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Neck Pain
Surfer's Neck and Shoulder Pain: Causes and Fixes
Long paddle outs hold your neck in extension and work your shoulders hard, so sore necks and cranky shoulders are common among surfers. Here is why it happens, what to change, and when to get checked.
Dr. Peter Thompson, DC Published October 23, 2026 Updated October 23, 2026 8 min read
Our Oceanside office is a few minutes from the Pier, so we see a lot of surfers, and the complaint is often the same. The session felt great, but by the drive home the base of the neck is tight, one shoulder blade burns, and turning to check a lane change is a chore. A long winter of bigger swells or a summer of daily dawn patrols tends to make it worse.
Most of this pain comes from paddling, not wipeouts. The good news is that it usually responds well to a few technique changes, some smart strength work on land, and timely care when it does not settle. Here is what is happening and what to do about it. Neck pain that shoots into the arm after a session can be a pinched nerve in the neck, which needs a slightly different approach.
Ready to get checked? See our neck pain treatment in Oceanside page or the new patient special offers.
Quick answer
Surfing neck pain usually comes from paddling, which holds the neck in extension while the shoulders repeat thousands of strokes. Fix it by lowering your chest, looking forward with your eyes instead of cranking your head up, choosing a board with enough volume, and building upper back and rotator cuff strength on land. Arm numbness or weakness needs an exam.
Key takeaways
- Paddling is the most common reported cause of surfing shoulder injuries, and it loads the neck at the same time.
- Most surf neck pain is muscle and joint strain from sustained extension, not a single wipeout.
- Board volume, chest position, and where you look change the load on your neck.
- Upper back mobility and rotator cuff strength protect both the neck and the shoulder.
- Arm numbness, weakness, or symptoms after a hard impact need prompt evaluation.
Why paddling is hard on your neck and shoulders
To paddle, you lie face down, arch your upper back, and lift your head to see the horizon. That holds the neck in extension for most of a session, compressing the small joints at the back of the neck and keeping the muscles at the base of the skull working without a break. Add a choppy day where you keep lifting your head to spot sets, and those muscles fatigue quickly.
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Meanwhile, your shoulders repeat the same overhead stroke hundreds or thousands of times. A 2024 systematic review in Acta Ortopédica Brasileira, available through the National Library of Medicine, found that roughly 15 percent of reported surfing injuries involved the shoulder, and in the studies that recorded a cause, paddling was the most common one. The authors pointed to repetitive overload and paddling posture as likely drivers.
When the upper back is stiff, the neck and shoulders make up the difference. That is why surfers who spend the week at a desk often feel it most. Our pages on neck pain and shoulder pain cover these patterns in more detail.
Common surf pain patterns and what they usually mean
Neck related headaches are common in surfers and usually respond to the same fixes that help the neck itself.
| What you notice | Common contributor | What usually helps |
|---|---|---|
| Ache at the base of the skull after long paddles | Sustained neck extension and tired suboccipital muscles | Lower chest position, eyes up instead of chin up, upper back mobility |
| Headache that starts in the neck after surfing | Neck muscle and joint irritation | Shorter sessions while it settles, neck strength work, an exam if frequent |
| Pinching at the front or top of the shoulder when paddling | Rotator cuff irritation or impingement | Stroke changes, rotator cuff and shoulder blade strength |
| Burning between the shoulder blades | Fatigued upper back muscles from arching | Rest days, thoracic mobility, gradual paddle volume increases |
| Tingling or numbness into the arm or hand | Irritated nerve in the neck | Professional evaluation, especially if it is getting worse |
Fixes in the water: technique and equipment
- Lower your chest a little. Paddling with a very high chest forces more neck extension. Find the position where the nose of the board stays just above the water.
- Look forward with your eyes, not your chin. Keep the back of the neck long and lift your head only when you need to spot a set.
- Use long, relaxed strokes with the hand entering in front of the shoulder, not crossing over the board.
- Choose enough board volume. An undersized board sits lower in the water and makes you work harder on every paddle.
- Check your wetsuit fit. A tight or stiff suit across the shoulders adds resistance to every stroke.
- Build session length gradually after time out of the water instead of jumping straight into two hour sessions.
- Sit up on your board between sets to give your neck a break from extension.
