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Ways to Minimize Shoulder Pain While Surfing

Updated: Apr 5

Minimize Shoulder Pain Surfing:

Fix it before it breaks

girl with shoulder pain

If you get a ding on your surfboard, it's better to get it fixed before it starts taking on a

lot of water and ruins the surfboard. The same goes for injuries. Chronic injuries that are ignored will likely worsen and eventually prevent you from surfing altogether. When injuries are addressed more immediately, they can resolve quicker and cause less damage. To minimize shoulder pain while surfing, you want to fix it before it breaks.


Rest isn’t always best. People commonly show up to physical therapy only after their home remedies of resting and icing were unsuccessful at healing the injury when they return to activity. We are commonly asked, ‘Why does it still hurt, I took a month off?’


Many times people avoid seeking medical help from an Orthopedic MD or a Physical Therapist for chronic injuries because they assume they will be told to stop their activity. A common misconception is that resting will heal the injury entirely. The body doesn’t heal that way. A month of resting = a month of deconditioning.


So yes, rest is good, but like most things in life, too much of a good thing can be bad! With rest comes de-conditioned muscles, which can lead to muscle imbalances or atrophy. Returning to previous activities with these types of strength deficits after a month of rest can result in rapid re-injury and chronic pain.



a diagram of re-injury cycle


Muscle atrophy occurs significantly faster than muscle strengthening. Although rest allows inflammation from a soft tissue injury to subside, it is not the complete solution. Activity modifications along with physical therapy can empower a person to work through an injury without having to give up their activity.


If you’re dealing with shoulder issues, I can help you navigate through it! I love to help people surf longer and avoid chronic injury through hands-on treatment and specific exercises tailored to address individual specific needs. I specialize in helping surfers get out of pain, prevent injury, and surf for as long as possible.


Common causes of shoulder pain:

  • Instability

  • Rotator cuff strains

  • Overuse

  • Arthritis

  • Upper back (Thoracic) stiffness

  • Neck issues


Wetsuit choice

Wetsuit Design: Chest Zip or Back Zip


Getting in and out of wetsuits can be a struggle, especially when dealing with shoulder pain.

Pros

Cons

Back Zip

  • Easier to get on/off

  • Easier to paddle in

  • Less resistance for stiff shoulders

  • Hard to reach behind back to zip up

  • Can be painful if have a RC injury

Chest Zip

  • Warmer, no back flushes of water

  • More restrictive paddling

  • Hard to get on/off

  • May be painful for someone with joint laxity or shoulder stiffness


Ultimately, it comes down to personal preference & fit. If you have shoulder pain, these may be key things to consider when you’re looking for a new wetsuit.


Spring Suit vs. Full Suit

  • No arms/Short arms - easier to paddle

  • Full arms - adds most resistance for paddling

Wetsuit Thickness

Preserving body temperature or body temperature may not be your highest priority if you’re only going to surf for a short session. You may be better off wearing a thinner suit to save your shoulders from paddling against more resistance if you’re only going to stay out for a short session.

  • Thicker = more resistance & warmer

  • Thinner = less resistance & colder


How to modify paddling when there’s shoulder pain

Paddling with Straight or Bent Elbow


If you’re experiencing pain while paddling, rotator cuff irritation may be the cause. The rotator cuff (RC) is designed to stabilize the shoulder joint during dynamic activities. RC injuries are common in repetitive overhead sports like surfing (paddling), swimming, throwing sports, and volleyball.


Most commonly irritated tendon is the supraspinatus, which exits next to the AC joint. Supraspinatus tendon irritation can be localized or send pain to the elbow or hand.


🔥Serious Rotator Cuff pain may present as:

  • Sharp Pain raising arm to side

  • Sharp Pain reaching behind back

  • Sharp Pain reaching overhead

  • Pain paddling under board

  • Band-like pain radiating to elbow or hand


’S’ Stroke: hand and arm move in an ’S’ shape to propel the water under the surfboard while paddling. As you take a stroke and rotate your shoulder moving the water under your board, you may experience pain in the shoulder. When the hand scoops water under the surfboard during an ’S’ Stroke, the shoulder internally rotates and the supraspinatus tendon is put on stretch.



a person paddling on surfboard
S Stroke


Pain during the internal rotation portion of paddling may indicate rotator cuff irritation.

If the supraspinatus tendon is irritated and put on stretch it will likely increase pain, irritation, and diminish paddling strength via muscle inhibition.


The body tends to find the path of least resistance. Pain will lead to changes in paddling mechanics, inhibit muscle activation, and result in muscle compensation patterns. Poor paddling mechanics combined with muscle inhibition can accelerate tissue break down and lead to injury, which can keep you out of the water for longer periods of time.


💡How to Modify:

  • Paddle with a STRAIGHT ELBOW

  • Uses more LATS

  • Keeping the elbow straight, the RC tendon isn’t put on as much stress

  • This minimizes strain of the rotator cuff that occurs with IR with a bent elbow

  • Give it a try next time you’re in the water and your shoulder is bothering you


⛔️Chronic irritation over time can lead to micro tears which can result in a full tear.

