Surfing and Back Pain: Understanding Pain and Recovery
Part 3 of the Complete Guide to Back Pain in Surfers
The foundations of recovery often lie beneath the surface. Photo by Reed Naliboff
If you've read Part 1...
If you've read Part 1, you already know that the relationship between surfing and low back pain is probably a little more complicated than most Instagram reels would have you believe.
Research on surfing is growing.
But there's still a long way to go.
There simply isn't much surf-specific research available yet.
The studies we do have point in some interesting directions, but they also leave plenty of unanswered questions.
Fortunately, this is where decades of research on low back pain in the general population become incredibly valuable.
Because while surfers place some unique demands on their bodies, they're still human.
And, in many ways, the factors that seem to influence back pain and recovery are remarkably similar whether you surf, skate, run, lift weights…
Perhaps the biggest change over the past few decades hasn't been discovering one new cause of back pain.
It's been realising that we were asking the wrong question.
Instead of asking, "What's the one thing causing this pain?", researchers have increasingly started asking, "What combination of factors might explain why this person is hurting right now?"
That shift has changed almost everything about how we think about recovery.
The Problem With Looking For One Magic Solution
If you've ever searched online for back pain advice, you've probably come across statements like these:
"Your hips are too tight."
"Your core is weak."
"You need these five exercises."
"It's your discs."
"It's inflammation."
"Your pelvis is out of alignment."
"Your fascia is tight."
The list goes on.
The problem is that low back pain is one of the most extensively studied health conditions in the world.
After decades of research involving hundreds of thousands of people, multiple clinical guidelines and countless systematic reviews, one message has emerged remarkably consistently.
Most episodes of low back pain cannot be explained by one single structure.
Or one single movement.
Or one single treatment.
At first, that can feel disappointing.
Life would certainly be easier if one stretch, one exercise or one treatment fixed every painful back.
Personally, though, I think it's actually good news.
Because it means that if stretching hasn't solved your pain, or that expensive treatment didn't provide the miracle you were hoping for, you haven't failed.
Your back is simply behaving like... a back.
Complex.
Human.
Sometimes frustrating.
Sometimes we’re so focused on finding one single cause for back pain that we miss the bigger picture. Photo by Prescott Horn
How Our Understanding of Pain Has Changed
For a long time, back pain was approached almost like a mechanical fault.
Like taking your car to a mechanic.
Find the broken part.
Repair it.
Problem solved.
For many years, healthcare worked in much the same way.
Find the damaged tissue.
Treat it.
Pain disappears.
Simple.
To be honest, as a health professional, there are days when I wish it really worked like that.
It would certainly make life easier.
And sometimes it does.
Someone develops pain because of a very specific problem.
The cause is clear.
Treatment is straightforward.
Recovery is relatively quick.
Those cases absolutely exist.
But they're not the whole story.
Today, we know that pain is influenced by much more than muscles, joints and discs alone.
Physical loading matters.
But so do recovery, sleep, stress, previous experiences, physical conditioning, general health, confidence in movement and many other factors.
That's one reason why two people can have remarkably similar MRI scans while living completely different lives.
One may surf every morning with barely any symptoms.
Another may need to think twice before sitting down on the toilet or bending over to tie their shoes.
The scan didn't necessarily change.
The person did.
Why Does Back Pain Sometimes Stick Around?
Pain is remarkably good at protecting us.
One of its main roles is to encourage us to change our behaviour when our body perceives that something may be threatening it.
Rest.
Slow down.
Move differently.
Give the body an opportunity to recover.
Most of the time, that's exactly what happens.
The pain gradually settles, and life moves on.
Sometimes, however, recovery takes much longer than expected.
Why?
Researchers still don't have all the answers.
But over the past few decades, several factors have consistently been associated with slower recovery and a greater likelihood of persistent pain.
One of them is repeatedly asking more from the body than it's currently prepared to tolerate.
Another is doing the exact opposite.
Avoiding movement altogether.
Becoming less active.
Gradually losing physical capacity.
Poor sleep also appears to play an important role. It influences pain sensitivity, physical recovery, mood, cognitive performance and many of the biological processes that support adaptation and repair.
Psychological factors matter too.
Stress.
Anxiety.
Low mood.
