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Letter from the Editor

Oct 08, 2021 ~ Author Andrew Nathanson, MD, FACEP, FAWM

Since its inception, hundreds, or perhaps thousands of years ago, when the first person laid on a wooden plank and rode a wave to shore, the sport of surfing has been in a continuous state of evolution. The heavy wooden boards ridden by ancient Hawaiians were eventually modified to include a single tail fin. Boards became lighter with the adoption of Balsa, and then fiberglass. More hydrodynamic, thinner, sharper fins were designed. Shorter, more maneuverable boards were developed, as was the leash. One fin became two fins, and eventually thrusters and quads. Surfing begat skimboarding, then windsurfing and kiteboarding. Foils, first developed for other forms of watercraft have since been adapted for surfing, opening up a whole new realm of wave-riding possibilities. 

As board designs and riding styles have changed, so to have the injury patterns associated with the sport. In his 1971 chapter on surfing injuries (Encyclopedia of Sports Science and Medicine, MacMillan & Co), Blankenship notes that the injury pattern seen among surfers during that era “might well be duplicated by placing a [person] in a 3-foot barrel, adding 1 or 2 rolling pins of 15-20 lbs. mass, sealing the barrel, and rolling it at 15-20 mph.” In other words, mostly blunt-force injuries that are randomly distributed. With increasing adoption of smaller and lighter pointy nosed thrusters with their sharper and more numerous fins, lacerations became much more commonplace. Widespread use of leashes decreased the number of injuries caused by other people’s boards, and likely decreased the incidence of drowning, but increased the number of injuries from one’s own board. Aerial maneuvers and more aggressive turns made possible by the short board era increased the prevalence of knee and ankle injuries which had been relatively rare among surfers in previous generations.

Now foils, with their long, sharp wings and mast, as well as higher top-end speed may harbinger a whole new set of surfing related injuries. Non-foilers have already sounded the alarms, much in the same way they did with the introduction of the SUP. In this edition of Surfing Medicine we explore some of these injury trends. Tcheyan describes a midshaft femur fracture sustained by a kite boarder, and our editorial staff present a case of a foiling injury to the foot. While surfing-related injuries remain relatively uncommon compared to other traditional and ‘extreme’ sports, and many can be avoided, they do keep us surf-docs in business!

On a more positive note, we review a study by Berg et al titled Characteristics of surfers as bystander rescuers in Europe, which finds that the vast majority of experienced surfers have performed in-water rescues, undoubtedly saving numerous lives. A touching memior of 30-years of SMA conferences and the positive influence they have had on one Aussie’s life is put forth by Stephen Titus. After reading Stephen’s article you can’t help but sign up for the next SMA conference in Tavarua, the Baja, or beyond – after negotiating the travails of the COVID pandemic this last year and a half, you deserve it!

With much Aloha.

Andrew Nathanson, MD, FACEP, FAWM

Posted in Letter from the Editor
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Summer 2018 Issue #31 Table of Contents

  • Letter from the Editor
  • No Other Options (a true story)
  • Big Wave Surfing: A physician’s perspective
  • Origins of the Paddle Out Ceremony
  • Case Report: 63 y.o. male surfer “found down”
  • What Happened to Zika?
  • Orthopedic Injuries in Professional Surfers: A Retrospective Study at a Single Orthopedic Center

Summer/Fall 2017 Issue #30 Table of Contents

  • Letter from the Editor
  • Don’t Eat the Fish!
  • A Surfing Life
  • The SMA Barefoot Doctor Course
  • The Surfer Health Study
  • Terry Farrell Interview
  • Case Report: Eye Trauma from a Surfboard

Summer 2016 Issue #29 Table of Contents

  • Letter from the Editor
  • Catching Waves: Perspectives of Physicians Who Surf
  • Should you Frika about Zika?
  • Case Report: A 29-Year-Old Female Surfer with a Thigh Laceration
  • Case Report: Central Cord Syndrome in a Bodyboarder
  • Images from Surfing Medicine
  • Druku’s Life
  • Druku: SMA Remembers a Great Man
  • SMA Conference Report – Nicaragua 2016

Summer 2015 Issue #28 Table of Contents

  • Letter from the Editor: Surfing Medicine to the Extreme
  • Sun Protection for Surfers
  • Cold Water Surfing and Hypothermia
  • 2013 Triple Crown + HIC Pro Injury Report
  • Wanna pee on my Wana? Sea Urchin Injuries, a Literature Review
  • Larger Than Life, Don James, MD
  • Granny and Doc
  • SMA Nicaragua Conference Report, May 28 – June 4, 2015

Winter 2014-15 Issue #27 Table of Contents

  • Letter from the Editor
  • Beware the Devil Fish – “Don’t tread on me”
  • SURF: A Unified Surfing Competition Medical Reference Form
  • Surf Stronger, Paddle Longer
  • Sea Ulcers
  • The SMA Scholarship Program
  • Tavi 2014 Summary
  • ASLS Portugal Conference

Fall 2013 Issue #26 Table of Contents

  • A Message from the (new) Editor
  • Case Report: A Nicaraguan Stowaway
  • Knee Injuries in the Barrel: How Heavy and Deep Can You Go?
  • Concussions in Surfers
  • Surfer’s Ear – The Bane of Cold Water Surfers
  • Surfing Injuries – Literature Review
  • Keeping the Stoke: Dealing with Declining Competence in the Aging Surfer
  • Helping Vets to Feel the Healing Waters

Fall 2019 Issue #32 Table of Contents

  • Letter from the Editor
  • Surfing Injuries at the Pipe Masters 2013-2017
  • A Non-Healing Surf-Wound
  • Images in Surfing Medicine
  • Terry Farrell Tribute
  • Surfing USA, a Literature Review
  • The Baker: Archives of the SMA

Fall 2020 Issue #33 Table of Contents

  • Letter from the Editor
  • In the Midst of the COVID-19 Pandemic, Should Surfers Continue to Surf?
  • Improving Safety in Surfing
  • Case Report: Widespread Pruritic Papules after Bodyboarding in Long Island
  • Case Report: Severe Fin Laceration
  • Tourniquets and Hemorrhage Control

Fall 2022 Issue #35 Table of Contents

  • Message from the Editor, 2022
  • Life Rolls On
  • Beware the Leash: Seymour Fracture of the Finger
  • Bill Jones Ph.D, in Memoria
  • The Old Man and the Sea: Video on Surfiatrics from the 2022 World Congress on Extreme Sports Medicine
  • Common Surfing Injuries: Video on Surfing Injuries from the 2022 World Congress on Extreme Sports Medicine
  • Images in Surf Medicine
  • Literature Review: Is Surfer’s myelopathy an acute hyperextension-induced myelopathy? A systematic synthesis of case studies and proposed diagnostic criteria.
  • 2022 Magdalena Bay Conference Report

Fall 2021 Issue #34 Table of Contents

  • Letter from the Editor
  • Impact of SMA Conferences on Wellbeing
  • Surfing and Health in the Covid-19 Era: A Narrative Review
  • Case Report: Femur Fracture in a Kitesurfer
  • Images in Surfing Medicine
  • Characteristics of Surfers as Bystander Rescuers in Europe
  • Acute Injuries in Surfing: A Systematic Review
  • Mag Bay 2021

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Contact the editor at ANathanson@Lifespan.org.

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