17 Common Fishing injuries (Prevention & Treatment)

All 17 common fishing injuries, from hook injuries to hands and eyes to sunburn, dehydration, cuts and strains from repetitive casting.

Wet decks cause falls, heavy gear causes back injuries, and the list covers insect bites, fish spines and teeth, sea sickness, hypothermia, boat propellers and lightning strikes.

No fish tale here, just real talk about fishing dangers.

Injury Rates and Numbers

The figures below come from injury surveillance data and peer reviewed studies. Each row names the population it was measured in, because rates from elite athletes and from recreational players are not comparable.

Finding	Measured in	Source
The national incidence of fishing-related upper extremity injuries treated in US emergency departments was 119.6 per 1,000,000 person-years in 2014.	US patients treated in emergency departments for fishing-related upper extremity injuries, 2014 (NEISS data)	Physician and Sportsmedicine, Gil et al., NEISS-based study
The finger was the most commonly injured site in fishing-related upper extremity injuries, accounting for 63.3% of cases, followed by the hand at 20.3%.	US emergency department patients with fishing-related upper extremity injuries, 2014 (NEISS data)	Physician and Sportsmedicine, Gil et al., NEISS-based study
Males had a fishing-related upper extremity injury incidence of 200 per 1,000,000 person-years, versus 41 per 1,000,000 in females.	US emergency department patients with fishing-related upper extremity injuries, 2014 (NEISS data)	Physician and Sportsmedicine, Gil et al., NEISS-based study
An estimated 412,171 pediatric patients were treated in US emergency departments for fishing-related injuries between 1997 and 2016.	US pediatric patients under 25 treated in emergency departments for fishing-related injuries, 1997 to 2016	Clinical Pediatrics, Vajdic et al., NEISS-based study
In fishing-associated ocular injuries, contusions or abrasions were the most common diagnosis, making up 40.7% of cases.	US patients with fishing-associated ocular injuries treated in emergency departments, 2005 to 2024	Peer-reviewed NEISS-based study on fishing-associated ocular injuries, PubMed PMID 41197757

Overview

Injury	Body area	Typical time out
Sunburn	Skin	3 to 5 days, 1 to 2 weeks if blistered
Hook Injuries (hands, eyes)	Hand and eye	Days, weeks if deep, months for eyes
Dehydration	Whole body	Same day to 3 days
Cuts and Lacerations	Hand and forearm	1 to 3 weeks, months if tendon cut
Sprains and Strains (often from repetitive casting)	Shoulder, elbow and wrist	2 to 8 weeks, 3 months plus if grade 3
Insect Bites and Stings	Skin	0 to 7 days
Injuries from Handling Fish (spines, teeth)	Hand and fingers	3 to 7 days, weeks if infected
Fall Injuries (from slipping on wet surfaces)	Whole body	1 to 3 weeks, 6 to 12 if fractured
Back Injuries (from lifting heavy equipment)	Lower back	1 to 6 weeks, up to 12 with sciatica
Tendonitis (from repetitive motion)	Elbow, wrist and shoulder	6 to 12 weeks, longer if chronic
Heat Exhaustion/Heat Stroke	Whole body	1 to 3 days, weeks after heat stroke
Sea Sickness	Inner ear and stomach	Hours ashore, 2 to 3 days to adapt
Hypothermia	Whole body	1 day mild, weeks if severe
Jellyfish Stings	Skin	Hours to 2 weeks for skin marks
Drowning	Whole body	Days to months, medically guided
Injuries from Boat Propellers	Legs and torso	Months to a year, often permanent
Lightning Strikes	Whole body	Days to weeks, months if resuscitated

Sunburn

Sunburn is radiation damage to the outer skin layer, the epidermis, caused by ultraviolet B light. On the water the dose is roughly doubled because sunlight reflects off the surface and hits the underside of your chin, nose, ears and forearms, the areas a cap never covers. Long static hours on a boat or bank mean the exposure builds without you noticing it.

Symptoms

• Skin turns red and feels hot several hours after you come off the water.
• Tightness and stinging when clothing or a shoulder strap touches the area.
• Blisters on the nose, ears or shoulders in more severe burns.
• Peeling skin a few days later.
• Chills, headache or nausea if a large area is burned.

How serious it is: A first degree burn stays red and painful and heals without marks. A second degree burn blisters, weeps and can scar, and a burn covering large parts of the back or shoulders can make you systemically unwell with fever and chills.

Typical time out: A mild burn settles in three to five days and does not stop you fishing if you cover the area properly. A blistering burn needs one to two weeks before the skin tolerates sun again, and skin stays sun sensitive for several weeks after that.

