LOCAL

Beach injuries can ruin a good day, change a life

Gray Hughes, rghughes@delmarvanow.com

Kids play in the waves in Ocean City, Md., during Memorial Day weekend 2016.

On a recent sunny afternoon, Katie Workman, of Doylestown, Ohio, was watching her son play on the Ocean City sand by the ocean — a body of water she won't even dip a toe in.

"I have never been in it," she said. "I don't want to be swept away by a shark."

But another danger lurks in the water, and it has nothing to do with fear of jaws: spinal and neck injuries.

Accidents involving those sent nine people to a hospital near Rehoboth Beach alone last year. Up the coast, hundreds are injured during the summer in the beach towns. And some say the chances for injuries may be worse along the coast's replenished beaches.

Trips to the emergency room occur in a variety of ways, such as diving into the water where it's too shallow or people landing on their heads after being hit by a wave that swept them off their feet.

Along with riptides, these are the types of injuries that lifeguards and emergency officials warn beachgoers about most.

Josh Basile knows how a good day at the beach can be ruined.

In August 2004, Basile's life as an 18-year-old changed forever when he was hit from behind by a wave.

Josh Basile was injured by a wave in 2004 when he standing in knee-deep water at North Bethany Beach. He is now a practicing attorney. This picture was taken when he was sworn in to the District of Columbia bar earlier this year.

He crashed into the surf, and his head hit the sand, which he described as hard as concrete. He couldn't move his arms or his legs as his friends dragged him out of the water.

"The second you put your guard down, something bad can happen," Basile said.

That day, Basile broke his neck and became a quadriplegic. Basile now works to make sure people are aware of the dangers of the ocean.

Experts warn that, without caution, injuries like Basile's are a a real possibility for beachgoers, but what's causing these punishing waves is questioned.

Basile urges caution for others now as they visit the beach, as do experts who have studied beach injuries.

“The analogy I use is, I ask people if they would close their eyes and run across Route 1,” said Dr. Paul Cowan, chief of the Department of Emergency Medicine at Beebe Healthcare in Lewes. “And everyone says of course they wouldn’t do that. Well, they are kind of doing the same thing when they turn their back to the waves.”

The unpredictable ocean

Sharon Howse was visiting Ocean City from Canada as she looked over the water on a recent afternoon.

She said she hasn't been swimming yet, but her family has. Howse has, however, frequented the ocean in many other places, and she treats it with respect when she does go in.

"I don't always feel safe," she said. "I nearly drowned when I was a kid, so that kind of scared me."

The ocean can be unpredictable, and the same is true for beach injures and environmental factors.

In this file photos, beachgoers body surf the waves near 28th Street in Ocean City.

Whether or not the waves on beaches like Ocean City, Maryland, and Rehoboth, Delaware, cause worse waves and therefore more injuries is hotly debated.

Some say rough surf is caused by beach nourishment, which changes the topography of the shoreline. Others argue it's the natural motion of the ocean.

Kent Buckson, the Rehoboth Beach Patrol captain, sees both sides of the beach nourishment discussion.

He has been involved with many beach nourishment projects, and he realizes the process is vital to supporting the town. He believes the process does change the way the waves break onto the beach.

Waves tend to break quickly and heavily onto the beach when nourishment is involved, he said, instead of rolling in like on a beach that does not use nourishment.

"There is something to be said about it," he said. "It changes the shoreline and how the waves break, and that causes injuries."

Beach nourishment pumps coarse sand up the shore, meaning the beach is going to be steeper, said Stephen Leatherman, a professor and director of the Laboratory for Coastal Research at Florida International University. Leatherman is known as "Dr. Beach" for his annual best beaches rankings.

Waves that catch air in the tube and crash in an exploding manner are known as plunging waves, he said. These waves are present when there is a shore break, which is when the waves are breaking directly onto the beach — something that lifeguards are often warning about along the coast.

