23 January, 2013 23 January, 2013

Dry Docked – How to Avoid Knee Injuries

Being an ‘action sport’, surf-related injuries are something we’ll all encounter somewhere along the line – some more often than others, and one of the most common areas to be effected by a bad wipeout or heavy landing are our knees. Boland ripper and Biokineticist Phil Nel has seen his fair share of surf-related knee injuries make their way through his practice, and below he explains in more detail just how our knees work and what we can do to strengthen them to avoid those lengthy dry spells while recovering from injury.


Beyrick De Vries flirts between success and possible failure (and injury) in Bali.

The act of surfing on a wave is one of the most dynamic sports on the planet, where we have three variables moving in different given directions – wave, board and surfer. Compare this to another sport, say gymnastics, where the body only interacts with fixed objects in a static environment. If you add the other natural variables of wind, water chop, currents and boils to this ocean mix, then you start to understand the true meaning of ‘dynamic’.

Over the past decade the act of surfing has literally leapt in progress. Hang Tens have been replaced with full rotation airs, and instead of simply charging triple overhead surf, adrenalin seeking surfers are now focussing on double-overhead steps on 3-storey waves. No wonder surfing related injuries are on the rise!

A knee is a hinge joint (with some rotation) that basically uses extensor muscles (Quadriceps) and flexor muscles (Hamstrings) to move the knee. The core and ankle muscles also offer very important stabilisation to the knee. The major ligaments of the knee can be torn in isolation, or in combination. The force and angle of the trauma will determine the extent of the injury. Often, the Meniscus (Cartilage) also tears with enough force.

During a turn like this by Slade Prestwich, the knee can be subjected to forces far in excess of three times your regular body weight.

During a turn like this by Slade Prestwich, the knee can be subjected to forces far in excess of three times your regular body weight.

Modern day measuring equipment (Isokinetic machines) enables us to know what the recommended strength should be for healthy, functioning joints. A competent surfer should be able to load at least three times their own bodyweight on their knees at the very least. The core muscles should also offer sufficient pelvic control and the foot muscles, sufficient ankle stabilisation. All these have to function together in synergy (aka balance). If this is not the case, the knee joint has to rely heavily on its ligaments to offer support. This could either lead to early knee degeneration or acute/chronic knee trauma.

The truth is that the act of standing on a surfboard doesn’t offer surfers enough ‘exercise’ to ensure a stable knee joint. Total time of standing might only add up to under a minute of ‘leg work’ per session. Beginners, weekend warriors and pros fall equal victim to debilitating knee injuries. It’s simple; the higher the level of surfing the higher the demand on the body.

The Good News
By cross-training and strengthening the surrounding foot, leg and core muscles, the knee joint becomes stable and increases performance. A scientific, surf-specific exercise program designed for the individual is necessary. Doing such a program under professional supervision proves even more effective. If you have, suspect, or are recovering from a current knee injury, it’s best to first see a trusted health care professional to diagnose and guide you in the right direction to a speedy recovery.

Cape Town shredder Neil Zietsman has been leading some great surf-specific exercise sessions of late. He is based in Kommetjie where he offers group and individual sessions. Below Neil demonstrates six basic exercises to start strengthening your knees and improving your surfing.


1. Lie flat on your back with arms spread out to your side. Grip the swiss ball between your feet and lift off the floor.

2. Twist with your legs and torso so that your right foot is above your left foot. The twist at your waist is important so that you are not just scissoring the ball.

3. Switch to the other side. Do two reps of ten.



1. Lying down, grab the swiss ball between your feet and lift into the air. Bring your upper body off the floor and grab the swiss ball from between your feet into your hands.

2. Bring the swiss ball over your head and lay back down.

3. Come up again keeping your feet in the air. Put the swiss ball between your feet and let go with your hands.


1. Standing on your right leg, put the top of your left foot onto the swiss ball.

2. Bend your right knee and at the same time push the swiss ball backwards. Make sure your knee doesn’t go in front of your toe as this will put too much strain on the joint. Do two sets of ten each side.



1. Take a big step forward with your left leg. Drop down into a lunge. At the same time rotate your upper body to the left.

2. To make this exercise more difficult you can hold a swiss ball out in front of you or use an elastic for resistance. Do two sets of ten each side.



