Objective Traditional balance training (TB) may have certain limitations in replicating surfing`s unstable conditions, which may somewhat restrict its sport-specific efficacy. Total Resistance Exercise (TRX) suspension training uses controllable instability to better enhance key balance abilities. This study compared TRX and TB effects on static, dynamic, and surfing-specific balance in elite surfers, and explored correlations between these dimensions to inform targeted training. Methods 32 surfers from the current Chinese National Surfing Team were randomized to TRX or TB groups (n = 16 each). Both groups completed 30-minute training sessions ×3/week for 8 weeks. Static balance (eyes-closed single-leg stand), dynamic balance (Star Excursion Balance Test (SEBT), Linear travel deviation test), and surfing-specific balance (Indo board lateral squat) were assessed pre- and post-intervention. Pearson correlations examined relationships between balance dimensions. Results (1) Both methods improved static balance (p < 0.01), but TRX group exhibited greater improvements (p < 0.001). (2) Dynamic balance improved significantly in both groups (p < 0.01), but TRX outperformed TB (SEBT: p = 0.034 for left leg, p = 0.043 for right leg; Linear travel deviation: p = 0.000). (3) Surfing-specific balance improved significantly in both groups (p < 0.01), with TRX superior to TB (p < 0.01); (4) Surfing-specific balance changes correlated significantly with static balance (moderate positive: r = + 0.487 for left leg, r = + 0.457 for right leg), multidirectional dynamic balance (weak positive: r = + 0.395 for left leg, r = + 0.363 for right leg), and directional control (moderate negative: r=-0.515). Conclusion TRX suspension training is more effective than TB in enhancing static, dynamic, and surfing-specific balance in elite surfers. Thus, TRX suspension training can serve as a preferred sport-specific training method for improving balance ability in elite surfers, providing practical support for them to cope with complex wave conditions in competitions and enhance competitive performance. TRX suspension training can be integrated into elite surfers` programs, aiding injury prevention and competitive performance optimization. Correlations support a hierarchical model where static balance provides a foundation, dynamic balance enables adaptation, and directional control reflects surfing`s uniqueness—findings that inform scientific design of surfing-specific training.
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