As the weather begins to warm up often people will change their exercise routine from the gym to being outdoors. A popular option is to use stand up paddleboarding for strength, endurance, flexibility, and creating a caloric deficit. Stand up paddle boarding is a great low impact option to reap the benefits for the cardiovascular system, musculoskeletal system, and most importantly enjoying the beach life.1

Unfortunately, paddle boarding is very demanding and has potential to cause an injury. According to a study published in the Orthopedic Journal of Sports Medicine the shoulder, lower back, and elbow are the most common areas of injury.2 Factors related to injury according to the findings include age, competitive status, and longer hours of participation. The most common types of injury were of the muscle and joint/ligaments. This is understandable based on the repetitive nature of the activity. These types of injuries can be magnified in areas such as Delmarva due to paddleboarding being a seasonal activity, novelty of the activity, and improper preparation of the musculoskeletal system.

The good news, the aforementioned injuries appear to be from the novelty of the activity and/or due to overuse. These types of injuries may cause a temporary bout of inflammation and pain that will subside with rest from the activity. If you sustain an injury please seek assessment and evaluation by a physical therapist to assist with the healing process and decreasing the likelihood of a future recurrence.

Tips to decrease injuries:
1) Choosing the correct location for paddleboarding. The ocean is more difficult to navigate due to the waves and wind thus requiring increased strength and endurance. A calmer spot on the bay will be easier and a better place to start.
2) Selecting the right board. There are multiple types of boards available on the market with each having its own purpose. When paddling on the open water of the ocean or bay a touring board has increased buoyancy and will be easier to track on the water due to the shape and length. If balance is a concern there are wider and more buoyant boards available. It’s important to also consider materials as well.
3) Using the paddle properly. This may seem obvious but the elbow of the bend points towards the rear of the SUP. This allows the user an easier stroke out of the water.
4) Preparation for the day; a dynamic warm-up will assist with preparing for the activity and decrease likelihood of a muscle strain
5) Proper technique for paddling will also decrease the likelihood of an injury. Paddle boarding requires strong shoulders, low back, and abdominals. There is a small amount of elbow bending during a proper stroke.

If you’re unsure about your ability to participate in this activity, seek out a physical therapist for an evaluation and plan of care to prepare you properly for the activity and the summer

For more information regarding paddleboarding in the area and group tours;

Bethany Surf Shop in Bethany Beach, DE
Walk On Water A Paddleboard Company in Ocean City, MD
Coastal Kayak, Fenwick, DE
Delmarva Board Sport Adventures in Rehoboth Beach, DE
48th Street Paddle Sports, Ocean City, MD
OC Sup Fitness, Ocean City, MD
99 Garfield Parkway
Bethany Beach, DE 19930

1. Schram, Ben, et al. “The Physiological, Musculoskeletal and Psychological Effects of Stand up Paddle Boarding.” BMC Sports Science, Medicine and Rehabilitation, BioMed Central, 10 Oct. 2016,…/s13102-016-0057-6.
2. Furness, James, et al. Epidemiology of Injuries in Stand-Up Paddle Boarding. Orthopedic Journal of Sports Medicine, June 2017,

Atlantic Physical Therapy
Adam Jones, DPT
Millsboro, DE