Wakesurfing Injuries and Safety: Propellers, Carbon Monoxide and Falls

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Late afternoon, the ballast tanks are full and the wave behind the boat is clean and steep. The rider tosses the rope into the boat and settles into the pocket, close enough to the stern to talk to the crew. That closeness is the magic of wakesurfing, and it’s also what makes its risks different from any other towed sport. The speeds are slow and most falls are soft, but the rider surfs a few yards from a propeller and right where engine exhaust gathers. This page covers wakesurfing injuries and safety: falls and the board, rope tangles at the start, the propeller, carbon monoxide, life jackets and when to get help. It’s for every level, from kids to World Series of Wake Surfing riders.

General information, not medical advice. If you’re hurt, see a sports medicine doctor, physical therapist (PT) or certified athletic trainer (AT); in an emergency, call 911. For the bigger picture, start at our wakesurfing hub.

What the research shows (and doesn’t)

There’s almost no wakesurf injury research yet: we found no study counting wakesurf injuries, only a case report, government measurements of exhaust behind surf boats, and Coast Guard numbers for towed water sports overall. In 2024 the Coast Guard recorded 19 deaths and 242 injuries in towed water sports, and 169 incidents in which someone was struck by a propeller. The advice below leans on what’s known about the boat, the exhaust and the water, where the most serious risks are.

Falls, the board and the boat

Surf boats run slowly, about 10 mph in a federal study, and your feet aren’t in bindings, so in most falls you and the board part ways. That changes the injury picture but doesn’t remove it:

• The loose board. A board with fins tumbling in the wave can hit you. Fall away from the board and cover your head with your arms as you come up.
• Don’t ride into the boat. The surf pocket is close to the stern, and a rider who pumps too far forward can reach the swim platform. The World Wake Association’s contest rules ban touching the boat or riding “unnecessarily close” to the swim platform; on a fun day, the same space keeps you off the hull and out of the exhaust. If you get too close, fall back or kick out.
• Knees and ankles. Twists and hard landings can still sprain an ankle or hurt a knee. The American Academy of Orthopaedic Surgeons (AAOS) lists a pop, the knee giving way and swelling within 24 hours as signs of an ACL tear, which always needs a doctor. After an ankle sprain, the National Athletic Trainers’ Association recommends at least three months of balance training.

Concussion: recognize it and sit out. A board to the head or a hard fall can cause a concussion. The CDC’s HEADS UP program says to remove anyone who may have one from activity: “When in doubt, sit them out”, for the rest of the day and until a health care provider clears them. Watch for confusion, a dazed look, headache, dizziness, nausea or blurry vision. Call 911 for danger signs such as a worsening headache, slurred speech, repeated vomiting, seizures, growing confusion or passing out. A helmet is optional; a water sports helmet such as the Pro-Tec Ace Water is a sensible choice for kids and for riders learning airs.

The rope at the start

Every wakesurf ride starts with a short rope, and that’s when slack line coils around the rider. A 2023 case report describes a 40-year-old man who fell while wakesurfing with the rope tangled around his arm and fully tore his biceps muscle. The authors note that in wakesurfing it’s beginners who are most at risk, at the start, unlike wakeboarding, where experts get hurt on jumps. The boating industry’s Discover Boating safety tips say the same thing simply: never wrap a slack line around your hand or arm while you work the board into the wave.

• Use a short, thick wakesurf rope made for the job, such as the SWELL Pro Wakesurf Rope (24 feet, 3/4-inch floating line).
• Let go if you fall, and once you’re in the pocket, pass the rope into the boat or toss it clear of the wave, the way NIOSH researchers describe the sport.

Propeller safety: only the right boat

A wakesurfer rides about 10 feet behind the boat, according to a NIOSH study for the Coast Guard. That’s why the boat type matters more here than in any other towed sport. Board maker CWB’s owner’s manual warns that wakesurfing close to a propeller can cause injury or death, and says to surf only behind boats with an inboard drive, where the propeller sits under the hull, and never behind outboard, inboard/outboard (sterndrive) or jet drive boats. Discover Boating, run by the boat manufacturers’ association, likewise says traditional sterndrives and outboards should never be used for surfing. Not sure about your boat? Ask its maker before anyone rides.

• Engine off for every swap. Discover Boating says never let a rider gear up on the swim platform, slip into the water or climb back aboard without first shutting off the engine. California’s boating agency notes that a propeller may still turn in neutral.
• Circle back; never back up to a rider in the water, and keep the rider on the driver’s side and in view, as the Coast Guard advises.
• Use the engine cut-off switch. On boats under 26 feet, federal law requires the driver to wear the cut-off switch lanyard while on plane or above displacement speed.
• A spotter every ride, whose only job is watching the rider. California, for example, requires an observer at least 12 years old.

