How Surfers Should Actually Heal Tendon Injuries

New research shows isometrics + collagen timing beat rest, ice, and “doing nothing”

If you surf long enough, tendon pain is almost guaranteed.

Achy shoulders after long paddle days. Stiff hips that won’t rotate like they used to. Ankles that feel sketchy every time you pop up or land an air.

Most surfers are told the same thing:

“Rest it. Ice it. Give it time.”

But new research shows that approach may actually slow healing and increase re-injury risk.

According to leading tendon researcher Dr. Keith Baar (UC Davis), tendons don’t heal best with rest — they heal best with the right kind of load, applied early, and paired with the right nutrition.

Let’s break down what the science says and how surfers can use it to fix the most common surf-related injuries.

Why Rest and Immobilization Can Make Tendons Worse

Tendons exist to transmit force — from muscle to bone.

When you completely remove load (boots, braces, excessive rest), the tendon doesn’t “recover” … it degenerates.

Dr. Baar explains it simply:

“If you take tension away from the tissue, you increase scarring and weaken the tendon.”

Research shows that immobilization causes collagen fibers to lay down in a disorganized pattern, creating stiff, weak tissue that’s more likely to flare up again once you return to sport.

For surfers, this is especially relevant because:

• Surfing loads tendons for long durations (paddling, stance holds)

• Forces are often low to moderate but repetitive

• Complete rest doesn’t prepare the tendon for those demands

The Science-Backed Solution: Low-Load Isometrics

Instead of dynamic movements or heavy strength training, Dr. Baar’s lab has found that low-load isometric contractions are one of the most effective ways to stimulate tendon repair.

Isometrics = holding tension without joint movement

Why they work:

• They apply controlled mechanical load

• They stimulate collagen remodeling without excessive wear

• They reduce pain while improving tendon capacity

📚 Research highlight:

Baar’s lab has shown that tendon collagen synthesis peaks within ~10 minutes of loading, after which additional work mostly adds fatigue, not benefit.

The Ideal Isometric Protocol (Backed by Research)

Use this framework for most tendon injuries:

• Hold: 30 seconds

• Rest: 2 minutes

• Sets: 4–5 holds

• Frequency: 1–2x per day

• Intensity: Low to moderate tension (no sharp pain)

The goal is tension, not pain.

Longer holds allow the “strong” parts of the tendon to fatigue, forcing load into the weaker, injured areas — exactly what’s needed for remodeling.

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How This Applies to Common Surf Injuries

1. Knee Pain (Patellar Tendon / Meniscus-Adjacent Pain)

Common in surfers due to:

• Deep compression during pop-ups

• Long stance holds

• Repetitive knee flexion

Best isometrics:

• Wall sits (knees around 90°)

• Split squat holds

• Front knee traveling slightly over toes

Hold for 30 seconds, focus on steady breathing, zero bouncing.

2. Hip Pain (Hip Flexor & Adductor Tendons)

Common in surfers due to:

• Explosive pop-ups

• Prolonged paddling extension

• Rotational demands during turns

Best isometrics:

• Split squat holds

• Copenhagen plank holds (for adductors)

• Hip flexor holds in half-kneeling position

Key: multiple joint angles, not just one position.

3. Ankle & Achilles Pain

Common in surfers due to:

• Repeated pop-ups

• Landing airs

• Uneven board pressure and foot placement

Best isometrics:

• Bent-knee calf holds (targets soleus)

• Straight-leg calf holds (targets gastrocnemius)

• Start with heel slightly elevated if sensitive

These are especially effective for chronic ankle stiffness that flares after long surf sessions.

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Nutrition That Doubles Tendon Repair Signals

Training is the stimulus — but tendons also need raw materials.

📚 Key study:

Shaw et al., American Journal of Clinical Nutrition (2017) Participants who consumed collagen + vitamin C before loading saw a 2x increase in collagen synthesis markers.

The Protocol:

• 15g hydrolyzed collagen

• 200–250mg vitamin C

• Taken 30–60 minutes before isometrics

Why it works:

• Collagen provides glycine + proline (primary tendon amino acids)

• Vitamin C is essential for collagen cross-linking

👉 Tip for surfers: choose collagen from skin sources (bovine hide or fish skin), not bone broth, to reduce heavy metal exposure.

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Start Loading Earlier Than You Think

Another important study comes from Dr. Michael Kjaer, a leading sports medicine researcher.

📚 Research finding: Athletes who began light loading 2 days post-injury recovered ~25% faster than those who waited 9 days.

Early loading is safe if:

• There’s no sharp or stabbing pain

• Movements are slow and controlled

• Load is kept submaximal

Dr. Baar’s rule of thumb:

“Burning muscle is okay. Ice-pick pain is not."

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Why Ice, NSAIDs, and RICE Fall Short

The traditional RICE protocol (Rest, Ice, Compression, Elevation) focuses on reducing inflammation — but inflammation is part of healing.

Dr. Baar notes that:

• Ice can reduce blood flow needed for repair

• NSAIDs blunt collagen synthesis

• Excess rest delays adaptation

Instead, he prefers short isometric holds to:

• Pump fluid through tissue

• Reduce swelling naturally

• Maintain tendon signaling

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How Surfers Should Progress

1. Start with low-load isometrics

2. Increase load gradually (not speed)

3. Add dynamic movements only once holds are pain-free

4. Progress back to surfing volume last — not first

You’re not trying to “train hard."

You’re trying to teach the tendon how to tolerate load again.

Final Takeaway for Surfers

Tendon pain doesn’t mean stop surfing forever.

It means load smarter, not less.

The research is clear:

• Isometrics rebuild tendon tissue

• Collagen timing accelerates repair

• Early, gentle loading beats rest

This approach doesn’t just heal injuries — it bulletproofs surfers against future ones.

Start slow. Stay consistent.

Your knees, hips, and ankles will last longer in the water because of it.

-Coach Paul