Objectives: To review the literature to examine the incidence of traumatic brain injury (TBI) in surfers and elicit the need for protective headgear in surfing. Head injuries are the most common injury among surfers, composing well over one-third of surfing-related injuries. However, surfers are doing little to mitigate the risk of head injury with a low incidence of helmet use.
Design: A systematic review of the MEDLINE database was performed in July 2019. Search terms included surfing, TBI, and headgear. Studies were included if they were in English, and examined the incidence of TBI in the setting of surfing or investigated the role of protective headgear while surfing. Cohort characteristics, methods of injury, and use of protective headgear were extracted.
Results: 7 eligible studies were identified with 6245 patients and 4478 total injuries. Risk factors for head injuries included older age, competitive status, surfing greater than 6.5 hours per week, and performing aerial maneuvers. 26% of the injuries were head injuries (n=1178), with an overall incidence of 3.8% for concussions (n=162). Only 7.2% (n=196) of surfers wore protective headgear or helmets. The most common method of head injury was direct trauma from striking their own surfboard.
Conclusions: Surfing poses a high risk of head injuries, particularly concussions. Although surfers recognizing the high risk of TBI and acknowledging that headgear is protective, many prefer to surf without them due to discomfort and effect on balance. Even though helmets have been adopted in other high impact water sports such as rafting, there remains a need in the surfing community to prevent head injuries.
Barbara Kozminski– Resident, SUNY Upstate Medical Center
Conan So– Medical Student, University of Maryland School of Medicine
James Meiling– PGY-1 Resident, Medical City Weatherford
George Raum– Medical Student, Philadelphia College of Osteopathic Medicine
Mary Showstark– Clinical Instructor, Yale University