Surfing Injuries: Cuts, Concussion, Surfer’s Ear and Rip Currents

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Shoulder-high and glassy, the best morning of the summer. You go for one more wave, get pitched at the bottom, and while you’re under the water the leash pulls tight and the board springs back toward you. You come up with a hand on your forehead and blood running into your eye. Surfing is one of the great lifelong sports, from groms on foam boards to sixty-year-old longboarders, but the ocean and the board itself cause a clear set of injuries. Here they are in plain language: how they happen, how to lower the risk, and the signs that mean “get out of the water and get it checked”.

This page is general information, not medical advice. If you’re hurt, see a sports medicine doctor, physical therapist (PT) or certified athletic trainer (AT); in an emergency call 911 or alert the lifeguard. For the bigger picture of the sport, start at our surfing hub.

What the research says about surfing injuries

A 2020 systematic review of 19 studies from Australia, Brazil, the UK, the USA, Portugal, Japan and Norway found that skin injuries (cuts and scrapes) were the most common type, 46% of all injuries, and that being struck by your own surfboard was the most common cause, at 38.6%. In US emergency departments from 2002 to 2013, lacerations were the most common diagnosis (40.7%), followed by sprains and strains, bruises and fractures; the legs, face and head and neck were the most injured areas, and 95.7% of patients were treated and sent home. The good news, in the authors’ words: surfing injuries are common but rarely serious.

Risk climbs with the conditions. In a prospective study at 32 professional and amateur contests worldwide, the injury risk was 2.4 times higher in overhead or bigger waves and 2.6 times higher over a rock or reef bottom than over sand.

The most common surfing injuries

Cuts from fins, the board and the reef

In a survey of 1,348 surfers, lacerations were 42% of all acute injuries; 55% of injuries came from the surfer’s own board, 12% from someone else’s board and 17% from the sea floor. Fins are sharp, noses are pointed, and reef and rocks are hard and full of things you don’t want in a wound. What helps: cover your head with your arms when you fall or surface, don’t surface right where your board will land, keep away from other surfers’ boards, use a leash that fits your board, and wear booties over shallow reef. Beginners are safer on foam (soft-top) boards; the 2020 review suggests foam boards and protective gear in dangerous or crowded spots may lower injury risk.

Caring for a cut: the CDC advises staying out of salt or brackish water with an open wound if you can, covering it with a waterproof bandage if it may get wet, and washing cuts right away with soap and clean running water after contact with seawater. Reef cuts often carry grit and coral bits. A cut that is deep, gaping, won’t stop bleeding, is on the face or has debris in it needs a doctor, and so does any wound that becomes red, hot, swollen or more painful, or comes with fever. Ask about your tetanus shot.

Head injuries and concussion

Board-to-head hits are the classic surfing head injury, and wipeouts that slam you into the water or the bottom can hurt too. In a survey of Australian elite surfers, 13 of 40 had a diagnosed surfing concussion, and the most common mechanism was contact with the water surface, not the board. A concussion in the water is extra dangerous: confusion and dizziness raise the risk of drowning.

Follow the CDC’s HEADS UP approach: if you think a surfer may have a concussion, get them out of the water and keep them out for the rest of the day until a health care provider clears them. Signs include headache, dizziness, nausea, blurry vision, confusion, feeling foggy and slow answers. Call 911 for the CDC’s danger signs: one pupil larger than the other, a headache that gets worse, slurred speech, weakness or numbness, repeated vomiting, seizures, increasing confusion, or loss of consciousness. If a surfer may have hurt their neck (a shallow sandbar or reef dive, neck pain, tingling or weakness), keep them still and get the lifeguard or emergency services.

Surfer’s shoulder

Most of a session is paddling, and that loads the shoulders hour after hour. A 2021 systematic review of the surf-paddling movement found the muscles doing the work are mainly the internal rotators and shoulder flexors, while the external rotators work only when the arm is out of the water. In surfers with shoulder complaints, external rotation strength and range of motion were reduced, and pain under the point of the shoulder (subacromial pain) may come with it. That’s why rotator-cuff and upper-back strength work is part of our surf training plan. Pain that wakes you at night, weakness lifting the arm, or a shoulder that slipped out of place needs a professional.

Low back pain and the pop-up

Paddling means lying prone with your back arched and your head up for long periods, and the pop-up adds a quick load on the lower back. A physical-therapy paper in the North American Journal of Sports Physical Therapy calls back pain during the take-off a common problem in surfers and describes a “knee pop-up” as an alternative for surfers with low back pain. A good board fit (more volume floats you higher and needs less arch), core and hip mobility work and shorter first sessions help.

One rare but serious condition every surf school knows: surfer’s myelopathy, a non-traumatic spinal cord injury linked to long periods of back hyperextension, mostly in first-timers. A 2022 review of 104 cases (median age 19) found every case began with sudden back pain, and bladder or bowel problems were the most frequent feature. If a beginner develops new low back pain during a lesson followed by leg weakness, numbness or trouble passing urine, get out of the water and go to the emergency department.

