Wipeout! Surfing Creates Wave Of Unique Injuries

When surfers are injured, many times there are no telltale abrasions since the impact is often with water and not a solid object. Surfers are also usually leashed to their boards, making it easier for them to strike the boards even after they tumble off.

"Emergency physicians need to diagnose quickly, but without an understanding of some of the unique aspects of surfing injuries, they're apt to take additional time trying to determine what happened," said lead author and recreational surfer Jeremy Kuniyoshi, M.D., a radiology resident at the University of California San Diego. "Most doctors know more about riding golf carts than riding waves."

Dr. Kuniyoshi examined the radiologic images of 135 patients with surfing-related injuries and grouped them into three main causal categories, each with commonly associated injuries:

* Paddling toward the surf * Catching a wave * Marine environment

Injuries associated with paddling toward waves included dislocated shoulders, as well as board traumas like skull fractures, facial fractures and bruises to the vocal chords. Common injuries suffered while catching or riding a wave included head and neck trauma, broken arms and legs, and damage to the knees. Environmental injuries included foreign matter in the lungs, damage to the ear canals from exposure to cold water, lacerations from surf board fins, and stings and bites from marine life.

"Once you hear the surfer's story, you can see how it happened," Dr. Kuniyoshi said. "But if you don't hear a story and you don't know much about surfing, the injuries really don't make sense."

The number of surfers in the United States increased nearly 50 percent to 2.18 million between 1987 and 2000, according to American Sports Data Superstudy of Sports Participation. Dr. Kuniyoshi, who's been surfing for three years, contends the sport is relatively safe and hopes his research will assist physicians faced with surfing injuries.

"An understanding of the common injuries that occur during various stages of surfing can help doctors order the right radiologic exams, know exactly what to look for in the images and ultimately make quicker and perhaps more accurate diagnoses," he said.

Co-authors of the surfing study are Mini Nutan Pathria, M.D., and David J. Smith, M.D.