Surfing Safely: Examining Concussions And Attitudes Towards Helmet Use Among Pro Surfers

PURPOSE: Incidences of concussions have been documented in competitive surfing populations. Helmet use has become more common among surfers however, factors that influence helmet use remain unknown; therefore the purpose of this study was to describe the perceptions of helmet use among professional surfers by injury history, sex, level of competition, and location. METHODS: A cross-sectional survey was disseminated via email listservs and in-person recruitment to professional World Surf League (WSL) athletes (n = 57; men: n = 37, 64.9%; women: n = 20, 35.1%). Participants included both Championship Tour (CT) athletes (n = 42) and athletes competing for CT qualification in the Challenger Series (CS) (n = 15). The main outcome measures included descriptive statistics of level of agreement among Likert-type scales on domains evaluating factors influencing helmet use among WSL athletes, as well as Chi Square analyses comparing group porportions (alpha = 0.05). RESULTS: A majority of athletes endorsed a history of previous helmet use (n = 31, 54.4%). Of those athletes with a history of helmet use, 29.0% also had a history of concussion compared to 19.2% of athletes without a history of helmet use (p = 0.157). Females had a greater frequency of prior helmet use compared to males (80.0% vs. 40.5%; p = 0.004). CS competitors reported a higher but not significantly different rate of prior helmet use compared to CT competitors (73.3% vs. 47.6%; p = 0.089). Athletes reported they would wear a helmet at Pipeline (84.2%) and Teahupo'o (80.7%) above an average wave height of 10.4 ft and 10.7 ft, respectively. Furthermore, 28 of 57 (49.1%) competitors endorsed they would wear a helmet surfing waves of consequence, typically defined as large barreling waves breaking over shallow coral reefs or rocky bottoms. CONCLUSIONS: Our preliminary findings suggest that variables related to injury history, demographics, level of competition, and perceptions of risk may influence helmet use among surfers. Specifically, athletes who previously had a concussion, identify as female, surf at lower levels of competition, or surf in high-risk locations were more agreeable with helmet use than their counterparts. Future research should expand upon the present sample, and incorporate additional levels of surfing athletes.