Surfing Injuries

Although surfing is thought to be a relatively risk free sport, with an incidence between 3 – 4 injuries per 1000 days of surfing, we think it’s wise that you know what to expect and what to do before riding the waves.

Surfing is an ancient sport originally from Hawaii. There is written evidence as far back as 1500 AD of surfing rituals or in Hawaiian it is called “he’e nalu”. Since reaching California in the early 1900s, the popularity of surfing grew rapidly. Bali has also been a major attraction for surfers. Kuta, Uluwatu, Padang Padang, are just to name a few of the favorite surfing “hot spots” in Bali. BIMC Hospital, which is located less than 30 minutes away from these surf locations, receive surfing–related injuries on a daily basis, especially during the months of July and August.

Below listed are the most common injuries in surfing seen at BIMC Hospital.

Laceration
This is the most frequent type of injury. These injuries were mostly caused by the surfers own board, contact with another surfer’s board, or contact with the ocean floor.

What to do?

Flush the wound with clean water. You can use mineral water, the best choice is to use normal saline sterile water.
If possible, gently scrub the wound with soap and water. Do not use alcohol or hydrogen peroxide, because while these are very good antiseptic solutions, scientific research also show they kill the tissue which lines a wound. This effect will leave a wound lined with a layer of dead tissue that is a perfect environment for bacteria to grow in.
Stop the bleeding by applying direct pressure on the wound with a clean cloth. Do not use a cotton pad because the cotton fibres will stick on the wound and are difficult to remove.
If you notice a large stab with a foreign object, do not attempt to remove it. Try to stabilize it and seek medical attention ASAP.
Superficial wounds can be self-treated with thorough cleansing, a topical antibiotic and good wound care afterwards.
However, you should remember: even small superficial scratches can lead to serious infection, such as cellulitis, if not handled properly. Whenever you have doubts you should seek medical attention soon. Read our previous article about cellulitis.
Generally the “golden period” for skin wound is less than 12 hours. This means if you get treatment, ie. sutures, staples, etc, within that time, you can expect good healing or as it is called, primary healing. Read our previous article about wound sutures.

Head Injury
With reference to the most common injury, laceration, surveys show that the most common site of a laceration is on the head. Every trauma on the head should have special consideration.

What to do?

One rule you should remember: Every trauma to the head should be seen by a doctor. Read our previous article about concussions.
Seek medical attention ASAP.
Also remember the possibility of neck injury, avoid neck movement as much as possible after the trauma, until the doctor confirms there are no serious cervical injuries.

Sprain, strain and dislocation
A sprain is an injury which occurs to ligaments caused by a sudden overstretching. The ligament is usually only stretched, but sometimes it can be snapped, slightly torn or ruptured, which are more serious and require a longer time to heal. While a strain is a similar injury which occurs to the muscles.
Dislocation is a term to describe a condition when bones at a joint moves from their normal position.
What to do?

Remember RICE: Rest, Immobilize, Compress, and Elevate, if it’s on an extremity.
Seek medical attention.

Shoulder dislocation is quite a common sport related injury, not only for surfers. Read our previous article about shoulder dislocation.

Fracture
The most common fracture type for surfers are nose fractures. Usually this is due to contact with the surf board.

What to do?

Wrap ice in a towel or cloth then apply it on the nose. Do not apply ice directly onto your skin.
Seek medical attention.

For fractures on the extremities, such as arms or legs:

Try to immobilise the extremity. If possible apply a splint or sling. You can use a rolled up newspaper or strips of wood as a splint. Immobilise the area both above and below the injured bone.
If you notice an open wound, possibly caused by the broken bone, you may attempt to rinse it with clean water and remove the dirt, but do not flush it as you would do to a simple laceration wound.
Seek medical attention ASAP.

Ear drum rupture
Perforation and rupture of the ear drum occurs occasionally, with an injury incidence of 5%. Although the eardrum would usually heal by itself, it is advised to see a doctor when you suspect you have this problem. If it is not managed properly the eardrum defect can be permanent and the middle ear will be easily infected causing chronic middle ear infections that can lead to serious complications, such as meningitis.

Safety equipments, such as nose guards, helmets, etc, are actually important to prevent these injuries. However, most surfers think these equipment and devices are “uncool” or would cause difficulties in surfing maneuvers. Consider them… it might save your life and your surfing days.

And one important thing is always follow the “unwritten rules of surfing”.

Good luck and surf safely!