You paddled out at Coolum, caught a rail on the takeoff, and something didn’t feel right in your shoulder on the way home. Or maybe your lower back has been grumbling after every session for the past month, and you’re starting to wonder whether to push through or pull back. Sound familiar?
The Sunshine Coast produces some of Australia’s best surf, and with that comes a surfing community that spends serious time in the water. More time in the water means more exposure to the specific physical demands of surfing. Paddling, pop-ups, rotational forces, wipeouts over reef, and hours of spinal extension create an injury profile that generic sports injury advice doesn’t fully address.
This guide is written specifically for surfers on this coastline. Whether you’re nursing something right now, trying to stay injury-free, or keeping a young grom safe in the water, you’ll find practical, locally relevant guidance here.
Already dealing with a surf injury? Book an assessment with the team at North West Physio Sippy Downs.
Common surfing injuries
Shoulder: Surfer’s Shoulder and Rotator Cuff Injuries
The shoulder is the most commonly injured area in surfers, and for good reason. Every paddle stroke places repetitive demand on the rotator cuff, the small but essential group of muscles that stabilise the shoulder joint. Over time, particularly in surfers logging regular sessions, this repetitive loading leads to the condition commonly called surfer’s shoulder.
Understanding the mechanism: The paddling stroke involves significant internal rotation and forward elevation of the arm, combined with the rotational movement of the trunk. When paddle technique breaks down (often due to fatigue, asymmetry, or poor thoracic mobility), the rotator cuff muscles compensate. This creates impingement of the tendons between the ball and socket of the shoulder joint, leading to the deep, aching pain that typically worsens with overhead activity and sustained paddling.
Surfers who favour one arm, those who paddle goofy or regular with a dominant-side bias, and those who surf long sessions without adequate recovery are most susceptible.
What rehab may look like: Conservative management for surfer’s shoulder focuses on reducing load, restoring range of movement, and progressively strengthen the muscles around the shoulder and scapular.
Lower Back: Extension-Based Pain
Lower back pain is the second most common complaint in surfers, and the mechanism is almost always related to the sustained spinal extension required for paddling. Lying prone on the board with the head and chest elevated puts the lumbar spine into prolonged extension — a position most people’s bodies aren’t conditioned for, particularly if the rest of their week is spent sitting at a desk.
Pop-ups add a rapid extension-rotation component. Done well, the pop-up loads the hips and legs. Done with tired or deconditioned mechanics, it loads the lumbar spine directly. Repetitive faulty pop-ups over the course of a season can lead to disc irritation, facet joint loading, or muscular strain.
Red flags to watch for: Lower back pain that radiates into one or both legs, is accompanied by numbness or tingling, or doesn’t improve with rest warrants prompt assessment. This pattern may indicate disc involvement and should not be self-managed.
Conservative management: Most surfing-related lower back pain responds well to physiotherapy. Treatment focuses on restoring lumbar mobility, strengthening the deep stabilising muscles of the core, addressing hip flexor tightness (which drives lumbar extension loading), and retraining pop-up mechanics.
Knee: Torque and Rotational Forces
Surfing places unique rotational demands on the knee that differ from most other sports. The bent-knee stance used for turning, combined with the rapid weight shifting and edge-to-edge transitions of riding a wave, creates significant torque forces through the medial collateral ligament (MCL) and menisci.
Wipeouts are another scenario that can cause acute sprains or meniscal tears.
Red flags for the knee: If your knee is locking, giving way, or swelling significantly after a wipeout, these symptoms suggest possible meniscal involvement that warrants imaging and professional assessment before returning to surfing. Don’t assume it’s “just a sprain” if the joint isn’t moving normally.
Ankle: Sprains and Fractures
Ankle injuries in surfers most commonly occur during wipeouts, particularly in shore break where the board or the seabed makes contact with the foot or lower leg at awkward angles. Reef break wipeouts carry additional risk of reef contact and laceration alongside sprain mechanisms.
If you’re bearing weight comfortably and there’s no bony tenderness along the length of the fibula or around the ankle bones, a ligament sprain is the most likely diagnosis. If you can’t weight-bear or there’s point tenderness over the bone, imaging to exclude a fracture is warranted before attempting to return to any activity.
Neck: Paddling Extension Strain
The sustained neck extension required to hold your head up while paddling is a source of chronic muscular and discal loading that many surfers underestimate. After a long session, the neck extensor muscles have been working against gravity for hours. Accumulated strain leads to localised muscular soreness and, in longer-term cases, disc and facet joint irritation.
Neck pain that refers into the arm, causes tingling in the fingers, or doesn’t settle within a few days should be professionally assessed.
Ribs and Chest: Costochondritis
This one surprises surfers when they hear the diagnosis. Costochondritis (inflammation of the cartilage connecting the ribs to the breastbone) develops in surfers from the sustained pressure of lying prone on a board. It presents as sharp or aching chest and rib pain that worsens with deep breathing, paddling, or when you press on the rib cartilage. It’s not dangerous, but it can be persistent if the loading pattern isn’t modified. Treatment involves load reduction, anti-inflammatory strategies, and addressing the padding and position on the board.
