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Injury patterns in competitive and recreational surfing: a systematic review
  1. Carlos Eduardo Miguelote de Pinho Monteiro1,
  2. João Moreira-Pinto2,3,4,5,
  3. Ana Catarina Queiroga3,5,6,7
  1. 1School of Medicine, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
  2. 2Department of Pediatric Surgery, Hospital-Escola da Universidade Fernando Pessoa, Porto, Portugal
  3. 3EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
  4. 4Instituto de Investigação, Inovação e Desenvolvimento (FP-I3ID), Fundação Fernando Pessoa, Porto, Portugal
  5. 5Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
  6. 6IDRA - The International Drowning Researchers’ Alliance, Kuna, Idaho, USA
  7. 7ILS Drowning Prevention Commission, International Lifesaving Federation, Leuveen, Belgium
  1. Correspondence to Dr Carlos Eduardo Miguelote de Pinho Monteiro, Universidade do Porto Instituto de Ciências Biomédicas Abel Salazar, Porto, Porto, Portugal; cempmonteiro{at}


Context Despite the growing evidence regarding surf-related injuries, investigation seems to overlook the differences between professional and recreational surfers’ injuries and their specific risk factors.

Objective This review aimed at identifying differences in injuries sustained by recreational and competitive surfers. It also presents research gaps and suggests recommendations for future injury research and prevention.

Methods Study search was conducted on MEDLINE/PubMed, SportDiscus and Web of Science databases. To be included studies needed to report original data, clearly specify if recreational and/or competitive surfers were included, provide information regarding acute surfing injuries and/or analyse data concerning those injuries.

Results 17 studies were included in the analysis. All included studies had at least Oxford Centre for Evidence-Based Medicine level of evidence 3. The percentage of recreational surfers sustaining at least one injury ranged from 31% to 35% in the 12 months prior to data collection and from 88% to 100% in lifetime while 42% to 49% and 81% to 100% of competitors were injured over the same periods. Competitive surfers appear to have a higher injury risk. Both recreational and competitive surfers appear to sustain more frequently skin, joint/ligament and muscle/tendon injuries affecting the lower limbs and caused by contact with their own equipment.

Conclusions Competitive status, less surfing experience, older age and prior surgical injuries are risk factors for sustaining injuries while surfing. The most common types, anatomical locations and mechanisms of injury seem to be similar between recreational and competitive surfers.

  • recreation / sports
  • systematic review
  • sports / leisure facility
  • exposure

Data availability statement

Data are available on reasonable request. Data may be obtained from a third party and are not publicly available.

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Data availability statement

Data are available on reasonable request. Data may be obtained from a third party and are not publicly available.

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  • Contributors ACQ and CEMdPM were responsible for the conceptualisation of the review protocol. CEMdPM was responsible for data extraction and analysis. ACQ, CEMdPM and JM-P were involved in the study design, screening process, interpretation and discussion of results and writing of the manuscript.

  • Funding This study was funded by national funds through the FCT—Foundation for Science and Technology, I.P., under the project UIDB/04750/2020.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.