Previous injuries and DCS threat

[JT2]

I have heard several dive professionals state that you are at greater risk of suffering a "hit" if you have had bone and joint injuries in your life than someone who hasn't. As someone who has a medical chart similar to Evil Kinevil, I am very interested in what the thought is behind this. I have broken over 30 bones in my body, had surgery on both knees, wrists and feet, and have suffered spinal trauma twice, yet I have never had any ill effects from diving, as a matter of fact it is quite the opposite in that a lot of times when I go diving I get relief from some of the most nagging body pains I have, especially in both of my Clavacles which have been broken a few times each. Have there been any studies done to determine which causes the greatest problem, the bone injuries, or the joint injuries?

 

[BillP]

Howdy JT2:

There's been some discussion on the board recently about the difference between theoretical concerns in diving and practical concerns. Your question kinda falls into that category.

The idea behind the concern about injuries and DCS is that a significant injury with resultant scar formation might affect blood flow to the injured area. If nitrogen has a hard time offgassing from a scar the diver theoretically would have an increased risk of developing DCS in an area of old injury.

In practice I would predict that you will not only be unable to find a single study comparing whether bone or joint injuries cause more problems with DCS, you will also be hard pressed to even find any published case reports of DCS specifically related to a healed bone or joint injury. It appears to be that uncommon.

Both certain kinds of bone fractures and commercial/military diving can be associated with a bone injury called osteonecrosis (bone death). But dysbaric osteonecrosis (osteonecrosis due to pressure) is almost unheard of in recreational divers, and I have not seen where a previous fracture that is not associated with osteonecrosis would disqualify a diver from commercial diving.

You can read more about fractures and diving on DAN's website at:

http://www.diversalertnetwork.org/medical/faq/faq.asp?faqid=140

and on Scubadoc's website at:

http://www.scuba-doc.com/divfract.html

I would think that the recommendations there would apply in general to joint injuries too.

HTH,

Bill

The above information is intended for discussion purposes only and is not meant as specific medical advice for any individual.

 

[JT2]

Thanks for the info and the link.