Stand Up Paddle Surfing (SUP) Injuries

Stand Up Paddle Surfing (SUP) Injuries

Do you Stand Up Paddle Surf?  Stand-Up Paddle Surfboarding (SUP) is a main stream water sport that is a hybrid of surfing and paddling.  It is tons of fun and an awesome workout.  My husband and I love it and started SUP over 10 years ago now.  We enjoy it so much that I chose to do my Sports Medicine Fellowship Research Project on it.  I basically looked at the injuries associated with SUP.  This post is dedicated to SUP and will go over associated injuries and ways you can prevent them.  It’s perfect for people with no knowledge about SUP looking to learn about it and for those who have been doing it for years and want to avoid or treat injuries.

History of SUP

Modern SUP has its origination in the Hawaiian Islands. The Hawaiian language translation is “Hoe He‘e Nalu,” which literally means, to stand, to paddle, to surf a wave.  In the early 1960s, the Beach Boys of Waikiki would stand on their long boards with outrigger canoe paddles to take pictures of the tourists they were teaching to surf. This is where the term “Beach Boy Surfing”, another name for Stand Up Paddle Surfing, originates.  Then, in the early 2000s big wave Hawaiian surfers Dave Kalama, Brian Keaulana, Rick Thomas, Archie Kalepa and Laird Hamilton used SUP to train when surfing conditions were low to strengthening their legs and core for tow-in surfing.  Eventually SUP was seen in events like the Moloka’i to O’ahu Paddleboard Race and Mākaha’s Big Board Surfing Classic.  There are now separate SUP divisions in outrigger, paddleboard, & surfing competitions.

stand up paddling

Modern SUP

SUP is a challenging core body work-out and is an alternative and fun way for many people to exercise.  Participants may choose to “paddle SUP” for distance alone or may prefer to “surf SUP” in which they ride waves as in traditional surfboarding.  Already an extremely popular sport in Hawai‘i, SUP has now expanded globally.  There are SUP competitions in the mainland US, Mexico, Africa, Europe, Australia, and New Zealand.  It is popular in warm coastal climates and resorts.  Many celebrities sample the sport, and cross-over athletes are training with SUP. SUP has been spotted around the globe, in lakes, rivers, whitewater, as well as in popular surfing lineups.

SUP popping up in popular surfing lineups has of course caused some turf wars with the surfing purists, especially here on Oahu where the waves are over-crowded.  I tend to agree with the surfers, stand-up paddle surfers should avoid the popular surfing spots, mainly because SUP can be done where surfing cannot.  So, I recommend taking the paddle a little farther out or to a remote location to a break that surfers can’t get to, mostly because with SUP you can.

SUP Equipment

SUP uses special boards that are typically longer (9 to 12 feet), thicker (3 to 5 inches), and wider (27 to 32 inches) than a standard surfboard.  Traditional SUP boards are constructed similarly to surfboards with a polystyrene foam core and a glass-reinforced plastic using epoxy resin.  The longer paddles, are similar to a long outrigger canoe paddles, and are made of fiberglass to propel the board through the water and to steer.  Lucky for everyone there are newer and cheaper options for blow up SUP boards, which I have seen used numerous times, especially at Ala Moana Beach Park.  Below are some price comparisons.






SUP Injuries

My study basically meant that I went out and surveyed stand-up paddle surfers around the island.  The results revealed a widely diverse group based on gender, age, and experience.  The participants were mostly men (66%), with an average age of 39 (range 14-61 years).  People spent more time in “SUP surfing” than in “SUP distance paddling” (7.6 vs. 4.1 average hours per week).  Other water sports that SUP athletes perform include longboard surfing (61.4%), shortboard surfing (43.2%), and outrigger canoe paddling (26.1%).

SUP demographics

52.3% of the people surveyed reported having experienced injuries or medical conditions related to SUP.  The most common location of injuries were the shoulder (20.4%) and foot (16.3%).  The most common injury types were shoulder sprains/strains (14.2%), foot lacerations/abrasions (8.2%), back strains (7.1%), and foot sprains/strains (7.1%).  Strains/sprains were the most common type of injury (51%), followed by skin lacerations/abrasions (25.5%), and bruises (12.2%).  No cases of skin cancer were reported.  Injury rates did not change based on gender, age (<40 vs. >40 years), or whether you SUP surfed vs. paddled.  New SUP participants (<12 months experience) had fewer injuries than more experienced participants.

SUP Injuries

Preventing SUP Injuries

There was a significant increase in injuries reported for participants with 12 months or more experience, compared to new participants with less than 12 months of experience. This is probably due to the fact that the longer you do a sport the more likely you are to experience some kind of injury from it.  Shoulder injuries were the number one location for injuries not surprisingly because of the paddling that is involved in SUP. Prevention of shoulder injuries usually means making sure proper form is being used while paddling. I  have seen many SUP paddlers using all shoulder motion while paddling.  Paddling, as any canoe paddler will tell/teach you, involves your whole core in a twisting motion using your  abdominal oblique muscles.  Your lower arm should be almost fully extended and your whole body is pulling and doing most of the work, again with your core, not your shoulders.

Foot lacerations and abrasions made sense because if you fall off the board then you would be likely to land on your feet.  Foot sprains and strains were a surprise to me initially.  I admit how much I personally use my intrinsic foot muscles for balance and can see how they would be damaged from overuse.  Avoidance of lacerations, bumps, and bruises could be done by making sure your balance is well established prior to starting SUP surfing and a more gradual increase in amount of activity is always recommended for new athletic activities, usually 10-15% increase per week.  The back strains are also likely a byproduct of poor form.  I actually had many people tell me how SUP stopped their chronic back pain, just due to how strong it made their core.

medication and needles

Treatment of SUP Injuries

Lacerations, cuts, abrasions, and bruises should be treated in the usual first aide fashion.  Clean all open wounds and cover with a clean bandage and antibiotic ointment to help prevent infection.  Icing any bumps will help with the pain and hopefully prevent any goose egg bruises.  If the cut is more like a slice, especially if it’s on the head/face or scalp, consider going to a doctor to get stitches or glue to keep it together.  Always seek medical care for any suspected infection.

Strains and sprains can be acutely treated with rest, gentle stretching, icing, and NSAIDs or Tylenol.  Sometimes a brace or taping will help, depending on the injury and location.  If pain persists or is severe then see your primary care provider, because maybe physical therapy will help.

You should always seek medical attention for any suspected fractures, dislocations, or concussions.

SUP Ala Moana

Please let me know in the comments if you have any SUP stories, questions, or concerns.


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