I think the pic is real. I cannot see anything in the water, sky, foliage, edges, lighting, shadows, etc. to suggest otherwise. I think the rope bend is probably because that's where the handle attaches to the main rope.
If it is fake, it's a pro level job. If it's a pro level job, it was probably done in Photoshop. There were no tags from Photoshop, Photopaint, PaintShopPro, or any other editor in the file, just the ones from the Nikon camera, so I don't think that it was ever touched with Photoshop.