Neck muscle activity in skydivers during parachute opening shock.

This observational study investigated skydiver neck muscle activity during parachute opening shock (POS), as epidemiological data recently suggested neck pain in skydivers to be related to POS. Twenty experienced skydivers performed two terminal velocity skydives each. Surface electromyography quantified muscle activity bilaterally from the anterior neck, the upper and lower posterior neck, and the upper shoulders; and two triaxial accelerometers sampled deceleration. Muscle activity was normalized as the percentage of reference maximum voluntary electrical activity (% MVE); and temporal muscle activity onset was related to POS onset. Our results showed that neck muscle activity during POS reached mean magnitudes of 53-104% MVE, often exceeding reference activity in the lower posterior neck and upper shoulders. All investigated muscle areas' mean temporal onsets occurred <50 ms after POS onset (9-34 ms latencies), which is consistent with anticipatory motor control. The high muscle activity observed supports that the neck is under substantial strain during POS, while temporal muscle activation suggests anticipatory motor control to be a strategy used by skydivers to protect the cervical spine from POS. This study's findings contribute to understanding the high rates of POS-related neck pain, and further support the need for evaluation of neck pain preventative strategies.

The Situated Management of Safety during Risky Sport: Learning from Skydivers' Courses of Experience.

The aim of this study was to determine how risks associated with skydiving can be managed within acceptable limits. Using "Course-of-Action" theory described by Theureau, four experienced skydivers viewed recordings of their jumps, from preparation to landing, to elicit their perceptions of these experiences. The sequences dealing with safety concerns were then extracted. Data analysis revealed seven typical sequences of activity to manage safety, labeled "To check the material during preparation," "To feel prepared and safe for the jump as the plane gains altitude," "To use the time of freefall," "To deploy the parachute," "To fly safely," "To ensure a safe landing" and "To organize the structured packing of the parachute." These results showed how the skydivers mitigated safety risks through a heightened awareness of critical elements in the unfolding jump activity and sequences of distributed and timed concerns and actions. The implications for accident analysis, prevention and education for training in risky sports activity are provided. Key pointsThe skydivers' activity could be broken down into seven safety sequences.Each safety sequence was defined by specific involvements and directions at the very moment of the situation.Skydivers' safety concerns are embedded in the succession of two types of temporal horizon organization: immediate and short-term.

Contemporary Outcomes and Patterns of Injury Associated With Parachuting Accidents.

BACKGROUND: Skydiving is an increasingly popular recreational activity in the United States and worldwide. While it is considered a high-risk sport, the United States Parachute Association reported a fatality of .28 per 100 000 jumps in 2022. Although mortality rates are low, the true rate of survivable injuries is unknown. Injuries requiring hospitalization are not uncommon and may be underreported in the literature. Anticipating these injuries and analyzing short-term outcomes following parachuting accidents would be useful for the development of mitigation strategies and to increase the safety of jumpers. METHODS: A retrospective cohort review of 126 consecutive patients presenting to a Level II Trauma Center after skydiving accidents between 2016 and 2023. Patient baseline characteristics, patterns of injury, surgical procedures, and in-hospital outcomes were reviewed. RESULTS: A total of 126 patients were included. One hundred and seventeen patients (93%) presented immediately following the accident, 65 (51.6%) were trauma activations, and 14 (11.1%) patients experienced loss of consciousness. Fractures of the lower extremity occurred in 57 (45%), fractures of the spine 48 (38%), upper extremity 13 (10%), pelvis 11 (9%). Of the spinal injuries, 10 injuries occurred in the cervical spine, 16 thoracic, 22 lumbar, 5 sacral, and 3 coccygeal spine. Eleven patients (9%) suffered multilevel spine injuries. Mean injury severity score was 7 (range 0-75). A third of patients required at least 1 surgical procedure (n = 43, 34%). Median length stay was 2 days (IQR 1, 5). Of patients who survived to our trauma center, there were two mortalities, both due to catastrophic intracranial hemorrhage. DISCUSSION: Although the 30-day mortality rate for patient who presented to our trauma center is low, it can bear significant risks including major injury. The most common injuries were lower extremity and spinal in origin with a third of patients overall requiring at least one operation.

