“…30 The risk for injury is high in both sports, with rapid acceleration up to 35 mph, lack of protective gear, and waterway obstacles such as towlines, boat propellers, and other skiers. To date, the majority of research has focused on water skiing and has shown an association with multiple injury types, including contusions, abrasions, lacerations, fractures, strains, sprains, § ruptured tympanic membranes, 14,27 vaginal lacerations, 9,14,15,18,19,24,28,36 enema injury, 3,16 infections, 14,25,27 cardiac trauma, 12 and spinal cord damage. 11,23,32 These water skiing–related injuries typically differ by level of experience, as novices are injured most frequently while submerged during takeoff with douche and enema injuries, while experts most commonly injure their knees, backs, or shoulders while falling.…”