Surfing Injuries – What Every Surfer Should Know

Posted on: May 18th, 2026 by Our Team

Surfing has evolved from its Native Hawaiian roots into a globally beloved sport, now featured in the Olympic Games. As the sport grows in popularity, so does the importance of understanding the injuries that come with it.

The Unique Demands of Surfing on Your Body

Surfing places demands on the body unlike almost any other sport. Paddling prone on the board mimics overhead swimming motions, engaging the rotator cuff, deltoid, pectoralis major, latissimus dorsi, and trapezius repeatedly. Unlike swimming, the legs provide no propulsion — making the shoulders bear the entire burden of moving through the water. This repetitive internal rotation pattern, combined with shoulder forward flexion, creates conditions ripe for subacromial impingement and rotator cuff overuse injuries.

The lower body faces its own unique challenges. Once standing on the board, the rear leg bears tremendous valgus (inward) stress during maneuvers like snapping, cutbacks, and landing aerial tricks. The front foot absorbs up to 72% of landing force — with loads reaching 160% of the surfer’s body weight — while the rear leg generates the torque needed to control the board. The spine is also chronically stressed: surfers must hyperextend the neck and lower back to see oncoming waves, placing prolonged strain on the cervical and lumbar spine.

How Often Do Surfers Get Hurt?

The injury rate in surfing is strikingly high — 98% of surfers sustain at least one injury over their career, and roughly one-third are injured every year badly enough to require treatment or time away from the sport. While most injuries don’t require hospitalization, 17–35% of orthopedic surfing injuries ultimately require surgery.

Head and Neck Injuries

The head and neck represent the most commonly injured region, accounting for 28–37% of all surfing injuries. The surfboard itself — through direct impact, fin lacerations, or collision with the ocean floor — is responsible for over half of these. Traumatic brain injury (TBI) accounts for 16% of head and neck injuries, and studies show 37% of surfers have sustained a concussion. Despite this, only 2–8% of surfers wear protective headgear — largely because of concerns about image and performance. Greater awareness and education around the life-altering consequences of TBI in surfing are urgently needed.

Shoulder Injuries

The shoulder is the most commonly injured joint in surfers, with 76% reporting shoulder symptoms at some point. Shoulder dislocations are the most frequent acute diagnosis, while chronic injuries include rotator cuff tears, labral tears, and impingement syndrome. In professional surfers, 73% of shoulder injuries required surgery. Older surfers are particularly vulnerable — surfing is one of the only high-demand overhead sports regularly practiced by individuals over 50, and the natural age-related degeneration of the rotator cuff combined with repetitive paddling creates a compounding risk.

Knee and Lower Extremity Injuries

The foot, lower leg, and knee are the most commonly injured lower extremity regions. Lacerations from surfboard fins account for 42% of lower extremity injuries. The most common knee injuries are medial collateral ligament (MCL) sprains and meniscal tears, both directly related to the chronic valgus loading of the rear leg during wave riding. The rear leg is injured more frequently than the front for this reason.

Spine and Nerve Injuries

Chronic neck and lower back pain from prolonged hyperextension while paddling are common complaints. A rare but serious condition called surfer’s myelopathy — most often seen in beginners — can cause leg weakness or even paralysis due to spinal cord ischemia from sustained hyperextension. A nerve injury called surfer’s neurapraxia, affecting the saphenous nerve of the inner thigh from prolonged board compression, is also increasingly recognized.

Prevention and Returning to Surfing

Knowing local wave conditions before paddling out significantly reduces injury risk. Shoulder strengthening — particularly external rotation exercises to counterbalance the internal rotation dominance of paddling — and thoracic extension exercises can help prevent impingement. Staying hydrated, warming up before sessions, wearing a wetsuit, and never surfing alone are all practical, evidence-supported steps every surfer should take.

Return to surfing after orthopedic surgery is very individualized. Encouraging data show 81% of patients return to surfing after total hip replacement and over 80% return within six months of hip resurfacing. Shoulder replacement data specific to surfing are still lacking, though shoulder arthroplasty outcomes in active patients are generally favorable.

The Bottom Line

Surfing is an incredible sport that rewards athleticism, balance, and ocean awareness. But it carries real orthopedic risk across every region of the body. Understanding your injury, getting the right diagnosis, and working Dr Mark Cinque, sports medicine specialist,  gives you the best chance of staying in the water for years to come.

Contact Dr. Mark Cinque at Scripps to schedule a consultation today