Fear of movement.
Catastrophic thinking.
General health also contributes.
Smoking.
Low levels of physical activity.
Reduced cardiovascular fitness.
Other health conditions.
Even our beliefs about pain can shape recovery. If every painful movement is interpreted as a sign of further damage, it's completely understandable that people begin to move less and protect themselves more.
Unfortunately, that protection can sometimes become part of the problem.
Reduced activity often leads to reduced physical capacity, making everyday movements feel harder than they once did.
A vicious cycle can gradually develop.
None of these factors explains every episode of back pain.
And none guarantees that pain will persist.
But together, they help explain why recovery is sometimes more complicated than simply treating one muscle, one joint or one disc.
Sometimes back pain is like that annoying guy in the lineup... It just won't go away. Photo by Byronet Media
What Does This Mean for Surfers?
Surfing places real demands on the body.
Long paddles.
Repeated pop-ups.
Rotation.
Compression.
Rapid movements.
Hours in the water.
Fatigue.
Surfing doesn't care whether you've been sleeping well recently.
It doesn't know work has been stressful.
It doesn't know you've spent the last three months sitting behind a desk.
Surfing simply ask your body to paddle, rotate, compress, extend and repeat.
Every physical activity places demands on the body.
Every body has a certain capacity to tolerate those demands.
Problems often arise when those demands exceed our current capacity.
Capacity isn't fixed.
Like strength, aerobic fitness or balance, it changes throughout our lives.
Imagine paddling out after several months away from the ocean.
You'd probably still remember how to surf.
Your body, however, might have forgotten what hours of paddling, duck diving and repeated pop-ups actually feel like.
Would your shoulders, back and arms have a few strongly worded complaints the following morning?
I'd be surprised if they didn't.
That doesn't necessarily mean your spine is damaged.
It may simply mean your body wasn't yet prepared for what you asked it to do.
The encouraging news is that capacity can be rebuilt.
Usually, it doesn't require highly "surf-specific" exercises performed while balancing on a Bosu ball.
Sorry if you've already bought one.
More often, it starts with things that sound almost boring.
Getting a little stronger.
Improving your general fitness.
Sleeping a little better.
Recovering properly.
Gradually exposing your body to the physical demands of surfing again.
Managing the things that are actually within your control.
You don't need to change everything overnight.
In fact, trying to improve everything at once is often a good way to improve nothing at all.
Pick one or two things.
Build from there.
Keep going.
Surfing is so much fun that it’s easy to underestimate the demands it places on our bodies. Photo by Jarno Colijn
Rethinking Recovery
Modern pain science doesn't promise pain-free lives.
What it offers is something far more realistic.
Pain doesn't automatically mean damage.
That doesn't mean you should ignore the pain.
It means asking a different question.
"Why is my body asking for more right now?"
More recovery?
More sleep?
More strength?
Better conditioning?
Perhaps the greatest contribution of pain science isn't giving us one more treatment.
It's reminding us that recovery is rarely about finding one magic solution.
It's about gradually building a body that's healthier, stronger and better prepared for the demands of surfing.
What’s Next?
We've explored what modern pain science tells us about back pain and why recovery is rarely as simple as fixing one structure.
In Part 3, we'll look at what the best available evidence says about recovering from low back pain, which approaches consistently seem to help, and what that means specifically for surfers.
Continue Reading
Part 4 – Recovering From Low Back Pain. What works for surfers.
Looking for a practical plan?
The Strong & Resilient Back Program turns the principles discussed throughout this series into a practical system designed to help surfers build a stronger, more resilient back and keep surfing for years to come.
Why you can trust this article
This article was written by Joao Batata, a clinician specialising in musculoskeletal health, exercise physiology, sleep medicine, and strength & conditioning. He has also been chasing waves for more than 30 years.
Every article published by the Beacon Surf Health is based on peer-reviewed scientific research, critically appraised through the combined lens of clinical practice and real-world surfing experience. The goal is not simply to explain the science, but to help surfers understand what it means in practice.
Articles are regularly reviewed and updated whenever new evidence meaningfully changes our understanding.
The information provided is for educational purposes only and should not replace personalised medical advice. If you have severe, persistent, or worsening symptoms, consult a qualified healthcare professional.
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