"As the wave breaks, it pulls the water into it, and that can pull people into it and make them hit their head on the sand because it's so shallow," he said. "It is a very bad situation. ... It is like jumping into a pool head first, but there is less there. Sometimes there's less than a foot."

This is the type of wave that caused Basile's life-changing injury.

Certain aspects of the water, such as weather and how it will affect the surf, do cause more water rescues, said Joe Donnelly, captain of the Bethany Beach Patrol, but he doesn't believe beach replenishment does.

In this file photo, the Ocean City Beach Patrol and the Ocean City Fire Department assist two swimmers at 71st Street.

“There is no rhyme or reason to predicting surf injuries,” he said. “There are those who suggest certain beach topography will lead to more beach injuries, but our statistics would not suggest that. We have the same beach topography here in Bethany every summer.”

The beach is dynamic, said Chris Gardner, a public information officer for the Army Corps of Engineers.

When a beach is widened, in between three to six months the slope will start to match the natural slope of the beach, he added. As time passes, beach nourishment is done to keep up with this process.

That process, Gardner said, plays no role in creating neck injuries.

“We have no data to suggest there is a correlation between recreational injuries and coastal management,” he said.

Butch Arbin, captain of the Ocean City Beach Patrol, said in his 45 years with the patrol, he has not seen anything to indicate beach nourishment is leading to more injuries.

Beach patrol members are very proactive when it comes to reporting neck injuries, so while it looks like there has been an increase of neck injuries since beach nourishment started, in reality more injuries are being treated as neck and head injuries as a precaution, he said.

"If you walked up to me on the beach with a bloody nose in 1975, I would have handed you gauze," he said. "If you were to do that now, it would be different. The mechanics of the injury that caused the bloody nose could have caused a spine injury, so we treat it like a spine injury."

A variety of injuries

Members of the Ocean City Beach Patrol practice a life-saving procedure on a fellow lifeguard during a re-certification session. The procedure, called the Hawaiian Sling, is a rescue technique in which lifeguards operate as a human backboard.

Not every injury on the beach is as traumatic as Basile's life-changing injury in 2004.

There are three categories of beach injuries, Donnelly, the Bethany Beach lifeguard captain said: general aid, lieutenant injury and ambulance injury.

There can be between two and 10 cases each day for a general aid injury, he said, which can be treated with a first aid kit.

The other two injuries, though, require more attention.

A lieutenant injury is an injury that requires assistance from a beach patrol lieutenant to administer aid, and an ambulance injury is an injury that requires assistance from an ambulance.

Bethany Beach Patrol saw 60 lieutenant and ambulance injuries during the summer of 2016, Donnelly said.

In Rehoboth, there were 319 injuries that required medical attention during 2016, ranging in severity from a splinter to broken arms, Buckson said.

There were nine injuries to the spine which required people to be taken off the beach.

But even with these injuries, there are some still who say they feel safe while swimming in the ocean.

Phil Poorman and Isabelle Purnel, both of Wilmington, were looking at the ocean on a day when the water was as aggressive as a swarm of bees that recently had its hive run over by a lawnmower.

Poorman said he would feel comfortable swimming in the ocean on a day like that but only if a lifeguard is around.

"If you are not an experienced swimmer, and if you don't know how to do any riptide stuff, I can understand why people would be worried," he said. "But, personally, I know how to. But I'd still stay away from the buffer zone when the ocean is looking like this."

Purnel, on the other hand, is more cautious.

In this file photo, Dewey Beach Patrol held their Annual Rookie Test on the beach at Dagsworthy Street in Dewey Beach on July 15 with 18 new candidates completing a series of endurance running, open water rescue, and swim drills to earn a place on the Beach Patrol.

She said she doesn't how to swim well, so she wouldn't go in the ocean when the waves are breaking as heavily as they were that day.

"If you don't know how to swim well, you should stay away," she said.

However, beach experts say the ocean does not discriminate against swimmers.

