Surfing Physiotherapy.
The physical demands of surfing
Surfing combines prolonged prone paddling, explosive pop-up mechanics, dynamic balance on an unstable moving surface, and the repeated wipeout and impact exposures of ocean conditions. The paddling component — which accounts for approximately 50 to 60% of a surf session in the water — loads the shoulder, cervical spine and lumbar spine in sustained positions that are the primary drivers of surfing's overuse injury profile. The pop-up — the explosive transition from prone paddling to standing — places brief but significant lumbar extension and rotational loading on the spine. Dynamic surfing on the wave demands ankle, knee and hip control on an unstable, constantly changing surface.
Brisbane's southside is within easy reach of the surf breaks at both coasts, and the surfing community is a significant part of the active population Articulate serves. At Articulate Physiotherapy in Tarragindi, we work with surfers at all levels — from beginners sustaining their first wipeout injuries through to experienced and competitive surfers managing the chronic overuse injuries of long surfing careers.
Common surfing injuries
Shoulder injuries are the most prevalent overuse injury in surfing — driven by the high paddling volumes that characterise a typical surf session. Rotator cuff tendinopathy and impingement from the repeated overhead paddling mechanics — the shoulder at or near full elevation for thousands of strokes per session — are the most common chronic presentations. The paddling stroke places the shoulder in a position of internal rotation and horizontal flexion that, sustained over high session volumes, produces the posterior shoulder tightness and rotator cuff overuse characteristic of regular surfers. Shoulder dislocations from wipeout impacts and arm catches are the most common acute shoulder injury.
Lower back pain — the most common complaint in experienced surfers — develops from the sustained lumbar hyperextension of the paddling position combined with the rotational loading of the pop-up and surfing stance. Lumbar facet joint syndrome from the repeated extension loading, disc irritation from the asymmetric rotational demands of duck-diving and surfing, and paraspinal overuse from sustained hyperextension paddling posture are the most common presentations. The asymmetric stance of surfing — leading foot forward — creates a consistent rotational asymmetry in the spine and hips that, over a long surfing career, produces predictable directional restrictions.
Neck and cervical spine pain — from the sustained cervical hyperextension of looking forward while paddling — is among the most common surfing complaints. The paddling position requires sustained cervical extension to maintain forward visual field — a posture that loads the cervical facet joints and posterior cervical musculature over the duration of a session. Cervical facet joint syndrome, cervicogenic headache and upper trapezius overuse are the characteristic cervical presentations in regular paddlers.
Knee injuries — medial collateral ligament sprains from the valgus stress of the surfing stance, meniscal injuries from the rotational loading of bottom turns and cutbacks, and patellofemoral pain from the sustained knee flexion of the surfing stance — are the most common lower limb presentations. The asymmetric surfing stance — one foot forward, one back, with significant rotational demands — creates knee loading patterns that differ from both symmetrical sport and other board sports.
Ankle injuries — lateral ankle sprains from wipeout impact and the dynamic balance demands of surfing — are the most common acute lower limb injury. The barefoot dynamic balance demands of surfing on an unstable surface make ankle proprioception and stability particularly important for injury prevention and rehabilitation.
Concussion from board impact and wipeout — particularly in heavy surf — requires the same structured concussion management protocol as any contact sport, including clearance before return to the water.
How can physiotherapy help?
Physiotherapy for surfing injuries addresses the specific paddling, pop-up and dynamic surfing demands of the sport alongside the general principles of shoulder, spinal and lower limb rehabilitation.
Shoulder rehabilitation for surfers addresses the rotator cuff and periscapular strength deficits that develop from high-volume asymmetric paddling — particularly the posterior rotator cuff deceleration and external rotation strength that protects the shoulder during the recovery phase of the paddling stroke. Posterior capsule management — addressing the tightness that develops in the dominant paddling shoulder — improves shoulder mechanics and reduces impingement loading. Antagonist strengthening — the pushing muscles that paddling undertains — is an important injury prevention component.
Cervical rehabilitation addresses the hyperextension overuse pattern of paddling — deep cervical flexor retraining, thoracic mobility and postural correction reducing the cervical stress of the sustained paddling position. Manual therapy targets the cervical and upper thoracic joint restrictions that accumulate in regular surfers.
Lumbar rehabilitation addresses the extension and rotation loading patterns of paddling and surfing — hip flexor flexibility that reduces compensatory lumbar extension in the paddling position, thoracic rotation mobility that distributes the rotational demands of surfing more evenly, and deep stabiliser retraining using real time ultrasound that builds the spinal support for high-volume paddling and pop-up mechanics.
Lower limb rehabilitation addresses the asymmetric stance demands of surfing — hip, gluteal and ankle stability work that supports the dynamic balance and rotational demands of riding waves. The asymmetric foot position of surfing means that rehabilitation must address the asymmetric hip and knee loading patterns rather than applying symmetric lower limb protocols.
Dry needling manages the cervical, trapezius, paraspinal and hip flexor trigger points common in regular surfers. Clinical Pilates provides trunk rotation, shoulder stabiliser and hip mobility work directly relevant to surfing performance.
