Chronic and Gradual-Onset Injuries and Conditions in the Sport of Surfing: A Systematic Review

Abstract

The majority of the previous literature investigating injuries in surfing have focused on acute or traumatic injuries. This systematic review appears to be the first to investigate the literature reporting on chronic and gradual-onset injuries and conditions in surfing populations. A search strategy was implemented on five databases in June 2020 to locate peer-reviewed epidemiological studies on musculoskeletal injuries or non-musculoskeletal conditions in surfing. A modified AXIS Critical Appraisal Tool was used to appraise all included texts. Extracted data included key information relevant to the epidemiology of the injuries and conditions. Twenty journal articles were included with the majority rated as good quality and a substantial agreement between raters (k = 0.724). Spine/back (29.3%), shoulder (22.9%), and head/face/neck (17.5%) were the most frequently reported locations of musculoskeletal injury, whilst the most common mechanism of injury was paddling (37.1%). Exostosis was the most frequently described injury or condition in surfing populations, with the most common grade of severity reported as mild obstruction. The key findings of injury type, location, severity, and mechanism can be used to develop relevant injury management and prevention programs for the surfing population, with an emphasis on chronic or gradual-onset spine/back and shoulder injuries, paddling technique, and education on the development and management of exostosis.

Rehabilitation and Prevention of Surfing Injuries: Literature Review

“…This review presented studies published between 2021 and 2022, being the first systematic review to evaluate previously published studies on the incidence of injuries [9][10].…”

“…The total sample of individuals analyzed between the two studies was approximately 17,019 individuals with a mean age of 27.5 years, most individuals are male, approximately 73% [9][10].…”

Surfing on the world stage: a narrative review of acute and overuse injuries and preventative measures for the competitive and recreational surfer

“…We believe studies reporting chronic and overuse musculoskeletal surfing injuries are significantly scarcer than those reporting acute surfing injuries. This is likely due to the lengthy periods of time required for the onset of symptoms, the difficulty in pin-pointing the exact activity where the injury occurred42 and the challenge of following up surfers to collect their data. Nevertheless, overuse injuries of the shoulder, lower back and neck are increasingly more common in surfers, which has been associated with prolonged periods paddling 6 9 10 43.…”

“…Correct paddling technique requires extension of the lumbar, thoracic and cervical spine, to allow for shoulder circumduction 6. Thus, it comes as little surprise that injuries of the lumbar and cervical paraspinous muscles are common due to their prolonged isometric hyperextension 42 43. It has been suggested that this isometric hyperextension causes muscle imbalances and may predispose surfers to acute musculo-ligamentous injuries 44.…”

“…Langenberg et al described the ‘surfer’s shoulder’ as one with deficits in external rotation strength and range of motion 46. The repetitive arm strokes in paddling may predispose surfers to overuse shoulder injuries 42. Paddling causes high rates of shoulder strains and impingement of the supraspinatus tendon, which may result in tendon degeneration after years of surfing.…”