Donnelly said he has observed no connection between days where the surf is rough and an increase of injures, and there can be just as many injuries on a calm day as on a rough day.

Beach injuries range from sprained ankles and broken wrists to broken necks, said Dr. Cowan, Beebe's chief of the Department of Emergency Medicine.

“We see these neck, back and head injuries,” he said. “But we don’t see a ton of them.”

The most common injuries he sees are injuries to the upper extremities, lower extremities, torso, and then head, neck and spine, he said. The most common manner that people injure themselves at the beach comes from when people are trying to exit the surf.

Another way by which people injure their head, neck and back comes from diving into the water in areas where it’s too shallow, said Dr. Herndon Murray, an orthopedic surgeon at the Shepherd Center, a hospital in Atlanta specializing in spinal cord injuries.

“Diving is a completely voluntary action, and it can ruin someone’s life,” he said. “We look back at 10 consecutive years of diving injuries, and a third of the injuries do occur at the beach. That surprised even us.”

Over a 10-year period between 2003 and 2013, diving was the fourth leading cause of spinal cord injury observed by the Shepherd Center, and oceans were the second leading area of these injuries in that time period, with 34 percent of spinal cord injuries treated by the Shepherd Center caused by diving coming at the beach.

Also, during the time period in which the Shepherd Center conducted its study, males were injured in beach accidents far more often than women — 89 percent to 11 percent — and people between the ages of 20 and 29, too, account for the most injuries, with 45 percent of injuries coming from this age range.

However, Cowan said they observe a bimodal trend, with people between the ages of 20-29 and those closer to Medicare age representing the two largest groups, and he is unsure why this trend is.

"What we don’t know entirely is who is sitting on the beach, so we don’t know if there are more older people sitting on the beach leading to those injuries," he said. "We are working on those types of questions this summer."

In this file photo, members of the Ocean City Beach Patrol stand guard at 82nd Street where they rescued a male subject from the Atlantic Ocean.

During the summer, the Shepherd Center observes more people becoming quadriplegics from diving injuries than driving injuries, which is one of the leading causes of injuries in young people, Murray said.

Despite his injury, Basile, now 31 and living in Bethesda, Maryland, has not let his injury slow down his life. He graduated from the University of Maryland, went to law school and passed the bar exam, and is now an attorney in the Washington, D.C. area.

And he still loves the beach.

“I have a thousand happy memories of the beach, and one tragic one,” he said. “I wish I could have that day back, but the beach is still full of smiles and fun times.”

On Twitter @hughesg19

Expert advice

Beach injuries, such as the severe injuries to the neck, can be prevented, said orthopedic surgeon Dr. Herndon Murray. To prevent neck injuries, he recommends people don’t dive at all. “Feet first every time,” he said. “Better to break your leg than your neck. Any dive can result in a lifetime of paralysis. People are just not aware of what can happen. It doesn’t happen that often, but if it happens to you it’s permanent.”
Bethany Beach Patrol Capt. Joe Donnelly recommends people take it easy, both getting in and out of the water. Communicating with lifeguards throughout the day is another way to stay safe at the beach, he added. “Checking with lifeguards on day-to-day conditions is probably the smartest thing to do,” he said.
Entering and exiting the water sideways is another way people can avoid injury, said Dr. Paul Cowan, chief of the Department of Emergency Medicine at Beebe Healthcare in Lewes. Waves have tons of energy, he said, and a 3-4 foot wave can have the same energy of a small car. “The analogy I use is I ask people if they would close their eyes and run across Route 1,” he said. “And everyone says of course they wouldn’t do that. Well, they are kind of doing the same thing when they turn their back to the waves.”
If a wave is approaching and exit is impossible, Rehoboth Beach Patrol Capt. Kent Buckson recommends going under the wave. He said swimmers need to pay attention to the wave break. “You are better off turning into the wave and going under rather than trying to exit quickly,” he said.