If you find yourself in this situation, these tips might go a long way. Photo: Mana Photo /

The Inertia

Hold-downs are an inevitable part of surfing. They can happen during big and small days. And the moments leading up to them rarely offer sufficient time to gather your thoughts. However, your chances of losing consciousness during a hold-down can be radically reduced by maintaining good physical fitness and cardiovascular endurance. Here we visit a few ways how you can lose consciousness during a hold-down, as well as what you can do to avoid it.

Causes of Losing Consciousness (Syncope)

1. Hypoxia is a term used to describe a decrease in oxygenation of the brain. There’s a wide range in the amount of time that a healthy individual can hold their breath (30 seconds on the lower end and up to over 6 minutes for highly trained divers). The length of time is also dependent on your level of activity. The higher your metabolic rate, the more rapid oxygen consumption you will have. Nutritional status can also play a part. A study from the European Journal of Sports Science found that fasting (not eating) overnight can improve an elite diver’s breath-holding performance.

2. Head injuries are probably the most intuitive and easiest to conceptualize. You hit your head, maybe see a big flash of light, and then pass out and lose consciousness.


3. Vasovagal syncope is an exposure to a stimulus. For example, extreme pain, prolonged standing, when it’s hot outside, or seeing blood can trigger a reflex controlled by the brain stem, which causes loss of consciousness. In the vasovagal reflex, a decreased heart rate and dilation of blood vessels cause a rapid drop in blood pressure and decreased blood flow to the brain. The decrease blood flow to the brain leads to a temporary shutdown of the reticular activating system (part of the brain that keeps you awake).

4. Vasomotor (blood vessel dilation) is a sudden drop in blood pressure that can occur after standing up from a seated or laying position (also known as orthostatic hypotension). In orthostatic hypotension, the body fails to constrict the blood vessels enough to maintain a normal blood pressure and blood flow to the brain. Contribuiting factors can be: dehydration, medications that cause the blood vessels to dilate, and neurologic complications of diabetes.

5. Excessively slow heart rate (bradyarrhythmia) is less than 40 beats per minute (resting). The heart rate is too slow to keep enough blood flowing to the brain. This is usually caused by heart related medical conditions or possibly a medication side effect.

6. Excessively high heart rate (tachyarrhythmia) is greater than 100 beats per min (resting). The heart is beating too fast to efficiently pump and maintain adequate blood flow to the brain, which can also be caused by a cardiac condition or a medication side effect.

What You Can Do to Avoid Losing Consciousness

A couple of things you can do before going under are: take a deep breath and protect your head. The ocean floor, rocks, and reef will always be the most common threat while surfing, as they can cause serious head and neck injuries. Your best bet during a hold-down is to relax, conserve your energy, and don’t panic.

For the longer hold-downs, try limiting oxygen consumption to the best of your ability. Limit your movement by avoiding fighting the currents that thrash your body around after a wipeout. Let it pass before trying to ascend to the surface. It goes without saying that training and exercising will improve your cardiovascular fitness, and, in turn, provide great overall benefits as you push yourself in bigger and bigger surf. Be safe out there.

Editor’s Note: The following article was coauthored by Benjamin Eovaldi.

For more of Robert’s work, visit his photography page at

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