Stingray Stings Suck – Here’s How to Treat Them

After 15 years of surfing in Southern California, my time had come.  In an eager attempt to wash off a crappy workday, I drove down to Oceanside Harbor for a quick session.  The waves were small but still looked like there were a few fun corners to be had.  Plus, the sun was out, and the water was warm.  It was going to be one of those sessions where I could just enjoy being in the water with low expectations.

I entered the water gingerly, looking for stingrays but mostly using the shuffle stomp method: shuffling forward and then stomping my heels once I’ve made forward progress to send out vibrations in an attempt to alert any nearby stingrays to my presence and have them swim away.  After about 10 steps into the water, I was knee deep and felt something on my foot – being an east coaster my first thought was a crab, it felt like a hard version of crab pinches I had sustained in my childhood (I was terrified of crabs as a kid).  But then I saw something move away, and I knew – it was a stingray.

I lifted my foot out of the water and saw a half-inch gash on the top of my foot right above the knuckle of my big toe that started spilling blood immediately.  NOT something I wanted to see.  Also, a direct hit.

A sense of dread fell over me…I didn’t really know what to expect.  I had heard many stories from friends, and they were all pretty grim: “worst pain ever, worse than childbirth, lightning”…you get the picture.  I hobbled over to the lifeguard tower and the lifeguard hopped down and squirted it with water to take a look at it and gave me a heat pack (not a cold pack – heat neutralizes the venom, but more about that later).  He instructed me to go home and put my foot in water as hot as I could stand.  However, I had parked in the 2-hour lot, which was a good 10-minute walk away and I already couldn’t put weight on the injured foot.  I asked if he could hail the truck over to take me to my car.  Thankfully, a truck was free and two other guards came to take me to my car (side note to the Oside guards: many thanks).

The pain started to spread and increase within minutes after getting shanked – I will say the instant it hit me wasn’t THAT bad.  It wasn’t like instant searing pain.  It definitely hurt but it was kind of a dull electric pain, like someone dropped a pointy hammer on my foot.  Very strange and kind of unnerving.

Driving home was a challenge.  Still in my wetsuit and the heat pack balanced on my foot I drove home using two feet – I couldn’t move my foot well enough or press strongly enough to use the brakes so I did that with my left foot.  I texted my roommates to put on some hot water for me, hoping to God they were home and saw the text.  Cursing and yelling I made the 10-minute drive home.

Luckily, they saw my text, and after the painful drive I put my foot in the bucket of hot water.  Apparently, the temperature range should be 110-115, and it’s hard to sustain that temperature without a pot of boiling water next to you to keep adding in small amounts.  The hot water definitely took the pain down several notches to where I could stop hyperventilating.  My roommates handed me a beer and some Advil.  I started to calm down, but then the pain kept coming in waves.  And kept coming.

It took 3 hours my friends.  3 solid hours of continually adding more boiling water to my bucket to keep the pain from becoming intolerable.  Apparently the longer you wait to get your sting into hot water, the worse the pain will get and the more it will spread – up my leg in my case.  I could feel fingers of pain starting to go up my leg by the time I got my foot in the bucket, but the hot water started to do its thing.  It had taken me around 30 minutes to get my foot into hot water which I believe led to the pain being a bit longer lasting.  Additionally, I sustained a direct hit – my roommate got hit the week prior but had only been grazed so her pain eased within 30 minutes of using hot water.  She also got her foot into hot water rather quickly – probably 15 minutes sooner than me.

Hot Water Denatures Stingray Venom

Apparently, the venom in stingray stings can be denatured (neutralized) by heat, and that is the goal of treatment: hot water as soon as you possibly can, and with the temperature range I said above: 110-115F.  If you’re near a lifeguard station set up to do this, you can get treatment earlier.  In my case they didn’t have hot water available, so I had to make my way home.

What’s In Stingray Venom?

