17 Common Sailing injuries (Prevention & Treatment)

All 17 common sailing injuries, from boom concussions and a fractured collarbone to back strain, rotator cuff impingement and ankle sprains.

Rigging and ropes cause cuts and hand fractures, and long days on the water bring sunburn, dehydration, heat exhaustion, hypothermia and eye injuries from glare.

Join us as we uncover common risks and help you sail safely through that sea of hazards.

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
A season-long prospective study of Australian sailing athletes recorded an injury incidence of 3.71 injuries per 365 athlete-days, with no difference between men and women.	92 Australian Sailing and SSPP athletes (training and competition), 2019-2020 season, published 2022	Journal of Science and Medicine in Sport (Robertson et al.)
In the same Australian cohort, female sailors had a 3.6 fold higher illness rate than male sailors, while their injury rate did not differ.	92 Australian Sailing and SSPP athletes, 2019-2020 season, published 2022	Journal of Science and Medicine in Sport (Robertson et al.)
A review of sailing injury epidemiology put the injury rate in elite Olympic class sailing at roughly 0.2 injuries per athlete per year.	Elite Olympic class sailors, Review published 2009	Sports Medicine, Neville V and Folland JP, The epidemiology and aetiology of injuries in sailing
America’s Cup crews were injured at about 2.2 injuries per 1,000 hours of sailing, but at 8.6 per 1,000 hours during fitness training on land.	Professional big boat (America’s Cup) sailors, Review published 2009	Sports Medicine, Neville V and Folland JP, The epidemiology and aetiology of injuries in sailing
The one published report on Paralympic class sailing found a much higher rate of about 100 injuries per 1,000 days of sailing.	Paralympic class sailors, Review published 2009	Sports Medicine, Neville V and Folland JP, The epidemiology and aetiology of injuries in sailing

Overview

Injury	Body area	Typical time out
Collarbone Fracture	Shoulder	6 to 12 weeks, longer after surgery
Ankle Sprain	Ankle	1 to 3 weeks, up to 3 months if severe
Back Pain Muscle Strains (Herniated Disc)	Lower back	1 to 3 weeks; disc 6 weeks to 3 months
Impingement of the Rotator Cuff	Shoulder	6 weeks to 4 months, longer if torn
Patellofemoral Pain Syndrome	Knee	6 weeks to 6 months
Hand Fracture	Hand and wrist	4 to 8 weeks; scaphoid 3 to 4 months
Sunburn	Skin	3 to 7 days, longer if blistered
Dehydration	Whole body	Hours to 1 day
Cuts and Lacerations (from rigging, ropes, or equipment)	Hands and skin	Days to 2 weeks; 6+ weeks if tendon
Sprains and Strains (often from repetitive actions or unexpected boat movement)	Whole body	2 to 6 weeks, 3+ months if complete
Head Injuries (concussions, often from boom impact)	Head	1 to 4 weeks, longer if repeated
Knee Injuries (sprains, strains)	Knee	2 to 6 weeks; 6+ months after ACL op
Overexertion leading to Heat Exhaustion or Heat Stroke	Whole body	1 to 2 days; weeks after heat stroke
Shoulder Injuries (rotator cuff, impingement)	Shoulder	6 weeks to 4 months, longer after repair
Drowning	Whole body	Same day off; weeks after resuscitation
Hypothermia (in cold weather conditions)	Whole body	Hours to 1 day; days to weeks if severe
Eye Injuries (from sun glare, rigging)	Eye	1 to 3 days; weeks if the globe is hurt

Collarbone Fracture

The clavicle is the strut that holds your shoulder away from your chest, and it breaks most often in its middle third. On a boat it usually gives way when you are thrown across the cockpit and land on the point of the shoulder, or when a swinging boom or a loaded sheet drives the shoulder down. Because the bone sits directly under the skin, the break is often visible as a bump or a step.

Symptoms

Sharp pain over the front of the collarbone that spikes when you lift the arm.
A visible bump, step or drooping of the shoulder on that side.
You instinctively hold the arm against your body and support the elbow.
Grinding or a crunching feeling when the shoulder moves.
Bruising and swelling appear over the bone within a day.

How serious it is: The mild form is an undisplaced crack where the bone ends still line up, and it heals in a sling. The severe form is a displaced or multi fragment break, a bone end tenting the skin, or an open wound over the fracture, and that is a surgical problem.

Typical time out: Six to twelve weeks before you are back on a boat with an undisplaced fracture, and three to six months when the break is displaced and fixed with a plate. The range is wide because bone union and confident load bearing on a moving deck are two different milestones, and grinding a winch loads the clavicle hard.

See a doctor if: Get medical help the same day if the skin over the bone is tented, white or broken, if the arm feels numb or cold, or if you are short of breath.

