The Surf is Up! Watch Out for Head Injuries

June 10, 2002 Summer is almost here. It's time to get out your surfboard, head to the beach and hit the waves! Of course, if you surf, it's important that you pay attention to weather and water conditions and use the proper equipment. A surfboard is made of a high density foam center that is wrapped in a fiberglass skin. Surfboards are great for catching waves, but they are not so great when they hit you in the head. Researchers in Rhode Island and Hawaii wanted to find out about surfing injuries to determine the risks involved with catching a wave. Led by Dr. Andrew Nathanson of the Department of Emergency Medicine at Rhode Island Hospital, the research team developed an Internet-based 30-question survey. The survey asked questions about the type of injuries a person suffered and the conditions of the water when the injuries occurred. Surveys from 1,348 people were analyzed. The people who completed the survey had surfed for an average of 11 years and had an average age of 28.6 years; most (90%) were male. Although most of the surveys came from surfers in the United States (76%), surfers from Australia (6%), England (5%), New Zealand (5%) and 44 other countries were included. Direct contact between a surfboard and a surfer was responsible for 67% of all sudden ("acute") injuries. Most (82%) of the board-related injuries were caused by a surfer's own board and 18% were caused by another surfer's board. Other injuries were caused by: Contact with the sea floor (17%): cuts and scrapes with coral and rock. Wave force (7%): eardrum ruptures, near-drownings, shoulder dislocations. Excessive body motion (5%): knee sprains. Marine animals (3%): jellyfish, sea urchin, stingrays, sharks, dolphins and seals. The majority of injuries (62%) occurred when surfers were riding a wave. Although the researchers believe that surfers spend less than 1% of their time "getting tubed," riding in the tube of a wave accounted for 10% of the injuries. Surfers also suffered injuries when they were retrieving their boards, paddling out to a wave, and getting in and out of the water. The most common injuries were cuts, followed by bruises, strains and sprains, and fractures. The head and neck were the most common sites of injury. Of those people who had a head or neck injury, 16% suffered a concussion and most of these occurred when a surfer's head struck his own board. The researchers also found that older surfers, more advanced surfers and large waves contributed to a greater likelihood of a significant injury. Based on the results of the survey, the researchers believe that surfboards could be improved to reduce injuries without changing the performance of the board. They propose that: The fins of a surfboard should be made with a softer material. The fins of a surfboard should have dull edges. The fins of a surfboard should be made to break away on impact. The nose and tail of some surfboards should be rounded. Rubber shock absorbers should be added to the nose, rails and tail of surfboards. The leash of a surfboard should be less elastic to prevent injuries from one's own board. Helmets should be used, especially in shallow water or when many other surfers are in the water. If these changes make it more difficult for surfers to carve turns or perform other maneuvers on the waves, it is unlikely that surfboard makers will modify their designs or that surfers will modify their behavior. The researchers believe that if these changes were mandatory during professional surfing competitions, then many recreational surfers would adopt these changes too.

References and further information: Nathanson, A., Haynes, P. and Galanis, D. Surfing injuries. American Journal of Emergency Medicine, 20:155-160, 2002.

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