See a doctor if: See a doctor if blisters cover a large area, if the burn is accompanied by fever, confusion or vomiting, or if a blistered area becomes increasingly red, swollen and tender after a few days.

What helps

• Get out of the sun and cool the skin briefly with a cool shower or damp cloth for pain relief.
• Apply a plain fragrance free moisturizer or aloe gel while the skin is still slightly damp.
• Drink more than usual, since a large burn pulls fluid into the skin.
• An over the counter anti inflammatory such as ibuprofen helps the pain in the first day or two if you tolerate it.
• Leave blisters intact, cover them with a loose dressing and keep the area out of the sun until it has healed.

Hook Injuries (hands, eyes)

A hook drives through skin and the barb anchors it in the tissue underneath, so it cannot simply be pulled back out along the entry path. On the hand it commonly lodges in the fingertip pulp or across a tendon sheath, which is why fingers dominate hook injuries. Casting, unhooking a thrashing fish and a snagged line released under tension are the three moments when the hook ends up in a person, and a hook flying back at head height can reach the eye.

Symptoms

• Sharp local pain with a visible hook or barb in the skin.
• Bleeding from the puncture, often less than you would expect.
• Pain when you try to move the finger, if a tendon sheath is involved.
• Numbness or tingling beyond the wound, suggesting a nerve is caught.
• Pain, watering and blurred vision if the hook has struck the eye.

How serious it is: A superficial barb in loose skin is a minor wound. A hook that has passed a joint, a tendon sheath, a nerve or the nail bed, or any hook near or in the eye, counts as serious regardless of how small the wound looks.

Typical time out: A simple hand puncture is fine within a few days once it is clean. A wound involving a tendon sheath, joint or nail bed, or one that becomes infected, means two to six weeks, and an eye injury is measured in months and depends entirely on what was damaged.

See a doctor if: Go to an emergency department rather than removing it yourself if the hook is in or near the eye, in a joint, near a large blood vessel, or if the finger goes numb, will not bend, or turns increasingly red and swollen over the following day.

What helps

• Cut the line and stabilize the hook rather than tugging at it, and never pull an embedded hook out of an eye.
• For a shallow barb in loose skin, the string pull or the push through and cut the barb technique can be done on the bank, but only if the hook is nowhere near an eye, joint or nerve.
• Irrigate the puncture generously with clean water once the hook is out.
• Check your tetanus cover, since puncture wounds from outdoor tackle are exactly the situation the booster exists for.
• Wear polarized eye protection and a hat while casting, which is the single measure that prevents the injuries with lasting consequences.

Dehydration

Dehydration is a net loss of body water and salt through sweating and breathing that is not replaced by drinking. Fishing hides it well: you stand still, the breeze on the water masks how much you are sweating, and there is often no convenient place to refill or to relieve yourself, so people drink less on purpose. Blood volume drops, and with it the ability to regulate temperature and to concentrate.

Symptoms

• Thirst and a dry mouth that keeps coming back.
• Dark, strongly smelling urine and long gaps between trips to the bathroom.
• Headache and a heavy, tired feeling in the afternoon.
• Lightheadedness when you stand up after sitting.
• Muscle cramps in the calves or hands.

How serious it is: Mild dehydration causes thirst, headache and reduced concentration and reverses within an hour of drinking. Moderate to severe dehydration brings dizziness on standing, a racing pulse, very little urine and confusion, and it merges into heat exhaustion.

Typical time out: A mild case is corrected the same day. If you were unwell enough to feel faint or to need medical fluids, expect one to three days of feeling drained before normal training or a full day on the water again.

See a doctor if: Seek medical help if someone becomes confused, cannot keep fluids down, faints, or has passed no urine for many hours.

What helps

• Drink steadily through the day rather than a large amount at the end, and carry more than you think you need.
• Use an oral rehydration solution or an electrolyte drink when you have been sweating for hours, because water alone dilutes your sodium.
• Get into shade for a while and loosen or remove waders, which trap heat and drive sweating.
• Keep alcohol for after the trip, since it increases urine output at the worst moment.
• Use urine color as your feedback: pale is fine, dark means you are behind.

Cuts and Lacerations

A laceration is a break through the full thickness of the skin, sometimes reaching the fat, tendon or nerve underneath. In fishing the usual causes are a filleting or bait knife slipping toward the holding hand, braided line under load slicing across a finger, and hands placed on barnacles, sharp rocks or a broken cooler edge. The finger and hand carry most of these wounds because they do all the work.

Symptoms

• A clean or ragged skin split that bleeds, often more than a puncture does.
• Pain at the wound edges and when the nearby joint moves.
• Reduced ability to bend or straighten a finger, if a tendon is cut.
• Numbness on one side of a finger, suggesting a digital nerve is involved.
• Increasing redness, swelling and throbbing over the following days if it becomes infected.