What helps

A simple sling for comfort in the first days, with the elbow and hand moved regularly so the arm does not stiffen.
An x ray early, because whether the ends are displaced decides sling versus surgery.
Gentle pendulum and passive shoulder movement within pain limits from the first week, rather than full immobilization until the pain stops.
Progressive rotator cuff and scapular strengthening once the bone is stable, guided by a physical therapist.
A staged return on the water: helming before trimming, trimming before foredeck work and grinding.

Ankle Sprain

A sprain overstretches or tears the ligaments on the outside of the ankle, most often the anterior talofibular ligament, when the foot rolls inward under body weight. On a boat that happens on a wet or angled deck, on a foot that catches a sheet or a track, or when the hull drops off a wave while you are moving forward. The inner and high ankle ligaments are hurt less often but take longer to settle.

Symptoms

Immediate pain on the outside of the ankle, often with a pop or a tearing feeling.
Swelling around the ankle bone within an hour or two.
Bruising that spreads into the foot over the next days.
Limping, and difficulty putting full weight through the foot.
A feeling that the ankle gives way on uneven or moving ground.

How serious it is: Grade 1 is a stretch with mild swelling and near normal walking, grade 2 a partial tear with clear swelling and an unstable feeling, grade 3 a complete tear with marked swelling and very poor weight bearing. Pain right over the bone rather than the soft tissue, or being unable to take four steps, raises the question of a fracture.

Typical time out: One to three weeks for a grade 1 sprain, four to eight weeks for grade 2, and two to three months or more for a grade 3 tear or a high ankle injury. Sailing lets you return earlier than running sports because you can work seated, but hiking out and moving on a heeled deck need the full recovery.

See a doctor if: See a doctor if you cannot take four steps on the foot, if the pain sits directly on the ankle bone, or if the foot looks crooked or feels numb.

What helps

Walk on it early within pain limits: protected loading beats days of complete rest for ligament healing.
A brace or taping for the first weeks, especially on deck, where the surface is unpredictable.
Balance and proprioception work, single leg stance progressing to unstable surfaces, which is the best evidenced way to cut repeat sprains.
Calf and peroneal strengthening, since those muscles are what actually catch the rolling ankle.
Short cooling for pain in the first hours if it helps you move, not as the main treatment.

Back Pain Muscle Strains (Herniated Disc)

Most sailing back pain is a strain of the deep lumbar muscles and the thoracolumbar fascia, provoked by lifting a sail bag with a twist, by hours of hiking out, or by holding a bent forward position at the foredeck while the boat slams. A disc problem is different: the outer ring of a lumbar disc tears and its inner material presses on a nerve root, which is why the pain then runs down the leg rather than staying in the back.

Symptoms

Pain and tightness across the lower back that worsens with bending and twisting.
Muscle spasm that locks the back in one position, often the morning after.
With a disc, pain shooting down the buttock into the calf or foot.
Numbness, pins and needles or weakness in one leg.
Pain that eases when lying down and returns as soon as you sit or hike out.

How serious it is: A simple strain hurts in the back only, moves within a few days and never involves the leg. A disc herniation with nerve root irritation causes leg dominant pain, sensory changes or weakness, and needs a proper examination.

Typical time out: One to three weeks for a muscular strain, six weeks to three months for a symptomatic disc herniation, since most settle without surgery but slowly. If bladder or bowel control or clear leg weakness is involved, timelines are decided by a specialist, not by the calendar.

See a doctor if: Seek care immediately for numbness around the groin or seat, loss of bladder or bowel control, or a leg that is clearly getting weaker.

What helps

Stay moving. Bed rest makes back pain last longer, so keep walking and return to light activity within a day or two.
Load the trunk deliberately: hip hinge patterns, dead bugs, side planks, and progressively heavier carries rather than endless stretching.
Change your deck habits, lift sail bags with the hips and both hands and set up so you are not twisting under load.
Physical therapy if pain is still limiting you after two to three weeks, or immediately when the leg is involved.
Imaging only if there is nerve involvement, trauma, or no improvement over six weeks, because scans of painless backs also look abnormal.

Impingement of the Rotator Cuff

The supraspinatus tendon and the bursa beneath it run through the narrow space between the humeral head and the acromion. Repeated overhead work, hoisting halyards, grinding, and holding the mainsheet high, compresses and irritates them, and the tendon reacts with swelling that makes the space even tighter. Poor shoulder blade control makes this worse, because the roof of the space does not clear the arm properly.

Symptoms

Pain on the outside of the upper arm, roughly where a sleeve badge sits.
A painful arc when you raise the arm to about shoulder height.
Pain when reaching behind your back or up to a halyard.
Aching at night, especially lying on that side.
The arm feels weak rather than truly unable to move.