It is important to listen to your body to address injuries before they become a big problem. Address the injury, don't ignore it.


⚠️ When to see the Ortho MD:

  • Severe Sharp pain with use

  • Consistent Moderate to Severe pain (4-10/10 pain)

  • Inability to raise arm over head

  • Severe arm weakness

  • Pain that radiates along the outside of the arm to the elbow or hand

  • Waking up due to pain


Manual Physical therapy is an ideal way to:

  • Improve pain free shoulder range of motion

  • Minimize pain to reduce muscle inhibition

  • Restore pain-free mobility and promote shoulder stability

  • Reduce muscle compensations and restore proper muscle firing patterns


Paddling a Surfboard with a Bent Knee


Experiencing shoulder pain paddling? Bending the opposite knee can help. It all relates to the posterior oblique sling of the shoulder. The posterior oblique sling connects the hip to the opposite shoulder, creating an X in your back.


  • Right Shoulder = Connected to the Left Lower back/Leg

  • Left Shoulder = Connected to the Right Lower back/Leg


Bending your opposite knee reduces torque on the shoulder. This helps reduce the strain on your shoulder by shortening the lever connecting your back and shoulder in the posterior sling. Additionally, paddling with a bent knee can reduce strain to the lower back as well. Ideally, this relates more to longboarding.



a man paddling longboard in ocean
Paddling with a knee bent

How to Modify:

  • RIGHT shoulder pain paddling ➡️ bend the LEFT knee

  • LEFT shoulder pain paddling ➡️ bend the RIGHT knee


Thumbs Up


Shoulder impingement occurs when the glenoid pinches the rotator cuff (supraspinatus) tendon against the acromion, creating a pinch when reaching overhead. Raising your arm overhead with the thumb up clears the joint from pinching. This theory can be applied to paddling. As the hand reaches overhead and enters the water, try keeping your thumb up as the during the initial part of the stroke as the hand enters the water to minimize overhead shoulder impingement while surfing.



Paddle Smarter, Not Harder


10 Ways to minimize bicep burn while surfing


1. Longer Board

  • Paddling a longer board will go faster with less effort & reduce strain to the shoulder

  • Size up. Use a board that is easier to paddle & get through the surf

  • A board that is too big can be challenging to get through the surf, so find a balance

2. Surf Smaller Waves

  • Minimizes shoulder strain while paddling and will leave you feeling less sore

  • Usually more rest between waves

  • Less strength needed to paddle out

  • Easier to go under waves without having to brace as hard

3. Surf Less Crowded Breaks

  • Safer when you’re not feeling 100%

  • Easier to get waves

4. Surf with Longer Rests between Sets

  • Taking a break after a strenuous paddle out will help with muscle recovery

  • Restores paddling power and endurance

5. Shorter Surf Sessions

  • Reduces irritation

  • Shorter surf sessions, helps prevent over doing it

6. Modify Activity

  • Don’t take as long of strokes paddling

  • Shortening your stroke can help ease impingement if you have pain reaching overhead

  • Don’t paddle so hard. Reduce the intensity of each stroke

7. Warm Up

  • Loosens up joints & soft tissue before activity

  • Reduces stiffness

  • Prepares the body for movement

8. Timing the Paddle

  • Paddle out between sets

  • Save your paddling energy

  • Avoid catching the first wave of the set so you don't have to go under the rest of the set

9. Paddling in the Channels

  • Paddling in deeper channels where waves are less likely to break

  • Helps to not get caught inside during a set

10. Using Rip Currents to your Advantage

  • Rips pull out to sea in deeper channels where waves are less likely to break

  • Paddling in the rip current pulling out to sea means less work paddling

  • *This is an advanced technique that requires significant ocean experience


Why Physical Therapy is essential for Surfing Longevity


Shoulder pain and injuries are one of the most common injuries surfers experience. The shoulder is the most mobile joint in the body, and can be the victim of overuse injuries, especially in surfers. Ultimately, physical therapists can help guide injury recovery during the healing process. Physical therapists are your best resource for guiding what you should be doing at your current stage during the recovery process. People re-injure themselves when they do too much too soon after an injury. Physical Therapy can enhance mobility while reducing pain and ultimately keep you surfing longer. Physical therapy can enhance the healing process by addressing pain, inflammation, joint restrictions, and movement pattern dysfunctions to promote optimal tissue recovery and healing. Physical therapists are experts in prescribing the right exercises and progressing them at the right time, with a specific amount of intensity or resistance. My goal as a physical therapist is to guide patients through injury recovery by providing individualized rehabilitative care specifically tailored to the patient’s needs and goals to get them back surfing as quickly and safely as possible.


woman sitting on surfboard in ocean

See you in the water,

Ashley




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