The Pipe Masters is the final event of the World Surf League Men’s World Championship Tour. We analyzed surfing-injuries documented by the onsite Medical Team during the Pipe Masters competitions over the 5-year period (2013-2017). The sum of all acute injuries treated during the study-period and sum of all surfer-heats (athlete exposures) were used to calculate an injury rate.We also calculated the proportion of all treatments provided by the medical team that were acute surfing injuries occurring during competition.
Purpose: To determine injury rate at the Pipe Masters Surfing Event during a 5-year period.
Design: Prospective Study
Methods: A Medical Team was onsite at the designated medical area at each event, with a team of Healthcare providers with multiple backgrounds, managed by 1-5 physicians overseeing all Medical Care. All acute injuries treated by medical staff were documented during 5 consecutive Pipe Masters World Championship Tour events from 2013-2017.
Results: Data from 2013-2017 Pipe Masters events found18 Injuries during 850 surfer-heats (athlete exposures) or an injury rate of 21 per 1,000 athlete exposures and 42 injuries per 1,000 hours of competitive surfing. A total of 311 patients weretreatedover the 5 events, 5.8% of which acute surfing injuries.
Conclusion: Injury rates at the Pipe Masters were significantly higher than those reported at other competitive surfing events.
Background
The Banzaii Pipeline is considered one of the world’s premiere winter surfing venues, known for producing extremely large, powerful waves, created by North Pacific storms which generate large ocean swells directed toward Oahu’s North Shore, forming large tubing waves over the shallow reef covered ocean floor. It is generally considered an expert only surfing beach, due to the challenging conditions found there, along with the competitive atmosphere and high potential for injury.
Numerous professional surfing competitions are held every year at this location. The Pipe Masters is the final event of the World Surf League (WSL) Men’s World Championship tour, and often determines the men’s worldchampion for the year.
Prior research has determined that, overall, surfing is safer than many traditional field sports such as soccer and American football.[1] However, some studies have found that risk of injury is increased in larger surf, and when surfing over a hard (as opposed to sandy) sea floor, suggesting that injury rates are likely to be significantly higher than average at this event.[2]
World Surf League competition format places, 2-4 surfers in heatslasting approximately 30 minutes. Heats are scored by a panel of judges with the top performingsurfersadvancing to the next round. Some rounds have a losers’ bracket with a double elimination format. The judging criteria are based upon “Commitment and degree of difficulty: innovative and progressive maneuvers; combination of major maneuvers; variety of maneuvers; speed, power and flow”.
Methods
Medical staff are on-site at all WSL championship events. A medical area is designated for the Pipe Masters as part of the competition site complex. Medical care is coordinated by a team of 1-5 physicians and staffed by health-care providers from a variety of backgrounds.Medical staff care for competitors with acute and chronic injuries, as well as other medical issues and also provide manual therapy such as Massage, Osteopathic and Chiropractic treatments. Bystanders and event staff are also occasionally treated by the Medical Team.
All treatments for acute and chronic injuries to competitors were documentedby medical staff during the study period. Documentation included the following information: Name, diagnosis, treatment, disposition, whether the injury occurred during competition or free surfing, and whether the patient was a competitor or non-competitor. Only acute injuries occurring to competitors during competition were included in this study.
Data regarding exposure time (time spent surfing during competition) was calculated as per the following example. Twosurfers competing in 30-minute heat represent 2surfer-heats, 1 hour of exposure, and 2athlete exposures. Aggregate exposure time and number of acute injuries for each annual competition was calculated and then a sum total for the 5 contests was calculated.
Results
There were 311 patient encounters over the study period, 18 of which were for acute surfing injuries occurring during competition. There were a total of 850 surfing heats and 425 hours of competitive surfing during the study period with a calculated rate of 21 acute injuries per 1,000 surfer-heats (athlete exposures) and 42 per 1,000 hours of surfing. On average there were 3.6 acute injuries occurring during competition per year, with an average of 62.2 patient encounters per year.
Of the 18 Injuries reported during competition, one was considered extremely serious, a pelvic ring fracture, which required Urgent Medical Stabilization and ambulance transport to a Level 1 Trauma Center, and eventual surgical intervention. Another serious injury of note was a shoulder dislocation, which was reduced and stabilized onsite. The other injuries treated were considered minor.
We also report the total number of patients seen at the events (311), to add another perspective of how many patients mightbe expected in the management of other surfing similar surfing contests.
Discussion and Conclusions
As the surfing culture and industry of surfing continues to grow, it is more important than ever to determine an accurate and objective exposure-related injury rate for surfing: the sport will be featured in the 2020 Tokyo Olympic Games.[3]
A previous study of competitive surfing Injuries reported 5.7 injuries per 1,000 surfer exposures, or 13 per 1,000 competitive surfing hours, using similar methodology. That study included contests held at a variety of surfing beaks, most of which have smaller and less powerful waves than those found at Pipeline. Our study of the Pipe Masters events found an injury rate that was nearly four times higher. These findings are in keeping with the general consensus among surfers that Pipeline is an extremely dangerous surfing breaks. Furthermore, while deaths among surfers are rare; there have been 11 well-documented deaths at Pipeline since the 1960’s. [4] Understanding injury rates and the number of treatments provided at the Pipeline Masters may help in planning and staffing models for other surfing competitions.
This paper is dedicated to Terry Farrell, DO, whose untimely passing was sadly felt by all of us in Surfing Medicine. Special thanks to the WSL Hawaii Medical Team for their tireless work at the events. Also thanks to Andrew Nathanson, MD for his editorial assistance on this report. LD
References
- https://www.olympic.org/news/welcome-to-the-wonderful-world-of-surfing
- Nathanson AT, Haynes P, Galanis DJ: “Surfing Injuries” American Journal of Emergency Medicine2002;20:155-160
- Nathanson AT, Tam-Sing K, Dao L, Bird S: “Competitive Surfing Injuries: a Prospective Study of Surfing-Related Injuries Among Competitive Surfers” American Journal of Sports Medicine 2007;35:113-117
- https://www.surfline.com/surfnews/article.cfm?id=1617