Low Back Pain in Surfers: Causes, Prevention, and Management

Surfing, a popular water sport enjoyed worldwide, offers numerous physical and mental benefits. However, it also poses a risk of low back pain (LBP) for many athletes. This blog explores the causes, prevention strategies, and management options for LBP in surfers, drawing from recent scientific literature.

Prevalence and Causes

Low back pain is one of the most common injuries reported among surfers. A 2014 Australian study ranked it as the highest surfing-related injury, accounting for 23.3% of all reported injuries[1]. The prevalence of LBP appears to be higher in older (>40 years) and more experienced (>20 years of surfing) surfers, with the 35-55 age bracket being the most affected[1].

Several factors contribute to the development of LBP in surfers:

1. Prolonged Prone Positioning: Surfers spend a significant amount of time in a prone position while paddling, which forces the lumbar spine into hyperextension. This position can lead to muscle fatigue and strain over time[1].

2. Repetitive Paddling Motion: The repetitive arm movements during paddling can cause overuse injuries, particularly when combined with poor thoracic spine mobility[1].

3. Explosive Movements: The "pop-up" maneuver, transitioning from lying to standing, requires explosive strength and can lead to acute injuries if performed with poor technique or inadequate core strength[3].

4. Biomechanical Stress: The combination of trunk flexion and rotation during turning and cutting movements can predispose the lower back to chronic injury[1].

Prevention Strategies

To reduce the risk of developing LBP, surfers should consider the following preventive measures:

1. Core Strengthening: Implementing exercises that target core muscles can improve stability and support for the lower back during surfing activities[1].

2. Improving Flexibility: Focusing on flexibility exercises for the hip flexors, hamstrings, and thoracic spine can help reduce excessive stress on the lumbar region[1].

3. Technique Refinement: Proper paddling posture and a controlled pop-up technique can minimise strain on the lower back[3].

4. Alternative Pop-up Technique: For surfers with existing LBP, the "knee pop-up" technique may be a less stressful alternative to the traditional prone pop-up[3].

Management and Rehabilitation

When LBP occurs, several management strategies can be employed:

1. Physiotherapy: A tailored rehabilitation program focusing on strengthening weak muscles and improving flexibility can be beneficial[2].

2. Sport-Specific Training: Implementing surfing-specific strength and conditioning exercises can help prevent future injuries[1].

3. Posture Analysis: Evaluating and correcting paddling posture can help reduce the risk of developing LBP. A 2022 study found that surfers who adopted a paddling posture with an angle greater than 23° between the spine and the board were less likely to report LBP[4].

4. Medical Evaluation: Persistent or severe pain may indicate underlying conditions such as surfer's myelopathy, a rare but serious complication that requires immediate medical attention[5].

Conclusion

Low back pain is a significant concern for surfers, particularly those with more experience or of advanced age. By understanding the biomechanics of surfing, implementing proper prevention strategies, and seeking appropriate management when needed, surfers can reduce their risk of LBP and continue to enjoy their time in the waves. Future research should focus on developing more specific prevention and rehabilitation protocols tailored to the unique demands of surfing.

Low back pain when you're out for a paddle? Call our experienced team on 0416 241 847 or head online to www.surfedge.physio/book-now and let us help you Recover. Perform Excel.

References:

[1] Furness, J., et al. (2014). Acute injuries in recreational and competitive surfers: incidence, severity, location, type, and mechanism. American Journal of Sports Medicine, 42(5), 1176-1184.

[2] Castagna, C., et al. (2022). Musculoskeletal pain related to surfing practice: Which role for sports rehabilitation strategies? A cross-sectional study. Journal of Back and Musculoskeletal Rehabilitation, 35(2), 375-382.

[3] Everline, C. (2010). Alternative Pop-Up for Surfers with Low Back Pain. North American Journal of Sports Physical Therapy, 5(1), 15-18.

[4] Gonçalves, J., et al. (2022). Paddling Posture Analysis in Surf: Its Relation with the Presence of Low Back Pain. Research & Reviews: Journal of Nursing and Health Sciences, 4(1), 1-5.

[5] Patel, N., et al. (2022). Acute paraparesis during surfing: the perils of riding the wave. Clinical Medicine, 22(5), 456-458.