Medical aspects of springboard diving

1. Medical aspects of springboard divingpart 1: a review of literaturepart 2: a questionaireBy Wes Zimmermann, M.D.specialist in sportsmedicine and occupational medicineAmersfoort, The NetherlandsNovember 2006, FINA, Athens45 minutes

2. Medical aspects of springboard diving

3. Medical aspects of springboard diving

4. Medical aspects of springboard diving Part 1: a review of literature • finding (medical) literature • a private collection • what is in the literature? • what is missing in the literature? • summary and invitation Part 2: a questionaire • what do coaches want? • Learning from other sports • questionaire

5. Part 1: finding (medical) literature • Internet: google • www.pubmed.gov • sportdiscus (Canada) • universities (masters and phD theses) • sport specific magazines (inside USA diving) • conference reports • colleagues

6. Part 1: a private collection • www.springschool.nl • Articles (2000) • Books (500) • unpublished papers (750) • directly related to diving

7. Part 1: what is in the literature? Types of articles (235 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 • examinations: the results of testing divers • prevention: how to prevent accidents and overuse-injuries • original research: results of experiments (new evidence) • reviews: a summary of articles by other authors (no new facts) • language: English (90%), German, other.

8. Part 1: what is in the literature? Areas of concern in diving: lower back (Groher 1969-1979, Mangine 1983) vestibular (Krejcova 1981, Novotny 1982) nutrition (Gess 1985, Abernethy 1987, Leung 1989) age and platform (Cameron 1991) degree of difficulty (Strupler 1982, Zimmermann 1993) wrist (Le Viet, 1993) shoulder (Rubin, 1993-1994) neck (Schneider 1962, Anderson 1993, Zhou, 1999) eyes (retina) (Wu, 1999)

9. Part 1: what is in the literature? Some available data in diving: Body type (Hebbelinck 1975, Lopez 1979, Thorland 1981, Khosla 1984, Sovak 1992) Vestibular training (Rau 1975, Gundlach 1984, Krueger 1985) Somersault machine (Krug 2000) Human performance limits (Knoll 2000) Talent identification (Wien 1988, Zimmermann 2006)

10. 1988 Olympic games

11. Part 1: 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 • questionaires vs. prospective research • older than 10 years • non published = not reviewed by experts

12. Part 1: summary and invitation • Please study the medical aspects of diving: some books and articles are available. • Please stimulate and assist experts who want to do (quality) research on diving. • Please help us collect articles on diving : www.springschool.nl

13. Medical aspects of springboard diving

14. Part 2: what do coaches want? • Practical information on training load and injury prevention • How do I select talented divers? • How fit are toplevel divers? • When is it safe to teach a diver a new (hard) dive? • How quickly can a diver go from 5 to 7 to 10 meter? • How much training is medically responsible? • contact persons for problems and questions • Good medical care for divers while at home • Good medical care for divers while at tournaments • diving literature • tape, braces (suitable for diving)

16. Part 2: Learning from other sports • Judo / boxing: a doctor decides whether the athlete can continue • football: a medical examination 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

18. questionaire please let us know: what do you think is important ? • What area of diving medicine needs research first? • What should be done (in rules /organisation) to prevent diving injuries? • do you have information for us?