Written by Pedro Seixas (physiotherapist) & edited by Ognjen Markovic (MD)  and Arvid Schigt (MD).

Injuries are common among surfers [1-3], and a Portuguese study (Author’s private practice) demonstrates that about 78,5% of Portuguese surfers already had a surfing injury.

What probably most of surfers don’t know is that a simple muscular pain might grow into a big problem. But not everything is bad news, because it seems that a substantial part of sports injury might be avoided through preventive methods.

Surfing injury origin

There are surfing related injuries that can only be prevented in a passive way, like feet lacerations (using booties), and a perforation of the eye (using nose guards [4]). However, we can do more for our body, by actively preventing musculoskeletal injuries.

These kinds of injuries have their origin, normally, in sustained postures, through stabilizing muscles overload (e.g. spine extension during paddling); overuse, resulting from technical gesture repetition during high intensity exercises over a short period of time (e.g. rotations + flexion of knees, torso); impact, of the wave and board over the body (e.g. lip snap) or the body over the board (e.g. landing floater/ aerial); or overuse without proper recovery/ rest (e.g. surfing for three consecutive days without stretching).

Injury prevention – Why? When? Where? How?

© 2012 (Bas Bartholomeus Photography)

Wipe Out in Hossegor, oktober 2012

Why? The real question should be “Why not?”. The worst that can happen to a surfer is being out of the water, and being out due to injury only worsens the scenario.

The physical demands involved in surfing, related to stopped-paddling transitions (explosive effort), associated movement of arms (take-off, paddling) and legs (trimming, bottom turn), and the amount of hours spent on surfing [5], lead to progressive diminishing of the surfer’s performance, and increasing fatigue levels. This may lead to a reduced neuromuscular control and, consequently exposing the surfer to injury occurrence.

Furthermore, treating sports injuries is often difficult, expensive and time consuming. Thus, preventive strategies and activities are justified on medical as well as economic grounds [6].

When? Before every surf session, with a good warm-up, from head to toe, giving priority to combined movements of flexion/extension and rotation, that put our body structures through bigger stress forces; after every surf session, with a complete stretching routine, approaching the main muscular groups involved in surfing (cervical, upper and low-backs, shoulders, hamstrings, and calf muscles); at the gym, through specific functional surfing training, simulating movement patterns used in the water, using unstable surfaces, Pilates balls, elastic bands, etc.; during surfing contests, using the presence of the physiotherapist to perform some muscular warm-up exercises before the heats, or recovering from them through stretching and specific massage, therefore contributing to the maintenance of physical performance during the entire competition; at home, where you can have your mini-gym with a simple Pilates ball and some elastic bands; at work, using your pauses to stretch (even while seated!) your cervical muscles and upper limbs, and replacing your office chair for a Pilates ball which will force you to be “well seated” by correcting your lower back posture.

Who? Everyone! Whether you’re a weekend or daily surfer, a kid or a grandfather, amateur or pro… everyone should do specific training to prevent surfing related injuries. The difference in the kind of training is at the intensity, frequency and duration of the exercises, and should be based on the age and clinical background of the surfer.

How? A good surf training session should be based on the preparation of muscles and joints to their function – surfing! Therefore, you should start with a good warm-up (10-15min.), performing light to explosive movements, reproducing surfing movement patterns. You can also perform some stretching, as long as it is dynamic, meaning putting your joints and muscles through constant movement. If you stretch too much, in a static way, you’ll put the muscles to “sleep”, giving them extra length, reducing their ability to generate power, speed and explosive efforts [7].

The training session itself can be based on several approaches like, intercalary and multi-station training (endurance), proprioceptive, balance and coordination exercises (control and stability over the surfboard), plyometric exercises (endurance to explosive efforts) and specific strengthening (muscular mass gain).

Studies demonstrate that these different kinds of training preparation to sports activity can reduce up to 50% the probability of injury occurrence [8].

A cool-down at the end of the training may facilitate lactate removal from muscles, the slow return from vasodilation, and gradual return of blood to the central circulation[9]. Cooling down leads to an increase in cardiac vagal tone and a reduction in resting heart rate, compared to complete rest without cool-down[10]. Five minutes of walking or calisthenics may be helpful. It is also advisable to perform stretching, now in a static way to return the muscle its normal length. You should start with all main muscular groups involved (10-15min.) and, at the end of the day another stretching session focused on more specific areas, but reaching the entire body.

Breathing… is vital!

During each of the three previous training stages, it’s important to breath properly. Since your not lifting heavy weights you don’t need to hold your breath – unless you’re doing apnoea training to feel more comfortable during wipeouts.  Always try to exhale during the most strenuous phase of the exercise, and whenever possible, with your abdominals contracted, so that you can protect your lower back spine – even if your doing a simple leg crutch. Train your paddling exhaling every 2 or 3 paddling strokes and simulate your cut-backs exhaling at the speed your torso turns. Now try this when you go surfing!

Main benefits

By adopting strategies that aim at injury prevention (daily or while training) you are improving your flexibility, muscular endurance and strength, muscular and joint mobility; improving body alignment, posture and your cardiorespiratory condition; reducing fatigue levels and health costs related to injury treatments; and obviously, preventing surfing related injuries.

I got injured..now what to do?

The most important thing is to get quickly and proper evaluation by a doctor or physiotherapist, in order to start your treatment and/or rehabilitation as soon as possible. The early diagnosis will minimize secondary consequences associated to the main injury, as functional or compensations, that would delay recovering time and consequentially, returning to water. Moreover, if you haven’t broken every single bone of your body, there are always some areas of your body you can train, keeping active and fit – for that you should talk to your physiotherapist, which is the most adequate professional to prescribe you exercises while you are injured.

After all this, if you are still not convinced on starting an injury prevention routine, here’s a guy who learned it the hard way some years ago:

For me training is a lot of injury prevention. I started training super seriously when I got injured

Mick Fanning

Reference List

  1. Taylor DM, Bennett D, Carter M, Garewal D, Finch CF. Acute injury and chronic disability resulting from surfboard riding. J Sci Med Sport 2004 Dec;7(4):429-37.
  2. Lowdon BJ, Pateman NA, Pitman AJ. Surfboard-riding injuries. Med J Aust 1983 Dec 10;2(12):613-6.
  3.  Nathanson A, Bird S, Dao L, Tam-Sing K. Competitive surfing injuries: a prospective study of surfing-related injuries among contest surfers. Am J Sports Med 2007 Jan;35(1):113-7.
  4. Sunshine S. Surfing injuries. Curr Sports Med Rep 2003 Jun;2(3):136-41.
  5.  Taylor KS, Zoltan TB, Achar SA. Medical illnesses and injuries encountered during surfing. Curr Sports Med Rep 2006 Sep;5(5):262-7.
  6.  Parkkari J, Kujala UM, Kannus P. Is it possible to prevent sports injuries? Review of controlled clinical trials and recommendations for future work. Sports Med 2001;31(14):985-95.
  7. Mendez-Villanueva A, Bishop D, Hamer P. Activity profile of world-class professional surfers during competition: a case study. J Strength Cond Res 2006 Aug;20(3):477-82.
  8. Aaltonen S, Karjalainen H, Heinonen A, Parkkari J, Kujala UM. Prevention of sports injuries: systematic review of randomized controlled trials. Arch Intern Med 2007 Aug 13;167(15):1585-92.
  9.  American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 1998 Jun;30(6):975-91.
  10. Takahashi T, Okada A, Hayano J, Tamura T. Influence of cool-down exercise on autonomic control of heart rate during recovery from dynamic exercise. Front Med Biol Eng 2002;11(4):249-59.

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