How serious it is: The mild form is a reactive tendon and bursa that hurts only with overhead load and settles with loading work. The severe form involves a partial or full thickness cuff tear, where you cannot hold the arm out to the side against gravity and strength does not come back with exercise.

Typical time out: Six weeks to four months with a structured strengthening program, and six to nine months if a full thickness tear is repaired surgically. The range is broad because tendons respond to progressive load over months, not to a period of rest.

See a doctor if: See a doctor if the arm drops when you try to hold it out sideways, if weakness came on suddenly after a fall, or if night pain wakes you every night.

What helps

Progressive rotator cuff and scapular strengthening, starting with isometrics at a tolerable pain level and building to loaded external rotation and rows.
Relative rest from the provoking motion rather than a sling: keep sailing, but hand the halyard work to someone else for a few weeks.
Technique and setup: use the legs and body weight on the grinder, keep the elbow lower on the mainsheet, and share overhead tasks.
Physical therapy if there is no meaningful change after four to six weeks of self managed loading.
A corticosteroid injection is at most an exception for pain that blocks all rehabilitation, since it helps short term but tends to leave tendons worse in the long run.

Patellofemoral Pain Syndrome

The kneecap slides in a groove on the front of the thigh bone, and the cartilage behind it takes very high pressure whenever the knee is bent under load. Hiking out with the knees bent, kneeling on the foredeck, and repeatedly squatting under a boom loads that joint for long periods, and the pain appears when the load outgrows what the surrounding muscles can control. Weak hip and quadriceps muscles let the kneecap track badly, which concentrates the pressure on one facet.

Symptoms

A dull ache around or behind the kneecap, hard to point to with one finger.
Pain that builds during long hiking sessions and eases when the leg is straight.
Discomfort after sitting with bent knees for a long time.
Pain on stairs, particularly going down.
Occasional grating or a feeling of the knee giving way.

How serious it is: The mild form is pain only during and after long bent knee loading and it settles overnight. The more stubborn form hurts on everyday stairs and lasts months, and a knee that locks, swells or truly gives way points to a different problem such as a meniscus or cartilage injury.

Typical time out: You rarely stop sailing entirely, but expect six weeks to six months for the pain to resolve, depending on how long it has been present. Long standing cases take longer because muscle capacity has to be rebuilt, not just symptoms calmed.

See a doctor if: Get it checked if the knee swells within hours, locks in one position, or buckles so that you cannot trust it.

What helps

Hip and quadriceps strengthening, especially hip abductors and external rotators, which is the best evidenced treatment.
Manage the dose: shorten hiking sessions, alternate sides where the boat allows, and build hiking time back up gradually.
Padding and hiking shorts or knee pads that spread the pressure of kneeling and hiking.
Taping or a simple brace as a short term aid while strength catches up, not as a permanent fix.
Physical therapy if the pain is unchanged after six to eight weeks of consistent strength work.

Hand Fracture

Most sailing hand fractures involve the metacarpals or the finger phalanges, broken by a hand caught between a line and a winch drum, a hand crushed against a stanchion, or a fall onto the palm. A fall onto an outstretched hand can also break the scaphoid in the wrist, which is the fracture most often missed because it only causes a modest ache in the hollow at the base of the thumb.

Symptoms

Immediate pain and rapid swelling over the back of the hand or a finger.
A finger that sits crooked, rotated or shortened when you make a loose fist.
You cannot grip a line or close the hand fully.
Bruising across the palm or the back of the hand within a day.
Point tenderness in the hollow at the base of the thumb after a fall on the palm.

How serious it is: Undisplaced fractures of a single metacarpal or phalanx are treated with a splint or buddy taping. Displaced, rotated, multiple or open fractures, and any joint surface involvement, need surgical fixation, and a rotated finger is a surgical indication even when the x ray looks minor.

Typical time out: Four to eight weeks for a simple undisplaced hand fracture, and three to four months for a scaphoid fracture or after surgical fixation. The scaphoid is slow because its blood supply is poor and it can fail to unite.

See a doctor if: See a doctor if a finger is visibly rotated or crooked, if the finger is pale or numb, or if there is a wound over a knuckle after impact.

What helps

Get an x ray. Hand fractures that are set late heal in the wrong position, and a normal looking scaphoid x ray does not rule the fracture out.
Splinting or buddy taping only for as long as needed, then early guided movement of the uninjured joints to prevent stiffness.
Hand therapy for tendon gliding and grip strength as soon as the fracture is stable.
Sailing gloves and disciplined winch technique on return, keeping fingers clear of the drum and the self tailer.
Short cooling and elevation in the first hours for pain and swelling while you arrange assessment.

