Joshua john dimery

Head related injuries with Surfing and preventions of wearing headgear Joshua John Dimery Marine Sport Science, Falmouth Marine School 077 03523110 01823 413173 josh@dimery.co.uk

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Abstract The aim of this study was to verify the incidents of injuries to the head of surfers, and why surfers disregard protective head gear. There were 34 surfers observed from 10am through to 2pm, January 7th, 2012. Of those 34 surfers, 15 filled in a survey. 12 out the 15 were male and 3 were female. The mean age for the 15 surfer’s was 24. It was found that 11 head injuries had occurred out of those 15 surveys answered. A large proportion of this was by being hit by another surfboard. 7 out of 15 felt that fashion is important therefore, why wear a helmet? 2 surfers who have worn the helmets said comfort was an issue. 4 out of 15 said they haven’t heard of the equipment or that there isn’t enough word of the availability of such things. Finally 4 out of 15 said they’ve never felt the need of wearing one, as they haven’t heard of or witnessed any head injury incidences.

Introduction Base, Antonio et al 2007(16) (see A31-A33) completed a study of professional surfer’s and their history of injuries they have attained. It is often thought surfing is an extreme sport and is seen to be unpredictable with its different change in directions and possible contact with a surfboard or the seafloor(1-3).

Surfing is increasingly growing in participation; however, it has not been made clear to beginners the dangers of surfing. The perceptions of surfers regarding the needs for protective headgear are astonishing. The negative aspect of safer equipment is producing an effect on beginners, as they feel in order to become a surfer you have to act and look like one too. Therefore, there is a disregard for helmets, which could potentially stop an injury that could be life threatening.

Methodology:           

Pick a popular surf spot making sure there is reasonable swell to pick a good demographic of surfers Produce a survey which will attain the best possible feedback Check the wording on each question, making sure there isn’t any ambiguity, imprecision or assumption as this can reflect on any feedback from the participants Both open and closed questions are to be used to gain detailed feedback When the questions are finalised, sort them into order.

Instructions are to be included on the questionnaire. Participants answering the surveys must be clear on how to answer the questions.

Always ask people similar to the group selected, to complete a survey even if time is short. It will give an idea of what is expected in the results.

Try out methods of analysis. For example, checking through 6 completed surveys for any problems that may arise can help.

Complete any final adjustments that need to be done in order to complete the survey.

Chose a time period and chose a suitable spot so as to observe surfers to see who’s wearing protective head gear.

Finally when asking a participant to complete a survey, offer to write for them as they may be wet from being in the sea. This will also save time for oneself and the participant.

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After, note down the results and complete tables contrasting the results.

Results Table 1.1 Observational analysis of surfers wearing headgear (34 surfers) Type of protection Surfers Observed Neoprene 32 Plastic helmet 0 None 5 The results obtained from observing 37 surfers, from 10am to 2pm, proved that a popular choice of head protection was the neoprene hood, with 32 wearing one. This could be because of the time of the year, January 7th, 2012. Winter time is proven to be cold in Cornwall, and can reach temperatures of 8 Degrees Celsius.

Retrieved from www.cornwall-online.co.uk

Table 1.2 Injuries occurred to the face (15 surfers) Type of injury Survey answers Other surfers board to the face/ head

5

Hit the reef/ sea floor Hit an object whilst surfing Hit by own board Collision with other surfer

2 0 5 1

None 5 Table 1.2 describes the types of injuries surfers have experienced in the past. The answers were retrieved from 15 random surfers. The most common injuries were noted down; getting hit by another surfer’s surfboard in the head or face and getting hit by their own board. However 1/3rd of the group answering the questions have not yet experienced an injury, raising the question, is surfing that dangerous, or do certain people push the limits? And, is this having an effect on beginners? (DiMarto)(8) Table 1.3 have the surfer’s tried equipment available? (15 surfers) Have the surfers asked to do the Answers survey ever worn head protection before?

Yes (neoprene hood) 12 Yes (plastic reinforced helmet) 4 No 4 Table 1.3shows how popular the neoprene hood is with over 2/3rds having worn one before. This may be due to having a routine during the winter time as the waters are cold. However (table 1.5) could suggest half of the demographic understand the causes of surfer’s ear, therefore, use a neoprene hood to eliminate the cause.

