Summer is full steam ahead, and now more than ever, people are eager to enjoy the hot weather and other fun in the sun activities. With increased activities also comes increased injuries, so before you pack up your sunblock and a good book for a relaxing day at the beach, learn from a few of Rothman’s physicians on common injuries sustained at the beach and how to prevent an unexpected trip to the doctor’s office.
What are the most common ortho injuries you have treated/heard of in relation to patients attending the beach?
Dr. Brandon Erickson, Sports Medicine Surgeon - Now that summer is upon us and people are anxious to get out and head to the beach, we have started to see some common upper extremity injuries sustained while at the beach. These injuries include clavicle fractures, shoulder dislocations, rotator cuff tears, and shoulder impingement.
Clavicle fractures are most common from a trauma where the person is knocked to the ground and lands hard directly on their shoulder, either from a wave knocking them over or a tackle in a football game.
Shoulder dislocations also happen from trauma, but this often occurs when the person falls, but the shoulder is away from the person’s body, and as their arm hit the ground, the shoulder pops out.
As for rotator cuff tears and shoulder impingement, these injuries often occur from overhead activities such as throwing a frisbee, baseball, or football, or repetitive activities such as building a sandcastle. The shoulder can also become inflamed from carrying heavy beach equipment to and from the car.
Dr. John Koerner, Spine Surgeon – The most common injury I see from patients going to the beach is a lumbar spine strain or pulled muscle, which usually is the result of being hit by a large wave. Typically, this resolves with rest and anti-inflammatories over the course of a few days. If there is no improvement, it is possible that a more serious injury such as a lumbar disc herniation or even a minor broken bone has occurred.
Although it is rare, the most devastating injury I see in relation to the beach accidents is a spinal cord injury. This typically occurs from people body surfing and hitting their heads into the sand in shallow water. This causes the neck to flex or extend beyond the normal limits, which can cause a spinal cord injury and paralysis. Even experienced swimmers can have these devastating injuries, and people should be very cautious when the water is rough, as well as when it is very shallow.
Dr. Melody Hrubes, Sports Medicine (Non-Operative) – Often, due to the increased instability of the sand, ankle twisting or knee swelling. The sand is less stable so people think it's softer on the joints, but it creates instability up the biomechanical chain so requires a higher level of joint stability from secondary stabilizers like tendons and muscles.
When going to the beach for the day, what activities should people avoid or go easy on?
Dr. Hrubes – Too much of anything without a break can be bad! You may be having fun but with your endorphins flowing you might not feel the aches and pains that might typically stop you from pushing too far and causing injury. There is a small difference in exercise load between a nice muscle soreness because you worked out and an injury. If it's a new activity, stop and cool down, hydrate, and make sure you warm up before jumping back in.
Dr. Erickson - It’s really not about avoiding any activities as much as it is about getting your upper body ready to participate in the activities you want to do. If your goal is to throw a frisbee around, it is worthwhile to stretch your shoulder as well as your hips and torso as tightness in your lower extremities can predispose you to injuries in your shoulder and elbow. up is also key. If you are going to play in an ultimate frisbee game or football game, take 10 minutes to warm up throwing disc or the football so that when the game starts, your shoulder isn’t cold. This will mitigate injury risk to your shoulder and elbow. Finally, It is important to have a home stretching and strengthening program to keep your upper extremities in as good of shape as possible.
Dr. Koerner – When the water is rough, people should be very cautious about swimming, especially if they are not experienced swimmers, or may not be in great shape.
Any suggestion for how people can prep for a fun and safe day in the sun?
Dr. Koerner – Always swim near lifeguards and if the water is rough, consider staying out of the water that day. Once in the water, try not to turn your back on the incoming waves.
Dr. Hrubes - Think about your footwear for traveling to and from the beach. If you have new flip-flops think of blisters, bring bandaids or try them out at home beforehand. Also, don't forget to pack rehydration supplies—replenish the electrolytes you'll be sweating out!
Dr. Erickson – While we are talking about upper extremity injury prevention, making sure to wear sunscreen and sunglasses are probably the most important things one can do when heading to the beach. In regards to the shoulder, elbow, wrist, and hand it is important to stretch before you engage in any physical activities, especially on the beach. Don’t just focus on stretching and warming up your upper body; make sure you stretch your hips, hamstrings, calves and ankles as this will help prevent you from falling, which is one of the causes of shoulder injuries.
What’s your favorite beach activity?
Dr. Erickson – My personal favorite beach activity is throwing the football and, when the opportunity arises, playing a full out tackle pickup game. Unfortunately, there are some inherent risks with playing tackle football on the beach like clavicle fractures (I broke my clavicle playing football during college) and shoulder dislocations, but as a former football player, this is something I love. Ultimate frisbee is something I also enjoy, but to be perfectly honest, as a former wide receiver, I can help my team when it comes to catching, but I have some work to do on the accuracy of my throws.
Dr. Koerner – I enjoy swimming and body surfing, but I’m starting to be a little more cautious as I get older. Most of the time now I end up building sand castles with my kids.
Dr. Hrubes - I like to be in the water; snorkeling is my favorite!
Any last thoughts or wrap-up? Tips?
Dr. Erickson – Any time you participate in sports on the beach you are at risk of injury. However, by stretching, warming up, and playing smart, your injury risk will decrease significantly. Make sure you pay attention to your body when you’re playing, and if your shoulder starts to bark at you, back down from throwing that day. If carrying the beach chairs and umbrella all at once is painful, make one or two extra trips with fewer things in your hands (everyone, myself included, likes to make as few trips from the car to the beach as possible, but it’s not worth flaring your shoulder up to save yourself one extra trip to the car). Lastly, don’t forget to ice your shoulder down when you get home from the beach if you’ve had a big day of activities (remember, ice is nice). Now go out and enjoy the beach!
Dr. Hrubes - The beach and sand are a great way to change up or diversify your regular workout routine. Sand and water can challenge different muscle groups.
Dr. Erickson is a Sports Medicine Surgeon and with a special interest in shoulder, elbow and knee injuries to athletes and non-athletes alike. He sees patients in Manhattan and Westchester County, NY. For more information or to make an appointment please visit www.RothmanNY.com or call 888-636-7840.
Dr. Hrubes is a Sports Medicine (non-operative) Physician and previously served as the Medical Director of the Radio City Rockettes. She has an interest prevention and biomechanical rehabilitation in athletes, performing artists, endurance sports, and female athletes. For more information or to make an appointment please visit www.RothmanNY.com or call 888-636-7840.
Dr. Koerner is a Spine Surgeon and sees patients in Bergen County, NJ (Paramus, Montvale and Rutherford). For more information or to make an appointment please visit www.RothmanNJ.com or call 888-636-7840.
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