Surfing is one of the most rewarding ways to stay active. It builds strength, balance, endurance, and confidence while allowing athletes to enjoy the ocean. However, like any sport, surfing carries injury risks. Understanding these risks and taking preventive steps can help surfers of all ages stay healthy and spend more time in the water.
Who Is Most Likely to Get Injured?
Surf injuries can happen to anyone, but certain groups are at higher risk:
- New surfers who have not yet mastered wave judgment and board control
- Experienced surfers attempting larger waves and advanced maneuvers
- Children and adolescents, who appear to have higher concussion rates than adults
- Surfers in crowded conditions
- Athletes surfing beyond their skill level
- Individuals using alcohol or recreational drugs
The good news? Many surfing injuries are preventable.
A Special Message for Surfers and Rip Currents
Surfers should always enter the water at beaches where lifeguards are on duty. While rip currents can sometimes help surfers paddle beyond breaking waves, they can also create powerful and unpredictable conditions that quickly become dangerous. Having trained lifeguards nearby provides an important layer of safety and ensures rapid assistance if an emergency occurs.
What to Do If You Are Caught in a Rip Current
If you find yourself caught in a rip current:
1 Stay calm and avoid panicking.
2 Do not attempt to swim directly against the current, as this can quickly lead to exhaustion.
3 Swim parallel to the shoreline until you are out of the current’s flow.
4 Once free of the current, swim at an angle back toward shore.
5 If you are unable to escape, conserve your energy by floating or treading water and signal for help by waving and calling out.
Understanding how rip currents work and knowing how to respond can help keep you safe while enjoying the ocean.
Head Injuries and Concussions in Surfing
One of the most concerning surf-related injuries is concussion. These injuries often occur when surfers strike their board, the ocean floor, or another surfer. Even relatively small waves can generate significant force when combined with underwater rotational movement.
RELATED INFORMATION: Click here for more information on What Is a Concussion?
Returning to Surfing After a Concussion
Returning to surfing requires more than simply waiting for symptoms to improve. Gradual progression should be supervised by a medical professional experienced in concussion recovery and may include:
1 Addressing any balance, coordination, or visual tracking concerns
2 Having no post-concussion symptoms
3 Swimming in a pool without flip turns
4 Progressing to swimming with flip turns and underwater diving skills
5 Practicing paddling in calm water
6 Standing on the board in shallow water without waves
7 Riding small waves straight ahead
8 Gradually introducing turns, cutbacks, and larger waves
Surfers should not return to challenging conditions until they are symptom-free and medically cleared.
RELATED VIDEO: Return to Play Programs After Concussion
Surfboard-Related Trauma
(With contributions from Dunsborugh PhysioTherapy Center)
Many surfing injuries occur from direct contact with the surfboard.
Common injuries include:
- Facial lacerations
- Broken noses
- Dental injuries
- Rib injuries
- Fractures
- Deep cuts and soft tissue injuries
Approximately half of all surfing injuries involve lacerations, many of which occur during wipeouts when surfers strike the seafloor or a board fin.
Prevention Tips
- Maintain adequate spacing from other surfers
- Avoid crowded surf breaks when possible
- Use nose and fin guards on beginner boards
- Wear a wetsuit for additional protection
- Learn proper wipeout techniques
- Protect your head when managing board recoil from the leash
Neck and Spine Injuries
Although less common, neck and spinal injuries can be severe.
Risk increases when surfers:
- Dive headfirst into shallow water
- Surf shore-breaking waves
- Strike reefs or sandbars
- Experience forceful wipeouts
Prevention Tips
- Never dive headfirst into unfamiliar water
- Learn proper techniques for navigating large waves
- Roll with your board in shallow-water situations
- Understand local surf conditions before entering the water
Shoulder Injuries: The “Surfer’s Shoulder”
Many surfers spend nearly 80% of their session paddling. This repetitive overhead motion can lead to chronic shoulder problems.
Common conditions include:
- Shoulder impingement
- Labral injuries
- Multidirectional instability
- Rotator cuff irritation
- Growth plate injuries in younger athletes
Common Paddling Mistakes (and How to Fix Them)
(With contributions from One Nine Physical Therapy)
Dropping the Elbow and Entering Water with the Thumb
Allowing the elbow to drop below the hand decreases efficiency and increases shoulder stress. Entering the water thumb-first can also reduce the space available for proper shoulder mechanics.
Fix: Keep the elbow higher during the stroke, engage the entire forearm during the pull phase, and enter the water with the fingers rather than the thumb.
Paddling Too Fast
Quick, shallow strokes increase fatigue and reduce efficiency.
Fix: Focus on long, deliberate strokes using proper technique.
Poor Board Position
Lying too far forward or backward alters shoulder mechanics and increases strain.
Fix: Find the board’s “sweet spot” where it rides flat with the nose slightly elevated.
Shoulder Injury Prevention
- Strengthen the rotator cuff and scapular stabilizers
- Stretch the chest muscles regularly
- Improve thoracic spine mobility
- Focus on efficient paddling mechanics
- Address pain early before it becomes chronic
RELATED VIDEO: Common Athletic Injuries – Shoulder Injuries
Knee Injuries
Surfing places significant stress on the knees during turns, cutbacks, and landings. The back leg is often at greatest risk due to the force generated while pushing off or kneeling to catch a wave.
Common injuries include:
- Anterior cruciate ligament (ACL) injuries from rotational falls
- Medial collateral ligament (MCL) injuries from forceful push-off movements
- Meniscus tears
- Knee bursitis
Prevention Tips
- Maintain proper stance mechanics
- Avoid excessive twisting
- Build lower-body strength and stability
- Progress gradually into advanced maneuvers
Surfer’s Ear: An Often-Overlooked Problem
Repeated exposure to cold water and wind can lead to a condition called surfer’s ear (exostosis), a condition characterized by abnormal bone growth within the ear canal. Over time, this growth can trap water and debris, increasing the risk of infection and hearing problems.
Symptoms
- Recurrent swimmer’s ear
- Muffled hearing
- Ear pain
- Water trapped in the ears
Prevention
- Wear surf-specific earplugs
- Use a hood or cap in colder conditions
- Dry ears thoroughly after surfing
Early prevention can significantly reduce the risk of needing surgery later in life.
Preventing Swimmer’s Ear
Swimmer’s ear is a common infection among surfers and swimmers.
Helpful prevention strategies include:
- Using physician-recommended preventive ear drops after water exposure
- Using over-the-counter drying drops
- Drying ears gently after surfing
- Avoiding aggressive ear cleaning that may damage the ear canal lining
RELATED INFORMATION: Preventing Swimmer’s Ear
Sun Protection: Every Surfer Needs a Plan
Surfers often spend hours exposed to ultraviolet (UV) radiation reflected from both the sun and the water.
Long-term sun exposure increases the risk of:
- Skin cancer
- Premature skin aging
- Sunburn
- Eye damage
Sun Safety Recommendations
- Apply broad-spectrum SPF 30-50 sunscreen
- Reapply every two hours and after prolonged water exposure
- Wear UV-protective rash guards
- Use polarized sunglasses when not surfing
- Seek shade during peak UV hours when possible
Final Thoughts
Surfing offers tremendous physical and mental health benefits, but injuries can occur when preparation, technique, or environmental awareness is lacking.
The best injury prevention strategies are surprisingly simple:
- Know your limits
- Respect ocean conditions
- Master proper technique
- Protect your head, ears, and skin
- Progress gradually as your skills improve
With the right preparation and awareness, surfers can reduce injury risk and enjoy many healthy years in the water.
Stay safe, surf smart, and have fun out there.