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Table 1.4 Reasons for not wearing protective headgear Reason for not wearing Survey answers protective equipment Fashion

6

Comfort Not heard of availability Never felt the need to wear Popularity of product is low

2 4 4 4

Table 1.4 suggest reasons for why surfers may not wear protective headgear, and possibly avoid the use. It can be seen that over 1/3rd of the participants all thought that fashion was a factor for not using headgear. From more descriptive answers (see A1A10) it was described that surfer’s have a style or image, therefore can’t wear head protection because it will ruin their persona.

Table 1.5 How many people recognise what surfers ear is?

Do surfers know about Survey answers surfer’s ear?

Yes 6 Not fully 3 No 6 Table 1.5 is demonstrating out of 15 surfer’s, how many know, or recognise what the condition surfer’s ear is? Surfer’s ear can relate to this case study as head protection (a neoprene hood) during the winter can diminish the onset. Almost 2/3rds know or have heard about the problem. However, 1/3rd haven’t heard of this problem. This raises the question, is there enough word of mouth, or even promotions to the use of headgear, and why surfer’s should use them? (Renneker, 1987)(9) Retrieved from www.surfline.com

Table 1.6 Perceived risk values for not wearing protective headgear while surfing Risk value Survey answers Low risk 0 Medium risk 5 High risk 10 Table 1.6 is showing what the participants thought of the risk values when a surfer is not wearing head protection. 2/3rds thought that there would be a higher level of risk of injury if the surfer was not to wear headgear. However 1/3rd thought differently, opting for a medium level. This could relate to (table 1.3 and 1.4) as there were 4 surfers who have not worn the headgear and 6 surfer’s thought that image was a necessity.

Table 1.7 Perceived risk values for wearing protective headgear while surfing Risk value Survey answers Low risk 7 Medium risk High risk

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Table 1.7 is showing what the participants thought of the risk values when a surfer is wearing head protection. Half of the participants have opted for medium risk and low risk, this could relate to peoples perceptions of how dangerous surf can be and any experiences had in the past. (Nathanson et al 1999-2000)(13)

Discussion In the present case study, the results show that surfer’s are aware of head protection being available, however, there is a percentage that remain unclear about the use of protection (see table 1.3 and 1.4). It can not be proved that surfer’s use neoprene headgear for the reason of auditory injuries (6-7). However, Renneker, 1987(9) suggests that the “eardrum may easily be ruptured or perforated when the surf is big and hard breaking”. This is from the pressure of the water acting on the small space in the ear causing it to pop. The most common problem surfer’s face in the winter is surfer’s ear. Booth, 1988(10) explains, “cold water, spray and wind rushing in and out of the ear canal, stimulates the tissues to produce excessive bone growth”. This can cause partial deafness in the person. Therefore this can suggest why the majority of surfers observed were wearing neoprene hoods.

Lowdon, B 1983(12) calculated the injury rate of surfing for minor to major injuries to be 3.5 per 1000 surfing days. However, the year of this comment was in 83’ therefore can rule out this statistic, as equipment has become more advanced and also participation is increasingly higher and still growing each day. 2/3rds of the participants asked about past injuries, stated, they have had a collision with their own board or another surfer’s board. These collisions can result in minor or in some cases major injuries (see table 1.2) DiMarto(8) explains the death of a surfer in ‘Pipeline Masters’. This could explain how location could be a significant factor, in terms of wave size, formation and bathymetry. It is the surfer’s choice where they chose to surf, and it could prove fatal if protective gear is not used. DiMarto(8) states the wave height was running at 8-12ft and Watanabe was driven into 3ft of shallows, and received injuries to the head and neck. (see A34) Making surfboards safer, in aspects of design, will never happen. McGee, 1992(11) says that, “some surfers have developed a fatalistic acceptance of the idea that, if a board is going to hit you, it will. It is not worth compromising surfboard performance to reduce that risk”. This can relate to (table 1.4) as it was found that surfers feel the need to follow a predetermined persona, which is almost seen as living life dangerously and disregarding the fact of wearing protection.

Nathanson et al 1999-2000(13) produced a study where wave action and ocean bottom were proved to also have an effect on additional factors that cause injury. In addition to this, environmental effects on surfer’s is hard to change, however, sand bars that create deep, shallow plunging waves, can be altered to create a safer wave.

