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Diving (Care of the Young Athlete)

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Competitive springboard and platform divers
start training and competing at an early age. Many Olympic and world champions
are 18 years of age and younger.

Diving is considered a collision sport because of
the impact with the water on entry. A diver entering the water from the 10-meter
platform is traveling almost 40 miles per hour. These forces are enough to break
bones and dislocate joints. Divers are also at risk of injuries from hitting the
board or platform as well as overuse injuries similar to gymnasts from frequent
jumping, back arching, trunk flexion, and back twisting. Injuries can also occur
from training on “dry land.” This type of training usually
includes weight lifting and the use of spotting belts, trampolines, and
springboards.

While injuries do occur in competitive diving,
unsuper?vised or recreational diving is associated with a far greater
risk of serious injury or even death. The following is information from the
American Academy of Pediatrics about how to prevent diving injuries. Also
included is an overview of common diving injuries.

Injury prevention and safety tips

  • Rules. Swimmers should
    follow pool rules at all times, including

    • Never swim alone.
      The pool should be supervised.

    • Don’t run on pool
      decks and wet areas.
      Abrasions and contusions
      (bruises) commonly occur from careless falls.

    • Don’t dive in
      shallow water or any water where the depth is not
      known.
      Swimmers should know how deep the pool is and
      avoid diving into shallow pools less than 3 feet deep. This will
      help prevent serious head and neck injuries.

  • Equipment. Safety gear
    includes

    • Swim caps

    • Sun protection
      (sunscreen, lip balm with sunblock) when outdoors

  • Emergency plan. Teams
    should develop and practice an emergency plan so that team members know
    their roles in emergency situations in or out of the water. The plan
    would include first aid and emergency contact information. All members
    of the team should receive a written copy each season. Parents also
    should be familiar with the plan and review it with their children.

Common injuries

Shoulder injuries

Shoulder injuries typically occur during
water entry when arms extended overhead get forced back. Athletes usually
feel the shoulder pop out of joint when their shoulders are dislocated. Most
of the time the shoulder goes back into the joint on its own; this is called
a subluxation (partial dislocation). If the athlete
requires help to get it back in, it is called a
dislocation. Risk of dislocation recurrence is high for
youth participating in these sports. Shoulder strengthening exercises,
braces and, in some cases, surgery may be recommended to prevent
recurrence.

Chronic shoulder pain is usually due to a
pinching of the rotator cuff (the tendons around the top of the shoulder).
This is more common in athletes with weak shoulder blade muscles. Symptoms
include a dull pain or achiness over the front or side of the shoulder that
worsens when the arm is overhead. Treatment involves exercises to strengthen
the shoulder blade muscles and the rotator cuff.

Neck injuries

Repetitive extension of the neck on water
entry can cause an irritation of the neck joints. This results in muscle
spasms and stiffness when rotating the neck or looking up. Athletes with
tingling or burning down the arm may have a cervical disc herniation or
“stinger” and should see a doctor. Stingers are stretch
injuries to the nerves in the neck and spine. Because the force of impact is
greater with 10-meter platform diving, there are more complaints of neck
problems with tower divers.

Elbow injuries

Elbow pain can occur when an
athlete’s elbow hyperextends on entry into the water. The ulnar nerve
(“funny bone”) can be stretched and cause pain, numbness, or
burning down the arm into the fingers. If the ligament of the elbow is
stretched, it can cause pain, weakness, and instability of the elbow.
Athletes with pain on the outside of the elbow may have a condition called
osteochondritis dissecans. This condition can cause an
inability to straighten the elbow and locking, catching, or swelling of the
elbow. X-rays may be needed to confirm diagnosis.

Wrist/hand injuries

When divers enter the water, they grasp
their hands one on top of the other with the palm facing toward the water.
As they try to “punch” a hole in the water, the wrist gets
bent backward. Doing this repetitively causes pain, swelling, stiffness, and
irritation of the wrist joint. This can be treated with rest, ice, and
nonsteroidal anti?inflammatory drugs. Taping or bracing the wrist can
also prevent further injury.

When divers reach for the water and attempt
to grasp their hands for entry, they occasionally hyperextend the thumb.
This causes a sprain to the base of the thumb. Symptoms include pain,
swelling, instability, and weakness of the thumb. This can be treated, and
may be prevented, by taping the thumb while diving. Occasionally, a custom
thumb splint or even surgery is necessary to stabilize the thumb.

Low back pain

Spondylolysis, stress
fractures of the bones in the lower spine, is due to overuse from arching or
extending of the back. Symptoms include low back pain that feels worse with
back extension activities. Back or reverse dives are often more painful.
Treatment of spondylolysis includes rest from diving, physical therapy to
improve flexibility and low back and core (trunk) strength, and possibly a
back brace. Athletes with low back pain for longer than 2 weeks should see a
doctor. X-rays are usually normal so other tests are often needed to
diagnose spondylolysis. Successful treatment requires early recognition of
the problem and timely treatment.

Disc injury may cause low
back pain that occurs with flexion—including pike and tuck dives. The
pain is usually worse on one side, extends into the buttock, and
occasionally down the leg. Disc-related pain can also occur with sitting,
lifting, jumping, and twisting. Successful treatment requires early
recognition of the problem and timely treatment.

Knee injuries

There are thousands of jumps in practice for
each dive seen in competition. Jumping causes pressure on the kneecap and
can result in pain in the front of the knee. Patellar tendonitis (also
called jumper’s knee) causes pain just below the kneecap. Treatment
requires identifying and addressing the causes of the pain.

The number of dives performed; dry land
training; poor flexibility; strength imbalances; and malalignment of the
hips, knees, and feet can also contribute to knee pain. Because corrective
shoes, orthotics, and knee braces aren’t practical while diving,
physical therapy, patellar taping, and training modifications are the
mainstays of therapy.

Other medical issues

Divers are at risk for a variety of medical
concerns as well, including

  • Swimmer’s ear and sinusitis from
    too much water in the ear

  • Ruptured eardrums from impact in the
    water and acute pressure changes

  • Cuts, scrapes, bruises, fractures, and
    head or facial injuries from hitting the board, platform, or pool
    deck

  • Sunburn or rashes from the sun

Remember

Diving injuries can be prevented when safety
guidelines are followed.