Surfing is a sport that has been growing rapidly in popularity, yet little is known about surfing injuries. Purpose: To calculate an accurate injury rate for competitive surfing and to describe the relative frequency, mechanisms, and risk factors for acute surfing injuries. Study Design: Descriptive epidemiology study. Methods: This prospective study of acute competitive surfing injuries was carried out at 32 professional and amateur surfing contests worldwide between 1999 and 2005. All acute injuries sustained during competition were recorded by on-site medical personnel. The wave size, type of seafloor, and number of surfing heats were also recorded for each day. The total number of injuries was divided by the total number of athlete exposures to determine injury rates. A multiple logistic regression was used to determine risk factors for injury. Results: There were 116 injuries documented, 89 of which occurred during competition. There were 15 675 athlete exposures, yielding an injury rate of 5.7 per 1000 athlete exposures, or 13 per 1000 hours of competitive surfing. There were 6.6 significant injuries per 1000 hours of competitive surfing. Risk of injury was 2.4 (95% confidence interval, 1.5-3.9) times greater when surfing in waves overhead or bigger relative to smaller waves and 2.6 (95% confidence interval, 1.3-5.2) times greater when surfing over a rock or reef bottom relative to a sandy bottom. Conclusion: There were 13 acute surfing injuries per 1000 hours of competitive surfing. The risk of injury was more than doubled when surfing in large waves or over a hard seafloor.
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