Stay Strong on the Water: Injury Prevention Tips for Stand-Up Paddleboarding (SUP)

Stand-up paddleboarding (SUP) has exploded in popularity—and for good reason. It’s a low-impact, full-body workout that builds balance, strength, and mindfulness, all while soaking in the beauty of nature. But like any physical activity, SUP can come with risks if you're not properly prepared.

As physical therapists, we often see injuries related to poor form, weak stabilizing muscles, or sudden overuse—especially in the shoulders, lower back, and knees. Whether you're a beginner or an experienced paddler, incorporating a few simple injury-prevention strategies can help you stay safe and strong on the water.

Common SUP Injuries

Understanding what can go wrong helps you prevent it. The most common injuries we see from SUP include:

• Shoulder strain or impingement from repetitive paddling

• Lower back pain from poor posture or weak core engagement

• Wrist or elbow pain from incorrect grip or paddling technique

• Knee discomfort from balance compensation or kneeling too long

Pre-Paddle Warm-Up

SUP may seem gentle, but it engages a lot of muscle groups. Start with a quick 5–10 minute warm-up before hitting the water:

• Arm circles to loosen shoulders

• Torso twists to wake up the spine

• Hip openers like lunges or leg swings

• Balance drills to activate stabilizing muscles

🟢 PT Tip: If you're paddling from a kneeling position to start, ease into standing gradually and avoid sudden movements.

Core Is King

Your core plays a major role in keeping you balanced and reducing stress on your lower back. Add these to your off-the-water fitness routine:

• Bird-dogs and dead bugs for stability

• Planks (front and side) for control

• Bridges to strengthen the posterior chain

🟢 PT Tip: Engage your core throughout your paddle session by gently pulling your belly button toward your spine—this keeps your low back supported and helps with balance.

Protect Your Shoulders

The repetitive motion of paddling can lead to overuse injuries, especially in the rotator cuff and upper traps. Focus on:

• Strengthening shoulder stabilizers (e.g., rows, external rotations)

• Stretching chest and upper back to maintain mobility

• Avoiding overreaching or using too wide a grip when paddling

🟢 PT Tip: Keep your top hand at shoulder height or below during the stroke to reduce strain.

Check Your Technique

Poor technique puts extra strain on joints and muscles. If you’re new to SUP, consider taking a short lesson to learn efficient paddling mechanics and proper foot stance. Key tips:

• Keep knees slightly bent and feet shoulder-width apart.

• Use your whole body—not just your arms—to paddle.

• Keep your gaze forward to maintain balance and posture.

Post-Paddle Recovery

After paddling, take a few minutes to cool down with gentle stretches:

• Hamstring and quad stretches to release tension from standing

• Child’s pose or cat-cow to relax the spine

• Doorway shoulder stretch to open the chest

• Wrist stretches to ease repetitive strain

🟢 PT Tip: Hydrate and refuel post-session, especially if you’re out in the sun or paddling for long durations.

When to See a Physical Therapist

If you're experiencing consistent pain during or after SUP—especially in the shoulders, back, or knees—it’s best to have it evaluated. Physical therapists can assess your movement patterns, identify imbalances, and design a program to keep you paddling safely.

SUP is an amazing way to enjoy the water and stay fit—but it takes more than balance to avoid injury. With the right warm-up, strength routine, technique, and recovery plan, you’ll enjoy more time on the board and less time on the sidelines.

Have questions about SUP prep or recovery? Our clinic is happy to help you build a personalized injury prevention plan. Paddle smart, stay strong, and enjoy the ride!