Medical aspects of springboard diving summary of a private literature collection and

an opinion

By Wes Zimmermann, M.D. specialist in sports medicine and occupational medicine

Amersfoort, The Netherlands

May 2013, Leipig, Germany

25 minutes

Medical aspects of springboard diving

1. introduction of your speaker

2. finding (medical) literature

3. a private collection

4. what is in the literature?

5. what is missing in the literature?

6. An opninion: we need safer rules and regulations

7. take home messages

Relevant publications by Wes Zimmermann

Medical aspects of springboard diving diver 1972-1991 1983 Edmonton

Medical aspects of springboard diving coach 1988-2009 2006 Kuala Lumpur

Medical aspects of springboard diving physician in the royal dutch army 2000-present

2. Finding (medical) literature

• Evidence based method:

• www.pubmed.gov

• www.sirc.ca

• www.worldcat.org

• www.openthesis.org

• Collectors method:

• Internet: google (scholar)

• sport specific magazines (inside USA diving)

• conference reports

• colleagues

3. a private collection

www.divingliterature.com

Articles (2600)

Books (800)

unpublished papers (1000)

directly related to diving

Diving books! (2 of each)

4: what is in the literature? Medical aspects of diving

Types of articles (339 items):

case reports: one patient with a rare injury

clinical reports: several patients with a similar injury

epidemiology: the number of injuries in a group

original research: results of experiments (new evidence)

reviews: a summary of articles by other authors

(no new facts)

language: English (80%), German, other.

4. Epidemiology:

(Zimmermann 1993, Wu 1999, Wingfield 2004, Mountjoy 2009, 2010)

major accidents are rare overuse injuries are common

4 what is in the literature?

Areas of concern in diving:

lower back (Groher 1969-1979, Rossi 1978, Strupler 1982, Rossi 1990, Wu 1999, Baranto 2006, Anderson 2009, Narita 2011)

vestibular (Krejcova 1981, Novotny 1982)

nutrition (Gess 1985, Abernethy 1987, Leung 1989, Ismail 2000, Petersen 2006)

age and platform (Cameron 1991, Miller 1999, Mathews 2007)

degree of difficulty (Strupler 1982, Zimmermann 1993)

wrist (Le Viet 1993, Xu 1999)

shoulder (Rubin 1993-1994)

neck (Schneider 1962, Anderson 1993, Xu 1999, Badman 2004)

eyes (Krejci 1982, Xu 1999, Wu 1999, Lohr 2011)

foot and ankle (Zimmermann 1993, Mizel 1996)

Area of concern: the eyes of the diver,

an Asian problem?

4 what is in the literature?

Medically related research topics in diving:

Body type (Hebbelinck 1975, Lopez 1979, Spurgeon 1981, Thorland 1981, Khosla 1984, Sovak 1992, Geithner 1993, Carter 1994,1997)

Vestibular training (Langer 1975, Gundlach 1984, Krüger 1985)

Somersault machine (Krug 2000, Naundorf 2001-2006)

Orientation (Sands 1991, King 1999)

Motor patterns (Shapiro 1993, Mathiyakom 2006, Zhao 2008, Kong 2010)

Motor performance (Gardiner 1972, Kerr 1980, Shea 1985, Rubin 1993, Sands 1999, Goto 2007, Wang 2007)

Human performance limits (Knoll 2000)

Talent identification (Krohn 1972, Huwe 1981, Wien 1988, Distelrath 1992, Malina 2007, Zimmermann 2009)

Talent selection (Raspopova 1980-2005, O’Brien 1993, Köthe 1997, Erogina 2003)

Training load (Minganti 2011)

Jet lag (Leeder 2009)

Research results:

The somersault machine

made in Leipzig!

5 What is missing in the literature?

Volume:

the number of articles is small compared to other sports

Quality of evidence:

the articles are not very good, according to modern standards of research

• expert opinion vs. proof from research (data collection)

• questionaires vs. prospective research

• older than 10 years

• non published = not reviewed by experts

6. An opinion: we need safer rules and

regulations

We must review the rules from a safety point of view; we must

address the age group rules, both for the young (juniors) and the old

(masters) divers.

Examples from other sports:

Judo / boxing: a doctor decides whether the athlete can continue

Football: a medical examination is needed to play in the World Cup

Tennis: medical care of top level athletes concentrated in one city

(ATP, London)

Tennis: a magazine on medical research in tennis

6. An opinion: introduction of a concept

Low risk diving

Recreational nature

1-3 lessons a week

Degree of difficulty < 2.6

Injuries: 4.0 / 1000 hours

High risk diving

Competitive nature

> 3 sessions a week

Degree of difficulty > 2.6

107, 205, 305, 405 etc.

Injuries: 8.8 / 1000 hours

A clear warning:

The history of Russian diving shows that speeding

up of diving into adolescence never led to higher

results and usually ended with injuries (physical or

psychological) and the early completion of the

athletic career.

Raspopova 2005

2013: addition of a new sport:

new safety challenges

age-limits?

7 Take home messages

Diving literature is available on www.divingliterature.com

Divers have few catastrophic accidents

Divers have many overuse injuries

Divers should actively seek more medical attention

Modern research on the medical aspects of diving is needed

We need safer diving rules and regulations

Relevant publications by

Wes Zimmermann

A safe but demanding sport, FINA Aquatics journal, november

2007 (D790a).

Dutch Diving Fitness Test, Sport en Geneeskunde, may 2009

(D898).