Sunburn

Ultraviolet radiation damages the DNA of skin cells in the epidermis, and the redness is the inflammatory response that follows hours later. On the water the dose is far higher than it feels, because the sea and the sails reflect UV back at you and the wind removes the heat that would normally warn you. The undersides of the chin, nose and ears burn on a boat in a way they do not on land.

Symptoms

Skin that turns red and feels hot and tight, usually four to six hours after exposure.
Stinging pain on contact with clothing or a harness.
Blisters when the burn is deeper.
Peeling after a few days.
Chills, headache or nausea when a large area is burned.

How serious it is: A superficial burn is red and painful and heals with peeling. A deeper burn blisters, and a burn covering a large body area with fever, chills or faintness is a form of sun poisoning that needs medical care.

Typical time out: You do not need to stop sailing, but expect three to seven days of discomfort and one to two weeks before the skin is back to normal. Blistered areas need to be covered and kept out of the sun for the rest of the trip.

See a doctor if: Seek care for widespread blistering, fever and chills, faintness or confusion, or any burn on a small child.

What helps

Cool the skin with cool water or damp cloths and drink more than usual, since burned skin loses fluid.
Plain moisturizer or aloe based gel for comfort, and leave blisters intact.
An anti inflammatory painkiller in the first day or two if you tolerate it.
Cover up rather than reapply: a long sleeved UV shirt, a wide brim hat under the helmet, and a buff for the neck do more than any lotion.
Broad spectrum SPF 50 on the face, ears, backs of hands and under the chin, reapplied every two hours and after every soaking, plus polarized sunglasses.

Dehydration

Sailing is a slow leak of body water: you sweat under foul weather gear, the wind evaporates it before you notice, and salt spray plus the inconvenience of drinking on deck mean intake lags behind loss. Blood volume falls, the heart works harder for the same output, and both muscle function and concentration drop before you feel truly thirsty.

Symptoms

Dry mouth and a thirst that keeps returning.
Dark, strongly smelling urine and going less often.
Headache and a heavy, tired feeling out of proportion to the work.
Dizziness when you stand up from the cockpit.
Slower decisions and small handling mistakes late in the day.

How serious it is: Mild dehydration means thirst, dark urine and tiredness that fix themselves with drinking. Severe dehydration means dizziness on standing, a fast pulse, confusion or no urine for many hours, and it borders on heat illness.

Typical time out: Mild cases resolve within a few hours of steady drinking, moderate ones within a day, and anyone who needed intravenous fluids should treat it as a full day off the water at minimum. Recovery is slower in heat and when several days of underdrinking have stacked up.

See a doctor if: Get help if the person is confused, cannot keep fluids down, faints, or has not passed urine for many hours.

What helps

Drink to a schedule rather than to thirst, with a bottle in a holder you can reach without leaving your position.
Add electrolytes on long hot days or when sweat leaves salt marks on your gear, since plain water alone can dilute sodium.
Use urine color as your check: pale straw is the target.
Vent or shed layers before you soak them, because trapped sweat under waterproofs is the main hidden loss.
Rehydrate deliberately after sailing as well, so you do not start the next day already down.

Cuts and Lacerations (from rigging, ropes, or equipment)

The skin is cut or torn by broken wire strands in standing rigging, by sharp split pins and cotter pins, by knife and shackle work, and by rope running fast through a bare hand, which produces a friction burn rather than a clean cut. Deeper wounds on the hand matter more than they look, because tendons, nerves and small arteries lie just under the skin at the palm and the fingers.

Symptoms

An open wound with bleeding that may be brisk on the palm or scalp.
Stinging pain that quickly settles into a throb.
Difficulty bending or straightening a finger, which suggests tendon involvement.
Numbness on one side of a finger, which suggests a cut nerve.
Increasing redness, heat, swelling or pus over the next days.

How serious it is: A superficial cut through the skin only can be cleaned and closed on board. A wound that gapes open, spurts, exposes fat or tendon, involves a joint, or was made by a rusty or salt encrusted fitting needs professional cleaning and closure.

Typical time out: Superficial cuts stop limiting you within a few days and heal in one to two weeks, deeper wounds needing stitches take two to three weeks before full grip loading, and a tendon or nerve repair means six to twelve weeks with hand therapy.

See a doctor if: Seek care if bleeding does not stop after ten minutes of firm pressure, if a finger will not bend or feels numb, or if the wound becomes red, hot and painful after a day or two.

What helps

Firm direct pressure with the cleanest material available, held continuously rather than lifted to check.
Irrigate generously with clean drinking water once bleeding is controlled, since flushing out debris matters more than any ointment.
Close small clean cuts with adhesive strips or skin glue, and keep the dressing dry, which on a boat means a waterproof cover and a glove.
Confirm tetanus vaccination is current, and treat marine wounds as contaminated because seawater carries organisms that ordinary first aid does not cover.
Wear sailing gloves for sheet handling and tape sharp pins and turnbuckles, which removes most of these injuries at the source.

