webs build strength in the biceps and triceps. This matters for anyone who leans on their arms for transfers, crutches, or getting in and out of the pool. Arm strength also matters for upper-limb amputees for whatever compensatory work the sound arm is already doing daily.

Stand in waist-high water with your arms down, palms facing forward, elbows close to your body.
Raise your forearms to the waterline, then reverse direction and push your hands back down until your arms are straight.
Repeat 12 to 15 times per side, or until fatigued.

For a residual limb, this may need a strap-based variation instead of a gripped hand web. But it’s best to ask your PT first.

Arm Strengthening With Water Weights

Water weights—foam barbells that add resistance underwater—work the same muscles with a bit more load.

Grip the bars with palms facing up, raise your forearms to the waterline with elbows tucked in.
Then flip your palms to face the pool floor and push back down to a straight-arm position.
Repeat 12 to 15 times or until tired.

Like the hand web exercise, this is grip-dependent, so a residual limb variation would need PT input on adapted attachment.

Kickboard Resistance Exercise

Stand with your legs comfortably apart and your core engaged. Extend one arm and hold a kickboard at each end.
Keeping your other elbow close to your body, pull the kickboard toward your center, then return to start.
Repeat 12 to 15 times, then switch arms.

If you’re doing this unilaterally on your sound arm, that’s a valid single-side version of the exercise. You don’t need to force a two-arm hold to get the resistance benefit.

Leg Strengthening With a Noodle

Tie a water noodle in a knot around your foot or water shoe.
Standing with your back to the pool wall for support, straighten the working leg in front of you, then bend the knee to about 90 degrees. Repeat 12 to 15 times, then switch sides if applicable.

For a residual lower limb without a foot to anchor the noodle, ask a PT familiar with amputee rehab about noodle placement above the residuum or other resistance variations.

The Bottom Line

Aquatic exercise can work at any fitness and amputation level, on your own or in a class. If you’re newer to the amputee life or haven’t tried structured pool exercise before, loop in your PT or prosthetist before starting, given how much extra load your sound side may already be carrying.

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