Do you know how to deal with an injury on your SUP?
In our latest excerpt from the series of SUP SAFETY books written by Bill Dawes, National Safety Officer for stand up paddleboarding in New Zealand, we’re going to look at another paddleboarding emergency scenario and how to deal with it, utilising and building upon the processes covered in the previous blog articles in this series. Over to Bill…
Dealing with an injury
In last months’ blog I looked at what to do in the event of an equipment-related problem while you’re out paddling. (The previous articles in this series can be accessed here) The article finished with a challenge - have a go at thinking through how the process would work in the event of a physical problem. Something has gone wrong with you. How would you deal with it?
So here goes. First off, it’s important to understand that this is serious. Unlike environmental or equipment issues, if you’re hurt and in pain you do not have the same capacity for problem solving or simply powering your way out of the situation. So it’s more important than ever to have done some thinking about this in advance, so that you aren’t having to work out a plan while impaired.
Possible medical issues that you might encounter on a paddleboard can span health issues (ie you become ill), musculo-skeletal issues (ie you pull or strain something), or actual physical injuries. We’re going to focus on injuries for the purposes of this blog, as statistically it’s the most likely of the three scenarios. Check the relevant chapters in book 3 of the SUP SAFETY series for the full story on the other two types of medical issue that you might encounter.
Before we get into the specifics of the various injuries that might happen, let’s look at the process in general. As always, we follow the GAGA acronym.
GROUP
If you’re with other paddlers, let them know you’re hurt, and if the injury was caused by an external hazard then be sure to warn the rest of the group so they don’t suffer a similar fate! If anyone in the group is medically trained then you’re in luck, but for the sake of this exercise let’s assume that you’re on your own.
ASSESS
If the injury is at all consequential, then your plan should be focussed on getting to the nearest shore or safety as quickly as possible. Remember the very first point on the universal DRSABCD emergency plan for dealing with a medical situation; remove the casualty from danger. If something goes wrong while you’re on the water, the best place to be is off the water. Otherwise the emergency services can’t get to you. And even if they could, it’s extremely difficult to give medical attention to someone floating on a paddleboard.
However, it might just be that your injury has upped the stakes. If you were already battling your way back to shore against a strong headwind before the injury happened, or perhaps crossing a harbour-mouth with a really strong outgoing tide, then your situation has suddenly become extremely serious. Recognise this NOW. That is the point of this ‘assessment’ phase - you need to understand the situation and how it’s going to play out, because you need a plan before you go any further.
GET HELP
Let someone else know the situation. Even if you’re 100% sure that you can make it safely back to shore under your own steam, it’s still a really smart plan after any medical incident to let someone else know what’s happened. Promise to check in again once you’ve reached shore safely, and agree a plan on what happens if you don’t make that check-in call. This is really important. What seems at first like a minor injury may deteriorate rapidly once you start trying to paddle. It may become too painful to continue, and/or you may go into shock. Remember too, you may need someone to drive you to a medical center once you reach the shore. Don’t be driving yourself if you’re losing blood or are in serious pain. Indeed, ideally you shouldn’t even be walking up the beach unaided, certainly not trying to lift your board up onto the car roofrack! If the injury is serious enough that you need to call the emergency services right now, remember to say where you’ll meet them – assuming you can make it to shore. If you’re being blown out to sea and you’re calling for lifeboat or coastguard assistance, make sure they know that you’re injured, as speed will be of the essence.
ACT
Before you put your plan into action, there are a few even more immediate considerations in this scenario, especially if you’re on your own.
Stay low: If you’re hurt, stay down. Don’t even think about standing up. Remain kneeling, sitting or even laying on your board, so that if shock kicks in or you get dizzy from the pain or whatever, you’re less likely to fall into the water - which really will not help in any way right now!
Get your buoyancy aid working: If there is even the remotest likelihood that your wellbeing is going to degrade further, then sort out your buoyancy aid now while you still can. If you’re wearing permanent buoyancy, simply check it’s on properly and appropriately tight. If you’re wearing a beltpack, now is the time to activate it, or at very least, get it open and over your head, so that all you need to do is inflate it. Just get it on, so it’s ready to go. This is a really important one!
Now you can think about getting yourself to safety. Remember, stay down, kneeling or seated, while you paddle. If there are others with you, ask someone to paddle close by so they can keep an eye on you – better still, can they take you under tow?
