Extreme Sports Series: Understanding The Demands of Surfing (part 1)

 In Exercise and Health


In this series of blogs I will address some of the most common extreme sports, starting with surfing. It is important to acknowledge that surfing can be further subdivided into bodysurfing, bodyboarding, longboarding, shortboarding, tow-in and more recently stand-up paddle boarding. This blog will focus on its most popular form, shortboards.

Extreme Sports Brief Overview

Firstly, I would like to point to a particular trait which is normally present in those who engage with an extreme sport. They have a particular mind-set and temperament that can manage high-risk activities in a controlled manner. It is known that temperament traits are neurochemically regulated and can also be heritable, which means these participants can be seen as genetically hardwired to engage in extreme sports. In other words, equipped with the mind frame to manage danger successfully.

Omer Mei-Dan, an Orthopaedic Surgeon and BASE jumper from Israel, mentions in his book that the new and inexperienced participant as well as the experienced extremist are the two groups at higher risk of injury.

Other particularities observed with extreme sport rehabilitation, including surfing, are the fact those participants or athletes are more resistant in accepting changes in sports participation due to injury or prevention. Moreover, a gradual return to sport is not always feasible as full commitment may be required for safety reasons. For instance, one cannot paddle out on 6ft surf expecting to be ‘half-ready’ to drop-in on a wave. The consequences, even in smaller surfing conditions and among professionals can be disastrous.

one cannot paddle out on 6ft surf expecting to be ‘half-ready’ to drop-in on a wave. #performbetter @pogophysio Click To Tweet

Surfing Injury rates and risk factors

In a survey study performed with the general surfing population between 1998 and 1999, 1,348 respondents account for 1,237 acute injuries and 477 chronic injuries. From the acute injuries lacerations were represented by 42%, contusions 13%, sprains/strains 12% and fractures 8%. A total of 37% of the acute injuries occurred to the lower extremities and another 37% to the head and neck. As expected, 52% happen via contact with the surfer’s own board, 12% from another’s board and 17% from contact with the sea floor. Still according to this survey, older surfers, more expert surfers, and those engaged with big wave surfing presented with relative higher risk of significant injury (2)

Considering competitive surfing, another study conducted between 1999 and 2005 over 32 professional and amateaur surfing contests presents with further data. A total of 116 injuries were documented where 89 happened at competition. The injury rate given was 5.7 per 1000 athlete exposures or 13 per 1,000 hours of competitive surfing. Also, further data, which coincides with the previous mentioned survey, report that those surfing waves overhead or bigger had 2.4 fold injury risk increment in relation to smaller surf conditions and similarly a 2.6 fold injury risk increment when surfing over a rock or reef bottom in comparison to a sand bottom (3).

A third study conducted in Australia 2015 estimated 37 million surfers worldwide with 2.5 million in Australia alone, which means just above 10% of the Australian population engages with surfing as a sport at some level. From the total study participants, 91.3% were males and 43.1% competitive surfers. A total of 512 acute injuries were assessed as major, which was defined by having 1 or more day off work and/or surfing or having to attend to a medical professional. The shoulder, ankle and head/face were the most affected sites, represented by 16.4%, 14.6% and 13.3% respectively. Muscle and joint were the most affected, representing a combined total of 58%.

Interesting, with the evolution of the sport, an increase of aerial maneuvers has been seen. The same authors report that those surfers completing aerial maneuvers had a higher incidence of injuries.

With the evolution of the sport, an increase of aerial maneuvers has been seen. #performbetter @pogophysio Click To Tweet

Unfortunately, the fatality rate of surfing is unknown. In Hawaii, between 1993 and 1997, 306 drowning deaths occurred. Bodyboarders and surfers accounted for 17 of the 238 ocean-related drownings. There also 2 fatal shark attacks to surfers in the same period. This authors also reports on an unpublished review performed via database search from 1984 to 1998 which yield 95 surfing related fatalities. The breakdown was 63 drownings where 11 due to concussion, 4 due to seizures, 4 due to leash strangulation, 12 due to shark attacks, 8 due to lightning strikes, 2 from fins lacerations, the remainder numbers were of unknown cause (1).