Carbon monoxide: the danger in the pocket

Boat engines make carbon monoxide (CO), a gas you can’t see, smell or taste. The Coast Guard warns that it collects around the stern and swim platform at slow speeds, while idling and even after the engine stops. Wakesurfing puts the rider in exactly that spot: slow speed, close to the stern, low to the water. In a 2004 NIOSH study on two inboard ski boats running at about 10 mph, a wakesurfer riding behind the boat with a standard stern exhaust breathed CO peaks as high as 832 parts per million; behind a boat with a side exhaust system, the same rider’s exposure was about 99% lower. NIOSH also found CO was highest near the water’s surface and fell with distance and speed.

Early CO symptoms (irritated eyes, headache, nausea, weakness, dizziness) are easy to blame on sun or a beer, and the Coast Guard notes that exertion speeds up CO absorption. A rider who passes out in the water can drown.

• Ride far enough back to be out of the exhaust, as CWB’s manual advises, and keep sets short. If you can smell exhaust, you may be breathing CO.
• Change the boat’s heading relative to the wind if exhaust is drifting onto the rider or the back of the boat; CWB notes this can help. A badly tuned engine makes more exhaust.
• Nobody on the swim platform while the engine runs, and never “teak surf” (holding the platform, then body-surfing the wake right behind it). The Coast Guard says teak surfing is never safe; it is not the same thing as wakesurfing.
• Headache or dizziness = get out of the wave. Move the person to fresh air and get medical help unless you’re sure it isn’t CO. Unconscious, confused or not breathing normally: call 911.

Drowning and life jackets

In all US recreational boating in 2024, 76% of the people who died drowned, where the cause was known, and 87% of those who drowned weren’t wearing a life jacket. A rider hit by a board or dizzy from CO is exactly who a life jacket is for.

• Wear a Coast Guard approved life jacket made for towed sports; check the label, since the Coast Guard notes some jackets are not approved for water skiing or wakeboarding. Discover Boating calls a Type III vest-style jacket the best choice.
• Comp vests and inflatables don’t count. Some surf “comp vests” aren’t Coast Guard approved (check the label), and inflatable jackets aren’t approved for towed sports in states such as California. State laws vary: Pennsylvania lets wakesurfers wear a water ski wetsuit instead of a jacket, but World Wake Association contests require an approved jacket for every rider. Our rules page covers the laws.
• Kids need a jacket sized for their weight, snug enough that it doesn’t ride up over the chin. See our youth wakesurfing page.
• No alcohol for the driver, spotter or rider. Alcohol was the leading known factor in fatal boating incidents in the Coast Guard’s 2024 report.

Water, skin and sun

• Warm freshwater and your nose. Infections from the ameba Naegleria fowleri are rare (fewer than 10 US deaths a year), but the CDC suggests avoiding warm, low water and using a nose clip.
• Algae. The CDC says to stay out of water that smells bad, looks discolored or has scum, and to follow posted advisories.
• Cuts, sun and heat. Clean cuts with soap and running water. Sun and heat are on our Lake Day page.

When to get help

• Call 911 now: an unconscious or confused rider, concussion danger signs, any propeller injury or heavy bleeding, trouble breathing after being under water, a suspected neck or back injury or possible CO poisoning.
• See a doctor soon: a knee that popped, gave way or swelled; an ankle you can’t walk on; a weak, bruised or misshapen arm after a rope tangle; deep cuts; any suspected concussion.
• See a PT or athletic trainer: pain that keeps coming back, a knee or ankle that feels unstable, or a plan to get back on the wave after an injury.

Next: training, recovery and Coast Guard approved vests on the gear page. Wakeboarders have their own guide: wakeboarding injuries. For a team-sport comparison, see soccer injuries.

Wakesurfing injuries and safety: FAQs

Is wakesurfing safer than wakeboarding?

Speeds are slower and your feet aren’t in bindings, so many falls are gentler. But no research compares injury rates, and wakesurfers ride much closer to the propeller and the exhaust.

Can you wakesurf behind an outboard or sterndrive boat?

No. Board makers such as CWB say to surf only behind inboard-drive boats, where the propeller is under the hull, and the boating industry’s Discover Boating says traditional sterndrives and outboards should never be used for surfing. The rider is only about 10 feet from the stern.

How do wakesurfers get carbon monoxide poisoning?

By breathing exhaust that collects behind a slow-moving boat, right where the surf pocket is. Ride far enough back, keep sets short, and get out of the wave if you get a headache or feel dizzy.

Is teak surfing the same as wakesurfing?

No. Teak surfing means holding onto the swim platform and then body-surfing the wake a few feet behind it, right in the exhaust. The Coast Guard says it is never a safe activity. Wakesurfing uses a board and a rope to get up, on boats built for it.

Do I need a life jacket to wakesurf?

Wear a Coast Guard approved, non-inflatable life jacket. Some states make exceptions (Pennsylvania allows a water ski wetsuit), but a jacket floats you if a board or carbon monoxide knocks you out, and World Wake Association contests require one.