Drowning & Traumatic Injuries
While the majority of SUP drowning victims were novices not wearing a life-jacket, at least one drowning victim has died on a river when her leash snagged on hidden debris. Death from head injuries is also a concern when examining surf related accidents. And finally, mild traumatic knee and elbow injuries have occurred in whitewater paddlers. Interestingly, much of the protection available is controversial: The pros and cons of wearing, a leash, helmet, or knee & elbow pads are discussed below.
To Wear or Not to Wear...a Leash
Purchasing and wearing a leash with your paddle board should NOT be a forgone conclusion but it should be a serious consideration. Your board floats. If you don't wear a life-jacket, you will want to keep your board handy. A leash in flat, calm, protected water, especially for novices, may not be necessary and may well impede learning. On the other hand, wearing a leash while touring, in waves, or surf is usually a pretty good idea and will save you a long swim, or worse, should you fall off your board in heavy surf, strong current, or high wind. Wearing a leash in whitewater is a bit controversial. If you spend a lot of time surfing or running high volume rivers, consider a leash. If you run creeks and small rivers with debris and/or mid-river rocks, you probably shouldn't wear one as it increases your chances of entrapment. If you do choose to wear a leash in whitewater, you'll want one that clips to your life-jacket or waist (not your ankle or knee as these are difficult to reach in strong current), has quick release and break-away functions, and practice using it in strong current. If you choose to wear a leash in flat-water or surf and don't typically wear a life-jacket, you'll likely want one that attaches to your ankle or knee.
To Wear or Not to Wear...a Life-jacket
While wearing a life-jacket definitely increases your safety, they are somewhat constraining, are hot in the summer, interfere with tan-lines, and are therefore, controversial. Your choice to wear one (or not) depends on your paddling background and your risk assessment: Surfers tend to shun life-jackets and rely on their swimming ability and their board's floatation for protection; whitewater paddlers tend to bring and put on a life-jacket out of force of habit; and novices tend to wear what their instructor or friends wear. Manufacturers try to address comfort via design; inflatable life-jackets stored in belt-packs and activated by a pull-tab are available. No life-jacket will maintain an unresponsive person face up in rough water. NOTE: Many states consider paddle boards a water craft and require operators to either wear a life-jacket or have one on board; some states require board to have lights if used after dark.
To Wear or Not to Wear...a Helmet
Over the years, people have started to wear helmets in lots of sports where they didn't used to: biking, skate boarding, and skiing to name a few...so why not with an SUP? There have been head injuries and deaths in the surfing community (primarily from hitting their board) yet most surfers shun helmets in the same way they do life-jackets. This trend carries over to SUPs. Conversely whitewater paddlers have grown accustomed to wearing a helmet; after all, if you paddle a kayak or C-1, you are essentially tied into your boat with thigh braces and a spray skirt, and being upside down with rocks coming at your head seems to suggest, even to the most brain dead, that a helmet is a good idea. Again, this trend carries over to SUPs. Flat water canoeists and kayakers typically don't wear helmets (not much momentum if you aren't be pushed around by the water) and, once again, this trend carries over to SUPs. Should you wear a helmet? The answer is easy if you've had a previous head injury and are paddling in surf or whitewater: Wear one. Period. For everyone else, it's controversial. You need to make a personal risk assessment and then a decision. Base both on the likelihood of falling and hitting your head (on the board or something else). The bottom line is that it's safer to paddle with a helmet in the surf and whitewater, than not.
To Wear or Not to Wear...Body Armor
What? Wear body armor? Are you serious? Well, yes, on whitewater (or if you kneel on your board a lot). If you paddle on shallow rivers or tight rivers with lots of exposed rocks you should consider wearing knee and/or elbow pads. Also consider armored shorts with hip and sacral protection. Having your board stop suddenly after scraping the bottom on a rock tends to toss you forward onto the board or into rocks on the bottom of the river. Most paddlers land hard reasonably hard on their knees, elbows, hips, or back. All are somewhat fragile and hurt considerably when abruptly contacting a rock. Pads protect them.