What has bony ear canals, knobby knees, spotty eyes and a severe case of sunburn?
A surfer, of course.
Those maladies are just some of the more common medical ailments that can hinder a surfer's search for the perfect wave.
People have misconceptions, though, about what it is that makes surfing a dangerous sport, said physician Mark Renneker, president and founder of the San Francisco-based Surfers' Medical Assn., which claims a membership of more than 600 dues-paying doctors worldwide who surf.
"When people think of surfing injuries and ailments, they think of shark attacks, drownings and breaking necks," said Renneker, who also edits Surfing Medicine, the journal for the association. "The truth is, those are rare occurrences."
Less exotic and more chronic are injuries and ailments that occur when surfers spend long hours in the water being exposed to the sun and wind, said Dr. Paula Luber of Prompt Care Emergency Center in Westminster, which cares for a number of patients who have surfing-related injuries.
The injuries and ailments, however, are all preventable, said Luber, who, although not a surfer herself, is married to one.
One of the more common surfing injuries is getting cut by the sharp fins and tails beneath surf boards, Luber said. She advises surfers to sand down the sharp fins (although surfers say this will alter the board's performance) and cover the nose with plastic guards.
Still more dangerous injuries can happen to surfers, although debilitating mishaps are becoming rarer. Paralyzing neck injuries can be sustained when surfers dive into shallow water and hit the beach bottom hard, said physician and surfer John Skinner. He founded Hoag Hospital's Wipeout program--aimed at preventing surfing injuries--in 1983 after he noticed that a large number of patients with spinal-cord injuries were being transported to the Newport Beach hospital directly from area beaches.
Through the program, a 28-minute docudrama was produced that depicts an athlete who was paralyzed after he dove into shallow water. The film, shown to thousands of students throughout Southern California, also offers tips on how to avoid such injuries, which, Skinner believes, are the most tragic.
"One minute, they are young, healthy people and the next, they are paralyzed for life," he said.
Neck injuries are less common now because surfers have learned to become more careful, Skinner said.
More routine are surfing injuries that can be treated through "basic emergency medicine," Renneker said.
"There's no real mystery on how to handle a sprained ankle," he noted.
But doctors who treat surfing patients need to understand the sport to help their patients recover from their medical problems and avoid them in the future, Renneker said.
Doctors have to learn to treat surfers as serious athletes, Luber concurred. Surfers can't just be told to give up the waves until their injuries are healed, she said.
"That's like telling a marathon runner he can't exercise for months on end," Luber said. "Like runners and weight lifters, surfers have the obsession to surf."
Doctors not familiar with surfing often are befuddled by such surfing ailments as surfer's ear and knobbies. Surfer's ear is the growth of bony segments in the ear canals, most likely the result of a surfer's constant exposure to cold wind and water, Luber said. Ears can literally close up if the bony growth is not checked, she said.
Surfers can protect themselves by wearing earplugs or wet suits with hoods. However, surfers often balk at hoods.
"They think it's 'uncool,' because they think they look like wimps," Luber said. "It's hard to get them to wear them."
Surfers can also be afflicted by knobbies, or extra tissue growth on top of their knees, feet or ribs. Knobbies result from the constant contact surfers have with their boards when they paddle.
In addition, too much sun and wind exposure can pose medical problems to a surfer. Cataracts are common, because a surfer's eyes are frequently exposed to the sun. Surfers can also suffer from pterygiums, which occur when the white part of the eye grows over the cornea to protect it from wind and salt contact.
For all the injuries and ailments in the surfing world, though, surfing medicine is not taken all that seriously, Luber said.
"People still laugh at surfing medicine. It's still good enough for a chuckle," she said.
But surfing medicine can be just cause for a nice trip to Tavarua Island in Fiji and other hot spots, Renneker said. Fiji was the location for the first medical conference on surfing, held in 1986. In addition to sharing the latest information, the doctors were able to take on some of the best waves in the world.