Surf Smart, PREVENT Injury

Surfing is not the first thing you think of when considering sports-related injuries. However, it has its fair-share of complications. Surfing poses risks of concussion, head injury, and even spinal fractures. Although these injuries are scary, they are much less common and not necessarily preventable with preparation (other than looking out for nearby kooks). Many musculoskeletal injuries, on the other hand, are preventable. This blog outlines some simple preemptive steps you can take to protect yourself from sprains, strains, and worse.

Mobility! Mobility! Mobility!

The BEST thing you can do for your surfing longevity is to ensure that you have the mobility required to execute those tight turns and tuck into the occasional barrel. Your ankle and great toe flexibility both play key roles in preventing injuries from your feet to the low back. Without adequate great toe and ankle flexibility, you place increased stress on your knees and hips to compensate with increased flexion. At the knee, these compensations typically lead to ligamentous sprains due to overstretching at the joint, whereas the hips tend to suffer from impingement due to jamming them into excessive flexion. This can lead to excess bony build-up causing further mobility restrictions and increasing pain that will progressively worsen over years. A lack of mobility in the legs can also lead to increased emphasis placed on your low back to compensate through spinal flexion. The coupling of lumbar flexion with rotation during a quick turn or boosted air make for a recipe for disaster…a disc herniation. This injury can, and will, come back to haunt you again and again unless you take steps to treat it and prevent future recurrence.

When it comes to the shoulders there is a lot that can go wrong from a lack of mobility to poor strength and mechanics. The most common motions lacking adequate mobility in the shoulder are external rotation (rotating the shoulder out) and horizontal abduction (bringing the arms both up laterally and back behind you), the culprit is your most dominant paddling muscles… pectoralis major, subscapularis, teres major, and latissimus dorsi. You will also want to ensure that you have sufficient thoracic spine extension to allow you to lift your chest off the board, instead of relying on neck extension.

Warm up before you paddle out

Warming up is the easiest and least time-consuming thing you can do to protect yourself from surfing injury. There are a million videos out there on HOW to warm up, so let’s focus on the WHY… The stress-strain curve represents the relationship between the amount of stress a tissue can sustain prior to strain (aka injury). As a tissue is lengthened it will first go through a period of taking up the slack (toe region), there is no risk of failure here. Next, the tissue will move into the elastic region, this is where your tissue is lengthening through its available range. Hence … mobility! mobility! mobility! Once the limit of your mobility has reached its yield point, this is where you move into permanent changes to the tissue by means of micro tears (plastic region). Now the plastic region is still normal, in fact, you want to reach this region while stretching in order to make lasting improvements in your mobility. However, what comes next, and with much less build-up, is your failure point. Once you reach this point your tissue will undergo a rapid rate of progressive tissue failure (tearing) until you reach complete rupture. The purpose of warming up is to increase the temperature and mobility of your tissues. Increased tissue temperature extends your tissue’s elastic region, thus more stress is required prior to tissue failure. The opposite is also true, decreased temperature will proportionally lower the amount of stress needed to tear a tissue. This is why it is particularly important to warm up when surfing in cold water. It is also a good idea to keep moving while in the water to ensure that you aren’t losing the warmth you gained at the beginning.

Proper training

Now, this does not mean you repeat simulated surf maneuvers and balance on unstable surfaces for 60 minutes and then go out surfing for 3 hours…this will likely just lead to overuse injuries. Proper training means that you are training for correct mechanics, balancing your strength, and preparing your body for the stresses of surfing. Mechanics training should include specific attention to your shoulder mechanics, the ability to hip hinge properly and to reach a deep squat/lunge position. If you are advanced enough to be doing airs then you will need to spend time on your power and on appropriate shock absorption for landing.

As much as you’d like to just build up strength in those paddling muscles, likely what you need are gains in your antagonist muscle groups to ensure that you are well balanced. It is typically the imbalances that ultimately lead to injury. It will be especially important to strengthen your rotator cuff (specifically your external rotators), middle and low traps, deep neck flexors, glutes, and core. The core is an especially important area of focus for surfers. There is a great deal of core involved in all aspects of surfing…producing power, absorbing shock, and especially when controlling those aggressive rotational movements.

Although there are many potential hazards and unpreventable injuries that can occur while surfing, the most common are usually avoidable. Now you know WHERE to focus your energy and WHY, the rest is up to you!

Allison is the Director of Physical Therapy at NAKOA. She earned her Doctorate in Physical Therapy from St. Augustine University in 2011. Allison is passionate about making a positive difference and helping people live pain-free. She loves working with all types of impairments including acute sports-related injuries, repetitive overuse injuries, post-surgical patients, and challenging cases of chronic pain. She is thankful to be able to spend ample time with every patient, allowing her to deliver the highest quality-of-care. Although she continues to grow and support our incredible therapy program with ease, Allison also manages to balance being a wife, a new mom, and an athlete all at the same time. We couldn’t have found a more capable, talented, and kind-hearted woman to lead our therapy team, we are incredibly grateful to have her.