Here's a thought, did you know that knee injuries are the most commonly treated ailment on the Championship Tour? Stomping those huge airs will eventually take a toll, hell, even some gouging turns are going to strain that back leg.
But did you also know that in terms of recreational sports, surfing is actually one of the safest sports in terms of injuries? Right here, we caught up with Dr Christopher James Prosser, who is the WSL's medical director to talk common injuries on tour, treatments and a new product called Active Skin Repair by BLDG Active.
MSW: How long have you been the WSL Medical Director?
CP: I’ve been working with the WSL (then-ASP) since 1994. Before that, I’d done medical work with the X-Games and also the PGA tour in Australia. In the ’90s, there was a handful of us in Oz, we were essentially a team covering the Southern Hemisphere events with another team covering the Northern Hemisphere. In the early 2000s, things evolved professionally and we started writing minimum standards for education/qualification of our practitioners and evacuation processes.
What we do [now] is really look at injury prevention, study the recordings of injuries
Things got more serious for the better. What we do [now] is really look at injury prevention, study the recordings of injuries, and ultimately figure out how to minimise impact of those injuries. The surfers on Tour have such an incredible craft and our job is to keep them in the playing field, so to speak. We do that through prehab, rehab and sound care on Tour. We have a large group of medical support teams.
What’s the gnarliest injury you’ve ever had to treat on Tour?
Well, there are impact injuries like abrasions, cuts and lacerations that are significant, but one in particular was back in 2003 when photographer Jack McCoy nearly got his head ripped off at Teahupo’o while filming.
Spinal injuries, like Glenn Hall’s in Fiji or Bede Durbidge’s in Hawaii, were both life-threatening. I’d say those were the scariest. Most of what we see, though, between 30-50%, is axial: neck, mid-back, lower back and pelvis. These are injuries caused by repetitive overuse and many surfers are often still functioning with them. As far as acute injuries, most of what we see are natural-footer surfers’ right knees, mostly MCL injuries. Those are the ones that cause them to miss events, which of course, affects re-qualification for that year.
How do they usually happen, airs?
Yeah, most are on impact, so they’re landing a floater or an air (like John John did recently) or they’re getting pinched in a barrel, so there’s an awkward compression. They’re usually not from mid-face turns, but on a pivotal, critical part of the wave. With airs, there’s a lot more foot fractures and ankle sprains, too, from landing something. So basically, less upper limb and more lower limb injuries. Our female surfers have also become much more similar to our male surfers as far as progression goes, so they’re seeing the same injuries, as well.
Do different locations tend to cause different injuries?
Absolutely. When there’s reef involved, the injuries increase, as well as with the waves getting overhead. Tahiti, Fiji, Bali — that’s clearly where a lot of the cuts, scrapes and blunt trauma happen. But, statistically, surfing is actually a fairly safe sport — about one injury per 1,000 hours of surfing. Recreationally, that is. But when we look at it competitively, ten times the injuries happen. So, per 100 hours of surfing, we see around one to three minor injuries.
Seems like there’d be some big challenges with treating guys at more remote locations, too, huh?
Yes, some of the events can be in Third World locations, so if we’re in an isolated place like, say, Fiji, we always take action and have emergency doctors there so we can have everything we need to stabilise the patient on site. So then, if the patient needs to be evacuated, he/she is stabilised till a helicopter or plane arrives.
It was the same situation in Bali. In Tahiti, for instance, we pretty much have a M.A.S.H. hospital setup, so there’s no time wasted out there. Of course, everywhere has great local doctors and great local hospitals, but sometimes there’s just not always a “Level 1” facility around. Which is why we prepare.
Speaking of Bali and Tahiti, what’s the deal with that first aid spray everyone’s been using for cuts lately?
Yeah, the BLDG Active product you’re referring to is a new skin repair spray and gel that we started testing on the road last year for injuries requiring stitches, or skin abrasions and reef cuts at a bunch of the events. The product’s been a great success. It’s actually for a lot more than cuts.
A good example was in Bali. We probably applied the stuff on one-third of our athletes who had stitches, as both a sterilizing agent to take sutures out, and then to treat the inflammatory components in these types of wounds. It was also used to treat itching related to sea lice, for disinfecting sea urchin wounds, and even as a broad hand sanitizer, too.
Interesting. And how is this BLDG Active stuff different than other sprays you’ve used?
As a doctor, I think the greatest thing is tapping into our body’s innate ability to heal itself. So for instance, in response to trauma, our bodies produce hypochlorous acid, which reduces inflammation, reduces infection, and speeds up recovery.
The BLDG Active spray (from an FDA-approved lab) taps into our bodies’ own mechanisms of healing in the same way our bodies naturally would. So, we’d use the spray to disinfect the wound, then the gel to fill the wound in, and the product doesn’t kill healthy tissue like other sprays do. It’s also super easy to travel with; our athletes are practically bathing in it [laughs]. But, yeah, from rashes to sunburns to stitches, there is a wide range of uses with it.
But, statistically, surfing is actually a fairly safe sport — about one injury per 1,000 hours of surfing
Lastly, what are some things you would recommend average surfers do to prevent injuries?
Fundamentally, I think it’s about getting everything aligned in your body and proper breathing, and getting our muscles balanced does that. Getting into a program around breathing and functional movement, whether that’s yoga or pilates, that’s the best thing an athlete can do in order to make themselves stable and flexible for effortless movement.
I think surfing is such a joyful hydrotherapy, so even just connecting back with having fun in the water prevents injuries, you know? But I think movement and breath is where it starts.