How serious it is: A shallow cut through skin only, with edges that sit together, is minor. A cut that gapes, that will not stop bleeding with pressure, or that comes with lost movement or lost sensation involves deeper structures and needs to be seen the same day.

Typical time out: A simple cut is comfortable in five to ten days, though the scar stays tender for weeks. A cut needing stitches keeps you off knives and heavy tackle for two to three weeks, and a tendon or nerve repair means two to three months of hand therapy.

See a doctor if: Get it seen if bleeding does not stop after ten minutes of firm pressure, if you cannot fully move or feel the finger, if the wound gapes open, or if it turns red and hot with a fever a day or two later.

What helps

• Firm direct pressure with a clean pad for a full ten minutes before you look at it again.
• Irrigate with plenty of clean drinking water, since flushing matters more than what you put on afterward.
• Cover with a clean dressing and change it once a day while it is weeping.
• Wounds contaminated with fish slime, seawater or brackish water deserve a lower threshold for medical review, because the bacteria involved are not the usual skin ones.
• Keep a filleting glove and a knife with a guard in the box, and cut away from your holding hand.

Sprains and Strains (often from repetitive casting)

A strain is a tear within a muscle or its tendon, a sprain is a tear within a ligament. Repeated casting loads the rotator cuff and biceps tendon at the shoulder, the common extensor tendon at the outer elbow and the wrist extensors, because each cast is a fast acceleration followed by an abrupt stop. Sprains at the ankle or wrist usually come from a stumble on a bank or a wet deck rather than from the cast itself.

Symptoms

• Pain that starts during a session and is worse the next morning.
• A specific sore spot you can point to with one finger.
• Weakness or reluctance to load the limb, for example a lighter grip on the rod.
• Swelling or bruising within a day, in a more substantial tear.
• Stiffness after sitting still that eases once you move.

How serious it is: The usual scale runs from grade 1, a stretch with a few torn fibers and normal strength, through grade 2, a partial tear with weakness and bruising, to grade 3, a complete tear where the muscle or ligament no longer works and the joint feels unstable.

Typical time out: Two to three weeks for a grade 1, four to eight weeks for a grade 2, and three months or more for a grade 3 or after surgical repair. The spread is wide because a shoulder that has to cast overhead all day is a harder end point than simply walking without pain.

See a doctor if: See a clinician if you felt a pop and immediately could not use the limb, if the joint gives way, if there is a visible deformity or a gap in the muscle, or if you cannot bear weight on an injured ankle.

What helps

• Reduce the load rather than stopping completely: short casts, a lighter rod, fewer repetitions, and build back as pain allows.
• Start gentle pain free movement within the first days, because early controlled loading recovers strength faster than waiting out the pain.
• Progressive strengthening of the rotator cuff, forearm and grip, continued for at least three months once symptoms settle.
• Change the mechanics that caused it: use your trunk and legs in the cast, switch to a two handed rod for long sessions, and alternate arms where the fishery allows.
• See a physiotherapist if it has not clearly improved in three to four weeks, and reserve imaging for suspected complete tears or unexplained persistent pain.

Insect Bites and Stings

A bite or sting injects saliva or venom into the skin and the reaction you see is your own immune response to it, mostly histamine released in the dermis. Anglers are exposed because the productive hours at dawn and dusk on still water are exactly when mosquitoes, midges and blackflies are active, and wasps are drawn to bait and food on the bank. Ticks matter separately, since they can pass on infections during a long attachment.

Symptoms

• An itchy raised bump appearing within minutes to hours.
• A hot, sharply painful spot with a sting, easing over some hours.
• A spreading red patch around the bite over the following day.
• Widespread hives, a swollen lip or tongue, wheeze or faintness in a severe allergic reaction.
• An expanding ring shaped rash days to weeks after a tick bite.

How serious it is: Most reactions are local and settle in days. A large local reaction can swell an entire forearm and is unpleasant but not dangerous. Anaphylaxis, with breathing difficulty, throat swelling or collapse, is a medical emergency and can develop within minutes.

Typical time out: None for ordinary bites. A large local reaction is uncomfortable for three to seven days, and after an anaphylactic reaction you should not fish alone or far from help until you have been assessed and carry an adrenaline autoinjector.

See a doctor if: Call emergency services for any breathing difficulty, throat or tongue swelling, faintness or widespread rash after a sting, and see a doctor for a spreading rash, fever or joint pains in the weeks after a tick bite.

