Fly Fishing (and Tenkara) Injuries

I dare say that if I were to ask fly anglers why they love fly fishing (tenkara included) most answers would have something to do with being outdoors and that it helps reset their stress meter. I bet they’d say it’s good mental health therapy. And you know what? I’d agree with you!

But while fly fishing can be relaxing, meditative, and good for your mental health, it also has the potential to cause injury and even threaten your life! So, for a moment, let’s review some of the potential injuries that can befall us while we’re out doing what we love to do.

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Orthopedic Injuries

Probably the most common injuries that happen from fly fishing are orthopedic in nature. Some of these happen because of the repetitive nature of casting, but others can be from direct stress and strain of holding and manipulating a rod or falling. Some of these potential injuries include: Angler’s Elbow, carpal tunnel syndrome, rotator cuff syndrome, various other hand/wrist injuries, as well as neck and lower back injuries. Then, of course, there’s hip, knee and ankle injuries from walking on uneven ground and falling.

Angler’s Elbow, analogous to Tennis Elbow, is inflammation of the tendons and ligaments in the forearm that causes pain when moving the wrist or making a fist. This inflammation is caused by micro-tears, and is often related to repetitive use of these muscles under load stress (such as using long, tip heavy rods). Carpal tunnel syndrome is caused by pressure on the median nerve in the wrist, leading to numbness, tingling, and pain, especially in the thumb, index, and middle fingers. Again, it’s classically a repetitive use injury and is common among anglers. Tenkara may increase the risk when compared to conventional fly fishing, as there is generally more wrist action with tenkara casting than traditional fly rod casting.

Another common injury among anglers is rotator cuff syndrome. This syndrome is a group of conditions that affect the rotator cuff, a group of four muscles and tendons that surround and stabilize the shoulder joint. More common in older individuals, it can cause pain in the shoulder and greatly limit the casting range of motion of an angler. Other injuries include those of the hand and wrist, neck and lower back. Frequently, these are a result of falling, something that all anglers are at risk of doing. Sometimes it’s not the impact of the fall that renders that injury, but the sudden bending and twisting that involuntarily occurs as the person tries to recover their balance during the fall.

And while we are mentioning falls, there are two basic types: ground level and elevated. Both types can inflict injury but generally speaking, elevated has the potential for more serious injuries. Climbing or scrambling down a steep slope or cliff to get to that beautiful stream comes with some inherent risks of injury.

So, how do we prevent these types of injuries? For Angler’s Elbow, use of rods with a lower rotational moment (less tip heavy) may help. This also goes for rotator cuff injuries. Heavy rods and especially those that are tip heavy put more stress and strain on your physiology than do lighter ones. These types of injuries also have a propensity to increase as you get older. Haven’t ever had “tennis elbow” or shoulder problems? Good for you, but wait until you’ve traveled around the Sun a few more times, then you’ll know what I’m talking about!

As far as falls, wear proper foot protection with stabilization and grip accessories. We’re talking wading boots with metal studs or cleats, or even felt (where local regulations allow). I’m fond of aluminum cleats. For me, they work the best. Oh and using a wading staff wouldn’t go amiss either.

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Impalement Injuries

Of course, it goes without saying that hook impalement is one of the most common injuries sustained when fly fishing. After all, we are purposely causing a sharp metal object to fly through the air, right past our heads, at speeds some estimate at around 70 miles per hours (or faster). If not flying through the air, hooks still pose impalement danger when handling. So, while getting a hook in your eye is absolutely catastrophic, hooking your finger will also cause significant pain and suffering.

Prevention? The use of eye protection is an absolute must when fly fishing, but a wide brimmed hat may also be of some protection. Oh, and need I say that barbless hooks are the way to go, not just for easy release of the fish!