If you’re alone, and there is any likelihood you will struggle to make it to shore, are there any closer options? A nearby boat with people on board, perhaps? Use your whistle, scream, yell, wave your paddle, do whatever you can to attract people’s attention.
Typical injuries
You may think it unlikely that you’ll injure yourself while paddleboarding, but the research for the safety books actually found quite the opposite. Several scenarios kept on cropping up, often enough to make them well worth including on the list of things that all paddleboarders should probably think about how to deal with (or indeed, take some action to prevent them occurring).
I’m not going to include third party collision scenarios here; if you’re hit by a jetski or launch then anything could happen and it won’t be pretty, but on the bright side, at least it means there are other people in the vicinity to give you aid! The scenarios here are things that can happen potentially when you’re on your own, so it’s going to be entirely down to you to deal with them. I’m not going to get into more detailed first aid processes either. Go do a first aid course to learn those.
Cut foot
Foot damage is by far the most common injury that occurs in paddleboarding, albeit due to stepping (or falling) off your board rather than the act of paddleboarding itself. As it’s generally the result of being in shallow water, there may well be accessible dry land near by, in which case you can go ashore and sort it out. However, it may well happen in a less ideal location. Maybe you fall or step off your board in a shallow part of the bay or lake and come down with some force onto an oyster shell, a sharp rock, a bit of glass? Suddenly you’ve got a cut foot, and you’re a long way from home. If it’s bleeding badly then it’s going to keep on bleeding while you’re standing up and paddling, so take this one seriously. As with any bleeding injury, try and stop the bleeding by applying pressure to the wound. You can usually improvise with an item of clothing. Bunch one bit up to create a pad to place onto the wound, then use the rest of the garment to wrap around the foot and tie it on tightly.
If you’ve lost blood you may get light-headed so - as with any injury scenario - stay low, and paddle back to shore from a kneeling or sitting position. As previously discussed, if you’ve got a beltpack buoyancy aid, have it at least semi-deployed in case you go into shock and fall into the water. If it’s a bad cut and you are likely to need some stitches, you should definitely call ahead so there’s someone waiting to drive you to hospital, or if the situation warrants, an ambulance is waiting to meet you. You don’t want to be driving yourself.
Prevention: Footwear is of course a great way to reduce the risk of injuries to the feet, even though it's not considered cool by many to paddleboard with boots on. Thinking about the depth of water before you step off (and if in doubt, always getting off slowly rather than taking that quite literal leap of faith from a standing position) is another really good way of avoiding twists, sprains and tendon injury, as well as the risk of standing on something sharp. Likewise, whenever you fall in, try to keep your feet up as much as possible if there is any risk of the water being shallow.
Dislocated shoulder
There have been quite a few unlucky instances of this happening when someone catches their arm on the board or paddle during the falling-off process, resulting in a dislocation. It’s not something you can easily mitigate against; it’s just super bad luck if it happens. Please don’t entertain any thoughts of hurling your paddle away from you every time you fall off so as to avoid landing on it: you’re far more likely to lose your paddle or hit someone else with it than you ever are of injuring yourself on it!
A dislocated shoulder while you’re in the water is not good news, as it is going to be very hard (and painful) to get back onto your board. The thicker your board (or the higher the cockpit sides, as with race boards), the harder it will be. Have a go anyway; in an emergency situation you’re always better off out of the water than in it. You may be able to pull yourself on with your good hand, even if it is painful. Try getting on over the tail, which hopefully you can submerge at least a little bit. If you can’t get out of the water then if you’re wearing an inflatable buoyancy aid, deploy it immediately then try and summon some help. You’re going to need help even if you can get back onto your board, because paddling is going to be pretty much out of the question.
Cracked ribs
Again relatively uncommon, but a realistic risk on hard boards, and something I’ve been unfortunate enough to have personal experience of on no less than three occasions in my 18 years of paddleboarding. However, on two occasions it was while SUP surfing and I was simply unlucky enough to fall onto the rail of my board from a considerable height. In decent surf that stuff just happens and there’s nothing you can really do to mitigate against it – other than not going out when it’s bigger than about waist high! The most recent occasion though was during a downwinder, when I realized I was going to fall, but made the rookie error of trying to land on the board rather than fall into the water, resulting in my coming down hard onto the cockpit edge. I then had to endure a very painful few miles of paddling to get home. Lesson learned there!