The ground is the limit: epidemiology of skydiving accidents over 25 years and in 2.1 million jumps in the Netherlands with sub-analysis of injuries reported by medical professionals in the past five years.

BACKGROUND: Skydiving is the fastest nonmotorized sport; and consequently is not without risk. In the last decades, skydiving has become considerably safer but injuries and fatalities still occur. Incidents are reported to and administered by the Royal Netherlands Aeronautical Association (KNVvL). From 1995 to 2020, 2715 incidents were reported; of which 1503 resulted in injury and 26 in fatality. There is a need for more information available on the particular type, severity, and factors which contribute to skydiving-related injuries worldwide. This study aims to investigate patterns in occurrence rates, examine demographic and skydiving-related factors linked to injuries, and analyze the types and severity of injuries relating to these contributing factors. METHODS: The Dutch KNVvL database - covering more than 25 years of data - was examined for contributing factors. An analysis of the severity and types of injury resulting from incidents over the last five years were matched with a search of hospital databases. RESULTS: The rate of injuries pattern increases starting from 2016, with novice jumpers having the highest risk of injury. Most injuries occur during the landing phase. The lower extremities and the spine are most affected, with fractures being the most prevalent type of injury. More than half of the patients were admitted to hospital, with 10% requiring surgery, resulting in months of rehabilitation. CONCLUSION: This study is the first in the Netherlands, and only the second worldwide to analyze technical incident databases in combination with data from medical information systems. Skydiving accidents of experienced jumpers should be considered as 'high-energy trauma,' therefore treatment should follow standard trauma guidelines. In less experienced skydivers, it is critical to conduct a secondary survey to assess the extremities adequately. Clinicians should also pay attention to friction burns that can arise due to friction between the skin and skydive equipment, a phenomenom that is already known in road traffic accidents.

Exploring jump experience, risk perception, anxiety and self-confidence in skydiving: A mixed methods approach.

Skydivers are required to interpret person-context characteristics to overcome inherent internal challenges (i.e., fear and anxiety) and external challenges (i.e., equipment malfunctions) to successfully perform. Research suggests that as skydiving experience increases, skydivers' self-confidence in their actions increases, while their perception of risk and anxiety decreases. However, there is a lack of research investigating the influence of experience and considerations of performance in extreme sports. This study examined the influence of skydiving experience on the interpretation of risk perception, anxiety and self-confidence. Participants comprised 503 experienced Australian skydivers (Mage = 40.10, SDage = 12.40; 79.5 % male). Using a mixed methods approach, skydivers completed measures of risk perceptions, anxiety, and self-confidence related to skydiving, as well as open-ended questions on their skydiving experiences. The findings indicated that increases in jumping experience led to greater self-confidence, and self-confidence mediated the relationship between all elements of jumping experience and cognitive and somatic anxiety associated with skydiving. Thematic analysis reinforced that skydivers understood the inherent risks associated with skydiving, and that skydivers adopted positive strategies that promoted self-confidence and mastery to perform successfully, while also managing their interpretations of risk and associated anxiety that potentially exists. Further research is needed to better understand the interpretation of person-context situations in extreme sports and recognize the important affordances for performance.

Recreational Skydiving-Really That Dangerous? A Systematic Review.

Skydiving have gained mainstream popularity over the past decades. However, limited data exist on the injury risk or type associated with skydiving. This systematic review evaluated the injuries and fatalities of civilian skydivers. A PRISMA-guided literature search was performed in MEDLINE, Web of Science, Cochrane Library, and Embase using the following MeSH terms: "skydiving" or "parachute" alone or in combination with "injury" or "trauma" was performed including all studies through June 2022 in both English and German. Additionally, injury reports from the German, American, and British Parachute Associations were reviewed. Of the 277 articles matching the selected search terms, 10 original articles and 34 non-scientific reports from various skydiving associations were included. More than 62 million jumps were evaluated, with an average of 3,200,000 jumps per year, which showed an average injury rate of 0.044% and an average fatality rate of 0.0011%. The most common injuries sustained by recreational skydivers involved the lumbar spine and lower extremities. Injuries were most commonly reported during the landing sequence. With modern equipment and training methods, fatalities occur in less than 1 per 100,000 cases, and serious injuries requiring hospitalization in less than 2 per 10,000 cases. This puts the assessment of skydiving as a high-risk sport into perspective.

