Short answer
Paddling loads the shoulders for long periods, and lying arched on the board loads the lower back and neck. Shoulder pain in surfers is usually rotator cuff-related; back pain is usually joint and muscle overload in extension. Both respond to managing session length after time off and strengthening for the demands of paddling.
Common causes
Paddling volume
Long sessions after weeks out of the water.
Arched position
Lying with the back extended and the neck looking up.
Pop-ups
Repeated fast extension and rotation.
What usually helps right now
- Build session length gradually after time off.
- Add shoulder and upper back strength work.
- Warm up on the beach before paddling out.
What to avoid
- Marathon sessions on the first good swell after a break.
- Paddling through sharp shoulder pain.
When to book an assessment
- Shoulder pain at night.
- Back pain lasting more than a week.
Get urgent medical care if
- Sudden weakness lifting the arm after a wipeout.
- Neck injury after hitting the bottom: seek emergency care.
How we treat it
- AssessHistory, movement and clinical tests, with screening for anything that needs a doctor.
- ExplainA clear diagnosis in plain language, and what recovery usually looks like.
- TreatHands-on care where it helps: joint and soft tissue work, dry needling or adjustments.
- RebuildExercises and a training plan so it holds up, with an end point.
Questions
Why does my lower back hurt after surfing?
Lying arched on the board for long periods loads the lower back.
Can I keep surfing with shoulder pain?
Usually, with shorter sessions and a strength plan.