Department of Orthopaedic Surgery

The Department of Orthopaedic Surgery offers services and programs through the following Divisions. Use these links to directly access all our Department sites.

Sports Medicine

Surfing Injuries


Millions of surfers worldwide are prone to a unique constellation of acute and chronic conditions. The most common orthopedic surfing injuries are sprains, strains, dislocations, and fractures, with an overall rate of 3.5 injuries per 1,000 surfing days1,2. The most commonly affected areas for sprains, strains, and dislocations are the lumbar and cervical spine, shoulder, knee and ankle. For fractures, the head is the most common site, mostly involving the nose and teeth, though fractures of the rib are the second most common site. Craniospinal fractures are rare but of particular concern because of the serious consequences, including paralysis and death.


There are three common mechanisms for surfing injuries:

Wipeout – contact with the ground surface – whether it be reef, rock or sand – can cause injury, the type and extent depending on the surfer’s position and contact area. Common injuries include

  • over-flexion of the cervical or lumbar spine

  • forced shoulder depression and contralateral lateral flexion of the cervical spine resulting in traction to the brachial plexus

  • landing on the point of the shoulder causes trauma to the acromio-clavicular joint, fracture to the clavicle, or the shoulder being forced into anterior subluxation.

Big drop at take-off – when standing up on fast, steep waves, the surfer’s feet can land off-centre, putting excessive rotational or medial/lateral force through knees or ankles, leading to acute knee and ankle, ligament and joint surface injuries.

Chronic overuse – injuries of the shoulder, neck, back and elbow are common and relate to prolonged time spent paddling, tummy down, on a board.


Protective Equipment

Using the proper equipment can help to prevent injuries.

  • hard plastic or rubber nose guards fitted to the front tip of the board to soften the blow if contact is made during a wipeout

  • helmets in large waves or when surfing over reefs

  • longer leash can also be very helpful in preventing contact injuries with the board.

Knowledge of the Specific Surfing Conditions

i.e. shallow breaks, reef breaks, etc


A surfer’s flexibility is very important to both injury prevention and performance. Surfers are notoriously bad at warming up, but 10 minutes of loosening up before jumping in the water can make a big difference to performance and injury prevention.

  • thoracic spine extension, posterior rotator cuff, scapular retractors, pectoralis, latissimus-gluteus myofascial system, lumbar spine flexion/extension, hip flexion, hip rotation, ankle dorsiflexion

Conditioning training

Surfing involves major challenges to balance, so core stability work should clearly form an integral part of training.

  • closed-chain leg strength exercises such as squatting, and upper-body strength work to push off the board

  • Work towards developing power. Plyometrics and agility exercises are ideal and should be included in a phased program

  • Most importantly, do not allow any strength program to compromise flexibility


Acute injuries should be managed as they would for any other athlete. Rest, Ice, Compression, Elevation. There should be an emphasis on returning a full range of motion for injuries at the back, shoulder, knee, and ankle joints. A Physical Therapist can work with you on reaching rehabilitation goals specific to surfing and your individual needs.