Surfing Injuries

 

The sport of surfing represents a multibillion dollar retail business and includes a unique culture of people, lifestyle, jargon, and fashion. The American Sports Data Superstudy of Sports Participation estimated that there were 2.18 million U.S. surfers in 2000, a 50% increase from 1987. Other studies have estimated worldwide participation in surfing at over 18 million people.

Although surfing has dramatically increased in popularity since the early 60s, little research has been done on surfing-related injuries. Compared to other sports like soccer, basketball, football, and hockey, surfing is generally considered as one of the safer sports by various sports agencies. However, both overuse and acute trauma injuries do occur.

What Causes Surfing Injuries?

While the risk of injury from marine life like seals, stingrays, sharks, seals, and jellyfish are ever-present threats to surfers, there are actually many other sources of injury common to the sport of surfing. Based on exit data taken from a number of professional and amateur surfing competitions, acute traumatic injuries comprise an estimated 75% of all surfing-related injuries.

Traumatic injuries can be caused by any of the following: direct contact between a surfer and his own or another surfer’s board; contact with the sea floor, coral, or rocks; unsuccessful aerial tricks; the force from a wave impact; and wipeouts. On the other hand, most overuse injuries are caused by the repetitive body motions involved in turning maneuvers and paddling. The size of the wave, surfing conditions, surfer’s age and experience, hours surfed per day, and body mechanics can all impact a surfer’s risk of injury.

What Are Some Common Surfing Injuries?

Subcutaneous, Muscle, and Bone Contusions

A contusion, also called a bruise or hematoma, is caused by a blunt force trauma between a hard object, such as a surfing board or the sea floor, and an area of the surfer’s body, such as a calf or quadriceps. The impact causes the tissue to compresses inwardly and damage the capillaries in the affected area, but it doesn’t break the skin. The damage allows blood to seep from the capillaries into the surrounding tissues. The seeping blood is what creates the black-and-blue appearance of a contusion. The pain of a contusion is caused by nerve endings within the affected tissue detecting the increased pressure caused by the seeping blood. Depending on the force behind the impact, the injured capillaries can be just at skin level or within muscle tissue or bone.

The severity of a bruise is classified using a zero to five scale called the harm score:

0 harm score - a light bruise to the skin surface without any damage.
1 harm score - a light bruise to the skin surface with little damage.
2 harm score - a less than moderate bruise the produces some damage.
3 harm score - a serious bruise that produces dangerous damage.
4 harm score - an extremely serious and dangerous bruise.
5 harm score - a life-threateningly dangerous bruise.

Knee Sprains

A knee sprain is the abnormal stretching or tearing of one or more of the ligaments in the knee. The knee joint consists of three bones - the femur, tibia, and patella. The medial collateral ligament (MCL) on the inside aspect of the knee, the lateral collateral ligament (LCL) on the outside aspect of the knee, the anterior cruciate ligament (ACL) toward the front aspect of the knee, and the posterior cruciate ligament (PCL) toward the back aspect of the knee are the four main ligaments stabilizing the knee. The collateral ligaments prevent the knee from moving too far to either side and the cruciate ligaments prevent the tibia bone from sliding too far forward or backward.

The ACL and MCL are the most often injured knee ligaments in surfing. The abnormal stretching or tearing of the ligament is often seen when the surfer has their foot and lower leg planted on the surf board and either makes a move that rotates the upper leg too far to either side (excessive body torque) or when the side of the knee comes into contact with an object, like a wave or a collision with another surfer, that forces it beyond its normal range of motion.

Knee sprains, like all sprains, are graded based on the severity of the injury:

Grade I - one or more knee ligaments are stretched or microscopically torn, but the knee is fully functioning and stable.

Grade II - one or more knee ligaments suffer moderate tearing. The joint becomes loose and moderately unstable.

Grade III - one or more knee ligaments suffer significant to complete tearing. The joint is highly unstable and it’s often impossible to bear weight on the affected leg.

The back, shoulder, ankle, and elbow are other common sites of surfing-related sprains.

Rotator Cuff Injuries

The rotator cuff is made up the supraspinatus, infraspinatus, subscapularis, and teres minor muscles and their tendons. The rotator cuff is what stabilizes the shoulder during movement. The most common mechanism of injury is from repetitive overhead motions, such as during paddling out for a wave. However, the rotator cuff can be injured from a direct blow to the shoulder.

Rotator cuff injuries usually involve the irritation and inflammation of a rotator cuff tendon (tendinitis) from overuse -or- a rotator cuff muscle and/or tendon being abnormally stretched or torn (strained) from overuse or a traumatic incident. An injury can begin as chronic tendinitis and progress to a strain if left untreated.

Rotator cuff strains are graded one through three based on how severely the musculotendinous unit is stretched or torn:

Grade I - the rotator cuff is abnormally stretched or suffers microscopic tearing, but the shoulder joint remains stable and retains full range of motion.

Grade II - moderate tearing of the rotator cuff with moderate joint instability. Range of motion may be decreased.

Grade III - extensive to complete tearing of the rotator cuff with significant to complete joint instability and immobility.