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Environmental Injuries

Environmental dangers are too many to go into in any detail, but suffice it to say that there are dozens of potential dangers present when you walk out your door. Not including the dangers of driving (other cars and deer strikes), some of these hazards include sunburn, insects (mosquito, ticks), poisonous plants (poison ivy, nettles), snakes, bears, dehydration, heat injury and hypothermia, to name a few. Tick borne illnesses are rapidly increasing across the nation and some, like Lyme Disease are now present where they used to not be (like Idaho) due to climate change and tick migration. Others, like sunburn, may hurt a little now but increase your risk of skin cancers decades in the future. The outdoors is a dangerous place, but that is where the fish are, so that is where we go!

To mitigate some of these, consider using sun protection in the form of clothing, hats and sun screen. Also, were appropriate, the use of insect repellants (DEET, picaridin, permethrin, etc.) may be of some use. If you choose to use permethrin, remember that it is highly toxic to aquatic insects and fish in its liquid form. Once it’s completely dried it adheres to clothing fibers tightly and is not considered toxic to aquatic life, but to be extra cautious, maybe consider not using it on clothing that you plan submerging, like socks, shoes and pants (trousers).

And what about bears? Well, have fun. This link will give you some suggestions, but remember, DEET won’t keep them away!

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Water Injuries (Drowning)

Of all the dangers we face when fly fishing, drowning is the worst. Falling into very cold water, that is often moving in fast, chaotic currents, cannot only knock the breath out of you, but also disorient you and cause you to go into panic mode. Falling into the stream current is a very serious matter, and whether you’re wearing waders or not, can put you at risk of drowning.

But it doesn’t take very deep water for you to drown. Many anglers don’t wade in water deeper than their knees, and so they may think that they are safe from drowning. Unfortunately, this is not the case. If you wade in water deeper than the length of your arms, you are at risk of drowning. This is from a life threatening situation called foot entrapment.

Foot (or boot) entrapment is where the angler’s boot is caught under or between rocks or logs that are on the stream bottom and can’t be removed. The hydrologic force of the water (which is from the force of gravity, as water moves down slope) pushes the foot and leg into the obstruction and then forces the person over onto their face, downstream of the obstruction. The force of moving water keeps their head downstream and under the surface, and if the water is deeper than the length of their arms, they will drown. There is no way that the person can get free of the obstruction, sometimes even with rescuers present. Remember, foot entrapment kills!

If you do fall into moving water where swimming is required, here are some recommendations:

1. Get rid of your rod. It’s not more valuable than your life! If the current is stronger than you can effectively swim out of, position yourself on your back, feet downstream, hips and feet up (to avoid foot entrapment). Slowly paddle with your arms to steer towards calmer water.
2. Unless you get out of the strong current, do not attempt to stand up unless you can first stop yourself by grabbing the bottom with your hands (again, to lessen chance of foot entrapment).
3. If you encounter a log jam, or tree branches in the current called “sweepers or strainers” that can’t be avoided, roll over onto your stomach, and swim forcefully downstream, head first. When you get to the log, use your arms to attempt to crawl up and over the obstacle. Do not try to go over a log feet first. This is because the current will generally suck you under as soon as your feet hit the log. Again, you are not strong enough to counter the force of moving water.
4. If there are no log sweepers ahead and your way is clear, stay on your back, feet downstream. Stay relaxed and search for an exit. When you see an area of slower current or an eddy, roll over and swim head first aggressively toward it. Remember, your life depends on it!

And when it comes to wading in deep water, consider using a wading staff strong enough to support your weight, and with chest-high waders always use two wading belts, one around your waist and a second up higher around your chest. The one positioned up on your chest should be elastic so that it will conform to your chest as you breath. These two belts will keep water out of your waders much better than just one wading belt.

Finally, wearing an Auto/Manual Inflatable Life Vest is also advisable when you are wading in deep water. Unfortunately, these are rarely used by the fly fishing community.

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Conclusion

Fly fishing (including tenkara) is a wonderful way to enjoy the outdoors. It helps destress and decompression from life’s burdens, which is something every one needs from time to time. But fly fishing comes with inherent risks. Some of these risks may be minor annoyances, but some can kill you. Taking a little time to prepare, practice and prevent these risks will make your fly fishing experience better and more enjoyable. As the old saying goes, an ounce of prevention is worth a pound of cure! Have fun, but please be careful out there!

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