Incidence and prevalence of injuries and illnesses in competitive diving athletes – a systematic review

Abstract

Introduction: The Olympic sport of diving involves competitive disciplines of 3m springboard and 10m platform. The objective of the systematic review was to identify the incidence and prevalence of injuries and illnesses in competitive diving athletes. Methods: The review followed the PRISMA guidelines, and was registered with PROSPERO (#CRD42020157117). Five electronic databases (Medline, EMBASE, SportsDiscus, PyschInfo and Google Scholar) were searched on the 19th of December 2019. Studies were eligible for inclusion if they: (1) included competitive diving (springboard, platform) injuries and/or illnesses, (2) human participants, (3) full-text available, and (4) written in English. Studies were excluded if they (1) only included non-competitive diving populations (i.e. scuba), (2) recreational/community diving injuries or illnesses, (3) inclusion of other aquatic sport data without delineation from diving athletes’ data, (4) studies with the following research designs: reviews, opinion articles, abstracts, conference proceedings, and (5) less than sub-elite level of athlete. Two reviewers independently applied the eligibility criteria and performed the risk of bias assessment. The AXIS was used to assess cross-sectional studies, and a modified version of the NOS was used for cohort studies. Results were summarised into three tables: injury, illness, and case studies. No meta-analysis was completed due to the heterogeneity of study design and methodology. Results: The search identified 2,026 potential articles, with 24 studies meeting the eligibility criteria. Eleven cohort studies, three cross-sectional, and ten case series/studies were included. Competition-based surveillance periods were responsible for (10/15) injury, and (8/8) illness papers. Competition injury prevalence varied from 2.1% to 22.2%. Non-competition injury prevalence was reported as high as 85.7% for wrist pain and 89% for low back pain. Across all studies, injuries were most frequent to the shoulder, wrist, and lumbar spine. Illness prevalence ranged from 0.0% to 22.2%. The most frequent illness types were respiratory and gastrointestinal. Discussion: Injuries to the lower back, shoulder, wrist/hand are commonly reported in diving athletes. Diving athletes most likely experience low-back pain within 12-months of sports participation. Whilst competing, diving athletes incur changes to the lumbar disc and/or vertebrae. Diving athletes seem susceptible to illness during competition events. A publication bias was observed towards cohort studies from competition settings. Out of competition epidemiological data is required to inform prevention priorities. My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this abstract.