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Table 1 An overview of articles that analysed or described surf paddling kinematics

From: The Surfer’s Shoulder: A Systematic Review of Current Literature and Potential Pathophysiological Explanations of Chronic Shoulder Complaints in Wave Surfers

Study Study type Focus N Findings
Surf kinematics
Nessler et al. 2015 [20] Cohort study Wetsuit vs non-wetsuit effect on muscle activation in paddling; EMG/8 camera Vicon analysis 12 -Mid deltoid, infraspinatus and upper trapezius peaks at recovery phase
-Peak triceps brachii, erector spinae and LD during propulsion phase
-Mid trapezius activity peak at the end of propulsion.
Nessler et al. 2019 [21] Cohort study LD, upper + mid trapezius, post + mid deltoid surface EMG changes at different water velocities 12 -Mid deltoid, post deltoid and trapezius most active at the start of paddle motion
-LD is most active in mid-stroke.
-LD: propulsion
-Deltoid: arm placement and return
-Trapezius: scapular rotation
Carter et al. 2015 [19] Cohort and literature study Shoulder elevation in relation to paddle activitiesa 54 Negative correlation between hours of board paddling and shoulder elevation scores.
Paddle movement (no original data):
-Starts in a forward flexed position with scapula protraction, glenohumeral abduction and flexion to catch the water.
-Glenohumeral IR and extension follows while the thorax extends.
Consistent cycling through these positions predisposes to impingement.
-IR is a dominant movement, propelling the surfer, mainly by pectoralis major, LD and subscapularis.
-Decreased ER may result as result of subsequent tightness, limiting scapular posterior tilt.
Posture and ROM
Furness et al. 2014 [10] Retrospective cohort study Retrospective analysis of chronic injuries in surfers 1348 -Prolonged paddling is leading cause of chronic shoulder injuries.
-Shortening of the muscle units of the shoulder muscles may result in muscular imbalance.
McBride and Fisher 2012 [15] Cross-sectional study Identification of shoulder complaints in professional surfers 15 Clinical findings in 30 shoulders:
-4/30 tendonitis
-3/30 impingement.
-8/30 had winging of the scapula during shoulder abduction.
-2/30 had active signs of external impingement
-3/30 had grade I anterior instability
Lassalle et al. 2012 [16] Cohort study Physical examination of surfers with and without shoulder complaints 25 76% of surfers had shoulder pain
In the painful group:
-Impingement in 53–63%
-ER decreased compared to the non-painful group
Shoulder strength in surfing
Furness et al. 2018 [22] Cohort study Internal to external strength ratio examined in professional surfers and reliability of testing. 21 More strength in IR muscles compared to ER muscles
Comparable to other sports with repetitive overhead arm movements
Madeira et al. 2019 [23] Cohort study Compares IR in surfers to reference population 5 In surfers: higher values for IR and smaller percentage for ER/IR ratio compared to reference population
  1. IR internal rotation, ER external rotation, EMG electromyography, ROM range of motion, LD latissimus dorsi muscle
  2. aProne paddling and knee paddling are both mentioned
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