Surfs up! And keeping injury risks down

The obvious injuries that any surfer will be aware of include head injuries or cuts from fins, reefs, or rocks. In addition to gashes, eye injuries, and concussions, surfers, whether professional or amateur, can also damage their musculoskeletal system. Revered London-based consultant orthopaedic and sports medicine surgeon Mr Simon Moyes describes other injuries to be aware of, how to prevent them, and when to see a specialist for diagnosis and treatment.  

What are the most common surfing injuries?  

Some of the most common surfing injuries include:

• shoulder impingement: tubes of muscles and tendons, the rotator cuff, stabilise the shoulder joint. If the tendons swell or become inflamed; they can get pinched by other parts of the shoulder causing pain and potentially leading to a rotator cuff injury.
• back sprains and strains
• hip flexor strain
• ankle stiffness

What causes injuries in surfers?

Padding in the prone position for long periods can cause shoulder and back injuries. The muscles that are used become overdeveloped in comparison to other muscles, and this can cause swollen and inflamed tendons. The enlarged tendons can get trapped between other shoulder structures, causing pain. The prone position can also put the lower back under a lot of pressure. Weak core strength contributed to back injuries too.

Sudden and abrupt twisting and turning motions can strain the muscles. The hip naturally rotates towards the back foot, which strains the hip flexor tendon in the front of the pelvis.  Similarly, a poor technique ‘popping up’ from paddle to surfing can cause more strain and eventually pain.

Old ankle injuries, such as a previous strain or fracture, can inhibit a surfer’s ability to squat deeply into their turns. The build-up of scar tissue in the ankle can lead to the tightening of ligaments and tendons and cause ankle stiffness, which can lead to torn tendons or tendonitis.

What are the symptoms of common surf injuries?

The symptoms depend on the type of injury. Typical signs of a musculoskeletal injury may include:

• pain when extending the arm, lifting your knee to the chest, or stretching the hips
• tenderness in the front of the shoulder
• shoulder weakness or stiffness 
• muscle spasms
• swelling or bruising

How are common surfing injuries treated?

Prior to any treatment, an injury from surfing should be diagnosed by a sports medicine specialist. Back strain, for example, could be confused with a slipped disc, fractured vertebra, or trapped nerve.

Shoulder impingement injuries respond well to treatment with physiotherapy and anti-inflammatory medication.  Persistent problems may be treated with steroid or cellular injections to reduce swelling and promote healing. Rarely arthroscopic surgery would be used.

Back pain, similarly, can be treated with physiotherapy and anti-inflammatory medicine in the early stages of recovery. Improving core strength and developing upper back strength and flexibility can reduce pain, speed up recovery, and prevent reoccurrence.

Strains on the hip flexor are most effectively treated with anti-inflammatory medicine and rest. Physiotherapy, exercises, and gentle stretches improve flexibility. If there is a tear in the tendon or muscles, surgery may be needed.

Ankle stiffness can be improved with physiotherapy and stretching to support the ankle structure.

How can common surfing injuries be prevented?

It is important to work on flexibility and strength before surfing, similar to the physical preparation required before going snowboarding or skiing. The crucial area to strengthen is the core, not only for balance and control but to protect the lower back from injuries.  Strengthening the muscles in the shoulder and the legs as well as stretching the shoulders and hips will prevent injuries. Immediately before surfing, it is vital to warm up well, particularly focusing on areas of the body that are susceptible to injuries.

If you’ve sustained an injury from surfing and want to get back on your feet (and board) as soon as possible, book a consultation with Mr Simon Moyes directly via his Top Doctors profile.