Epidemiology of skydiving-related deaths and injuries: A 10-years prospective study of 6.2 million jumps between 2010 and 2019 in France.

OBJECTIVES: To analyse the data on skydiving deaths and injuries collected prospectively by the French Parachuting Federation (FFP) between 2010 and 2019. DESIGN: Prospective cohort study. METHODS: Data on number of skydiving deaths and injuries were collected prospectively between January 2010 and December 2019, among all skydivers licensed to the FFP, via a standardised report form that included the skydiver's sex and level of experience (classified as tandem, student, or experienced), deaths, injuries, and injury location. The number of licensees, jumps, skydiving deaths and injuries were analysed descriptively and expressed as rates per 100,000 jumps and per 1000 skydivers with 95% confidence intervals (95%CI). RESULTS: Among the almost 6.2 million jumps performed by 519,620 skydivers over 10 years between 2010 and 2019, 35 deaths and 3015 injuries were reported, corresponding to 0.57 deaths (95%CI 0.38 to 0.75) and 49 injuries (95%CI 47.0 to 50.1) per 100,000 jumps. Male skydivers had a five times higher deaths rate than women (RR=4.8, 95%CI 1.5 to 15.6). There was no death in tandem skydivers. Student skydivers had a six times higher risk of injuries than experienced skydivers (RR=6.1, 95%CI 5.7 to 6.6) and tandem skydivers had a significant lower risk of injuries than experienced skydivers (RR=0.07, 95%CI 0.06 to 0.08). 83.3% of the injuries occurred during the landing phase and 64.3% concerned the lower limb. CONCLUSIONS: This large survey shows that the highest risk of death concerned experienced and male skydivers, and the highest risk of injuries concerned student skydivers. It also shows the safety of tandem skydiving. These results can be of help to develop skydiving-related deaths and injuries risk reduction strategies, and thus improve the global skydiving safety and the skydivers' health.

Putting the flight in "fight-or-flight": Testosterone reactivity to skydiving is modulated by autonomic activation.

Sensation-seeking (SS) involves the tendency to pursue exciting activities, potentially including risky behaviors (e.g., substance use, risky sexual behavior). Testosterone is associated with cortisol, SS, and autonomic nervous system (ANS) functioning. Testosterone reactivity/recovery during sky-diving and its relationship to cortisol response, ANS response and SS were examined. Forty-four participants provided reactive saliva samples and autonomic activity data before, during and after sky-diving and as well as basal day saliva samples. Testosterone reactivity/recovery to skydiving was significantly greater than basal day measurements. Testosterone responsivity to skydiving was predicted by increased cortisol, increased sympathetic activity (heart rate) and reduced parasympathetic activity (RMSSD). Independent of physiological effects, increased SS predicted testosterone responsivity to skydiving. These data suggest that testosterone reactivity, and its relationship to ANS responsivity, may be associated with pleasurable responses to risky/intense situations. These data may be useful in developing novel intervention strategies for risky behaviors.

Hangman's Fracture Caused by Parachute Opening Deceleration Captured on Video.

BACKGROUND: Nonlethal cervical spine injuries in skydiving are rare due to the associated high mortality. Here, we report an unusual pathomechanism leading to a Hangman fracture in a semiprofessional parachute athlete. CASE DESCRIPTION: The moment of injury was captured on a first-person video and identified as a rough parachute opening deceleration during canopy deployment, caused by failure of the parachute inflation control device. Fractures of the C2 pars interarticularis with C2/C3 instability were treated by anterior cervical diskectomy and fusion, and the patient reached full recovery. CONCLUSIONS: Excessive deceleration during canopy deployment may pose a risk for life-threatening cervical spine injuries in skydiving.