Sprains and Strains (often from repetitive actions or unexpected boat movement)

A sprain is a stretched or torn ligament at a joint, a strain is a tear in muscle or its tendon. Both happen on a boat when a load arrives faster than the muscle can control it: the hull drops off a wave while you are braced, a sheet loads suddenly, or you catch yourself in an awkward position. The muscle tendon junction of the hamstring, calf and shoulder is the usual failure point, and ankles, wrists and thumbs are the usual sprains.

Symptoms

Sudden pain during a specific movement, sometimes with a pulling or popping sensation.
Swelling and later bruising over the injured area.
Pain on stretching or contracting the muscle involved.
Loss of strength or a joint that feels loose and untrustworthy.
Stiffness that is worst the following morning.

How serious it is: Grade 1 is a minor tear with normal or near normal strength, grade 2 a partial tear with clear weakness and swelling, grade 3 a complete rupture with a visible gap or a joint that is unstable. Grade 3 injuries and any joint that will not hold weight need assessment.

Typical time out: Two to three weeks for a grade 1 injury, four to eight weeks for grade 2, and three months or more for a complete tear or after surgical repair. Where the injury sits matters as much as the grade, since a thumb sprain still lets you helm while a calf tear does not let you move on deck.

See a doctor if: See a doctor for a visible dent or gap in a muscle, a joint that will not move or take weight, or numbness beyond the injury.

What helps

Reload early and gradually. Pain guided movement in the first days produces better tissue than immobilization.
Build back with eccentric and progressively heavier strength work, since strength deficits, not pain, drive reinjury.
Support the joint with taping or a brace for the first weeks in the specific situation that caused it.
Fix the trigger: better handholds, a foot brace, and not moving on deck unclipped or unbraced in a seaway.
Physical therapy when strength has not returned after three to four weeks, or immediately for a suspected complete tear.

Head Injuries (concussions, often from boom impact)

A concussion is a functional disturbance of the brain caused by an impact or a rapid acceleration of the head, not a structural break. On a sailboat the classic mechanism is an uncontrolled gybe where the boom crosses the cockpit at head height, and secondary mechanisms are falling against a winch or the mast in a seaway. Loss of consciousness is not required for a concussion to have happened.

Symptoms

Headache and a pressure feeling in the head after the impact.
Dizziness, unsteadiness or nausea.
Feeling slowed down, foggy or unusually emotional.
Blurred vision and sensitivity to light or noise.
Difficulty remembering the minutes before or after the hit.

How serious it is: A concussion is the mild end and its symptoms settle over days to weeks. The dangerous end is bleeding inside the skull or a skull fracture, signaled by worsening headache, repeated vomiting, unequal pupils, weakness on one side, seizures or increasing drowsiness, which is an emergency at sea.

Typical time out: Typically one to four weeks for a first concussion, with a staged return that only starts once symptoms are settled at rest, and considerably longer if symptoms persist or it is a repeat injury. Never let someone return the same day, since a second impact before recovery is far more damaging.

See a doctor if: Call for emergency help for any loss of consciousness, worsening headache, repeated vomiting, seizure, confusion that deepens, or weakness or numbness on one side.

What helps

Remove the person from any active role immediately and do not leave them alone, on a boat that also means the risk of falling overboard.
Relative rest for the first day or two, then light activity below the symptom threshold rather than a dark room for a week.
A staged return: light aerobic work, then boat handling, then full crew duties, moving up only if symptoms stay quiet.
Medical assessment for anyone knocked out, still symptomatic after a week, or on blood thinning medication.
Prevent the next one: a preventer rigged downwind, a called gybe, disciplined head clearance under the boom, and a helmet in high performance dinghies.

Knee Injuries (sprains, strains)

The knee is held by the collateral ligaments at the sides, the cruciate ligaments inside, and the menisci as shock absorbers between the bones. Sailing loads it in two ways: a twisting force when a foot is trapped under a hiking strap and the body rotates, which strains the medial ligament or the meniscus, and long isometric holding while hiking out, which strains the quadriceps and its tendon.

Symptoms

Pain on the inner or outer side of the joint line, worse when twisting.
Swelling that develops over hours, or within minutes with a more serious tear.
The knee feels unstable or gives way on a moving deck.
Catching, clicking or a locked feeling with a meniscal tear.
Difficulty fully straightening or fully bending the knee.

How serious it is: Grade 1 to 3 applies to ligament injuries, from a stretch to a complete tear. Swelling within the first hour, a knee that locks, or clear instability suggest a cruciate or meniscal injury rather than a simple sprain and calls for examination.

