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Prevention of Diving-Related Spinal Cord Injury

A decade's worth of Shepherd Center statistics shows diving has historically been the fourth leading cause of paralyzing spinal cord injury among patients treated at the rehabilitation hospital.

These injuries are also among the most preventable.

Now, thanks to the efforts of Shepherd Center physician Herndon Murray, M.D., and the hospital's injury prevention program, Shepherd Center has seen a dramatic reduction in the past 18 months in spinal cord injuries caused by diving.

Diving is simply not worth the risk, Dr. Murray says. The only safe dive is the one you don't take. Listen as Dr. Murray explains the injury prevention program and why diving is such a dangerous activity.
Prevention of Diving-Related Spinal Cord Injury
Featured Speaker:
Herndon Murray, MD
Herndon Murray, M.D., medical director of Shepherd Center's Spinal Cord Injury Program, is board certified by the American Board of Orthopaedic Surgery. He is a graduate of the University of Georgia and Tulane University. He completed his orthopaedic training at Georgia Baptist Hospital, Scottish Rite Children's Hospital, and Rancho Los Amigos Hospital in California.

Dr. Murray is a member of the American Spinal Injury Association, the Medical Association of Georgia, the Georgia Orthopaedic Society and the Medical Association of Atlanta. He is also a clinical instructor of the division of orthopaedic surgery at Emory University.

Dr. Murray was recently named to U.S. News & World Report magazine's Top Doctors list.

Melanie Cole (Host):  A decade’s worth of Shepherd Center statistics show diving has historically been the fourth leading cause of paralyzing spinal cord injury among patients treated at Shepherd Center. These injuries are also among the most preventable. My guest today is Dr. Herndon Murray. He’s the medical director of Shepherd Center Spinal Cord Injury Program. Welcome to the show, Dr. Murray. Tell us a little bit about diving. Why is this such a dangerous thing to do and it causes so many injuries? 

Dr. Herndon Murray (Guest):  Well, I think the public has been unaware of the epidemic of spinal cord injuries we see at Shepherd every summer for diving. For example, in 2011, we had 28 diving injuries at Shepherd. They’re usually young people in spinal cord injury rehabilitation because they’re quadriplegic because they dove into water. 

Melanie:  Wow. This is really something that people don’t even think about and it’s preventable. Tell us a little bit about some of those statistics and what people can do to avoid this completely. 

Dr. Murray:  Well, very briefly, 90 percent of the injuries were in young men. Girls are obviously smarter than boys are in this regard. The predominant age group is teenagers to 20-year-olds. It happens during the summer in Atlanta—June, July, and August. Surprisingly, one-third of the diving injuries happened at the beach, where someone would run, dive headfirst into the waves. That surprised even us. 

Melanie:  That certainly is unexpected, to think that just a shallow dive, like you’re diving into the waves at the beach, could be something that causes such a severe injury. What else are some of the causes? 

Dr. Murray:  Well, we’ve started a prevention program to make people aware that diving is a high-risk activity and any single dive can potentially result in a lifetime of paralysis. There’s an alarming lack of awareness of the dangers of diving headfirst into any body of water. 

Melanie:  What would you like the public to know about avoiding a diving injury altogether? 

Dr. Murray:  Well, we think this is an entirely preventable catastrophe, and our message is don’t dive. Go into water feet first every time. Break a leg, not a neck. In fact, it seems to be having some effect. Last year, in 2014, we were down from 28 diving injuries down to 10. And more strikingly, we had zero diving injuries in the State of Georgia last year. In 2011 and 2013 combined, we’d had 13. I think the message is getting out there not to dive, go in the water feet first, don’t break your neck. 

Melanie:  When you dive, your body is like a torpedo, Dr. Murray. When you jump in, is it a similar effect or is there more of a bigger base that slows you down a little bit? 

Dr. Murray:  No, same effect. What we want is for someone to go feet first so if they do hit something unexpectedly, it will break their leg. Because if they’re going in feet first, it’s going to break their neck and they’ll be paralyzed. You can recover from a broken leg. It’s hard to recover from a broken neck. 

Melanie:  Dr. Murray, you’re saying do not dive. Go in feet first, but parents listening might say, “My son wants to get on the diving team at school.” Is diving for sport different than what you’re discussing? 

Dr. Murray:  I think if you are in a controlled environment, in a school or other pool that has swimming and diving coaches present and you are working on a goal to be on the diving team or the swimming team, I think that is totally acceptable. I will say that Japan had so many diving injuries in their schools that they did restrict all diving in their schools and just about wiped out spinal cord injuries in Japan. 

Melanie:  Really? That is definitely something for parents to consider if their children want to get on the diving team is that Japan eliminated this and their spinal cord injury rates from diving have dropped. 

Dr. Murray:  I will say that we’ve never had a spinal cord injury from a dive that was supervised in a pool or coaching type setting. Our injuries occur in swimming pools, rivers, creeks, lakes, oceans that are not supervised by a coach. I don’t believe we’ve ever had one. Well, I can say, we’re certain we’ve never had one that a diving or a swimming coach was present for. 

Melanie:  Tell us a little bit about the injury prevention mission of Shepherd Center. 

Dr. Murray:  Well, what seems to be the two most effective prevention programs are involving young schoolchildren and letting them hear from a young person who was injured diving—in other words, a peer—that is now at a wheelchair permanently. All the studies are showing that what the kids will remember most is the presenter when it is one of their peers. They won’t listen to me. They probably won’t listen to you. But if they hear from a kid their age that did dive and regrets it and wishes he had never taken that dive, that really sticks with them. The other thing is mass media exposure, such as hopefully we’ll get today, to make people aware of this. When someone comes in from a small town or out-of-town and has had a diving injury, we try to get it publicized in the local area with the newspaper, the radio, Facebook, et cetera, and let everybody know that somebody from their hometown got hurt diving. That emphasizes the danger of diving. 

Melanie:  It’s so interesting that you use patients to help make these children aware because the risky behavior, the risk-taking behavior especially, as you stated, in teenage boys, they feel immortal. If they’re on the swim team, Dr. Murray, then they feel sometimes that they are even more less at risk for this because they’re such a good swimmer that it wouldn’t happen to them. Is that something that is discussed, that these patients were on swim teams as well and that doesn’t preclude you from this injury? 

Dr. Murray:  Well, I don’t recall any of them as elite athletic swimmers. Most of these are casual diving injuries. Maybe the swimmers are more aware of the dangers of diving, but not really happening very often in elite swimmers. 

Melanie:  In just the last few minutes, if you would, give your best advice. Tell the listeners, the parents listening that have children that go out to the beach and go to the local pools and go to lakes around them and that might consider this risk-taking behavior that could alter the course of their life. 

Dr. Murray:  Well, obviously you want to direct the message to teenage boys. But since teenage boys don’t listen to anybody, we also have to include their parents, their girlfriends. We want the girlfriend to say, “Joe, don’t dive in that creek. I know you’re handsome and I know you’re wonderful, but don’t dive in there.” We want the teenagers now, as they get older and they start having children, this is going to be like seatbelts and bicycle helmets. Nobody jumped on the bandwagon right away, but there’s been a slow evolution in using bike helmets, using seatbelts, and I hope that as these kids grow older, they’ll have it ingrained in their minds not to dive. 

Melanie:  It’s truly so dangerous and there’s an injury prevention mission at Shepherd Center. To learn more about that, you can go to That’s Thank you so much, Dr. Herndon Murray. You’re listening to Shepherd Center Radio. This is Melanie Cole. Have a great. Thanks so much for listening.