Acute vs. chronic surfing injuries
Understanding this distinction helps you make better decisions about when to push through and when to back off.
Acute injuries happen in a defined moment like a wipeout, a bad landing, or a reef impact. They present with immediate pain, swelling, and loss of function. These should generally be assessed promptly. Many acute injuries respond well to early, appropriate treatment and return to surf sooner when managed correctly.
Chronic injuries develop gradually through repeated loading over weeks or months. They often start as mild discomfort that surfers push through, then become more persistent and harder to settle. The critical point here is that the longer a chronic injury is ignored, the more the body adapts around it, and those adaptations often create secondary problems that extend recovery significantly.
The principle is straightforward: the longer you wait, the longer recovery takes.
Managing minor soreness at home
Not every ache after a surf session requires a physio appointment. Here’s a practical guide to short-term self-management for mild post-surf soreness.
- Ice in the first 24 to 48 hours for acute swelling or hot, inflamed areas. After 48 hours, gentle heat can help tight, sore muscles.
- Gentle movement is usually better than complete rest for muscular soreness. Light walking, stretching, or easy swimming keeps blood flowing without adding load.
- Monitor the pattern. Normal post-surf soreness improves within 24 to 48 hours. If pain is getting worse, not better, or is still present at the same level after three to four days, it warrants professional assessment.
- Can you still paddle tomorrow? If the answer is “only if I manage it carefully,” that’s your body telling you something. One rest day taken early is worth two weeks of forced rest later.
When to seek physiotherapy for surfing injuries
Consider booking an assessment if you notice any of the following.
- Pain that doesn’t improve within three to five days of rest
- Swelling, bruising, or joint instability following a wipeout
- Pain that radiates into the arm or leg, or causes numbness
- A knee that locks, catches, or gives way
- Recurring pain in the same area session after session
- Any neck or back pain that doesn’t settle with a day or two of rest
- Pain that’s changing your technique or stopping you surfing normally
Surf-specific injury prevention
The pre-surf warm-up
If you only make one change to your surfing routine, make it a five-to-ten-minute warm-up before every session. Cold, tight muscles loaded under the demands of surfing are significantly more vulnerable to injuries. A good pre-surf warm-up includes thoracic rotations, hip circles, shoulder rolls, and gentle spinal extension movements, mobilising the exact areas that surfing loads most heavily.
Work with our Sunshine Coast physiotherapists to create an injury-prevention plan
Our physiotherapists can help you build a personalised plan focused on rotator cuff strength, core stability, lower-body strength and flexibility to help prevent injury, support rehabilitation and even improve performance out in the surf.
For families with young surfers
Parents watching their kids learn to surf at Mooloolaba or Kawana often ask when to be concerned versus when to expect normal soreness.
Young surfers developing through adolescence face an additional consideration: growth plates. Open growth plates in the knee, ankle, and shoulder can be vulnerable to repetitive loading forces that adult bone handles without issue. Pain that persists around growth areas in a young surfer warrants professional assessment rather than a “push through it” approach.
Common beginner injuries relate to falls and poor technique, like shoulder strains from paddling with unfamiliar mechanics, knee soreness from awkward pop-ups, and ankle sprains from shore break tumbles. Ensuring boards are appropriately sized for the child’s weight and height reduces both the likelihood of falls and the severity of impact injuries when they do occur. Supervised progression through surf schools with properly credentialed instructors significantly reduces injury risk compared to self-directed learning.
If your child is complaining of pain that persists beyond a day or two, isn’t improving with rest, or is affecting their enthusiasm for the water, a physiotherapy assessment can clarify what’s going on and get them back to enjoying surfing safely.
For competitive surfers
If you’re competing or teaching surf lessons multiple days per week, the injury picture is different from recreational surfing. Volume and load accumulation matter. Competing through the second half of a competition day with a niggling shoulder or a tweaked knee is a short-term decision with potentially long-term consequences.
Pre-season movement screening, involving identifying asymmetries, strength imbalances between the regular and goofy side, and restricted ranges before the season peaks, gives you the information to address issues proactively rather than reactively.
Managing chronic injuries during active competition periods requires a different approach than managing them in the off-season. Our Sippy Downs physiotherapists are experienced in surf-specific injuries and can help you develop a plan that allows you to maintain training and competition load while addressing underlying issues.
How North West Physio Sippy Downs supports Sunshine Coast surfers
Our Sippy Downs clinic is positioned to serve surfers from across the Sunshine Coast. Our team treats surfing injuries regularly, and many of us know these breaks firsthand.
We offer comprehensive surf injury assessments, sport-specific rehabilitation, and performance-focused programmes for recreational surfers and competitors alike. Whether you’re trying to understand a current injury, get back in the water sooner, or build a prevention programme before next season, we can help.
Ready to get back in the water? Book your surf injury assessment at North West Physio Sippy Downs today.