What helps

• Scrape a bee sting out sideways rather than squeezing it, and wash the area.
• A cold pack for ten to fifteen minutes reduces pain and swelling.
• An oral antihistamine for itch, and a short course of hydrocortisone cream for a stubborn local reaction.
• Remove a tick promptly with fine tipped tweezers close to the skin, pulling straight out, and note the date.
• Repellent containing DEET or picaridin on exposed skin plus long sleeves at dusk does far more than treating bites afterward.

Injuries from Handling Fish (spines, teeth)

Dorsal and pectoral spines on catfish, bass, perch and many saltwater species puncture the finger pulp, and in some species the spine carries venom in a sheath along its groove. Teeth and gill plates on pike, bluefish and barracuda cut, and gripping a fish across the gills puts your fingers exactly where they can be cut. These wounds are deep and narrow, which traps bacteria from the fish and the water inside.

Symptoms

• Immediate intense pain out of proportion to a small puncture, typical of a venomous spine.
• Throbbing that spreads up the finger or hand over the first hours.
• Swelling and redness around the wound.
• A visible cut across a finger or knuckle from teeth or a gill plate.
• Worsening pain, stiffness and swelling a day or two later, which points to infection.

How serious it is: A shallow scrape is minor. A deep puncture from a spine, especially one that leaves fragments behind, or any wound over a finger joint or tendon sheath, carries a high infection risk and should be treated as significant even when the entry point is tiny.

Typical time out: An uncomplicated puncture settles in three to seven days. An infected hand wound means one to three weeks on antibiotics and sometimes a hospital stay, and a deep infection of a tendon sheath can cost months of hand function.

See a doctor if: Seek medical care the same day if the finger swells, becomes stiff and hurts sharply when someone straightens it, if red streaks track up the arm, or if you develop a fever after a fish puncture or bite.

What helps

• Irrigate the wound thoroughly with clean water as soon as you are back at the boat or bank.
• For a venomous spine, immersing the hand in water as hot as you can comfortably tolerate for twenty to thirty minutes eases the pain considerably.
• Check for a retained spine fragment, since a piece left behind is the usual reason a wound will not settle.
• Have a low threshold for seeing a doctor about hand punctures from fish, because the bacteria in fish slime and water often need specific antibiotics.
• Use a landing net, long nose pliers, a lip grip and cut resistant gloves, and learn the safe hold for the species you target.

Fall Injuries (from slipping on wet surfaces)

A slip on a wet deck, an algae covered rock or a muddy bank sends the foot out from under you with no time to protect yourself. The common results are a wrist fracture or sprain from the outstretched hand, a bruised or fractured tailbone and ribs, an ankle sprain where the foot wedges between rocks, and a head strike against a gunwale or boulder. Wading adds the extra hazard of falling into moving water.

Symptoms

• Immediate localized pain and difficulty bearing weight or using the limb.
• Rapid swelling and later bruising over the injured area.
• Pain on deep breathing or coughing after landing on the ribs.
• Visible deformity or an odd angle in a fractured or dislocated limb.
• Headache, confusion, nausea or memory gaps after a blow to the head.

How serious it is: Most falls produce bruises and sprains that settle within weeks. A fall becomes serious when there is a fracture, a head injury with any loss or alteration of consciousness, or a fall into cold or moving water, where drowning and cold shock become the main threats.

Typical time out: Bruises and mild sprains take one to three weeks. A wrist or ankle fracture typically means six to twelve weeks including rehabilitation, and rib fractures hurt for four to six weeks because you cannot rest breathing.

See a doctor if: Get urgent help for an obvious deformity, an inability to bear weight for four steps, numbness below the injury, worsening headache, vomiting or drowsiness after a head strike, or increasing breathlessness after a chest injury.

What helps

• Studded or felt soled boots on rock and a properly fitting non slip deck shoe on a boat, matched to the surface you actually fish.
• A wading staff and moving one point of contact at a time in current.
• Get up slowly and check yourself over before you try to walk out, and let someone know if you hit your head.
• Brief cooling and paracetamol or an anti inflammatory for the first day, then start moving the area gently rather than immobilizing it.
• Return to full activity in steps and expect a bruised joint to be stiff before it is painful.

Back Injuries (from lifting heavy equipment)

Most fishing back pain is a strain of the paraspinal muscles and the small facet joints of the lumbar spine, provoked by bending forward while twisting, which is exactly the motion of lifting a cooler over a gunwale or dragging a kayak up a bank. A disc can bulge and press on a nerve root under the same loading. Long static hours seated in a boat or hunched over a rod stiffen the same structures before you ever lift anything.

