Even though surf at Sandy Beach was relatively small, lifeguards and paramedics treated four people for injuries suffered in the ocean, a spokeswoman for the Ocean Safety and Emergency Medical Services Division said.

A local woman, 52, hit her head on the reef as she dove under a wave at about 2:45 p.m. Sunday. At about the same time, a 53-year-old Montana man, who was apparently bodyboarding for the first time, fell off his board and struck his face on the sand and reef, Shayne Enright, a spokeswoman for Honolulu’s Emergency Services Department.

Paramedics took both victims to the hospital in stable condition after lifeguards stabilized the patients.

Then, just after 5 p.m., a 19-year-old local woman suffered an ankle injury when a wave crashed into her and a 23-year-old local woman went over a wave and hit the sand, Enright said.

Lifeguards responded to both incidents and paramedics treated and took both patients to the hospital in serious condition.

"The surf was about one foot today but despite the waves being small, Sandy Beach is still considered a hazardous break. Ocean Safety always advises beachgoers to check with lifeguards before going into the water," Enright said in an e-mail.