Words Glenn Phipps – Exercise Physiologist at The Movement Lab

BA5T1828Matt Banting, who’s currently out of Trestles on knee injury. With any luck (and a lot of physio), we’ll hopefully be seeing him in France. Photo: Andrew Shield

It seems as if getting a knee injury is the bees knees on the pro tour right now (sorry-I’m aware this isn’t a very fun-knee pun).

So, what makes a surfer prone to a knee injury? And, are you at risk of joining the bung knee party yourself? Well in the first instance copping a chunk of fibreglass to the knee won’t win any friends, and is sure to have you sidelined on the dancefloor for a few months. But there are definitely a few things that can make you more susceptible to a knee injury.

It’s no surprise that the knee is so prone to bending and twacking and hurting. With a limited range of motion, the amount of load it has to carry and the potential for twisting motions to damage the knee, it’s a wonder we stay upright as much as we do. Given that the knee is really just one bone sitting on top of another, it is asked to do more jobs than a work experience kid at a Chinese Nike factory.

So, what can put you even further at risk for knee injuries? I’m going to list a few things here, but this list is by no means exhaustive. I point out a few things to highlight that gauging injury risk isn’t as simple as you might think.

Previous injury

An old knee injury, or even hip or any lower leg injury, can increase your risk of blowing out the knee. This can be due to changes in integrity of the joint itself, or changes in loading patterns on the knee as a result of altered movement patterns and muscle activation. Old injuries might also increase laxity of the joint, and especially in the case of inadequate rehab, reduction in proprioception (an awareness of the relative position of the knee).

Aerobic Fitness

Research has been mixed in this area, but many findings have shown increased risk on knee injuries with lower levels of aerobic fitness. This may be due to early fatigue of the muscles that support the leg.

 DSC1645Despite his bung knees, Matt scored the cover of Surfing Life 318 a while back. And this was the shot, by Andrew Shield.

Genetics

Unfortunately, if you’ve been passed on a few bum genes from the olds, then ACL injuries or the like in the old man brings up your risk of ACL tear to double its original. This is a pretty tough one to do anything about, but something to think about and be wary of, anyways.

Flexibility

Research ((http://www.archives-pmr.org/article/S0003-9993%2896%2990137-9/abstract)) has shown increased risk of knee injury with tight iliopsoas muscles (hip flexors), and abnormally high and low levels of flexibility in the hamstrings. So if you’re tight? Stretch it out.

Landing mechanics

This is a variable that has most commonly been studied in single and double leg jump landings. Basically, collapse of the knee when landing from a jump is correlated with greater risk of knee injury. It would make sense that we could also apply this this to some extent when landing a heavy floater or aerial. In this case, however, it is probably much harder to control, given the forward momentum of the board – but something to consider for sure, if not only for the realisation that having a strategy to safeguard your knees is extremely important.

Neuromuscular factors

This is probably where we can do the most to lower our risk. Things like whether we are more dominant in one leg, or muscle group, can increase injury risk. This may be a result of anatomic alignment or biomechanical changes from a number of causes, but regardless, some action can be taken to give the knees a fighting chance.

There’s an obvious one that pops up here: limb dominance. Whilst your shredding hard the rear leg is doing way more work than its lazy friend up front.  While this is important for your surfing, resulting changes that occur in your day to day activities might not be so cool. If your only physical activity is surfing, and you spend the rest of your days in front of a computer or the like, then you need to do something to address this now.

Postural stability and balance is obviously important in avoiding looking like a kook, but also in avoiding knee injury – whether as a result of a direct impact on your surfing, or neuromuscular changes that indirectly impact your knee. But beware! Don’t see this as a green light into drowning your training with bosu balls. More on this is coming later.

Matt Banting talks the injury that kept him our of the 2015 J-Bay Open from Quiksilver on Vimeo.

Muscle strength and reaction time

A difference in the strength between the hamstrings and the quadriceps is often debated as to whether this may increase knee injury risk. The thinking is that a ratio that sees the quads as being significantly stronger than the hamstrings can impact the hamstrings ability to help the ACL stabilise the knee and stop it from becoming unstable, which may happen as the quads contract during a sudden change of direction.

Weak glute muscles can also change the way you load the knees, and not only cause injury, but cause dreaded poo-man-itis, where your surfing resembles that of a human prepping for excretion. In my practice with surfers, I often see weak muscles in the glutes corresponding with tight hip flexors that cause the pelvis to tilt. To add to this, a reduction in core strength (lumbopelvic stability) can also reduce your ability to absorb impact when you land an air or floater, which means you’ll be copping that gnarly move in the knees.

These are just a few of the reasons that surfers are so prone to knee injury. Well and good, you say –so what do I do about it? Stay tuned for part two, where I’ll give you some strategies for how to stay shredding. Despite what you may think, it doesn’t involve jumping around like a clown on a bosu ball, or similar.

Note: don’t jump around like a clown on a bosu ball.

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Glenn Phipps is an in demand Exercise Physiologist who currently works with the world’s best athletes in SUP, Surfing, OCR and MMA. He is also the official Sports Scientist for the ESPN program Search 4 Hurt, and has been featured in various health and fitness publications. When not bringing clarity to the confusing world of health and fitness, he can be found lamenting why everyone wants to surf at the same time as him, and hanging out with the people he made. 

You can find out more about Glenn and his business, The Movement Lab, right here. Or, find him on Facebook. As an added bonus for being a Surfing Life reader, he’s offering 10% off your first appointment – if you’re looking for online help, he’ll offer you a second month free for his unique online training program. Just mention this article.

And, stay tuned for his next feature as Surfing Life’s in house health expert.

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