Symptoms

• A sharp catch in the low back at the moment of lifting or twisting.
• Stiffness and spasm that is worst on the following morning.
• Pain that eases with gentle walking and returns after sitting still.
• Pain running down the back of one leg past the knee, if a nerve root is irritated.
• Numbness, pins and needles or weakness in the foot in a nerve related case.

How serious it is: A simple mechanical strain hurts a lot but is not dangerous and improves steadily. Involvement of a nerve root brings leg pain, numbness or weakness and takes longer. Loss of bladder or bowel control or numbness in the saddle area is a rare emergency.

Typical time out: A mechanical strain settles enough for light fishing in one to two weeks and fully over four to six. Genuine nerve root pain often takes six to twelve weeks, and longer if surgery is needed.

See a doctor if: Seek care urgently for numbness around the groin or saddle area, loss of bladder or bowel control, progressive leg weakness, or back pain with fever or unexplained weight loss.

What helps

• Stay moving within your pain limits, since prolonged bed rest reliably makes back strain worse.
• Short term pain relief so that you can keep walking, plus heat rather than prolonged cooling for muscle spasm after the first day.
• Break lifts down: two smaller trips with the cooler, a trolley for the kayak, and turn your feet instead of twisting your spine.
• Build hip and trunk strength between trips, because a strong hip hinge is what keeps the lift off your lumbar spine.
• See a physiotherapist if it is not clearly improving after two to three weeks, and keep imaging for cases with nerve symptoms or red flags, since scans of painless backs often look abnormal anyway.

Tendonitis (from repetitive motion)

What used to be called tendonitis is now usually a tendinopathy: the tendon has been loaded faster than it can adapt, so its collagen becomes disorganized rather than simply inflamed. In fishing it typically hits the common extensor tendon at the outer elbow, the wrist extensors, the thumb tendons at the wrist from constant reel handling and, in overhead casters, the rotator cuff. Long sessions with a heavy rod after months of little use are the classic setup.

Symptoms

• Pain at a specific point on the tendon, worse when you grip or lift.
• Stiff, sore warm up at the start of a session that eases and then returns worse afterward.
• Weak grip, dropping things such as a mug or pliers.
• Tenderness when you press the tendon or its attachment on the bone.
• Pain when carrying a bucket or opening a jar, not only when fishing.

How serious it is: Early cases hurt only after activity and settle with a few days of reduced load. Established tendinopathy hurts during activity and into daily life, has usually been going for months, and takes a structured loading program rather than rest to turn around.

Typical time out: Rarely a full stop, but expect six to twelve weeks of modified loading for a straightforward case, and three to six months for a long standing one. The range is wide because recovery follows how consistently you do the strengthening, not the calendar.

See a doctor if: See a clinician if the pain came on suddenly with a snap and you lost strength, if the area is hot and swollen with fever, or if there is numbness or tingling instead of simple soreness.

What helps

• Reduce load without stopping: shorter sessions, lighter tackle, and pain kept to a mild, settling level rather than none at all.
• Progressive strengthening of the affected tendon, including slow heavy and eccentric work, done most days for at least three months.
• Fix the mechanics and equipment: rod weight and balance, grip size, reel position and a rod holder or belt for heavy trolling.
• A counterforce brace at the elbow or a wrist support can take the edge off during a session, but it is a crutch, not the treatment.
• A corticosteroid injection can relieve pain quickly but tends to leave tendinopathy worse at six to twelve months, so keep it as an exception rather than a first step.

Heat Exhaustion/Heat Stroke

Heat exhaustion is circulatory strain: fluid and salt loss plus blood diverted to the skin leaves too little for the brain and muscles. Heat stroke is the next stage, where the core temperature climbs past the point at which the body can regulate it and the brain stops working normally. Anglers are exposed by open water with no shade, reflected radiation, and waders or bibs that stop sweat evaporating.

Symptoms

• Heavy sweating, weakness and a pounding pulse.
• Headache, nausea and dizziness, especially on standing.
• Cramping in the legs or abdomen.
• Confusion, slurred speech, irritability or unsteady walking, which signal heat stroke.
• Hot skin that may be dry, and collapse or seizure in severe heat stroke.

How serious it is: Heat exhaustion leaves the person unwell but mentally clear and reverses with shade, fluid and cooling. Heat stroke involves altered mental state and a core temperature above roughly 104 degrees Fahrenheit, and it is a life threatening emergency in which minutes of cooling matter.

Typical time out: After heat exhaustion, expect one to three days of feeling weak before a full day in the heat again. After heat stroke, return is medically supervised and commonly takes several weeks to a few months, because heat tolerance stays impaired.

See a doctor if: Call emergency services immediately for confusion, unusual behavior, seizure or collapse in the heat, and start cooling while you wait rather than after help arrives.