There have also been cases of people falling onto the deck of their board, but actually impacting directly onto their mobile phone which was in their buoyancy aid front pocket, resulting in cracked ribs and a cracked phone! Not a great outcome. Again, this shows that electing to fall onto your board is rarely a great idea if it’s a hard board - you’re always much less likely to hurt yourself falling into the water. (On an inflatable it’s less of a problem, unless there are fittings on the side that you’ll be falling onto).
The (sort of) good news is that, while extremely painful, you can usually continue to function with bruised or cracked ribs, so you should be able to make it home. Indeed, you may actually think you’ve got away with it and continue with your session (as I did with one of the surfing rib-cracks). However, that tends to just make the injury worse and the recovery time much longer. Fortunately, you’re very unlikely in any paddleboarding scenario (other than being hit by another craft at high speed) to smash your rib cage so badly that you actually break a rib, which would of course be a whole different ballgame in terms of danger.
Injuries from your equipment
People getting injured by their own equipment is surprisingly common. A board deck bristling with bungees, fittings, action cams, plus a whole lot of luggage such as drybags full of spares, water bottles, comms, etc, does mean that an awkward fall can very easily lead to injury. Either due to falling onto something hard or sharp, or - even more common - getting fingers caught in bungees during a fall, often leading to rather nasty tear injuries.
A hand or finger injury may not sound particularly dramatic, but actually, it’s quite a big deal if it means you can’t easily paddle! The same advice will apply as for dislocated shoulders; you may still be able to paddle on one side (the opposite to your injured hand) by cradling the top of the paddle with your palm or forearm.
Board-mounted cameras deserve a special mention here. Yes it’s great to get some fun footage of yourself, but a whole lot of action cams get lost each year by people falling and knocking them off into the water - often injuring themselves in the process too. So don’t be thinking about doing something like this until you’re really confident on your board. A lesson that applies even more in SUPsurfing – putting your camera on the nose of your surfSUP is just tempting fate!
The risk of this sort of injury can of course be mitigated almost entirely by removing all that excess baggage from your deck. If you don’t ever use the bungees, take them off. Avoid the temptation to travel with a whole stack of stuff on your board unless you really really need it. It’s a) weighing your board down, b) potentially increasing the risk of injury should you slip or fall, and c) useless if you lose your board anyway. In Book 1 of the SUP SAFETY series which is all about safety equipment for SUP, I explain the four golden rules of safety equipment, which are very relevant to this point. The second golden rule of safety equipment is that it’s useless unless it’s actually in your hands when you need it. Which it isn’t, if you’re incapacitated in the water and/or you’ve lost your board. All that stuff on the deck is of no value at all if you can’t get to it. So don’t ever be carrying important safety equipment on your board. If you can’t carry it on your body (again, without it being likely to injure you should you fall), it’s no use.
In summary
While you can reduce the risk of injuries by removing excess clutter from your deck and wearing appropriate footwear, the reality is that most SUP injuries come down to bad luck. However, how well and easily you recover from the situation is greatly influenced by your immediate actions.
Recognise the severity of the situation. If the result of the injury in any way degrades your paddling capabilities and general well being, then it’s time to head for home.
Take precautions so that if things get worse and you end up in the water, you’re going to be able to survive.
Call for help immediately, or at very least, let someone else know. Remember that even if you make it back to shore OK, you may still need assistance from there. Don’t be driving yourself to hospital if you’re injured or ill.
Get to safety as soon as you can
Once again, the injury scenario is a whole lot easier to deal with if you’re with other paddlers. They can take charge of the situation, look after you, get you to shore, tow you back or whatever. The reality is that in the vast majority of paddleboard problem scenarios, having other paddlers nearby is a good outcome. Paddling with others is always a wise plan.
In next month’s article, we’re going to consider one of the absolute worst case scenarios that can befall a paddler on an inflatable board. Until then - happy (and safe) paddling!
This text is extracted and modified from Book 3 of the SUP SAFETY - How to stay safe on your stand-up paddleboard series by Bill Dawes, available in Kindle or paperback form from Amazon. If you’d like to learn more about being safe on your stand up paddleboard, which includes understanding your safety equipment, understanding how to read and interpret the environment around you, and of course what to do when things go wrong, we’d thoroughly recommend checking out the books for yourself.