Although Stand Up Paddleboarding (SUP) is a fairly new recreational and competitive sport, as Physical Therapists we are already seeing injuries that people have sustained, primarily due to poor conditioning, positioning and biomechanics on and off the board.  Here are some tips for you to be  safe, efficient, and injury free as you enjoy this very enjoyable sport.

SUP is a wonderful exercise in that it allows our bodies to function in the upright position, which is how we, as humans, are designed so that our musculoskeletal, neurological and sensory systems are in a natural state of optimal performance.  Paddling upright on the board loads our rotational forces, which helps to stabilize and strengthen the entire kinetic chain, as we pass over an unstable surface (the water).
SUP Biomechanics (how all movements and postures of the body interact together to make up a functional whole) for injury prevention:

1. Foundation:  the foundation of the body has to do with the core and the spine, from the rib cage to the hips.  The core muscles and movements live in the middle of the body.  Low back pain, strain and disc issues are common SUP injuries.
     a. Sternal lift:  Keep your chest lifted as it does when you take a deep breath in.  This means that you breathe into and out of your abdomen with you diaphragm muscle.  Keep the chest lifted through ALL phases of paddling.
     b. Athletic Stance: Place your feet shoulder width apart and get your weight on the big toe mound of the foot.  Keep your knees soft and slightly flexed.

2.  Shoulder:  the most common injury that Physical Therapists see from SUP are rotator cuff injuries and tears.  Down the road we expect that arthritis related to this sport will be a problem.  Again, with proper education these injuries can be entirely avoided.
a. When standing on your board in the positions described above, the arm that is placed at the top of the paddle should be positioned so that the elbow is no higher than the shoulder. This keeps the shoulder blade tightly into the trunk, which will stabilize the shoulder joint.  The arm then moves as a component of the trunk and allows the strong muscles of the trunk to do the work of propulsion.

3. Legs, hips, pelvis: This is the area from the belly button to the big toes.  Following these tips will lead you into a powerful, efficient, sustainable, safe power stroke of the paddle and forward movement of your board.
a. You are in your sterna lift (chest high), athletic stance (feet at shoulder width, ankles, knees, hips soft and flexed, and your point of contact is at the base of your big toes and heels.) This stance will automatically activate the muscles of your inner thighs (adductors,) and the muscles of the inner thighs will activate the muscles of the buttocks (gluts).  The gluts will activate  the abdominal muscles, which are huge power generators in stand up paddleboarding.
b. When you begin paddling you must reach your paddle into the water without ANY slumping of the spine (affecting the discs). The forward movement of your trunk must come only  from your hips.
c. Any loss of balance will be due to compensatory muscle motions taking place if you bear weight on your little toes vs. your big toes.

In Summary:
The power that is generated from our muscles can be compared to a rubber band.  If the length is increased there is more stored energy and a greater potential for muscle work to get done; or the more “snap” the muscle has.With the proper  stance, positioning and movement on the board you are going through a rhythmic cycle of lengthening (or loading) the muscles for explosive power and shortening the muscles for stability.

Review of position:
1.    Sternal Lift
2.    Athletic stance
3.    Softly flexed ankles and knees
4.    Foundation of weight bearing through the big toe mounds and heels
5.    Movement of trunk is at the hips, not the low back
6.    Always start the paddling cycles with your trunk positioned vertically to the water. (upper body is straight)

Flexibility:  There are many muscle groups that coordinate for proper, safe and efficient paddling.  Stretching these muscles is absolutely necessary in order to get into the proper positions of SUP, as well as for overall joint safety.
a.     Hamstring stretches
b.    Calf stretches
c.    Trunk stretches
d.    Shoulder stretches
e.    Low back stretches
f.    Neck stretches

Lifting your board:  As with any lifting of a heavy, bulky, awkward, large object please use your lifting skills of bending your knees, and pulling the board close to your body, and lifting with your legs as opposed to your back.

For more education on safe, enjoyable, competitive Stand Up Paddleboarding injury prevention, please contact the Mountain Center Physical Therapists and Certified Athletic Trainers/Strength and Conditioning Specialists. Please remember that SUP injuries are most often the result of repetitively using poor mechanics over time, so start by doing everything correctly!