What helps

• Move into shade or a cabin, lie down and raise the legs.
• Remove waders, bibs and outer layers so that sweat can evaporate.
• Cool actively with water over the skin, wet towels and any breeze, and put ice packs at the neck, armpits and groin. Cold water immersion is the fastest cooling method in suspected heat stroke.
• Give cool fluids with electrolytes, but only if the person is fully alert.
• Plan around the heat: fish the early and late hours, carry a bimini or umbrella, and build up gradually rather than making the first hot day a full session.

Sea Sickness

Motion sickness comes from a mismatch between what the balance organs of the inner ear report and what your eyes see. Below deck or while watching a rod tip, your eyes register a stable scene while the inner ear registers pitch and roll, and the brain reads the conflict as though it were a toxin. Diesel fumes, staring down at tackle and rigging line in a cabin all make it worse.

Symptoms

• Yawning, sighing and a cold sweat before you feel sick.
• Pale skin and a feeling of unease in the stomach.
• Headache and heavy drowsiness.
• Nausea followed by vomiting.
• Complete loss of interest in eating, drinking or fishing.

How serious it is: Most cases are mild and fade after a day or two at sea as you adapt. It becomes serious when repeated vomiting leads to dehydration, or when someone is too unwell to stay safe and hold on in rough conditions.

Typical time out: Symptoms usually settle within a few hours of getting back on land, and adaptation on a multi day trip typically takes two to three days. There is no lasting damage.

See a doctor if: Get help if vomiting continues for many hours with no fluid staying down, or if there is confusion, severe headache or fainting, which are not part of ordinary sea sickness.

What helps

• Take medication before you leave the dock, not after symptoms start: antihistamines such as cinnarizine or meclizine, or a scopolamine patch applied hours in advance.
• Stay on deck amidships where the motion is smallest and keep your eyes on the horizon.
• Avoid reading, staring at a phone and long spells in the cabin or engine fumes.
• Keep something light in your stomach and sip fluids rather than fishing on an empty one.
• Ginger and acupressure bands help some people and carry no downside, though the effect is modest.

Hypothermia

Hypothermia is a fall in core body temperature because heat is lost faster than it is produced. Water carries heat away from the body many times faster than air, so wet clothing, standing in a river for hours or a fall from a boat all cause it far quicker than the air temperature alone would suggest. Wind on wet skin and long motionless spells with no muscle activity finish the job, which is why it happens in spring and fall as often as in winter.

Symptoms

• Uncontrollable shivering and cold, pale skin early on.
• Clumsy hands that cannot tie a knot or work a zipper.
• Slurred speech and slowed thinking.
• Stumbling and poor coordination.
• Shivering stopping, drowsiness and confusion, which mean it is getting worse, not better.

How serious it is: In mild hypothermia the person shivers and is still fully alert, and rewarming works well. In moderate to severe hypothermia the shivering stops, consciousness fades and the heart becomes irritable, so the person must be handled gently and warmed under medical care.

Typical time out: After a mild episode, most people are back to normal in a day. Moderate or severe hypothermia means hospital rewarming and one to several weeks of recovery, longer if there is frostbite or a cold water immersion event.

See a doctor if: Call emergency services if the person stops shivering, becomes confused or drowsy, or cannot be roused, and move them gently rather than rubbing or shaking them.

What helps

• Get out of the wind and water and swap every wet layer for dry ones, starting with hat and gloves.
• Insulate from the ground as well as around the body, since a cold deck or bank drains heat continuously.
• Warm sweet drinks and food for someone who is alert and shivering, no alcohol.
• Apply warmth to the trunk rather than the limbs in a shivering casualty, and avoid vigorous rubbing of cold skin.
• Dress in layers with a windproof outer shell, carry a spare dry set in a waterproof bag, and wear a flotation suit or life jacket in cold water where a fall is the real risk.

Jellyfish Stings

Jellyfish tentacles carry stinging cells called nematocysts that fire venom into the skin on contact. Anglers meet them when hauling nets and lines through a bloom, when handling a leader that has dragged through tentacles, and when wading in warm coastal water. Fragments of tentacle stuck to line, gloves or a boat rail can still fire hours later.

Symptoms

• Immediate burning or stinging pain in a line or whip shaped pattern.
• Red raised welts tracing where the tentacle touched.
• Itching and tingling that persists after the pain fades.
• Blistering or dark marks in stronger stings.
• Cramps, nausea, sweating, chest or abdominal pain or breathlessness in a systemic reaction.

How serious it is: Most stings in temperate waters are painful but local and settle over hours to days. Stings from box jellyfish and Irukandji species, and any sting covering a large area or affecting a child, can cause systemic illness and are emergencies.

