What you should know about the medical checkup for freediving:
- Why is a diving medical checkup needed?
- How do I find a qualified doctor?
- Does the diving medical checkup assessment need to be repeated?
- What does the examination look like?
- What are the costs?
- Under what circumstances are further examinations recommended?
- Are there special examinations for freediving?
- Diving and Covid 19?
- Which document do I need as proof?
Why do I need a medical checkup for freediving?
The purpose of the checkup is to find out from a qualified diving doctor (see point "How to find a qualified doctor") whether diving can be practiced safely based on the general condition and especially based on the condition of relevant organs and body parts such as lungs, ears, or heart (for more details see point "How exactly does the checkup look like"). The checkup is primarily preventive and serves to prevent diving accidents. Everyone should have an interest in having a comprehensive checkup before diving, which confirms a diving suitability.
No matter if fresh, salt or mixed water, we are diving in unknown and unfamiliar terrain. The same physical forces such as gravity or ambient pressure suddenly have a completely different effect on the human body. The term diving physics explains all possible laws and properties that work differently underwater.
Harmless physical conditions, such as a slight cold or a scratchy throat, can have a completely different effect on the human body at a depth of only a few meters with an increased ambient pressure underwater - sometimes causing permanent damage.
At a depth of 10 meters, the air volume is already reduced by 50%. This means that an average lung volume of 6 liters of air is reduced to 3 liters in a few seconds. This means that the absolute pressure difference is greatest in the first 10 meters. Especially when freediving with only one breath before the dive, the pressure has an intensive effect on the body and especially on the ears, sinuses, the inside of the mask, lungs and chest.
Not to mention the different behavior of the human physiology under water, we are mentally accompanied by all kinds of emotions when we dive down and ascend again. The range of emotions is very wide and can range from the greatest joy and bliss to slight discomfort, stress or even fear in challenging situations. Suddenly cool to cold temperatures as well as increasing darkness underwater, which we often encounter in domestic waters, together with the exploration of new depths, lead to new unknown impressions for each individual.
In addition to your own safety underwater, participation in a variety of activities during freediving requires a positive assessment of your suitability for diving.
Possible activities that require a medical checkup:
- Participation in a Freediving course,
- Access to a deep pool such as Y40 or Deepspot
- the participation in a national or international competition (e.g. national the Swiss Deepdiving Championship, the Swiss Pool Freediving Championship, or internationally for ex. a competition organized by AIDA)
How do I find a qualified doctor?
Legally speaking, a certificate can be obtained from any general doctor. Legal protection is important and often a prerequisite for e.g. participating in a Freediving course.
However, an accurate health assessment by a qualified doctor should be considered at least as important. It is really important to consult a physician who is trained in diving medicine. Specific expertise is usually not available from other doctors.
The Gesellschaft für Tauch- und Überdruckmedizin (GTÜM) has put online a list of explicitly certified diving physicians for the countries CH (via the Swiss Society for Underwater and Hyperbaric Medicine), AT (via the Gesellschaft für Tauch- und Hyperbarmedizin) DE, IT, LUX, GB, ES and NL.
Via the DAN website, you will also find valuable information about DAN Medical Team physicians, information about the Diving Accident Hotline, and the other areas of responsibility of the Medical Team.
We have had good experiences with the following doctors near Zurich:
- Dr. med. Danielle Gyurech & PD Dr. med. Julian Schilling Travel Clinic Forchstrasse 92, 8008 Zürich +41 44 380 36 36, https://g.co/kgs/vwAmKm *Discount for Kaluna Freediving Tribe - drop us an E-Mail!
- Dr. med. Daniel Blickenstorfer, Fuhrstrasse 15, 8820 Wädenswil, 044 780 17 27, firstname.lastname@example.org, https://goo.gl/maps/5kyMTxsWdavjQgEy8
If you have questions that go beyond the normal scope of an examination, we can recommend to get in touch with a true luminary in the field of diving medicine from Innsbruck:
- Ltd. OA Dr. Frank Hartig. Universitätsklinik Innere Medizin I, Anichstrasse 35, A-6020 Innsbruck, email@example.com, +43-512-504-27057, www.i-med.ac.at/notfallmedizin/, www.tauchmedizin-tirol.at
Does the medical checkup have to be repeated?
Yes, depending on whether the diver is a professional or a hobby diver, the diver must repeat the assessment annually or every two to three years. Individual organizers have different requirements for the validity of the diving suitability. In case of doubt, it is worthwhile to find out in advance what the exact requirements of specific organizers (e.g. Y40) are.
If you want to take part in competitions, you need a diving fitness certificate, e.g. an "AIDA MEDICAL STATEMENT" filled out and signed by a doctor (see below under "Which certificate do I need for Freediving?"). This certificate of fitness to dive must not be older than one year.
After a diving accident or other physical impairments that could be relevant for diving, the diving fitness should be re-assessed by a diving physician.
What does the medical checkup look like?
