SPORTS MEDICINE

Dr. Steve Badolato

Surfing Injuries

SURFING IS A SPORT that has been growing rapidly in popularity in all age groups.  Brevard County, Florida offers many of the best surfing locations on the East Coast of the United States.

Although surfing is often perceived as a very dangerous sport, a recent study suggests just the opposite.  In this study, which appeared in The American Journal of Sports Medicine, it was discovered that surfing was safer than football, basketball, and even soccer.  Injury rates of various sports were studied with football reporting about 33 injuries per 1,000 hours of play, soccer about 19,, basketball about nine, and surprisingly, surfing had only about six and a half significant injuries per 1,000 hours of surfing.

On average the risk of significant injury with surfing is relatively low. With that said, the diverse aspects of the sport create a wide variety of related health issues and risks unique to the sport that all surfers should acknowledge and try to prevent.

STAND UP GUYS: Dr. Lance Maki (top), and surfing Hall of Famer Skip Savage, do some stand up paddling off Cocoa Beach, Florida. Stand up paddle surfing, or SUP, is a surface water sport, a variant of surfing where the surfer uses a paddle to move through the water while standing on a surfboard.

Common Surfing Injuries
The most common significant surfing injuries are run-of-the-mill sprains and strains, followed by cuts, bruises, and broken bones.  The impact with the surfboard or the ocean floor, and the force generated by large waves, cause most traumatic injuries.

More advanced surfers who surf larger waves under more extreme conditions have more severe injuries (even drownings) when compared to less experienced surfers under safer conditions. Many of the injuries sustained are the direct result of the surfboard itself. The leash is a line that is attached from the surfer’s ankle to the board and can cause and prevent injury. It can reduce injury by preventing a loose board from hitting others but can also cause a recoil injury to the surfer.

Shark Attacks
I have managed many surf related injuries, including, on more than one occasion, a surfer that was bitten by a shark.  Recently, a patient presented with a large bite to the foot (photo below) resulting in a noteworthy injury with complications requiring stitches, surgery, and antibiotics.

This patient’s encounter was fairly typical of most shark bites while surfing.  In most situations the shark’s reputation is far worse than his bite.  About half of all unprovoked shark attacks worldwide involve surfers.

According to the International Shark Attack File, by far the most common bites on surfers are “hit and run” attacks which typically occur in the surf zone.  The victim rarely sees the shark, and after inflicting a single bite or slash wound it usually will not return.  These attacks are frequently the case of mistaken identity.  It is suspected that upon biting, the shark quickly realizes the surfer is a foreign meal and immediately releases. Shark bites are rare, and, as in this case, the injuries are mostly confined to the leg below the knee and seldom life threatening.

Marine Hazards

• Jellyfish: These marine invertebrates have tentacles with venom filled cells (Nemocyst) that can inject toxins (envenomation) into the skin causing burning, redness, swelling, and rashes.  If a surfer comes in contact with these animals, the goal should be to remove the tentacles, soak the affected area in hot water with immediate washing of the area with vinegar, ethanol, or even urine to provide relief of symptoms. The use of an antihistamine such as benadryl is also helpful.  Individuals with severe symptoms or contact with several jellyfish should seek immediate medical attention.
• Stingrays: These bottom dwelling creatures are encountered while surfers are entering or exiting the water. Their tail has a sharp spine that can penetrate skin causing a puncture wound or laceration with severe pain out of proportion to the appearance of the wound.  Initial treatment with hot water immersion inactivates the toxin injected during the assault.  One recommendation made to me by Cocoa Beach resident, and Hall of Fame Surfer Skip Savage, is to shuffle your feet while entering and exiting the water to scare the stingrays away.
• Ear Problems: Outer ear infections are relatively common with surfers. These are caused by chronic exposure to moisture. If infection occurs, treatment with antibiotics is necessary. Prevention includes use of earplugs while surfing and routine use of isopropyl alcohol/vinegar mix in the outer ear canal after. Eardrum rupture may occur when a surfer is struck by a strong wave or hits the water with sufficient force after a fall.  Most ruptures heal spontaneously.
• Sun Exposure: Surfers have increased risk for skin cancer which can be mitagated by the routine use of sunscreen and protective clothing. Regular skin cancer screening by a physician is also valuable for early detection of cancerous lesions.

In summary, with attention to these surf related health risks, the sport of surfing can be a great source of healthy fun, exercise and life long recreation.

A Florida native, Dr. Badolato received his medical degree from the University of South Florida School of Medicine and did his residency training at St. Vincents' Medical Center in Jacksonville. Dr. Badolato is Board Certified and has fellowship training in sports Medicine with a specialization in non-operative musculaskeletal medicine. Formerly a team physicians at Ohio State University, he was also the medical director for the world-renowned IMG Bollettieri Sports Academy in Bradenton, Florida. You can reach Dr. Badolato at 321-253-2169, or log on to PremierUrgentCare.com

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