As I sit trying to write an informative piece about “preparing for surfing”, a large part of me wants to say, “Go back to the Valley”! We don’t need more people in the water? In my day, I would drive all day and night for waves based on a scratchy phone report (probably made up), and my weak knowledge of weather maps. My trusty hand shaped surfboard cost a fortune and to be honest as I wanted to be like Kelly it was too small for most waves. But fun and uncrowded waves were pretty common. Now, with the advent of cheaper and better boards, online surf forecasting and live video streaming, a trip “out west” is on everybody’s weekend agenda. Add in the rapid rise in artificial wave technology, the addition of the WSL (world surf league) to mainstream prime-time television, and of course Tokyo 2020, and it’s not hard to see why surfing is becoming so popular. With that in mind, the rise of the kook (or beginner depending on who you talk to) is here to stay and no doubt will only increase.

 

The benefits of surfing have been known to those who have been involved in the sport for some time and is the reason it often becomes a compulsion for surfers. Evidence more recently has shown significant benefits as a result of surfing to physical and mental health in disabled children, war veterans and those with mental illness. The exercise is medicine revolution is also gaining significant momentum and getting your 150mins of weekly exercise can easily be ticked off when it's cooking in one session. Therefore I guess somewhat begrudgingly I should “share the stoke”. Here is my take on how to prepare for surfing.

When looking at epidemiology of acute injuries associated with surfing the data is limited. Thankfully we know death from surfing is rare. In fact, acute injury rates when compared to contact sports is relatively low. The most common cause for acute injury was due to “wiping out” or in other words, collisions with other surfers, the surfboard, or local environmental factors. These include the sand, reef, rocks or even marine life (dolphins?).

Chronic or overuse injuries are relatively common. These are more likely in experienced surfers and in a large part are proportional to the time spent in the water. Again, the evidence is relatively lacking but data suggests the lower back, shoulder and knee injuries are most common. Prolonged paddling in a prone position is a likely driver for both the lumbar spine and shoulder issues. As a surfer’s ability improves, the explosive nature of the hack, whack, reo, cuttie, float and other radical moves likely play a role. In our clinic we see a lot of surfers with injuries. The classic demographic is someone in there 40’s who became a tradie in order to drop tools whenever the waves are on. He or she has spent countless hours in the water and also usually has a physical job. They are often lean and strong and on the whole in excellent physical shape. Although very fit, this type of surfer has tended to neglect, or to a degree ignore their niggles. In my experience, the entire spine can be pretty worn out both clinically and radiologically. Rotator cuff and other shoulder pathology are common. Another notable issue that has been the driver for prolonged periods out of the water and even joint replacement is FAIS (femoroacetabular impingement syndrome).

There are also some important medical issues to consider. “Surfers ear” affects the experienced surfer particularly those who surf in cold water. As a result of recurrent exposure of the ear canal to cold water, bony exostoses can grow. These can grow large enough to substantially block the canal causing recurrent pain, hearing loss and recurrent otitis externa. Having your ears drilled due to “surfers ear” is usually a sign you charge big waves, and froth on getting in the water even when its freezing! Probably the most serious medical condition is skin cancers. New Zealand has one of the highest rates of melanoma in the world, and unfortunately, surfers are affected by this. Non-pigmented skin cancers like basal cell and squamous cell carcinomas are also very prevalent particularly on the face of older surfers. Sadly, as most people know melanoma can be devastating, non-pigmented skin cancers too, can cause significant morbidity and occasionally mortality.

Therefore, in order to prepare for surfing here are my considerations.

Safety

If you haven’t surfed before and intend joining the line-up there are some simple considerations for your safety. Firstly, paddling out in conditions that suit your ability is probably the most important yet overlooked factor. It may seem obvious, but being a competent swimmer clearly helps. Secondly, paddling straight out to the peak to join the crowds isn’t always best practice. If you are new to the sport, I would pick a spot that is not crowded. Knowing how to read the conditions and potential hazards like rips is something that takes time, so another option is splashing out on some lessons, or even ensuring you surf with a friend. On the whole learning or progressing is much easier and fun when you are not terrified, you’re in control, and are actually able to get out the back.

Musculoskeletal injuries

Unless you are a grommet, spend some time warming up and stretching before you get in the water. A regular strengthening regime focusing on your core, proximal chain control, scapular/cuff mechanics and overall balance and proprioception will go a long way to prepare you for those long sessions also. Thankfully one of the benefits of the televised WSL events, is we get to see our surfing heroes do exactly that! Also, should you develop a niggle or injury, don’t paddle through it. At Axis or through your local physio, we can help settle things and give you expert advice to maximise your surfing time and prevent long-term problems.

Medical issues

Slip, slop slap and wear a hat (yes even in the water). Get a skin check regularly and if you notice a skin lesion that is changing or concerning in anyway, get in to see your GP. Despite the badge of honour of having your ears drilled, you can’t surf for 3 months so to avoid this there are a number of specifically designed ear plugs you can wear, particularly in cold water.

The stoke

The benefits of surfing to physical and mental well-being are hard to quantify, but it’s those feelings that keep surfers going back for more. You should do it too. Get in the water! Regularly!


Surfers (me included) on the whole are a selfish bunch. We know we are on to a good thing and are there for somewhat reluctant to share. It can sometimes mean the surf can be an intimidating place. However, with a little respect, patience and time in the water you too can know the feeling. Get out there!

By Dr Simon Baker on