- unrestricted physical and mental capacity as well as complete autonomy (vs. child diving or diving for the disabled)
- Ability to assist your dive buddy in an emergency
What exactly is behind the prophylactic sports medical checkup in Switzerland, you can find with the following link "Diving fitness initial examination".
After inquiring with doctors in Switzerland and Austria, the examination includes an anamnesis/questioning of the patient, a clinical examination, in many cases a monaural ECG, and a small lung function test (spirometry). A stress ECG can be recommended from a certain age. This depends on the assessment of the physician. An X-ray of the lungs is hardly ever part of the normal examination, even from the age of 50. If specific questions arise, further examinations may be considered.
What are the costs?
Costs of the basic examination in Switzerland: depending on the effort involved, between 160 - 200 CHF
Duration: approx. 45-60 min
Under what circumstances are further checkups recommended?
I have asked further. If your medical history or special examination findings (e.g. an unknown heart murmur) indicate possible illnesses which could potentially be a problem during diving or could lead to a subsequent problem, then further examinations are necessary.
The costs of further examinations vary very much, but are usually covered by the health insurance, because it is no longer a hobby checkup, but a clarification of a (potential) disease.
Are there any special checkups relevant for Freediving?
According to professional societies, the examinations are the same as those of recreational diving. This can be confirmed by the doctors I spoke with.
I received a somewhat differentiated answer from Dr. Frank Hartig, senior physician of internal medicine at the University Hospital in Innsbruck. "According to professional societies, there are no special further examinations for apnea diving. However, in recent years a simple and elegant method has emerged. We always do the lung function and the measurement of oxygen saturation three times. At rest, after a short and intensive exertion (usually achieved by burpees or rope skipping) and after 15min after exertion. This way we can examine the function of the bronchi more dynamically".
Diving and Covid 19?
If someone has tested positive for Covid 19 or is suspected to have tested positive for Covid 19, it is imperative to seek further medical advice.
In general: If an infection is detected, you are not allowed to dive for 3 months after the end of the illness. After this period a diving fitness assessment must follow.
Even if the patients feel completely healthy again, the observations of Dr. Frank Hartig have shown that the lungs are very badly damaged in some cases after a Covid 19 disease.
"If these patients had trusted their subjective feeling of health and had gone diving, this would probably have been their last dive". Write Dr. med. Christian Wölfel and Dr. med. Martin Kraus in the September 2020 edition of “taucher revue” (p. 48-53, 09/2020).
SUHMS has developed a questionnaire for divers at Corona suspect which can be accessed online here or via smartphone.
What certification do I need for Freediving?
General physicians may issue a different certificate than qualified diving physicians, who follow a uniform certification format depending on the country through a society (such as the Swiss Society for Underwater and Hyperbaric Medicine, the Society for Diving and Hyperbaric Medicine (GTÜM) Germany, or the Society for Diving and Hyperbaric Medicine Austria).
Unabhängig davon hat das “MEDICAL CERTIFICATE: FITNESS FOR RECREATIONAL SCUBA DIVING” vom SUHMS (hier empfehlen wir, die Anmerkung “Freediving” hinzuzufügen) oder das “AIDA MEDICAL STATEMENT” einen universalen Charakter. Du kannst diese in jedem Fall als Nachweisdokument für deine Tauchtauglichkeit zum Freitauchen für die folgenden Aktivitäten gebrauchen:
Regardless of this, the "MEDICAL CERTIFICATE: FITNESS FOR RECREATIONAL SCUBA DIVING" from SUHMS (here we recommend to add the note "Freediving") or the "AIDA MEDICAL STATEMENT" has a universal character. Bring one of these documents with you to your appointment with a qualified diving physician.
You can use it in any case as a proof document of your fitness for freediving for the following activities:
- Courses, workshops, Freediving vacations like the "Swiss Deep Week" in Sharm el Sheik
- Competitions (validity 1 year),
- or for entry to deep pools such as the Y40 or Deepspot
Appendices: Documents & Sources
- Peter Nussberger: Tauchmedizin – ein Überblick. (PDF; 676 kB) In: Schweiz Med Forum, 2007, 7, S. 990–993; abgerufen am 17. Juni 2011
- Tauchtauglichkeit. GTÜM e. V. – Geschäftsstelle BG-Unfallklinik Murnau; abgerufen am 17. Juni 2011
- Interviews mit: Prof. Dr. med. Christophe Wyss von der HerzKlinik Hirslanden, Zürich, Schweiz; Ltd. OA Dr. Frank Hartig von der Universitätsklinik Innere Medizin I aus Innsbruck, Österreich; Dr. med. Daniel Blickenstorfer, Allgemeine Innere Medizin FMH, Ärztehaus Fuhrstrasse 15, Wädenswil, Schweiz
- Wikipedia “Tauchtauglichkeitsuntersuchung”: https://de.wikipedia.org/wiki/Tauchtauglichkeitsuntersuchung#cite_note-Tauchtauglichkeit-6