For Dr. Clayton Everline there’s no better preparation for surfing than surfing. The real workout comes after a surf session.

The North Shore surfer and orthopedist has a rigorous apres-surf stretching regimen designed to counteract the muscle imbalance that results from catching and riding a lot of waves. As with many things in Hawaii these days, his byword is sustainability.

"I found that consistency in surfing was the best training, but I had to make it sustainable so that I didn’t let cumulative overuse injuries keep me from enjoying myself," said Everline, 37, who treats patients at Straub Clinic & Hospital and teaches at the University of Hawaii’s John A. Burns School of Medicine.

It’s a fitness trend among today’s top surfers, many of whom follow routines that create flexibility without sacrificing strength. But the weekend surfer can benefit from that training, too, according to Everline.

He credits fellow Straub orthopedist Dr. Ed Weldon with developing many of the exercises and stretches that professional surfers use. The movements are aimed at preserving the shoulder capsule — a membrane that surrounds the muscle joints. It can get stretched or even ruptured from poor shoulder maintenance, Everline said, so keeping proper muscle tone and balance in the shoulder can help prevent injuries.

The exercises are deceptively subtle. To demonstrate one of them, Everline lies on his side with two high-density foam rollers under his torso, one at his armpit and the other at his thigh. With his legs spread, Everline gently rocks back and forth no more than a couple of inches.

For an extra shoulder stretch, he pushes his arm flush to the ground, a position known as a "sleeper stretch."

The exercises stretch a muscle in the armpit, the subscapularis. It can get especially tight in surfers because it’s responsible for the internal rotation involved in paddling, said Everline, co-author of "Surf Survival: The Surfer’s Health Handbook" (Skyhorse Publishing, 2011). Also getting a stretch is the latissimus dorsi, the broad muscle along the back, as well the hip flexors and other leg muscles stressed by popping up on a surfboard.

"What the foam roller does is it breaks up scar tissue," said Everline, who likes to do the exercise while playing with his infant daughter.

He’ll also sit on the foam roller, positioning his arms behind him and rock and forth to work his glutes. These muscles "tend to be underutilized in our current culture," he said. "We sit, we drive, we sit in hip flexion all the time, and so that tends to create some postural instability in our low back."

Another movement that uses a "T" strap stretches the pectoralis minor muscle, a relatively small muscle in the chest that gets a heavy workout from stroking into a wave.

"Surfers have a very tight and short pec minor," he said. "People used to call it muscle-bound, but now it’s called ‘upper-crossed syndrome’ — head forward, shoulders forward, hunched over. Computer posture, basically."

The condition can lead to abnormalities in the shoulder, such as tightness and arthritis, he said.

EVERLINE GREW up surfing the New Jersey shore, which has good waves during the fall hurricane season but little swell the rest of the year. He earned his medical degree at Seton Hall University in South Orange, N.J.

To satisfy his surfing passion and his desire to provide community service, he established a foundation to provide medical services to contests on the East Coast and the Caribbean. It proved so popular that Everline wound up working in Hawaii for the Vans Triple Crown of Surfing.

Presented with an opportunity to settle in Hawaii, he said "fuggedaboutit" to New Jersey and moved here five years ago.

"It just became serendipitous that I was able to have a career out here," he said.

While he loves the easy access to surfing he found in Hawaii — Everline bags quick 15-minute sessions behind his Moku­leia home before work — he discovered he had to refocus his training regimen.

Before coming to the islands, he had specialized in strength and conditioning, expecting to work with competitive athletes. And he worked out hard, too, piling on muscle to get ready for New Jersey’s short surf season. Lifting weights became a motivator.

"I was in the gym all the time," he said. "I was about 30 pounds heavier, but that was detrimental to my surfing. The volume of muscle and explosive power was great for football, but it’s not great for catching waves."

He researched training regimens aimed at improving his surfing and learned that lighter is better, enabling surfers to maneuver quickly in the waves. Everline now weighs a trim 165 pounds.

Everline surfs all over the North Shore, but he’s not out to compete with hard-core surfers for the wave of the day. If he goes to Pipeline, he’s satisfied to get one wave amid the hordes of aggressive shredders.

"I’m a bit of a hermit as far as surfing," he said. "I find my little secret spots and kind of play them out. I wouldn’t say I’m avoidant, but I use that time to decompress."