Stingray venom is an interesting cocktail, and there are several ingredients that lead to the awful and crushing pain.  It consists of the enzymes 5-nucleotidase and phosphodiesterase and the neurotransmitter serotonin.  Interestingly, the serotonin causes most of the pain by causing contractions of smooth muscle.  The enzymes both cause tissue and cell death and are why stingray wounds can keep bleeding for longer than most injuries of that size.  They also cause a slower healing process due to their destructive nature.

The barb itself has serrated edges that really do a number on skin and tissue on the way back out of you.  Sometimes barbs can get lodged in your body if they break off.  Even very tiny pieces can get left behind.

If you want to know more about how a stingray stings and where the stinger actually is, check out this article.

Should I See a Doctor?

You don’t necessarily have to go to a doctor or ER right away unless you are having severe and unusual symptoms such as shortness of breath, feeling faint, or heart palpitations.  Just get the sting site into hot water ASAP.  However, following the injury and within 24 hours, you absolutely may want to consider going to an urgent care or doctor to get a round of antibiotics and have them xray for pieces of barb left behind.

I don’t like antibiotics, but I had MANY friends who had been stung in the past message me on Instagram that they had gotten an infection at their wound site.  The amount of people that told me this was worrisome, so I looked it up – it turns out in one study (albeit rather small), 8 of 22 stingray stings they followed became infected.  That is much too high a number for me to take my chances, so I went for an xray (negative, thankfully) and a course of doxycycline.

According to a doctor at Monash university, “ciprofloxacin, doxycycline and trimethoprim-sulfamethoxazole appear to be the most appropriate antibiotics choices for prophylaxis or treatment of localised infection.”

There are many bacteria that live on marine creatures such as stingrays and given the deep puncture that the barb creates it can lead to severe infection even if you follow a diligent wound care routine.

Unfortunately, even with antibiotic prophylaxis, I STILL got what appeared to be a secondary infection.  A few days later my foot got very swollen, painful, itchy, and RED.  The urgent care doc I saw took it quite seriously and put me on two more antibiotics and drew a line around the redness.  If the redness had spread, she told me to make a beeline to the ER.  Kind of scary considering the nasty bacteria like vibrio that are out there in the marine world.

I had to keep my foot elevated, or it would start to throb in pain.  It really sucked.

Fortunately, the second round of two antibiotics nixed the infection and the redness slowly went away.

I’m not going to lie…I couldn’t wear a shoe for over a month.  It took several months for the sting to heal completely, and even now I have a bright pink scar on the knuckle of my big toe.

Avoiding Stingrays – Does The Shuffle Work?

The most common advice to avoid stingrays is to “shuffle”.  This means sliding your feet just under the sand as you move forward, kicking up sand and hopefully touching a stingray lightly from the side to scare it away rather than accidentally stepping on top of it and triggering its instinctual barb stab.

However, after many stories from friends and a few videos demonstrating the shuffle, it is clear that although the shuffle is better than nothing, it’s not always effective.

In an Instagram video from @thatsurfguy, he approaches a large fever of stingrays (did you know a group of stingrays is called a fever?) using the shuffle.  Some went skittering away, but some DID NOT MOVE at all.  And if you shuffle right into one, they’re probably going to shank you.

In my case, I was shuffling and then pounding the sand with my heels, and I never actually felt the stingray except for the barb.  According to a friend of mine who had 3 stings, “I’ve been stung three times. Once I stepped on the tail/barb. The second I was standing still and it ran into me and stung me. The third I was shuffling and brushed the side of it with the side of my foot and it stung me. The shuffle is a myth.”

So there you have it folks, you can be standing still and still get unlucky.  Now, that’s not that common–most of the time people step on one.  But I have seen wayyy too many people say that they were shuffling and still got stung.  According to the Instagram video experiment, the shuffle CAN work, but it’s not a surefire preventative measure.

My new strategy in addition to shuffle stomping is going to be submerging the nose of my board in front of me as much as possible.  Also slapping the water above me.  I’m probably going to look insane.  I don’t care.  I hope this to be my first and last time getting stung, however it seems that over the years the more you’re surfing sandy bottom beach breaks the more likely your odds of having a run-in.

Good luck out there and keep your hot water handy!