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Physio for surfers

Physio for surfers

How to stay wet, barrelled and happy surfing pain-free for as long as possible

If you’re anything like me, you often go to sleep at night dreaming of surfing uncrowded, perfect A-frame waves rolling in. Of the 37 million surfers worldwide who go in search of such perfect waves and uncrowded lines ups each year, 2.5 million of them call Australia home (4). No wonder the line ups are always crowded, but even more crazy, is that the research suggests that a whopping 1 in 3 of these surfers in Australia are likely to sustain an injury while surfing in 2020 (5). That’s a high injury chance!

My name is Jacob and I am a physiotherapist at Burleigh Heads and Broadbeach Physiotherapy, and like a lot of you reading this, love to surf at any chance I can get! In this blog I aim to unpack some of the main causes of surfing injuries and give you some practical advice on how to reduce the risk of sustaining a surfing injury so you can keep doing what you love in 2020 and beyond.

What causes surfing injuries?

Several risk factors for surfing have been identified in the research and these include:

  • Surfing for more than 7 hours per week
  • Competitive and aerialist surfing
  • Age – greater than 39 years old (chronic injury risk)
  • Wave size overhead of greater than 5-6 foot swell
  • Riding a short board, compared to a long board
  • Surfing over hard-bottom/reef, as opposed to over sand (8,9).

Acute surfing injuries

When it comes to acute injuries, approximately 50% of injuries occur from paddling and duck diving and half occur from direct trauma/contact injuries such as striking the water’s surface or stacking it (Taylor, et al, 2014).

Chronic surfing injuries

But when it comes to chronic injuries, 70% are associated with high intensity or prolonged paddling. Interestingly, in his study in 2018, O Neil et al., found that when surfing, 53% of time in the water was spent paddling. We spend more than half of our time surfing on our board paddling, positioning and fighting currents. As such, it makes sense that paddling accounts for such a high proportion of chronic surfing injuries.

So, what’s going wrong with the body to cause injuries while surfing?

A few mechanisms have been proposed by various authors. Poor endurance and fatigue (1), muscle imbalance between shoulder internal and external rotators (2) and poor mobility of the knee, shoulder and back and neck can all contribute to injuries arising from surfing (Blanch, 2004 & Edmonston, et al. 2012). MCL and medial meniscus injuries are very common amongst surfers due to the high level of stress placed upon the inside knee of the back foot while up and riding (6).

“How can I stop myself from sustaining a surfing injury this year?”

While there is no one key that will guarantee you won’t take the next wave on the head, lobster dive over the falls or feel sore after paddling for 5 hours at Kirra on the tail end of a storm swell, there are some things you can do to minimise the risk of getting a surfing injury. And the good news is, these things should all also actually help you surf better and have more fun too.

1) Warm up!

I know what you’re thinking…. “Nah…. I don’t warm up. Who does?” A Dynamic warm up before getting out for your next wave helps to increase your heart rate, gets your blood moving to your surfing muscles and helps prepare you for the surf coming up. I’d almost go as far as to say if you don’t warm up, you’re almost asking for a surfing injury at some point.

2) Understand your body.

Everyone’s body is different. There is no cookie cutter approach and each surfer’s body is unique in it’s needs, strengths and weaknesses. A physiotherapist will be able to assess the physical areas you need to improve to prevent surfing injuries and maximise your surfing performance.

3) Get mobile where you need it!

The vast majority of chronic low-back, and neck issues arise from a lack of mobility – that is, the stiffer we get through our hips, shoulders, neck and back, the harder it is to sustain the paddling posture required for surfing. A good physio, stretching program, regular massage, regular pilates or yoga class will help with this.

4) Get strong and stable in your main surfing muscles and movements.

Most surfing injuries require surfers to strengthen key muscle groups such as their back extensors, deep neck flexors, shoulder and knee stabilisers and core muscles. These muscles require good local muscle endurance to allow for the postures sustained in surfing. But how?

  • Ask your physiotherapist to set you up with a surf-specific gym strengthening program
  • Do a short course of physiotherapist-ran clinical pilates classes
  • Join a local yoga class
  • Get started on some specific home-based surf-specific strengthening exercises

5) Get a surf coach or a mate who’s better than you to check out and critique your paddling and surfing technique.

We often don’t realise what we are doing wrong and this where a second pair of eyes and good coaching can really help improve your surfing technique and thus reduce your injury risk.
So, what next?

If you or someone you know currently has a surf-related injury, consult your local physiotherapist who can help you get back out in the water, doing what you love, pain and injury free. Don’t put up with a niggling neck, back, knee or shoulder, get it sorted so you can go catch that next wave!

We’d love to help – call 5535 5218 to make an appointment.


1. Beach, M. L., Whitney, S. L., & Dickoff-Hoffman, S. (1992). Relationship of shoulder flexibility, strength, and endurance to shoulder pain in competitive swimmers. The Journal of Orthopaedic and Sports Physical Therapy, 16(6), 262. Retrieved from http://www.jospt.org/

2. Clarsen, B., Bahr, R., Andersson, S. H., Munk, R., & Myklebust, G. (2014). Reduced glenohumeral rotation, external rotation weakness and scapular dyskinesis are risk factors for shoulder injuries among elite male handball players: a prospective cohort study. British Journal of Sports Medicine, 48(17), 1327.

3. Edmondston, S., Ferguson, A., Ippersiel, P., Ronningen, L., Sodeland, S., & Barclay, L. (2012). Clinical and radiological investigation of thoracic spine extension motion during bilateral arm elevation. Journal of Orthopaedic & Sports Physical Therapy, 42(10), 861-869. doi:10.2519/jospt.2012.4164

4. Furness, J., Hing, W., Abbott, A., Walsh, J., Sheppard, J. M., & Climstein, M. (2014). Retrospective analysis of chronic injuries in recreational and competitive surfers: injury location, type, and mechanism. International Journal of Aquatic Research and Education, 8(3), 277-287. doi:10.1123/ijare.2013-0032


6. Hohn, E., Robinson, S., Merriman, J., Parrish, R., & Kramer, W. (2018). Orthopedic Injuries in Professional Surfers: A Retrospective Study at a Single Orthopedic Center. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine. doi:10.1097/JSM.0000000000000596

7. Moran, K., Webber, J. (2013). Surfing Injuries Requiring First Aid in New Zealand, 2007-2012. International Journal of Aquatic Research and Education, 7 (3), 192-203.\

8. Taylor, Bennett, D., Carter, M., Garewal, D., & Finch, C. F. (2004). Acute injury and chronic disability resulting from surfboard riding. Journal of Science and Medicine in Sport, 7(4), 429-437. doi:10.1016/s1440-2440(04)80260-3

9. Ulkestad, G. E., & Drogset, J. O. (2016). Surfing injuries in Norwegian arctic waters. Open Sports Sciences Journal, 9(1), 153-161. doi:10.2174/1875399X01609010153

10. Vanmechelen W, Hlobil H, and Kemper HCG. 1992. Incidence, severity, etiology and prevention of sports injuries – a review of concepts. Sports Medicine. AUCKLAND: ADIS INTERNATIONAL LTD. p 82-99.


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