Surfer’s ear

Surfer’s ear (external auditory exostosis) is bone growth in the ear canal from repeated exposure to cold water and wind. A 2024 systematic review of 19 studies and 2,997 surfers found it in 53% to 90% of surfers, an average of 67.8%. It can trap water, cause repeat ear infections and reduce hearing. Prevention is simple: earplugs made for surfing and, in cold water, a neoprene hood (a German study found hood use was linked to less severe exostosis). Yet a 2025 survey of California surfers found 65% had never used earplugs, mostly because of muffled hearing and comfort. Surf-specific plugs such as SurfEars are designed to keep water out while letting sound in. See an ear, nose and throat doctor for repeated blocked ears, pain or hearing loss.

Sun, skin and surfer’s eye

Hours on the water means sunlight from above and reflected off the surface. The American Academy of Dermatology (AAD) recommends a broad-spectrum, water-resistant sunscreen of SPF 30 or more, applied about 15 minutes before going out and reapplied every two hours and after swimming or sweating. A long-sleeve UPF rash guard like the O’Neill Basic Skins covers your back and shoulders without reapplying. Eyes need care too: the American Academy of Ophthalmology says pterygium, often called “surfer’s eye”, is a fleshy growth on the eye linked to sunlight, wind and dust, and recommends UV-blocking sunglasses. Have a doctor check any new or changing spot on your skin.

Rip currents and drowning risk

Rip currents are the ocean’s biggest everyday danger. NOAA says they can move at up to eight feet per second, faster than an Olympic swimmer, and that about 100 people die in rip currents each year in the US. The National Weather Service notes rip currents account for about 80% of beach rescues, and cites the US Lifesaving Association (USLA): the chance of drowning at a beach with lifeguards is 1 in 18 million. Surfers use rips to get out the back, which is fine on a board you’re attached to. The danger comes when you lose the board: a snapped leash, a beginner separated from a foam board, or a bodysurfer without fins.

• If you’re caught (NWS): stay calm, wave, yell, float. Don’t fight the current. Swim parallel to the beach until you’re out of the pull, then angle back to shore. If you can’t, flip on your back and float. A rip pulls you away from shore, not under.
• Stay with your board. It floats; you don’t have to.
• If someone else is caught: don’t go in after them. Alert a lifeguard or call 911 and throw them something that floats. NWS warns that people who try rescues alone or in human chains often end up needing rescue themselves.
• Before you paddle out: check the surf forecast and the NWS rip current risk, surf near a lifeguard when you can, never surf alone in big or unfamiliar surf, and be honest about your swimming. Cold water adds its own risks; see Session Day.

Breath-hold training belongs in this section too: never practice breath holds in the water alone, and never hyperventilate before going under. Hypoxic (“shallow water”) blackout gives little warning. Our training page explains why.

Gear many surfers use for prevention

None of these prevents injuries by itself, but they cover the most common problems on this page: plugs for surfer’s ear, a mineral sunscreen with water resistance, and a rash guard that blocks sun and wax rash.

When to see a sports medicine doctor, PT or athletic trainer

• Right away (911 or emergency department): a near-drowning, even if the person seems fine now; any concussion danger sign; a possible neck injury; back pain with leg weakness, numbness or trouble urinating; heavy bleeding; a possible broken bone or dislocated shoulder.
• Same day: a deep, gaping or dirty cut, a suspected concussion, a cut that came from a reef.
• Soon: a wound that turns red, hot or swollen; shoulder pain that keeps coming back when you paddle; low back pain that lasts more than a few days; blocked ears or hearing changes; a skin spot that changes.

A sports medicine physician diagnoses and decides on imaging; a physical therapist builds the shoulder and back rehab and the plan back to paddling; an athletic trainer often covers contests and school surf teams. Coming back is a process: paddle easy in small surf first, then build. Look after the basics on our surf recovery page, and compare with our soccer injuries guide for concussion return steps.

Surfing injuries: FAQs

What is the most common surfing injury?

Cuts. A 2020 systematic review found skin injuries made up 46% of surfing injuries, and the most common cause was being hit by your own board. Lacerations were also the top diagnosis in US emergency departments.

Should surfers wear helmets?

Few do, but head and face injuries are common. Researchers suggest protective equipment in dangerous or crowded spots, such as shallow reef breaks.

Can I surf with a cut?

The CDC advises staying out of seawater with an open wound if possible, and covering it with a waterproof bandage if it might get wet. Wash it with soap and clean water afterward and see a doctor if it shows signs of infection.

How do I prevent surfer’s ear?

Keep cold water and wind out of your ear canals: surf earplugs every session, and a neoprene hood in cold water. Studies find most long-time surfers have some exostosis, so start young.

What should I do if I’m caught in a rip current without my board?

Stay calm and don’t swim against it. The National Weather Service says to swim parallel to the beach until you’re free, or float on your back and wave and yell for help. A rip pulls you out, not under.

My back hurt after my first surf lesson. Should I worry?

Ordinary muscle soreness is common after hours of paddling. But sudden back pain followed by leg weakness, numbness or trouble urinating can be surfer’s myelopathy, a rare spinal cord injury in beginners: that’s an emergency.