A prospective analysis of injury rates, patterns and causes in Cliff and Splash Diving

Injury. 2017 Oct;48(10):2125-2131. doi: 10.1016/j.injury.2017.08.007. Epub 2017 Aug 5.


Introduction: Information about injuries and its differences in Cliff Diving (CD) and Splash Diving (SD) are unknown. It was the aim to analyse (1) injury rates, patterns and causes; (2) differences (in injuries) between both disciplines; and to (3) identify targets for future injury prevention interventions.

Methods: From April to November 2013, 81 cliff and 51 splash divers were prospectively surveyed with an encrypted, monthly e-mail-based questionnaire.

Results: During a total of 7857h diving with an average diving height of 13 (±7)m, an overall injury rate of 7.9 injuries/1000h of sport exposure was reported. Cliff divers most commonly suffered from injuries of the foot and ankle (18%; n=24) and neck and cervical spine (14%; n=19). In SD, the lower limb (52%; n=43) and lower back (23%; n=19) were most frequently involved. In 79% (n=49) of the cases, the injury happened while entering the water. Cliff divers were in 52% (n=15) of the injuries in a feet-first and in 14% (n=4) in a head-first position. Splash divers were in 45% (n=9) of the injuries in a back- or buttocks-first position. Most of the injuries were bruises (47%; n=104) and muscle strains (13%; n=28). The injury risk during practice was significantly higher than in competition (11.3 vs. 4.5 injuries/1000h; OR 2.5; p=0.001). The injury risk of experts (15.4/1000h exposure) was significantly higher than in professionals (6.3/1000h exposure; OR 2.4; 95% CI, 3.3-1.9; p<0.001), although the average diving height was significantly higher in professionals (19m±8 vs. 12m±6; p<0.001). Significantly more professionals performed dryland training compared to experts (p=0.006).

Conclusion: Most of the injuries are related to the water entry. The entry position plays a key role in injury patterns with pursuant differences comparing CD with SD. Although most of the injuries involved soft-tissue only, severe injuries have been reported. Targets for future injury prevention strategies include protection for the increased impaction at entry; adaption of the diving conditions in practice to those in competition; dryland training courses; and instruction of non-professional divers to teach appropriate diving techniques.

Keywords: Cliff diving; Epidemiology; Injury surveillance; Prevention; Splash diving; Sports injury.

MeSH terms

  • Adult
  • Athletic Injuries / epidemiology*
  • Athletic Injuries / etiology
  • Diving / adverse effects
  • Diving / injuries*
  • Female
  • Humans
  • Male
  • Prospective Studies
  • Stress, Physiological
  • Swimming / injuries*
  • Trauma Severity Indices
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / etiology
  • Young Adult