Objective: The primary objective was to investigate the incidence of concussion and the associated mechanisms of injury in elite Australian surfers. The secondary objective was to investigate the current perspectives and behaviors related to experiencing concussion in surfing. Design: A cross-sectional, retrospective, descriptive survey. Setting: Surfing Australia high-performance program. Participants: Forty nationally identified elite Australian surfing athletes. Intervention: A retrospective survey collected information pertaining to participant demographics, concussion history, potential concussive symptoms, such as headache, neck pain, dizziness, or unusual fatigue, following a wipeout, and participants' perspectives on concussion. Main Outcome Measures: Investigating concussion incidence among elite Australian surfers compared with potential undiagnosed concussive episodes. Results: Surfers with a history of diagnosed surfing-related concussion (DC) were compared with those with no history of a diagnosed surfing-related concussion (NDC). A total of 13 of 40 surfers had a DC, with "contact versus the water surface" identified as the primary mechanism. Both DC and NDC groups had a high frequency of concussive symptoms after a surfing wipeout with a total of 447 and 573 concussive symptom occurrences reported in the DC and NDC groups, respectively. Concern regarding the long-term impacts of concussion were reported in 25 of 40 surfers. Conclusions: The number of concussive symptoms reported by surfers who had not previously been diagnosed with concussion suggests that concussion may be underreported and underdiagnosed in elite surfing. This underscores the need for increased medical support, education, and improved safety protocols.
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