Doctor/Surf Prevention Editor
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landon mcnamara

Landon McNamara at Teahupoo. Photo: Tim McKenna.


The Inertia

Not so long ago, pro surfers wore helmets at surf contests. Top surfers like Tom Carroll or Gary Elkerton wore protective headgear either competing at Pipeline or free surfing at G-Land. Lately, it seems that very few surfers still wear a helmet, even in death-defying conditions. So why has the surf helmet dropped off the radar? Aren’t surfers aware of the risks of head injury? Or are they just too cool to wear a helmet?

An Australian study about the perception of the need for protective headgear revealed that less than 2% of surfers wore a helmet on a regular basis. A large majority of respondents believed that it would alter their surfing performance. Only 38% take the risk of head trauma seriously.

In fact, head trauma is by far the first cause of injury among surfers. Our study about surfing-related accidents in the southwest of France showed that 51% of injuries affected the surfer’s head (scalp or facial cuts, concussions, nasal fractures, dental traumas, perforated eardrums).

Head trauma can be caused by contact with the sea floor (rocks, coral reef or sand), but most of the time, the mechanism for head injury is direct collision with a surfboard (the surfer’s own surfboard or another surfer’s board). Sharp fins and pointed noses are the most frequent causes of lacerations (scalp lacerations can bleed profusely and cause hemorrhage).

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The major risk of head trauma for surfers is drowning, resulting from loss of consciousness in the water. Even if you lose consciousness for a few seconds, the risk of drowning is high if there’s nobody around to rescue you immediately. There is also an increased risk of drowning in case of confusion or disorientation caused by a concussion or in case of vertigo due to a ruptured eardrum.

In certain conditions, the helmet is not an option. It’s a necessity. Here are five situations where you should consider wearing a helmet:

1. Surfing a shallow reef: A helmet can be useful in waves breaking over sharp coral in shallow water. Surfing a reef break with a helmet reduces the risk of lacerations and serious head injury. Most of the fatal accidents at Pipeline or Teahupoo occurred as a consequence of a head injury (Malik Joyeux suffered from a head trauma before drowning at Pipe).

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2. In crowded lineups: Wearing a helmet is crucial in overcrowded spots where there is a high risk for collisions. Even if you surf small waves at a beach break, overcrowding should be a determining factor to wear a helmet. It’s not a matter of wave height: the majority of surfing accidents actually occur in small surf. Some locals at Mundaka wear a helmet to protect themselves from collisions with surfboards at their highly frequented spot.

3. For children: The head of a kid is fragile. It’s very important to protect it from trauma with potentially disabling consequences. You wouldn’t let your child ride a bicycle on the road without a helmet. It should be the same to surf crowded spots full of beginners with heavy boards like longboards or SUPs. Groms are small and more at risk to take a lost surfboard in the head as we saw in two dramatic surf accidents. 10 year old Ethan Ward suffered from brain injury after a surfboard hit him during a surf contest at El Porto Beach, California. 10 year-old Pascal D. had his skull crushed in 8 pieces after a beginner lost control of a longboard at The Pass, Byron Bay. It’s not worth the risk to let a child surf without a helmet in unsafe conditions. Some promising young surfers in Tahiti like Kauli Vaast wear a helmet. Even John John Florence and Jamie O’Brien wore a Gath to surf Pipe when they were children.

4. In big waves: A collision between the head and a surfboard or the ocean floor can induce a loss of consciousness and subsequent drowning preventable by the use of a helmet. It can also prevent a rupture of the eardrum which can cause dizziness and near-drowning experiences, even for skilled big wave riders like Greg Long or Jamie Sterling (see what probably happened to Kirk Passmore). Irish big wave rider Al Mennie suggests to wear a helmet with bright colors like orange to improve the visibility of the surfer in a rescue situation. At the time when big wave surfers develop all kinds of safety equipment and inflatable vests, it could be interesting to do R&D for waterproof headgear. During the last heavy session at Teahupoo, several surfers including Keala Kennelly, Garrett and Landon McNamara wore a helmet.

5. To protect yourself from the elements:
To stay warm: a helmet that covers the ears protects from the wind and cold water which are risk factors for exostosis aka “surfer’s ear”.
For sun protection: a helmet prevents overexposure of the head to the sun (especially useful for bald surfers) and participates in the prevention of skin cancer (carcinoma or melanoma) on the scalp. The visor on some models protects the face and the eyes from sun damage.

Lightweight and close-fitting helmets like Gath helmets protect against superficial head injury and tympanic perforation induced by water pressure.

A helmet won’t save you from a high impact collision with coral reef. It won’t prevent neck injury either. But in many circumstances, it will minimize the severity of head injuries and sometimes make the difference between life and death.

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Surfing doctors advise surfers to wear a helmet, but almost nobody wears it anymore. Given the frequency of head injuries, it’s striking that the use of helmets is neither advised by surfing federations nor promoted by surf companies.

By improving helmet design, manufacturers could make it more acceptable and fashionable. Maybe if Kelly Slater or Dane Reynolds wore a helmet during a contest, it could become popular. Surfers could also adopt the helmet for practical reasons as it can support a GoPro camera for example.

Every year, surfers lose their life or suffer from debilitating injuries because of a head trauma. With or without a helmet, it’s crucial to constantly think about protecting your head when you surf.

See also:

– Concussions in surfers.
– Surfing-related accidents: epidemiology and prevention.

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