Our physiotherapists Mauricio Bara and Emma Cameron both have experience in surf-related injuries and are members of the Australian Physiotherapy Association. Mauricio's APA Sports Physiotherapist credentials and personal water sports background inform his approach to surfing injury management and return-to-surf planning.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
Surfing combines prolonged prone paddling, explosive pop-up mechanics, dynamic balance on an unstable moving surface, and the repeated wipeout and impact exposures of ocean conditions. The paddling component — which accounts for approximately 50 to 60% of a surf session in the water — loads the shoulder, cervical spine and lumbar spine in sustained positions that are the primary drivers of surfing's overuse injury profile. The pop-up — the explosive transition from prone paddling to standing — places brief but significant lumbar extension and rotational loading on the spine. Dynamic surfing on the wave demands ankle, knee and hip control on an unstable, constantly changing surface.
Brisbane's southside is within easy reach of the surf breaks at both coasts, and the surfing community is a significant part of the active population Articulate serves. At Articulate Physiotherapy in Tarragindi, we work with surfers at all levels — from beginners sustaining their first wipeout injuries through to experienced and competitive surfers managing the chronic overuse injuries of long surfing careers.
Common surfing injuries
Shoulder injuries are the most prevalent overuse injury in surfing — driven by the high paddling volumes that characterise a typical surf session. Rotator cuff tendinopathy and impingement from the repeated overhead paddling mechanics — the shoulder at or near full elevation for thousands of strokes per session — are the most common chronic presentations. The paddling stroke places the shoulder in a position of internal rotation and horizontal flexion that, sustained over high session volumes, produces the posterior shoulder tightness and rotator cuff overuse characteristic of regular surfers. Shoulder dislocations from wipeout impacts and arm catches are the most common acute shoulder injury.
Lower back pain — the most common complaint in experienced surfers — develops from the sustained lumbar hyperextension of the paddling position combined with the rotational loading of the pop-up and surfing stance. Lumbar facet joint syndrome from the repeated extension loading, disc irritation from the asymmetric rotational demands of duck-diving and surfing, and paraspinal overuse from sustained hyperextension paddling posture are the most common presentations. The asymmetric stance of surfing — leading foot forward — creates a consistent rotational asymmetry in the spine and hips that, over a long surfing career, produces predictable directional restrictions.
Neck and cervical spine pain — from the sustained cervical hyperextension of looking forward while paddling — is among the most common surfing complaints. The paddling position requires sustained cervical extension to maintain forward visual field — a posture that loads the cervical facet joints and posterior cervical musculature over the duration of a session. Cervical facet joint syndrome, cervicogenic headache and upper trapezius overuse are the characteristic cervical presentations in regular paddlers.
Knee injuries — medial collateral ligament sprains from the valgus stress of the surfing stance, meniscal injuries from the rotational loading of bottom turns and cutbacks, and patellofemoral pain from the sustained knee flexion of the surfing stance — are the most common lower limb presentations. The asymmetric surfing stance — one foot forward, one back, with significant rotational demands — creates knee loading patterns that differ from both symmetrical sport and other board sports.
Ankle injuries — lateral ankle sprains from wipeout impact and the dynamic balance demands of surfing — are the most common acute lower limb injury. The barefoot dynamic balance demands of surfing on an unstable surface make ankle proprioception and stability particularly important for injury prevention and rehabilitation.
Concussion from board impact and wipeout — particularly in heavy surf — requires the same structured concussion management protocol as any contact sport, including clearance before return to the water.
How can physiotherapy help?
Physiotherapy for surfing injuries addresses the specific paddling, pop-up and dynamic surfing demands of the sport alongside the general principles of shoulder, spinal and lower limb rehabilitation.
Shoulder rehabilitation for surfers addresses the rotator cuff and periscapular strength deficits that develop from high-volume asymmetric paddling — particularly the posterior rotator cuff deceleration and external rotation strength that protects the shoulder during the recovery phase of the paddling stroke. Posterior capsule management — addressing the tightness that develops in the dominant paddling shoulder — improves shoulder mechanics and reduces impingement loading. Antagonist strengthening — the pushing muscles that paddling undertains — is an important injury prevention component.
Cervical rehabilitation addresses the hyperextension overuse pattern of paddling — deep cervical flexor retraining, thoracic mobility and postural correction reducing the cervical stress of the sustained paddling position. Manual therapy targets the cervical and upper thoracic joint restrictions that accumulate in regular surfers.
Lumbar rehabilitation addresses the extension and rotation loading patterns of paddling and surfing — hip flexor flexibility that reduces compensatory lumbar extension in the paddling position, thoracic rotation mobility that distributes the rotational demands of surfing more evenly, and deep stabiliser retraining using real time ultrasound that builds the spinal support for high-volume paddling and pop-up mechanics.
Lower limb rehabilitation addresses the asymmetric stance demands of surfing — hip, gluteal and ankle stability work that supports the dynamic balance and rotational demands of riding waves. The asymmetric foot position of surfing means that rehabilitation must address the asymmetric hip and knee loading patterns rather than applying symmetric lower limb protocols.
Dry needling manages the cervical, trapezius, paraspinal and hip flexor trigger points common in regular surfers. Clinical Pilates provides trunk rotation, shoulder stabiliser and hip mobility work directly relevant to surfing performance.
Our physiotherapists Mauricio Bara and Emma Cameron both have experience in surf-related injuries and are members of the Australian Physiotherapy Association. Mauricio's APA Sports Physiotherapist credentials and personal water sports background inform his approach to surfing injury management and return-to-surf planning.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
