How to Prevent Injuries from Surfing

This summer, elite surfers will compete up and down the Orange County coast at local surf competitions. If you’re a surfer, you already know the demands the sport can place on your body. These physical demands can also lead to a wide range of surfing injuries, from shoulder and back strains to knee sprains, ankle injuries, and impact-related trauma.

Fortunately, many common injuries in surfing can be prevented. Proper conditioning, technique, equipment selection, and recovery can help surfers prevent sports injuries and stay healthier, perform better, and catch more waves. Learn more from the sports medicine experts at Hoag Orthopedic Institute, OC’s leader for elite athletic care, about how to stay healthy on your board this summer.

Key Takeaways

• Many common injuries from surfing result from repetitive stress, sudden twisting movements, or impact during surfing accidents.

• Strength training, surf instruction, proper technique, and equipment suited to your skill level can help prevent surfing injuries.

• Warming up properly, following surf etiquette, and resisting the temptation to surf conditions beyond your skill level all reduce the risk of injury.

• Persistent pain, instability, swelling, or reduced range of motion after surfing should be evaluated by a sports medicine specialist.

Common Injuries in Surfing

The most common sports injuries from surfing include shoulder and hip specific injuries:

Shoulder Strains and Rotator Cuff Irritation

Hours spent paddling the surfboard place significant stress on the shoulders, especially if poor technique is used. Over time, this repetitive motion can cause muscle strains in the shoulder, rotator cuff tears, or shoulder impingement.

“Paddling on a surfboard puts a high level of stress on the entire upper body,” says Ted Gregorious, MD, team physician for the United States Boardriders Club and affiliated Hoag Orthopedic Institute sports medicine physician. “From the lats, deltoids and triceps to the rotator cuff, erector spinae, trapezius and rhomboids, upper-body strength and endurance are critical. Unfortunately, I’ve seen many surfers suffer repetitive use injuries from paddling, so it’s critical to work on upper-body strength.”

Hip Pain

Surfing also places significant demand on the hips. The hip flexors, like the rotator cuff, are a group of muscles that can be strained by repeatedly popping up to catch a wave. With professional surfers executing incredibly complex moves, the risk of injury further increases, according to a recent study.

“Pop ups, pumps and cut backs all require some pretty extreme flexibility from your joints and especially your hips,” says David Gazzaniga, MD, Division Chief of Sports Medicine at Hoag Orthopedic Institute and team physician for US Boardriders Club. “Stretching and working on mobility is crucial for joint health. I recommend the lizard stretch, where you start in a downward dog position, push your hips back and then step one leg forward to the outside of your hand. If you’re flexible enough, you can go to your forearms to maximize the stretch. Hold it for three to five deep breaths, and be sure to stretch both sides.”

Other surfing injuries can include:

• Neck and Back Pain: Surfers spend long periods paddling with the neck extended and back arched. This position can contribute to muscle fatigue, neck pain, and lower back discomfort.
• Knee Sprains and Meniscus Injuries: Quick turns, high-torque pivots, awkward landings, and wipeouts put stress on the knee joints. Surfers may experience knee injuries such as ligament sprains or meniscus injuries similar to those seen in many other sports.
• Ankle and Foot Injuries: Ankle sprains and foot injuries can occur during takeoffs, maneuvers, or falls. Uneven landings and sudden twisting forces are common causes.

• Head Injuries and Concussions: Collisions with a surfboard, the ocean floor, or another surfer can cause head injuries. While less common than other sports injuries, concussions and other head trauma do occur with surfing and should always be taken seriously.
• Cuts, Bruises, and Impact Injuries

How to Prevent Surfing Injuries Before You Paddle Out

You can prevent many surfing injuries before ever entering the water.

Build Surf-Specific Strength

Surfing requires shoulder endurance, core stability, balance, leg strength, and cardiovascular fitness. Regular strength training and conditioning help surfers build the stability and endurance needed for long sessions in the water. Better-conditioned muscles support the joints, absorb force more effectively, and are less likely to fatigue, reducing stress on tendons and other soft tissues.

Choose the Proper Equipment

It is easier to control a board suited to your height, weight, and skill level, so you are likely to experience fewer falls or collisions. Proper fins, surf leash, and wax all improve your control over the board, helping to prevent surfing accidents and injuries.

Learn Proper Technique

To stay healthy, Dr. Gregorius, who is also a local surfer, recommends refining your paddling technique to prevent surfing injuries. “In the water, keep your elbows bent during the catch phase,” he says. “This will lessen the strain on your rotator cuff.” He also recommends stretching to strengthen the stabilizing muscles. “Since paddling involves repeated internal rotation, use light resistance bands to practice external rotation to build endurance,” he says. “You can also counteract paddling posture with stretches like doorway chest stretches and lat stretches.”

Warm Up Before Every Session

Even experienced surfers who are in great condition benefit from a dynamic warm-up before entering the water. Preparing the muscles, ligaments, and tendons of the shoulders, core, legs, and back for activity can increase blood flow, improve performance, and reduce injury risk.

Injury Prevention Tips While Surfing

Surfing injuries often occur when fatigue, poor conditions, or split-second decisions lead to mistakes in the water.

• Know Your Limits: Attempting waves that are larger, faster, or beyond your skill level increases the risk of falls and injury.
• Follow Surf Etiquette: Understanding right-of-way rules and maintaining awareness of other surfers can help prevent collisions.
• Listen to Your Body: As muscles tire, technique often suffers. If your shoulders, back, or legs are becoming fatigued, end the session before poor mechanics increase your injury risk.
• Respect Ocean Conditions: Crowded lineups, shallow water, rocky reefs, and surf conditions that exceed your experience level can all increase injury risk and surfing accidents.

Recovery Tips After Surf Injuries

Taking the time for proper recovery can help prevent minor injuries from becoming more serious problems. After a surfing injury:

• Rest the injured area and avoid activities that worsen symptoms
• Use ice to reduce pain and swelling
• Gradually return to activity rather than rushing back into the water
• Seek medical evaluation if pain, swelling, or instability persists

When a Surfing Injury Calls for Orthopedic Care

If an injury from surfing causes pain, swelling, joint instability, or reduced range of motion that does not improve with rest and conservative care, seek medical attention. Persistent symptoms, difficulty bearing your weight, a suspected fracture, repeated injuries, or significant shoulder, knee, ankle, or back pain should be evaluated by a sports medicine specialist.

If pain persists, Dr. Gazzaniga recommends seeking physical therapy and consulting with an orthopedic surgeon. Chronic hip and shoulder issues requiring surgery are common among lifelong and elite surfers, with a number of high-profile surfers having undergone surgery to extend their careers.

“I have personally cared for a number of surfers who have needed hip arthroscopy,” Dr. Gregorius said. “At Hoag Orthopedic Institute, we offer innovative approaches to hip surgery that can help surfers begin physical therapy and get back on their boards sooner than ever.”

Hoag Orthopedic Institute’s renowned sports medicine physicians care for more Orange County athletes than any other hospital. From weekend warriors to the pros, our physicians offer treatments ranging from PRP therapy and cartilage restoration to minimally invasive and robotic-assisted approaches.