1. You can do this with your body weight, or with added weight. Take a wide stance.

2. Bend your right knee and sit backwards while keeping your left leg straight. The trick here is to turn your right foot inwards as you sit back into the lunge.

3. Do 12 reps alternating both sides



1. Take a wide stance and grab the kettle bell with both hands. Lift it up to waist height and push it down and back.

2. Let the kettle bell swing between your legs.

3. Swing the kettle bell back up to waist height and at the same time squeeze into your glutes and snap your hips forward. This forces the kettle bell back up in front of you.


For surf-specific training and workouts contact Neil Zietsman on neilziets@gmail.com or check out 3S training on Facebook here>>

For re-hab of a fresh or lingering surf injury contact Phil at Le Roux & Nel Biokenetics


  1. Mel Spears
    24 January, 2013 at 3:28 am · Reply

    I have done my ACL on both knees over the last 10 years playing football and snow skiing. This has prevented me from attempting and radical surfing moves. I have taken up Stand up paddling and this has strengthened my knees.
    My question is would I be able to do all these exercises with out risking injury?

    • Phil Nel
      24 January, 2013 at 10:50 am · Reply

      Best Mel,
      The anterior cruciate ligament prevents the femur from sliding backward on the tibia. It is responsible for a large part of the knee’s stability. It would probably be best to see a local Health Practioner that could do a few stress tests on the knee, seeing that you have a history. If you still experience instability during knee movements, then you should first be doing more conservative exercises, to gain strength. Even profesional athletes that recieve an ACL recon operation, return succesfully to high demanding sports after finishing their physical rehab 😉

      • Malcolm Mersham
        24 April, 2013 at 6:24 am · Reply

        Hey Phil

        Malcolm from Zululand here. Recently did my MCL surfing. I’ve been following the RICE (rest, ice, compression, evaluation) setup for the first week, reducing the swelling. I feel like I’m ready to start exercising and getting movement going. Can I simply follow the above exercises?

  2. Deonlaati
    25 January, 2013 at 8:51 am · Reply

    Thanks Phil
    lekker advice

  3. Leslie
    26 January, 2013 at 9:42 am · Reply

    Howzit Phillip!  C6 C7 prosthesis rehab seem to be ongoing but hell of a lot better than last year this time.  Let I just add to those lazy people like myself.  Keep doing the exercises otherwise its pointless.  Surfing again after major injury takes time but with rehab you get there.  Thanks Phillip for all the help you gave me last year and the year before. Cheers  Leslie

    Currently in Gabon,  Majumba ring any  bells?

  4. Nick
    28 January, 2013 at 9:32 pm · Reply

    I have recently tore my meniscus and had it repaired on 16 January. When do you think I would be able to return to surfing?

    • Phil Nel
      29 January, 2013 at 6:42 am · Reply

      Morning Nick.

      Your return
      to surfing will depend on the extent of the repair, inflamation, secondary knee injury (e.g MCL tear), age, weight, knee strength
      pre-op, and post-op recovery/rehabilitation (to name a few ;). To achieve
      normal knee function usually takes 4 – 6 weeks. But because of the high demand that surfing puts on the knees, you’ll need to be able to do advanced rehab (e.g pain-free dynamic
      stability) on the knee before returning to surfing. >12 weeks (April 2013) is a
      realistic goal. Ask your knee surgeon for approval to start post-op rehab, and
      find a local therapist (preferably with sports rehab experience) to guide you through this process.
      Best regards

  5. joana
    13 May, 2013 at 12:02 pm · Reply

    Nice doc. Thanks for sharing*

  6. Francois Theron
    9 July, 2013 at 6:34 pm · Reply

    Please don’t swing your kettlebells like that, you are hurting your back with your bad technique. You must bend at the hips, and keep your back neutral.

    Also, a great addition for leg strength, including knees, is squats/1 leg squats.

  7. knee support
    28 October, 2013 at 3:48 am · Reply

    sorting out degree all natural joint pain relief supplement that helps
    reconstruct tissue and may increase unit between the joints. likely avoid over
    the counter medications and analgesics that have aspect effects like, symptom,
    internal hurt and therefore kind

Leave a reply

Your email address will not be published. Required fields are marked *