Basic Physiological Demands

In competitive surfing, the greatest amount of time is spent paddling (54%). 28% of the time is spent stationary, 8% riding and 4% paddling into a wave (5). It will be expected that recreational surfers would have an increased stationary time, less paddling and riding times due to decreased fitness levels and skill.

In competitive surfing, according to one study, 61% of the paddling bouts fell between 1-10 seconds and 64% of the stationary bouts between 1-10 seconds. The highest speed recorded was 33.4 km/h via GPS tracking system and average distance covered 1,605m per heat. Heart rate mean was 139 bpm (5). In summary, competitive surfing is an intermittent high intensity activity. Breathing control techniques must be mastered for recovery during low intensity paddling bouts.

Other authors have compared professional and recreational surfers in their study. Findings are consistent with initial expectations and show that professionals have significantly greater aerobic capacity as measured via VO2peak, which is the highest volume of oxygen uptake measured during a given activity. Not to be mixed with VO2max, which determines the maximal oxygen consumption capacity for the individual. Anaerobic capacity was also found to be superior in among professionals. Arm span and total lean muscle mass were also correlated to performance indicators. Those findings suggest an adaption to the demands of the sport in those involved in competitive surfing, as well as a natural predisposing features such as arm span, which combines will lead to better physical performance in the water.

A last paper had a look into wave conditions, surfer ability and physiological performance of recreational surfers. The key findings were that the exercise intensity decreases as the ability of the surfer increases. More skilled, trained surfer will spend less energy or be able to tackle more challenging surfing conditions that directly demand better physiological responses. However, as wave size increases, there was decrease in physiological demands but increases in ride speed and covered distance (7)

Final thoughts

  • Injury risk increases with experience, exposure to aerial maneuvers and sea bottom type, notably rocks and reefs.
  • Although lacerations were appointed the most common type of injury for surfers. The data from that study comes out survey performed in the Emergency Department of Hospitals and is therefore biased towards this type of injury given the need to stop bleeding and medical management. Overall, muscle and joint injuries are the most common. I will expand on that topic during part 2.
  • Surfing requires is a intermittent high intensity activity and requires great aerobic and anaerobic capacities.
With the evolution of the sport, an increase of aerial maneuvers has been seen. #performbetter @pogophysio Click To Tweet

Bruno Rebello (APAM)

Bruno Rebello

Featured in the Top 50 Physical Therapy Blog


  1. Mei-Dan, O., & Carmont, M. R. (2013). Adventure and Extreme Sports Injuries Epidemiology, Treatment, Rehabilitation and Prevention. London: Springer London.
  2. Nathanson, A., Haynes, P., & Galanis, D. (2002). Surfing injuries. The American Journal of Emergency Medicine, 20(3), 155-160. doi:10.1053/ajem.2002.32650
  3. Nathanson, A., Bird, S., Dao, L., & Tam-Sing, K. (2006). Competitive Surfing Injuries: A Prospective Study of Surfing-Related Injuries Among Contest Surfers. The American Journal of Sports Medicine, 35(1), 113-117. doi:10.1177/0363546506293702
  4. Furness, J., Hing, W., Walsh, J., Abbott, A., Sheppard, J. M., & Climstein, M. (2015). Acute Injuries in Recreational and Competitive Surfers: Incidence, Severity, Location, Type, and Mechanism. The American Journal of Sports Medicine, 43(5), 1246-1254. doi:10.1177/0363546514567062
  5. Farley, O. R., Harris, N. K., & Kilding, A. E. (2012). Physiological Demands of Competitive Surfing. Journal of Strength and Conditioning Research, 26(7), 1887-1896. doi:10.1519/jsc.0b013e3182392c4b
  6. Furness, J., Hing, W., Sheppard, J. M., Newcomer, S., Schram, B., & Climstein, M. (2016). The Physiological Profile Of Male Competitive And Recreational Surfers. Journal of Strength and Conditioning Research, 1. doi:10.1519/jsc.0000000000001623
  7. Barlow, M. J., Gresty, K., Findlay, M., Cooke, C. B., & Davidson, M. A. (2014). The Effect of Wave Conditions and Surfer Ability on Performance and the Physiological Response of Recreational Surfers. Journal of Strength and Conditioning Research, 28(10), 2946-2953. doi:10.1519/jsc.0000000000000491

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