Typical time out: Two to six weeks for a grade 1 or 2 medial ligament sprain, six weeks to three months for a meniscal injury treated without surgery, and six to nine months after cruciate ligament reconstruction. The variation reflects whether a structure is merely irritated or actually torn through.

See a doctor if: Get assessed if the knee swells within an hour, will not straighten, gives way under you, or cannot take your weight.

What helps

Early protected movement and weight bearing within pain limits, keeping the knee straightening fully from the start.
Quadriceps and hamstring strengthening, then hiking specific isometric holds built up in graded time blocks.
Adjust hiking strap tension and position so the foot cannot trap the leg in a twist.
A hinged brace for the first weeks after a collateral ligament sprain.
Imaging and specialist review for a knee that swelled fast, locks, or stays unstable after four weeks.

Overexertion leading to Heat Exhaustion or Heat Stroke

Heat exhaustion is circulatory failure from fluid and salt loss combined with a body that cannot shed heat fast enough. Heat stroke is the point at which core temperature keeps rising and the brain stops working normally, and it is life threatening. On the water the risk is underestimated because wind and spray keep the skin cool while foul weather gear traps heat, and there is no shade in a cockpit.

Symptoms

Heavy sweating with cool, clammy, pale skin in heat exhaustion.
Weakness, nausea, headache and muscle cramps.
Dizziness or faintness when standing.
Confusion, irritability or slurred speech, which signals heat stroke.
Hot skin with sweating that has stopped, and collapse.

How serious it is: Heat exhaustion means the person stays lucid and improves once cooled and rehydrated. Heat stroke means altered mental state with a very high core temperature and is a medical emergency where minutes of cooling matter.

Typical time out: One to two days off the water after uncomplicated heat exhaustion, and several weeks with medical clearance after heat stroke, because heat tolerance stays impaired for some time afterwards. Anyone who has had heat stroke is more vulnerable to the next episode.

See a doctor if: Treat confusion, slurred speech, collapse or seizure in the heat as heat stroke and call for emergency help while you start cooling.

What helps

Stop, get the person into shade, strip the outer layers and cool aggressively with water over the skin plus airflow, and ice packs to the neck, armpits and groin.
Cool first, transport second, because time above a critical core temperature is what causes the damage.
Fluids with electrolytes if the person is alert and can swallow, nothing by mouth if they are confused.
Build heat tolerance over one to two weeks of gradually longer exposure before racing in a hot climate.
Plan the day around the heat: rig a bimini or spray shade at anchor, rotate demanding roles, and pre cool with cold drinks and wetted shirts.

Shoulder Injuries (rotator cuff, impingement)

The four rotator cuff muscles hold the humeral head centered in a shallow socket while the larger muscles move the arm. Grinding, hoisting, and hours of mainsheet trimming load these tendons overhead and repetitively, which causes tendinopathy and impingement, while a fall onto the shoulder or a sudden jerk on a loaded line can tear the cuff or sprain the acromioclavicular joint at the top of the shoulder.

Symptoms

Pain over the outer upper arm during overhead or across body movement.
Weakness when lifting or holding the arm out to the side.
Night pain when lying on that shoulder.
Clicking or catching as the arm passes shoulder height.
Localized pain and a step at the top of the shoulder after a fall, which points to the AC joint.

How serious it is: Tendinopathy and impingement are the mild end and respond to loading. Cuff tears cause true weakness and are graded partial or full thickness, and AC joint separations run from type I, a sprain, through type III, where the joint is clearly displaced with a visible step.

Typical time out: Six weeks to four months for tendinopathy, impingement or a type I to II AC injury, and four to nine months after a cuff repair. The wide range exists because tendon capacity is rebuilt over months and grinding is one of the most demanding shoulder tasks in any sport.

See a doctor if: See a doctor for sudden weakness after a fall, an arm that drops when held out sideways, a visible step at the top of the shoulder, or numbness down the arm.

What helps

Progressive loading of the cuff and the scapular stabilizers, from isometrics into heavy slow resistance over weeks.
Keep training the rest of the body and swap out the provoking task rather than resting the shoulder completely.
Coach the technique: grind with the legs and hips, keep loads close to the body, and rotate roles so one shoulder is not doing every hoist.
Physical therapy if strength or pain is unchanged after six weeks, and imaging if weakness is the leading complaint.
Treat a corticosteroid injection as an exception, useful only to unlock rehabilitation, since it helps for weeks but tends to worsen tendon outcomes over time.

Drowning

Drowning is respiratory impairment from immersion in liquid, and it usually begins on a boat with an unexpected entry into the water: a fall overboard, a capsize with entrapment under the sail or trapeze gear, or a knock on the head that removes the ability to swim. In cold water the immediate danger is not the lungs but the cold shock gasp response in the first minute, which forces a breath in at exactly the wrong moment.

