By Steven Mark
There are plenty of surfing books in different genres, from how-to to history, from who's who to where to go. Now you can add "health" to the list with publication of "Surf Survival: The Surfer's Health Handbook," authored by three experts: Drs. Andrew Nathanson and Clayton Everline and pioneering surfing health expert Dr. Mark Renneker. Their collected medical and surfing experience includes big-wave riding in Hawaii, California and around the world; research papers published in peer-reviewed and popular journals; and work at surf contests at Pipeline on Oahu's North Shore and Mavericks in Northern California. As surfers themselves, the doctors kept not only the physical maladies common to wave-riders in mind, but also the mentality that can make surfers difficult to treat.
"A lot of surfers are so enmeshed in surfing that they're not going to listen to a doctor who tells them not to surf," said Everline, sports medicine doctor at WorkStar Injury Recovery Center, a clinic in Ewa Beach. "We aim to work with that state of mind and at least try to get them to functionally brace or work around an injury."
At nearly 300 pages, "Surf Survival:The Surfer's Health Handbook" (Skyhorse Publishing, $14.95) offers a comprehensive look at health and medical issues related to surfing, including conditioning, first aid, CPR techniques, big-wave hazards and how to prepare for a "surfari" to remote locales where health care facilities are lacking and where you might need to know how to make an arm sling out of a T-shirt and some safety pins. The book is user-friendly, with photos and sketches demonstrating conditioning exercises and rescue techniques.
It is also a bit scary, with graphic photos of deep lacerations caused by sharp fins and board noses. "Those fins on your surfboard are the biggest teeth in the ocean," said Everline. The authors recommend using rubber-edged fins and nose guards.
Of particular interest to local surfers and beachgoers is a section on jellyfish. The book says vinegar, a commonly cited home remedy for jellyfish stings, has no effect on the type of box jellyfish found in Hawaii waters. Instead, flushing the affected area with hot water is advised.
"That may or may not explain why urination is a frequent home remedy," Everline said. "There's no scientific evidence to back that there's any chemical in urine is effective, it's just that warm water is the best pain relief."
"Surf Survival" also contains a foreward by noted surfer and board shaper Gerry Lopez and anecdotes and case studies. Renneker, who founded the Surfer's Medical Association in 1986 and co-wrote a column about health issues for Surfer magazine, said being a "surf doc" made collecting such stories easy.
"You're always giving curbside consultations or beachside consultations, so you see a lot of stuff," he said. "There's no shortage of maladies caused by surfing out there."
Renneker wrote a chapter on surfer's ear, a bony growth in the ear canal. Although the book mentions that cold water appears to be a factor in the affliction, Renneker said Hawaii surfers are also susceptible because they often surf in windy conditions and don't wear much protective clothing.
"It's how cold your head gets, whether by air temperature and/or wind evaporation," he said. "Wearing earplugs helps, wearing a surf cap helps."
Renneker surfs regularly at Mavericks and wrote a chapter on big-wave surfing. "For me it was sort of a wonderful experience from the perspective of being a big-wave rider from a physician's perspective," he said.
Renneker said there is anecdotal evidence suggesting that big-wave surfers are at risk for brain trauma, a syndrome he credited to Hawaii researcher Robert Speers.
"Surfers who fall in big waves, they tell you they see stars," he said. "But if you do that a lot, that's like playing football without a helmet … and then all these years later, what happens to all these people?"
Everline grew up surfing in New Jersey, got away from the sport during medical school, then vowed that "I would surf no matter what" when he started his medical residency. He wrote an article about surf health issues for the Journal of Strength and Conditioning, which led him to Nathanson, a San Diego native and emergency physician at Brown University in Rhode Island, who had written an article in the American Journal of Sports Medicine about injuries among competitive surfers.
They then linked up with Renneker, whose columns were compiled in the book "Sick Surfers Ask the Surf Docs" in 1993. A professor of family medicine at the University of California, San Francisco, Renneker said there is still more to be written about surf health.
"The ultimate, comprehensive handbook of surf medicine has yet to be written. This is pretty damn close. You learn more than you ever needed to know about some things, and other things you learn that you didn't know you needed to learn."