Want To Eliminate Neck Pain? Dr. John Baker Can Help
Surfer's neck refers to a pattern of neck discomfort, tension, or even nerve pain caused by the repetitive postural demands of paddling. Surfer's neck is usually the result of the neck being held in prolonged extension, often paired with excessive shoulder elevation and thoracic spine and ribcage rigidity. This pattern effectively cranks the neck into an extreme end-range position, causing excessive irritation and strain of the surrounding tissues. Add in dysfunctional breathing patterns and shoulder/arm mechanics, and you can bet you're likely in for some discomfort.
It's one of the most common overuse issues for surfers, especially those at breaks that require a lot of paddling through current or white water. Let's dive into why this happens, and what you can do to prevent it.When you paddle, your whole spine is in extension (not just the low back), your head is lifted slightly, and your arms are repeatedly reaching overhead. To support this, the shoulder girdle must coordinate with the thoracic and cervical spine. If the shoulder girdle is not stable it will not be able coordinate this movement fluidly and safely, which the brain will subconsciously pick up on, and rotate the shoulder forward and in to try and find stability. Although this does help prevent us from dislocating our arm/shoulder, it does significantly increase the stress on the shoulder and neck… Think of it like your body choosing the less disastrous of two bad options.
This forward and inward shift of the shoulder causes the shoulder to lose the ability to reach overhead smoothly, and forms a sort of shrugging pattern when reaching overhead during the stroke – which we will dive into more in a second. Interestingly enough, it's really the breath that can make or break the whole system.
Many surfers (and people in general) unknowingly breathe with their neck and shoulders – recruiting the accessory breathing muscles of the neck and upper back. More than just being inefficient, it causes the positional and movement issues discussed above..
In contrast, proper diaphragm-based breathing engages the entire abdominal wall—front, sides, and back. When the diaphragm descends on inhalation (think the flattening of a dome), it creates intra-abdominal pressure, stabilizing the thoracic and lumbar spine while allowing for fluid ribcage movement. This in turn optimizes the fascial and muscular tension through the torso, helping create better positioning and allowing for a balanced segmental spinal curve throughout the rest of the body – providing a stable base for scapulohumeral rhythm and a neutral neck position.
Without diaphragmatic control, you end up with a collapsed midsection, flared ribs, and elevated shoulders in an attempt to stabilize your body – all of which compromise shoulder mobility and load the neck.
Think about it like this… proper breathing mechanics is like paddling in a t-shirt or rashguard, fluid, minimal resistance and lots of range of motion… improper breathing mechanics causes you body to shift in a way that feels more like trying to paddle in a wetsuit that is one size too small – constricting, uncomfortable and restrictive in movement and flow.
Efficient paddling requires both dynamic scapular movement and a stable thoracolumbar foundation. When the breath and abdominal wall are working properly, you reduce the need for the neck to compensate. This means your shoulders can rotate and glide with the humerus, without your neck having to hyperextend or the neck muscles having to overwork.
Integrating the shoulder, torso and breath allows for stronger paddling and less wear and tear on your body. Because a stable trunk allows the force from each paddle stroke to flow through the thorax and shoulder complex, minimizing energy leaks and reducing the chance of injury.1. Learn 360° Diaphragmatic Breathing
Lie on your back or in a crocodile (prone) position and breathe into your entire abdominal wall—front, sides, and low back. I like to tell people to think about breathing into their tailbone or into their balls. You need to really think about breathing low in your body to begin with. Use your hands or resistance bands around your midsection to cue expansion, your brain sometimes can pick up on expanding areas more easily when there is a tactile cue.
2. Practice 360* Breathing while Talking and Moving
Once you know how to get that full, 360* expansion that we're looking for the next step is to train your ability to keep that full expansion while you breathe, talk and move – because when you're paddling you'll want to do exactly that, keep that expansion of the core while paddling and moving around in the water.
3. Integrate Breath + Shoulder Control in Surf-Specific Positions
If you are fortunate enough to be able to surf often, then you can just practice the 360* breathing, ability to hold that full 360* expansion and tension in the abdomen, and paddle. If you cannot, simply lie on your stomach on the ground and pretend like you're paddling. You'll find that your ability to maintain proper position is inferior to your ability to paddle to failure, this is ok for now but the goal is to get them to the same capacity over time.
4. Find a DNS Practitioner
DNS (Dynamic Neuromuscular Stabilization) is the best system that I have found for correcting surfer's neck. If you are struggling I would recommend looking for a chiropractor that practices DNS and seeking out their aid. Getting outside aid may speed up the process of improving your movement and symptoms significantly compared to self-treatment.
Surfer's neck isn't something that has to come with the sport. It's the product of poor mechanics, postural compensation, and disconnected breathing patterns. But with focused attention – training the breath, stabilizing the trunk, and improving shoulder function – you can keep your neck feeling good for the long haul.Want To Eliminate Neck Pain? Dr. John Baker Can Help first appeared on Surfer on Jul 8, 2025
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