Typical time out: Local pain typically eases within a few hours and the skin marks fade over one to two weeks. A systemic sting needs hospital care and days to weeks of recovery.

See a doctor if: Call for emergency help if there is chest or back pain, severe cramping, breathlessness, sweating with a feeling of doom, or a sting to the face or a large part of the body.

What helps

• Get out of the water and rinse with seawater, never with fresh water, which makes remaining stinging cells fire.
• Lift off visible tentacles with tweezers or a gloved hand rather than rubbing or scraping hard.
• Immerse the area in hot water at about 104 to 113 degrees Fahrenheit for twenty to forty five minutes, which is the best evidence based pain treatment for most species.
• In tropical Australian waters, dousing with vinegar before anything else is the local standard, since the species there are different.
• Wear a long sleeve rash guard and gloves when hauling through a bloom, and rinse gear before you stow it.

Drowning

Drowning is respiratory impairment from submersion or immersion. In fishing it rarely starts with poor swimming: it starts with a fall from a boat or bank, then cold water shock, an involuntary gasp underwater and rapid loss of hand and arm function within minutes. Waders filling with water, a life jacket left unworn on the seat and alcohol are the factors that recur in the reports.

Symptoms

• Silent, upright struggling in the water with the head low and no calling out.
• Coughing and choking on surfacing.
• Breathlessness, chest pain and a hoarse voice after coming out.
• Vomiting, extreme tiredness and confusion.
• Deteriorating breathing in the hours after the incident.

How serious it is: A brief aspiration with a cough that fully settles is minor but still deserves observation. Anyone who was unconscious, needed rescue breaths or has ongoing breathing symptoms is a serious case, and cold water drowning can require prolonged resuscitation before the outcome is known.

Typical time out: After a minor aspiration with observation, a few days. After a significant drowning event with lung injury, weeks to months, guided by medical review, and the psychological effects can outlast the physical ones.

See a doctor if: Anyone who has been rescued from the water and is coughing, breathless, drowsy or has been unconscious needs emergency assessment, even if they say they feel fine.

What helps

• Rescue without becoming a second casualty: reach or throw from land or the boat before you consider going in.
• Start rescue breaths and CPR immediately for an unresponsive casualty, since drowning is an oxygen problem and rescue breaths matter here more than in a cardiac arrest.
• Keep any rescued person warm and get them medically assessed, because lung problems can appear hours later.
• Wear the life jacket rather than carrying it, and use an inflatable model that you will actually keep on all day.
• Wade with a belt at the top of your waders, fish with someone else where you can, and leave the alcohol for after.

Injuries from Boat Propellers

A spinning propeller cuts repeatedly as it passes, so a single contact produces a series of parallel deep wounds through skin, muscle, nerve and bone. The typical mechanism is a person in the water near a boat that is still in gear, someone falling overboard from the bow, or an operator being thrown off and the boat circling back under power. Distances are short and the operator often cannot see the person in the water.

Symptoms

• Multiple parallel deep cuts, often the length of a limb.
• Heavy bleeding that soaks through dressings quickly.
• Inability to move or feel the limb below the injury.
• Visible bone or a limb at an abnormal angle.
• Pale, clammy skin, rapid breathing and rising pulse, which indicate shock.

How serious it is: Even so called minor propeller wounds are deep and contaminated. Serious injuries involve major blood vessels, nerve and bone, and can be fatal from blood loss within minutes or lead to amputation.

Typical time out: Months at minimum. Repair of muscle, nerve and bone plus rehabilitation commonly takes six months to a year, and permanent loss of function is common.

See a doctor if: This is always an emergency: call for help immediately, and do not wait to see whether the bleeding settles.

What helps

• Control bleeding first with hard direct pressure, and use a tourniquet high on a limb if the bleeding is arterial and pressure is not holding it.
• Keep the person still and warm, and do not remove anything embedded in the wound.
• Get emergency services and coordinates moving early, since access to open water takes time.
• Use the engine cut off lanyard or a wireless kill switch every single time the boat moves, which is what stops the circling boat scenario.
• Kill the engine and take it out of gear before anyone enters or leaves the water, and fit a propeller guard on boats used around swimmers and divers.

Lightning Strikes

Lightning injures through a direct strike, a side flash from a nearby object, ground current spreading out from the strike point and, less often, a contact injury through a conductive object you are holding. An angler on open water or on a flat bank is often the tallest object present, and a raised carbon rod makes it worse. Most of the harm is to the heart and nervous system rather than burns.