McDonald. D, Taylor. MD et al 2010(13) provides information which links in with (table 1.6 and 1.7), explaining that surfer’s questioned in Victoria, Australia, perceived surfing without headgear as moderate to high risk. These results are similar

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to the results on this study. It goes on to say that other sports are thought to be more dangerous. This may be due to asking surfers which have not had any bad experiences in the past, therefore feel there is no real danger. It could also represent the fact that these surfers have never surfed in a location where the environment plays a part.

(Nathanson et al 1999-2000)(13) Reviews of surfer’s using plastic reinforced helmets prove positive. “..the Gath helmet did give the added confidence needed to feel comfortable” (dailystoke.com, November 2010)(15) Conclusion This research found that surfer’s have a mixed yet sided opinion of why they wear headgear. It can be seen that head injuries are a common but serious form of injury within the sport of surfing. However, reinforcing this towards beginners is a different matter.

Frisby. R. 2010(14) includes in his case study, “surfers failed to recognise the awareness of conditions associated with surfing. A large number felt resigned to the fact that they would develop a condition, such as surfer’s ear”. People who are from dangerous surfing locations would be more inclined to use protective gear than those who surf a safer environment or wave.

McDonald. D, Taylor. MD et al 2010(13) found in a case study that 475 surfers thought that, wearing headgear would prevent injury. However, 400 different surfers reported that headgear restricted surfing performance and that they would rather surf without it. A question raised, is this attitude being relayed back to beginners and is this why people feel the need to disregard the need for headgear? Because a surfer said they restricts performance, people may not feel the need to wear one. (Table 1.4) Nathanson et al, goes on to say that “the main reason for not wearing the protection were; “no need”, discomfort, claustrophobia and effects on balance.

The positive feedback from wearing the plastic Gath helmets could establish a basis for beginners to start using protective headgear. It is said to promote a more comfortable and confident frame of mind when surfing. However, it widely depends on what kind of surf or environment the surfer is in. the shallower the water and steeper the wave, the more chance injury is going to occur.

References 1. Sunshine S. Surfing Injuries. Curr Sports Med rep 2003;2(3):135-41 2. Taylor DM, Bennedett D et al. Acute injury and chronic disability resulting from surfboard riding. J Sci Med Sport. 2004;7(4):429-37 3. Zoltan TB, Taylor KS et al. Health issues for surfers. Am Fam Physician.

2005;71(12):2313-7 4. Lawless L, Porter W et al Surfboard related ocular injuries. Aust N Z J Ophatammol. 1986;14;55-7

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5. Kin JW, McDonald HR et al. Surfing-related ocular injuries. Retina.

1998;18(5):424-9 6. Kroon DF, Lawson ML et al. Surfer’s ear: external auditory exostoses are more prevalent in cold water surfers. Otolaryngol Head Neck Surg.

2020;126:499-504 7. Hurst W, Bailey M et al. Prevalence of external auditory canal exostoses in Australian surfboard riders. J Laryngol Otol. 2004:118(5):348-51 8. DiMarto, J. Surfer dies at pipe. 2012 9. Renneker, M 1987b. Medical aspects of surfing. The Physician and Sportsmedicine. Vol. 15, No.12, December,p.96-105 10. Booth, G. 1988. Health risks and injury prevention. In B. Lowdon and M. Lowdown (Eds). Competitive surfing: a dedicated approach, p 231-255.

Victoria movement publications 11. McGee, B. 1992. Surfboard riding injuries in Wollongong, Australia. Surfing medicine, Spring, Issue 8, 19-21 12. Nathanson, A. Hayes. P. et al 1999-2000. Surfing injuries: an internet-based survey. Surfing medicine, winter, issue 8. p 3-4 13. McDonald. D, Taylor. MD et al. February 2010. Online based. Perceptions of surfboard riders regarding the need for protective headgear. Royal Melbourne Hospital, Australia 14. Frisby. R. 2010. surfing injuries in Otago and Southland, New Zealand.

Bachelor of sport and recreation. Southern institute of technology (appendix) 15. dailystoke.com, November 2010. Garage shaper. Gath convertible surf helmet: product review 16. Base, Antonio et al 2007. injuries among professional surfers. Rev bras med esporte

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