Indoor SUP for rehab – exercises for shoulders & back

Have you been recommended low-impact training for your shoulder or back injury but feel limited by traditional rehab exercises? Indoor SUP training offers a unique opportunity to combine functional training with the instability that activates deep muscle groups in a safe and controlled manner.

Traditional rehab can often feel monotonous and disconnected from real-world movement patterns. Many patients struggle with motivation when the exercises don't feel relevant to everyday activities. At the same time, fear of aggravating the injury can limit exercise intensity and slow recovery.

With over 18 years of experience in the SUP industry, Kona Sports has developed sup rehab methods that are used by physiotherapists and training experts across the Nordics. Indoor SUP training creates a controlled environment where the natural instability from the paddleboard activates stabilizing muscles without the risk of falling into the water or unpredictable weather conditions.

In this guide, you'll find eight professionally developed SUP exercises specifically designed for shoulder and back rehabilitation. You'll learn progressive exercises that build strength gradually, understand safety aspects of rehab training, and get concrete advice on when and how to integrate indoor SUP into your recovery process. All exercises are adapted for home use and require minimal equipment beyond a SUP board.

Table of contents

• SUP as a professional rehabilitation tool
• Shoulder Rehab Exercises (4 Important)
• Exercises for back problems (4 effective ones)
• Core & stability training
• Progression plan for safe recovery
• Safety during rehabilitation training
• Frequently asked questions about SUP rehab

SUP as a professional rehabilitation tool

SUP as a rehabilitation tool offers unique benefits that cannot be replicated by traditional land-based training or static training equipment. The natural instability from a SUP board activates proprioception and deep stabilizing muscles in a way that mimics real functional movements.

Scientific Benefits of Instability Training: Training on an unstable surface, like a SUP board, activates both primary and secondary muscle groups simultaneously. This creates functional strength that directly transfers to everyday activities like lifting, stretching, and balancing. For people with shoulder or back problems, this type of integrated training is often more effective than isolated exercises.

Controlled Progression: Unlike on-water SUP, indoor SUP training offers complete control over difficulty and environmental factors. You can gradually increase intensity without the risks of waves, wind or temperature. This is especially important during rehabilitation periods when safety and predictability are crucial.

Neuromotor Retraining: Shoulder and back injuries often affect neuromotor patterns and muscle activation. SUP training challenges these systems in a functional way that helps re-establish optimal movement patterns under controlled conditions.

Motivation and engagement: The fun and challenging nature of SUP training often increases patient motivation compared to traditional rehabilitation exercises, leading to better adherence and long-term results in the recovery process.

Low Load, High Activation: SUP exercises allow for muscle activation and functional training without high load on injured structures. This is ideal during the early phases of rehab when tissues are still healing but movement is needed for optimal recovery.

For professional rehab applications offers Indoor SUP solutions are controlled environments designed specifically for training purposes.

Shoulder Rehab Exercises (4 Important)

Shoulder rehabilitation exercises on SUP focus on restoring stability, range of motion, and functional strength to the shoulder complex. These exercises are designed for progressive loading and can be adapted to individual tolerance.

Exercise 1: Standing static arm raise  

Stand firmly on the SUP board with your feet hip-width apart. Slowly lift one arm at a time forward to 90 degrees, hold for 5-10 seconds, lower in a controlled manner. The unstable surface forces the shoulder blades to stabilize while the arm movement is performed. Start with 5 repetitions per arm, gradually increasing to 10-12.

Exercise 2: Wall press against an invisible wall  

Stand on the SUP and imagine you are pushing against a wall in front of you. Press your hands forward as if you were pushing against a wall, holding the tension for 10-15 seconds. This isometric exercise activates the serratus anterior and stabilizes the shoulder blades without stressing damaged structures. Perform 3-5 repetitions with 30 seconds of rest in between.

Exercise 3: Pendulum movement with body weight  

Stand on the SUP and place your hands on your hips. Allow your body to gently swing from side to side while maintaining balance. This creates passive movement in the shoulder joints while activating stabilizing muscles to maintain balance. Continue for 30-60 seconds depending on tolerance. Especially effective for frozen shoulder or after prolonged immobilization.

Exercise 4: Seated rotation with imaginary paddle  

Sit on the SUP board with your legs crossed. Make movements as if you are paddling, focusing on controlled rotation through the core muscles rather than forcing shoulder movement. This trains functional integration between the core and shoulders. Start with 1-2 minutes and gradually increase. Adjust the speed according to your comfort level.

Safety notes for shoulder exercises: Stop immediately if you feel sharp pain. Dull aches or muscle fatigue are acceptable, but sharp pain indicates overstimulation. Always start with smaller movements and shorter holds than you think you can handle.

Exercises for back problems (4 effective ones)

Back rehabilitation exercises on SUP concentrate on spinal stability, mobility improvement and functional strength throughout the entire spinal range of motion. The unstable surface naturally activates deep back muscles.

Exercise 1: All-fours with alternating arm/leg lift  

Get down on your hands and knees on the SUP board. Gently lift the opposite arm and leg at the same time - hold for 5-10 seconds - switch sides. The unstable surface makes this classic exercise significantly more challenging for core stability. Start with 3-5 repetitions per side.

Exercise 2: Seated Spinal Rotation  

Sit cross-legged on the SUP. Slowly rotate your upper body to the right and left as if you are looking over your shoulder. The unstable surface forces your deep spinal rotators to work harder to control the movement. Perform 8-12 movements in each direction at a slow, controlled pace.

Exercise 3: Modified lying bridge  

Lie on your back on the SUP with your knees bent and feet planted. Press your feet down and lift your hips up so that your body forms a straight line from your knees to your shoulders – this is the bridge position. Hold for 10–20 seconds. The unstable surface activates extra stabilizing muscles in your lower back and hips. Start with 3–5 repetitions.