Skydiving: The audiological perspective.

BACKGROUND:  Skydiving is a popular recreational sport for the young and old. There is minimal research pertaining to skydiving and its relation to the audiological system. The risks of skydiving in relation to the auditory system should be explored further. Aims: The main aim of this study was to explore the relationship between skydiving and audiology in South Africa. The sub-aims of the study focused on determining if skydivers were provided with safety precautions before they commenced with the dive, determining the middle ear pressure before and after the skydive and identifying the audiological symptoms that were present post-dive. This study also aimed at scrutinising the South African sports and recreation policy. Method: A mixed-method descriptive research design was utilised. Qualitative information pertaining to audiology was identified and recorded from the scrutiny of South Africa (SA) policy and the dropzone consent forms at two skydiving schools. Thirty-one skydivers were purposefully recruited to undergo a pre- and post-dive tympanometric assessment. Results: There is no information within the clearance forms that pertain to the audiological risks related to skydiving. There was a lack of information related to the risks of skydiving in the clearance forms at both dive schools. A statistically significant pressure change was noted in regular skydivers, regardless of the ability to equalise effectively during the skydive. Conclusion: This study identified the gaps in policy and clearance forms, highlighting the need for the inclusion of safety measures and risks in the documentation and legislation that governs the sport. Audiologists, sportspeople and medical advisors should be cognisant of the negative consequences that may be evident within the auditory system of skydivers.

Skydiving and the risk of cervical disc herniation.

The skydiving/parachuting sport which has recently gained popularity is also known for its accidents and injuries. However, there are a few studies related to its occupational ergonomic risks and occupational musculoskeletal diseases. It has been reported that the sudden hyperextension of the neck during the parachute opening, so called opening shock results in neck pain. It has been found that the jumpers are subjected to an average deceleration of 3-5 times the earth's gravitational acceleration (3-5 G) during parachute opening shock. It is considered that the spinal cord is destabilized by the impact of this force. This study presents the occupational cervical disc herniation occurring in the case of a subject who has been working as a skydiving/parachuting instructor for 25 years, and the ergonomic risks specific to the sports of skydiving. There is a requirement for systematic and representative studies related to the administrative measures to be taken in order to prevent the occupational diseases that may occur in the case of skydivers, the personal protective equipment to be used, and the employee. Int J Occup Med Environ Health 2018;31(2):243-249.

Características de composición corporal, ángulo de fase y agua corporal en paracaidistas chilenos de elite / Characteristics of body composition, phase angle and body water in elite Chilean skydivers

RESUMEN: Durante la práctica del paracaidismo, una deficiente composición corporal no sólo puede afectar el rendimiento deportivo, sino que, además, incrementa la probabilidad de sufrir una lesión o accidente grave. Conocer las características de sus componentes, podría ayudar a prevenirlas. El objetivo del estudio fue describir la composición corporal, ángulos de fase y agua corporal total en paracaidistas chilenos de alta competencia. Participaron del estudio 8 paracaidistas profesionales del Team Chile® (33,4 ± 4,9 años) con más de seis años de experiencia. La evaluación de las masas grasa, muscular, libre de grasa, magra y visceral, así como el ángulo de fase y el agua corporal total obtenida a través de impedancia bioeléctrica. Los deportistas presentaron un peso corporal de 76,7 ± 5,7 kg, estatura 1,72 ± 0,1 m e IMC 26,0 ± 1,9 kg/m2. La composición corporal promedio mostró un 20,6 ± 3,0 % de masa grasa, 44,9 ± 2,0 % de masa muscular y 79,4 ± 3,0 % de masa libre de grasa. El ángulo de fase promedio fue de 7,25 ± 0,33°. El agua corporal total de los participantes fue de 44,6 ± 3,2 1. Se concluye que los resultados obtenidos pueden ser utilizados por los profesionales de las ciencias del deporte como valores de referencia para el control de la composición corporal, fase angular y agua corporal en paracaidistas para optimizar el rendimiento deportivo y evitar lesiones.