Symptoms

• Collapse with cardiac and breathing arrest immediately after the strike.
• Confusion, memory loss and temporary blindness or deafness.
• Feathery branching skin marks or burns where metal touched the skin.
• Temporary paralysis and blue, cold arms or legs.
• Ringing ears, headache and persistent difficulty concentrating in the days afterward.

How serious it is: Injuries range from a stunned survivor with ringing ears and confusion who recovers, to immediate cardiac arrest. The main cause of death is the heart and breathing stopping at the moment of the strike, which is exactly why immediate CPR changes the outcome.

Typical time out: A survivor with minor effects may recover over days to weeks. Anyone who was resuscitated or has neurological symptoms needs months of medical follow up, and lasting problems with memory, sleep, concentration and chronic pain are common.

See a doctor if: Any lightning strike, including one that leaves the person walking and talking, needs emergency medical assessment because heart rhythm and neurological problems can appear later.

What helps

• Start CPR at once on anyone who is unresponsive: lightning casualties are safe to touch, and those in arrest are the ones who can be saved.
• Treat the multiple casualty situation in reverse to the usual rule and go to the motionless people first.
• Use the thirty second rule: if thunder follows the flash within thirty seconds, the storm is close enough to strike you, and stay off the water for thirty minutes after the last thunder.
• Get off open water and into a hard topped vehicle or a substantial building, and lay carbon rods down rather than carrying them upright.
• Check the forecast and radar before you launch and plan the run back, since the decision that matters is made before the storm arrives.

First Aid for Soft Tissue Injuries: PEACE and LOVE

Sports medicine has moved on from RICE. The current guidance, published in the British Journal of Sports Medicine in 2019, splits care into the first days after the injury and everything that follows.

PEACE, the first two to three days

• Protect: unload the area and limit movement that hurts, but only briefly.
• Elevate: keep the limb above heart level when you can.
• Avoid anti-inflammatories: they may blunt the healing you need.
• Compress: a bandage or taping limits swelling.
• Educate: your body heals this on its own; passive treatments rarely speed it up.

LOVE, from day three onward

• Load: return to movement as pain allows, early loading builds tissue.
• Optimism: expectations shape recovery more than most people assume.
• Vascularization: easy cardio that does not hurt brings blood to the area.
• Exercise: restore strength, mobility and balance before returning to play.

Ice still helps with pain in the first hours. What changed is the evidence that long icing and routine anti-inflammatory drugs slow tissue repair.

How to Lower Your Risk in Fishing

• Treat eye protection as standard tackle. Polarized glasses with side coverage and a brimmed hat protect against the hook that comes back at you on a snapped line, and against the reflected ultraviolet light that doubles your sun dose on the water.
• Wear the life jacket instead of stowing it, and use the engine cut off lanyard every time the boat is under way. These two habits address the injuries in fishing that are actually fatal.
• Match your footwear to the surface: studded or felt soles on rock and gravel, non slip deck shoes on a boat, and a wading staff plus a wader belt in current.
• Build up casting volume the way you would build up any other repetitive load. A full day with a heavy rod after a winter off is what produces the elbow and shoulder tendon problems, so add sessions gradually and share the work between arms or use a two handed rod.
• Handle every fish with tools rather than fingers: net, long nose pliers, a lip grip and cut resistant gloves, and learn the safe hold for the species you target before you unhook it.
• Plan the trip around water, sun and weather: carry more fluid than you expect to drink, fish the cooler hours in summer, take a dry spare layer in a waterproof bag, and check the radar before you launch so the storm decision is already made.

When to Stop and Get Medical Help

Most of the injuries on this page are treated at home. These signs are not.

• A hook in or near the eye, or any sudden change in vision, pain or watering after a hook or lure comes back at your face.
• A blow to the head with confusion, memory loss, repeated vomiting, drowsiness or a headache that keeps getting worse.
• An obvious deformity, an inability to bear weight or use the limb, or numbness and tingling below an injury, all of which suggest a fracture or nerve damage.
• Bleeding that soaks through dressings or does not stop after ten minutes of firm direct pressure.
• Confusion, slurred speech, unsteady walking or collapse in the heat, or shivering that stops while someone is still cold and wet.
• Breathing difficulty, throat or tongue swelling or faintness after a sting, and any breathlessness or drowsiness in someone who has been pulled from the water.

Sources

• Physician and Sportsmedicine, Gil et al., NEISS-based study
• Clinical Pediatrics, Vajdic et al., NEISS-based study
• Peer-reviewed NEISS-based study on fishing-associated ocular injuries, PubMed PMID 41197757

This article is general information, not medical advice. If you are hurt, a doctor or physiotherapist who can examine you is worth more than any web page. Last reviewed: August 2026.

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