Symptoms

Uncontrolled gasping and rapid breathing on hitting cold water.
The head low in the water with the mouth at surface level and no ability to call out.
Arms pressing down on the water instead of waving.
Coughing, choking and breathlessness after being recovered.
Confusion, blue lips or unresponsiveness.

How serious it is: The mild end is a brief aspiration with coughing that clears, though breathing problems can still develop over the following hours. The severe end is unconsciousness with no breathing, where immediate rescue breaths and CPR decide the outcome.

Typical time out: Anyone who was submerged and coughing needs observation for the rest of the day and should not sail again until reviewed. After a rescue involving CPR, recovery and return to the water are decided medically over weeks or months.

See a doctor if: Call emergency services for anyone recovered from the water who is coughing persistently, breathless, drowsy or confused, even if they seem fine at first.

What helps

Raise the alarm and start the recovery drill immediately: shout, point, throw flotation, and keep eyes on the person.
Reach or throw before you go in, since would be rescuers make up a real share of drownings.
Start rescue breaths as soon as the airway can be supported, because drowning is an oxygen problem and ventilation comes first.
Wear a lifejacket that actually fits and is fastened, use a harness and tether at night and in rough weather, and practice man overboard recovery with the crew you actually sail with.
Assume cold water shock: enter feet first if you can, float and control your breathing for the first minute before trying to swim.

Hypothermia (in cold weather conditions)

Hypothermia is a fall in core body temperature below the level at which the body works normally, and it happens on a boat through wind chill on wet clothing, spray, and above all immersion, since water pulls heat from the body many times faster than air. Muscle and nerve function degrade as the core cools, which is why hands stop working before the person feels seriously unwell.

Symptoms

Intense shivering that you cannot switch off.
Clumsy hands that cannot manage a shackle, a zip or a knot.
Slurred speech and slow, muddled thinking.
Withdrawal, apathy and poor decisions.
Shivering that stops while the person is still cold, which is a bad sign, not an improvement.

How serious it is: Mild hypothermia means shivering with a person who is still alert and can help themselves. Moderate to severe means the shivering has stopped, consciousness is reduced, and the person must be handled gently and rewarmed under medical care, because rough movement can trigger a dangerous heart rhythm.

Typical time out: Mild cases recover over a few hours to a day once warm, dry and fed. Moderate to severe hypothermia means hospital care and days to weeks before returning to the water, with medical clearance.

See a doctor if: Get emergency help when shivering has stopped but the person is still cold, when speech or consciousness is affected, or after any prolonged immersion.

What helps

Get the person out of the wind and spray, remove wet clothing, and insulate from head to feet including the surface underneath them.
Warm sweet drinks and food only while the person is fully alert, never alcohol.
Rewarm the trunk with warm packs or body to body heat inside a bag, and handle a severely cold person gently and horizontally.
Prevent it with proper layering: wicking base, insulation, and a genuinely waterproof outer shell, plus a hat and gloves, since a wet head and hands drive most of the loss.
Plan crew rotations in cold weather so no one stands a full watch soaked through, and eat regularly because heat production needs fuel.

Eye Injuries (from sun glare, rigging)

Two different problems share this heading. One is corneal damage from ultraviolet light reflected off the water, which burns the surface layer of the eye like sunburn and shows up hours later. The other is mechanical: a whipping line, a bungee hook, a shackle pin or a flogging sail hitting the eye and abrading the cornea or bruising the globe.

Symptoms

A gritty feeling as though sand is in the eye.
Watering, redness and a strong dislike of light.
Pain that came on several hours after a bright day on the water.
Blurred vision or a shadow in the field of view after a direct hit.
Blood visible in the front of the eye or a pupil that looks the wrong shape.

How serious it is: A simple corneal abrasion or UV keratitis is painful but heals fully within a couple of days. A penetrating injury, blood pooling in the front chamber, a distorted pupil or any loss of vision is a sight threatening emergency.

Typical time out: One to three days for UV keratitis or a small corneal abrasion, and weeks or longer for a blunt or penetrating globe injury, which is decided by an ophthalmologist. Vision must be normal before you take the helm again.

See a doctor if: Get to an eye specialist urgently for vision loss, a misshapen pupil, blood in the eye, or any suspicion that something penetrated it.

What helps

Flush gently with clean water or saline for a loose particle, and do not rub the eye.
Do not try to remove anything embedded, cover the eye with a rigid shield and get help.
Wrap around polarized sunglasses with full UV protection and a retaining strap, plus a brimmed hat, which cuts reflected glare from the water.
Eye protection when working on rigging or under load, and taped split pins so nothing sharp is at head height.
Medical review for any pain or blurred vision that is still there after a day, since infection of an abrasion is what damages sight.