SUMMARY: Unsuitable body composition in skydivers not only affect the sport performance but also could increase the probability of risk injury or severe accident; hence, to determine body composition characteristics could be helpful to prevent such events. This study aimed to describe body composition, phase angle, and total body water in highly trained Chilean skydivers. Eight Team Chile® professional skydivers (33.4 ± 4.9 years) with more than 6 years of experience participated in this study. Fat mass, muscle mass, fat-free mass, lean mass, visceral mass, phase angle, and total body water were measured by bioelectrical impedance. Skydivers had a bodyweight of 76.7±5.7 kg, a height of 1.72 ±0.1 m, and a body mass index of 26.0 ±1.9 kg/m2. Regarding body composition, they had a fat mass of 20.6 ±3.0 %, a muscle mass of 44.9 ±2.0 %, and a fat-free mass of 79.4 ±3.0 %. Phase angle and total body water were 7.25 ±0.3° and 344.6±3.2, respectively. The present findings could be useful to science sport professionals as reference values of body composition, phase angle, and total body water of highly trained skydivers to improve sports performance and avoid injuries.

Experience, cortisol reactivity, and the coordination of emotional responses to skydiving.

Physiological habituation to laboratory stressors has previously been demonstrated, although the literature remains equivocal. Previous studies have found skydiving to be a salient naturalistic stressor that elicits a robust subjective and physiological stress response. However, it is uncertain whether (or how) stress reactivity habituates to this stressor given that skydiving remains a risky, life-threatening challenge with every jump despite experience. While multiple components of the stress response have been documented, it is unclear whether an individual's subjective emotions are related to their physiological responses. Documenting coordinated responsivity would lend insight into shared underlying mechanisms for the nature of habituation of both subjective (emotion) and objective (cortisol) stress responses. Therefore, we examined subjective emotion and cortisol responses in first-time compared to experienced skydivers in a predominantly male sample (total n = 44; males = 32, females = 12). Hierarchical linear modeling (HLM) revealed that experienced skydivers showed less reactivity and faster recovery compared to first-time skydivers. Subjective emotions were coordinated with physiological responses primarily within first-time skydivers. Pre-jump anxiety predicted cortisol reactivity within first-time, but not experienced, skydivers. Higher post-jump happiness predicted faster cortisol recovery after jumping although this effect overlapped somewhat with the effect of experience. Results suggest that experience may modulate the coordination of emotional response with cortisol reactivity to skydiving. Prior experience does not appear to extinguish the stress response but rather alters the individual's engagement of the HPA axis.

State anxiety and cortisol reactivity to skydiving in novice versus experienced skydivers.

Previous studies have suggested that skydiving, a naturalistic stressor, is associated with increases in self-reported stress, anxiety and cortisol levels. However, it has not been established whether this stress reactivity is altered as a function of repeated exposure to skydiving. This is of interest due to previous observations that cortisol reactivity becomes habituated with repeated exposure to laboratory stressors, however, few studies have investigated such habituation to naturalistic stressors. State anxiety and cortisol reactivity to skydiving were measured in 11 first-time skydivers and 13 experienced skydivers (≥30 jumps, mean jumps=397.6), who were to complete a solo skydive. The novice skydivers reported significantly greater levels of state anxiety prior to the jump; however, there were no differences in pre-jump levels of salivary cortisol. Both groups exhibited significantly elevated salivary cortisol levels immediately post-jump, relative to i) pre-jump and ii) recovery. However, the two groups were indistinguishable with regard to their cortisol reactivity to the skydive. These findings support previous research demonstrating that skydiving elicits acute cortisol activation. Further, they suggest that i) cortisol reactivity does not habituate in experienced jumpers, and ii) that there is lack of concordance between self-reported levels of anxiety and biological stress reactivity in experienced skydivers.