Five land exercises for surfers with neck and shoulder pain
Do this routine three or four times a week, including on flat days. Stop any exercise that sends pain or tingling into the arm. A guided program through our corrective exercise service adapts these to your shoulder, your board, and how often you surf.
- Chin tucks: sit or stand tall and glide your chin straight back, making a gentle double chin. Hold 5 seconds and repeat 10 times.
- Foam roller thoracic extension: lie with a foam roller across your upper back, support your head, and gently arch over it. Move the roller up a few inches and repeat for 1 to 2 minutes.
- Prone Y and T raises: lie face down and lift your arms into a Y, then a T, with thumbs up and shoulder blades drawn back. Hold 3 seconds, 8 to 10 times each.
- Side lying external rotation: lie on your side with a small towel under the top elbow and rotate a light weight up toward the ceiling. Do 2 sets of 12 per side.
- Wall slides: stand with your back and forearms on a wall and slide your arms up without letting your ribs flare. Repeat 10 times.
When surf shoulder pain is more than soreness
Normal post session soreness fades within a day or two. Pain that lingers for weeks, wakes you at night, or makes it hard to reach overhead often means the rotator cuff tendons are irritated and need a structured plan rather than more rest.
Treatment usually starts with a thorough exam, then combines chiropractic care for the neck and upper back with targeted strength work. For rotator cuff tendon problems that have lasted more than a few months, shockwave therapy may be an option, and new patients can start with the $75 shockwave special. Hydrotherapy massage therapy can help with recovery between sessions. Surfers with knee, hip, or ankle issues from pop ups and wipeouts can read more on our sports injuries page.
When to see a chiropractor or doctor
Surfer's myelopathy is rare, but a review in the Journal of Spine Surgery notes it can worsen over hours, so do not wait it out.
- Neck or shoulder pain that lasts more than two weeks despite rest and technique changes
- Pain that wakes you at night or keeps you out of the water
- Tingling, numbness, or weakness in the arm or hand
- Headaches that are becoming more frequent after surfing
Seek urgent medical care if you have
Neck pain after hitting the bottom, a reef, or your board, especially with numbness, tingling, or weakness; loss of consciousness or confusion after a wipeout; or back pain during or after surfing that quickly progresses to leg numbness, leg weakness, or trouble urinating. That last pattern can signal surfer's myelopathy, a rare spinal cord injury most often reported in first time surfers that needs emergency care.
Getting help near the beach in Oceanside
Our Oceanside office on Vista Way is a short drive from the Pier and Harbor breaks, and our Oceanside sports injury care page explains how we work with active patients. Surfers farther south can visit our Carlsbad office in Bressi Ranch.
We offer same day visits most weekdays, Monday to Friday 10 AM to 6 PM and Saturday 10 AM to 4 PM, with free parking and Spanish spoken. New patients can start with the $49 New Patient Special, or the $75 shockwave special if shockwave is the right fit.
Frequently asked questions
Why does my neck hurt after surfing?
Paddling holds your neck in extension for most of a session while you look toward the horizon. That keeps the joints at the back of the neck compressed and the muscles at the base of the skull working without a break.
How do I stop neck pain when paddling?
Lower your chest slightly, look forward with your eyes instead of lifting your chin, use a board with enough volume, sit up between sets, and strengthen your upper back on land.
Is shoulder pain common in surfers?
Yes. Research reviews find the shoulder is one of the more commonly injured areas in surfing, and paddling is the most frequently reported cause.
Should I keep surfing with shoulder pain?
Mild soreness that fades in a day is usually fine. Pain that lingers for weeks, wakes you at night, or limits reaching overhead should be examined before it becomes a longer problem.
Can a chiropractor help surfing neck pain?
Yes. Chiropractic care for the neck and upper back, combined with corrective exercise for the shoulders, often helps. We refer out if an exam suggests a more serious injury.
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Written by
Dr. Peter Thompson, DC
Doctor of Chiropractic
Dr. Peter Thompson is a doctor of chiropractic at Pacific Spine & Rehab, which has offices in Oceanside and Carlsbad (Bressi Ranch). He writes about back and neck pain, sports injuries, shockwave therapy, and recovery after auto accidents.
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