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 Sailing

Rig a boom preventer when sailing downwind and call every gybe out loud, because the boom causes the injuries with the worst consequences on a sailboat.
Build grinding and hoisting strength on land in the off season, with rotator cuff, upper back and leg drive work, and increase hiking time gradually rather than jumping straight into long races.
Set up the boat so your body is not the handhold: foot straps and braces where you actually work, non slip where you actually walk, and one hand free for the boat when you move in a seaway.
Train the trunk and hips for the hiking position specifically, with graded isometric holds, since the lower back and the front of the knee fail from duration rather than from a single movement.
Wear the protective kit that matches the day: gloves for sheet work, wrap around polarized sunglasses, a UV shirt and hat in sun, and correct layering with a waterproof shell in cold or wet weather.
Manage fluids, food and watch rotation deliberately, because tired and dehydrated crew make the handling mistakes that turn into injuries, and land based fitness training also carries real risk, as America’s Cup crews were injured at about 8.6 injuries per 1,000 hours of onshore fitness training against about 2.2 per 1,000 hours of sailing.

When to Stop and Get Medical Help

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

Any head impact followed by confusion, memory gaps, repeated vomiting, drowsiness or loss of consciousness.
A limb that looks deformed, a bone end tenting the skin, or a joint that will not move at all.
Numbness, pins and needles, or a limb that turns pale and cold after an injury.
Confusion, slurred speech or collapse in the heat, or shivering that has stopped in someone who is still cold.
Anyone recovered from the water who is coughing persistently, breathless or drowsy, even if they seem to have recovered.
Loss of vision, a misshapen pupil, or bleeding inside the eye, and bleeding anywhere that does not stop after ten minutes of firm pressure.

Sources

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.

Frequently Asked Questions

How common are sailing injuries?

Sailing is not a high injury sport by the numbers. A review of the epidemiology put the rate in elite Olympic class sailing at roughly 0.2 injuries per athlete per year, and a season long prospective study of 92 Australian sailing athletes in 2019 to 2020 recorded 3.71 injuries per 365 athlete days, with no difference between men and women. What varies is the setting: America’s Cup crews were injured at about 2.2 injuries per 1,000 hours of sailing, and the one published report on Paralympic class sailing found a much higher rate of about 100 injuries per 1,000 days of sailing.

Which injuries are most common in sailing?

Two groups dominate. Overuse problems of the lower back, the knee and the shoulder come from hiking out, grinding and hoisting, and they build over weeks rather than happening in one moment. Sudden injuries come from the boat itself: a boom strike to the head, a fall on a wet deck causing an ankle sprain or a broken collarbone, and hands caught in winches or lines. Environmental problems such as sunburn, dehydration, heat illness and hypothermia are just as much part of the picture.

How long does it take to recover from a sailing injury?

It depends entirely on the tissue involved. A grade 1 ankle sprain or a muscular back strain usually settles in one to three weeks, a rotator cuff tendinopathy takes six weeks to four months of progressive loading, and a broken collarbone or a scaphoid fracture takes three months or more when surgery is involved. Sailing does allow an earlier partial return than most sports because you can often take a seated role first, but hiking out, grinding and foredeck work should wait until strength is genuinely back.

How can I prevent injuries while sailing?

Start with the boom, since head injuries carry the worst consequences: use a preventer downwind, call every gybe, and keep clearance drilled into the crew. Then build the physical capacity the sport actually demands, shoulder and upper back strength for grinding, trunk and hip endurance for hiking, and increase your time on the water gradually. Finally, treat sun, heat, cold and hydration as part of the safety plan rather than as comfort issues, and remember that off water fitness training has its own injury risk and needs sensible progression too.

When should I see a doctor after an injury on the boat?

Go the same day for any head impact with confusion, memory loss or vomiting, for a limb that looks deformed or cannot take weight, for numbness or a limb turning pale and cold, and for any eye injury with pain or blurred vision. Also seek help for a wound that keeps bleeding after ten minutes of pressure or becomes red and hot after a day or two. For overuse pain, a reasonable rule is to get it assessed if it has not improved after two to three weeks of managed load, or sooner if it wakes you at night.

Can I keep sailing while an injury heals?

Often yes, but with the role changed rather than the effort simply reduced. With a shoulder problem you can helm while someone else hoists, with a knee or back problem you can trim from a seated position instead of hiking. The exceptions are absolute: no sailing on the same day after a head impact, no active role while you are hypothermic or heat affected, and nothing on the water until vision is normal after an eye injury. If a task cannot be done safely for yourself or the crew, it is not a task to do injured.