Exercise 4: Cat-cow stretch on unstable surface in all fours position on the SUP, alternating between rounding the back (cat) and doing a slight backbend (cow). The unstable surface means that the movement must be performed slower and more controlled. Perform 6-10 cycles focusing on moving one vertebra at a time.

Core & stability training

Core training on SUP goes much deeper than traditional abdominal training. The unstable surface activates the deep, stabilizing muscles in the core, creating functional strength for everyday activities.

Deep Muscle Activation: SUP training automatically activates the transversus abdominis, multifidus, and pelvic floor muscles to maintain balance. Activation on an unstable surface like a SUP is often more effective than trying to consciously activate these muscles on stable ground.

Functional Integration: Core stability on SUP is developed in conjunction with full-body movements, creating usable strength for activities like lifting, twisting, and stretching in everyday life. This is especially important for people recovering from back injuries.

Progressive overload: You can gradually increase the difficulty by:

• Move from sitting to standing positions
• Adding arm movements during balance challenges
• Increase holding times for static positions
• Combine movements for greater complexity

Progression plan for safe recovery

A structured progression plan is essential for safe and effective recovery with SUP exercises. This plan should be tailored to the individual but follows general principles of rehab progression.

Week 1-2: Adaptation and basic balance

• 10-15 minutes of exercise 3 times per week
• Focus on feeling comfortable on the unstable surface
• Simple static positions: sitting and standing
• No forceful movements or long holding times

Week 3-4: Introducing basic movements

• 15-20 minutes of exercise 3-4 times per week
• Add simple arm movements in a seated position
• Start with short hold times (5-10 seconds)
• Introduce alternating between sitting and standing

Weeks 5-8: Increase complexity and endurance

• 20-30 minutes of exercise 4-5 times per week
• Longer hold times (10-20 seconds)
• Combined movements involving multiple body parts
• Introduction to dynamic exercises at controlled speed

Week 9-12: Functional integration

• 30-45 minutes of exercise 5-6 times per week
• Sport-specific or activity-specific movements
• Longer workouts with varying intensity
• Preparation for return to normal activity level

Signs of development:

• Pain-free movement during and after exercise
• Improved balance and coordination
• Increased muscle endurance
• Confidence in movements

Safety during rehabilitation training

Safety during SUP rehab requires extra attention compared to normal training because you are recovering from injury and training on an unstable surface.

Preparatory safety measures: Always use soft mats around the SUP board to protect in case of a fall. Make sure the training space is free of obstacles and has sufficient ceiling height. Have water and a phone within reach for emergencies.

Physical Warning Signs: Stop immediately if you experience: sharp pain; dizziness or nausea; severe muscle spasm; or loss of balance that feels uncontrollable. The difference between muscle soreness and injury pain is that muscle soreness decreases with rest, while injury pain often worsens.

Environmental factors: Never exercise when you are drunk, very tired or under the influence of medications that affect balance. Wear appropriate clothing that does not restrict movement but also does not risk getting caught. Avoid exercising immediately after meals or when you do not feel in touch with your body.

Medical Monitoring: Maintain regular contact with your physical therapist or doctor if you are using SUP training as part of formal rehabilitation. Document your training sessions and any reactions to report any changes in symptoms or function.

When to restart after a break: After illness or a training break of more than a week, start again from an earlier level in the progression plan. The body quickly loses adaptations to instability training.

Frequently asked questions about SUP rehab

Can I use SUP training for acute back pain?

During acute back pain (first 1-2 weeks), gentle movement is usually recommended rather than complete rest. Start with simple ground-based mobilization exercises first. Once acute pain has subsided (usually after 2-4 weeks), SUP training can be gradually introduced, focusing on very simple exercises in a seated position. Always consult a doctor or physiotherapist in case of acute back pain before starting any new training.

How often should I practice SUP rehab for best results?

For SUP rehab, 3-4 training sessions per week are usually recommended initially, with 10-15 minute sessions. This provides sufficient stimulation for neuromotor training without overloading the healing tissues. After 4-6 weeks, the frequency can be increased to 5-6 times per week if the body tolerates it well. Quality is more important than quantity - better with shorter, controlled sessions than long sessions that lead to fatigue and impaired technique.

What type of SUP board is best for rehab training?

For indoor SUP rehab training, a wide, stable board is optimal. Widths of 32-36 inches provide sufficient stability for safe training while still providing an instability challenge. The length should be 10-11 feet for good stability without being unwieldy indoors. Inflatable boards are often better for rehab because they provide a slightly softer landing in the event of a fall and are easier to store at home.

Do I need special equipment for indoor SUP rehab?

For basic indoor sup rehab, all you need is a suitable SUP board and soft surfaces around the training area for safety. Additional equipment that may be useful includes: yoga mat under the board for extra stability initially, small pillows or bolsters for support during seated exercises, low stool to help with getting on and off if balance is severely affected. Avoid complicated equipment initially - focus on mastering basic balance and movement first.

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Indoor SUP for rehab represents an innovative approach to functional rehabilitation that combines the proven effectiveness of instability training with the motivation and engagement that SUP activities create. By following these eight exercises and safety guidelines, you can use SUP as an effective tool in your recovery process.

As we at Kona Sports always emphasize: "Stand up people. Stand up life." For rehab patients, this means regaining control of their body and movement through safe, progressive training that builds both physical function and confidence. SUP training offers a bridge between rehabilitation and a return to an active lifestyle.

Are you ready to explore how SUP training can support your recovery? Discover our indoor SUP solutions designed for home training and rehab environments, or Contact our training experts for advice on how to safely integrate SUP into your rehabilitation process.