Water sports offer an exhilarating spectrum of activities, from the graceful strokes of swimming to the intense dynamics of rowing, kayaking, and triathlons. These aquatic pursuits immerse athletes in an ever-shifting environment that presents unique physiological and mechanical challenges, significantly heightening their risk of injury. Unlike their land-based counterparts, water sports demand repeated movements in unstable settings, which intensify the potential for musculoskeletal strain. For instance, the repetitive flexion-extension motions in rowing and canoeing put considerable stress on the lower back, shoulders, and knees. Research highlights that over 53% of rowers suffer from lower back pain during their careers, particularly in the lumbar region, due to these continuous motions [1]. Additionally, improper technique and equipment can further escalate this risk. Preparing for caring for athletes in the wet environment requires the clinician to have careful plan for extraction of the injured athlete and assuring that the team is well versed in emergency response to drowning or how to safely remove an injured athlete from the water. Prevention begins with pre-event planning but requires a highly trained rescue team to respond within the unique environment.