The mission? Bring practitioners up to speed on the many methods we’ve invented to wreck ourselves, so they can be prepared when they wheel in another human pretzel in a helmet.
The mission? Bring practitioners up to speed on the many methods we’ve invented to wreck ourselves, so they can be prepared when they wheel in another human pretzel in a helmet. (Photo: James Brunker/TandemStock)

19 Lessons I Learned from Extreme Sports Pros

The third annual International World Extreme Sports Medicine Congress confirmed our collective willingness to wreck ourselves in pursuit of stoke

The mission? Bring practitioners up to speed on the many methods we’ve invented to wreck ourselves, so they can be prepared when they wheel in another human pretzel in a helmet.
James Brunker/TandemStock(Photo)

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Global experts on how outdoor athletes stumble, trip, twist, crash, snap, pop, tear, and occasionally croak in hard-to-reach places convened in Boulder this month, courtesy of the University of Colorado’s sports medicine department. The mission? Bring practitioners up to speed on the many methods we’ve invented to destroy our bodies, so they can be prepared when they wheel in another human pretzel in a helmet. Here’s a primer.

Deep Diving

At a depth of 30 meters, a diver’s lung volume is a quarter of what it is at the surface and, like a sperm whale, continues to compress the deeper you go. For a dive of 100 meters, your tank is a complicated mix of gases that’s only 10 percent oxygen. If you breathed that same air at the surface, you’d die. Dive deeper than 400 feet and you need a battery of tanks with specific gas mixture recipes. Get it wrong and you die. All of which is why, while 100-meter dives are now routine, only three people have dived deeper than 800 meters and lived.

Heard: “With freediving, consciousness is the key to success.”

The Velodrome

The biggest risks for track cyclists are to the clavicle and wrist, thanks to what the Brits call “argy-bargy,” the elbowing and headbutting employed to fight for position in a sprint. Also, track cyclists have a hard time buying pants.


Fifty-two percent of climbing injuries are to the fingers.

Seen: An image of a “sheathed” finger was presented, in which all the skin and much of the meat from a central digit were unrolled past the knuckle and tucked up by the fingertip like a baggy knee warmer.


Horses are prey animals, so when a predator climbs on an unbroken horse’s back, the horse gets scared and flips over to try and squash it. Other common rodeo injuries include being stepped on hard enough to rip paisley and crack ribs, blowing an ACL while wrestling a steer to the ground, suffering an “open book pelvis” fracture from sliding forward on the spine of a thousand-pound beast, and a new one, thanks to helmet use: When a bull’s horns strikes the helmet, it spins on the head, shredding ears like a juicer. A rodeo doc’s common refrain: “It hurts because it’s still broken, but you’re riding anyway.”

Heard: “We determined the patient was titanium deficient.”

Formula 1 Racing

The average Formula 1 driver is 5'9″ and weighs 145 pounds, withstands more Gs than a space shuttle astronaut, and will peg his heart rate at 180 beats per minute for two hours at a time. Shorter stature is a plus, because the head is the highest part of the car, but it’s still only three feet off the tarmac, where it’s exposed to deadly flying debris from wrecks.

Kite Sports

According to a crack team of European researchers, most deaths in kite sports are attributed to gusts.

Extreme Swimming

Three ways you might die:

1. You get too close to a cargo ship’s wake, which churned up cold water from below, causing hypothermia—and you drown.

2. You drink Gatorade instead of plain water on an open-ocean swim, and the excess salt in your system stops your heart—and you drown.

3. You forget to load buckets of blood on the chase boat to keep the piranha behind you. They catch up—and you drown.


An orthopedist once jumped from a plane, hit terminal velocity of 120 miles per hour, and deployed his chute, and the forces dislocated his shoulder. While avoiding “browning out”—it’s common to toy with a loss of consciousness when the canopy decelerates you—he popped (the technical term is “reduced”) his shoulder back into place mid-flight and landed safely.


Injury rates in racing are directly linear with speeds. The downhill is more dangerous than the super-G, which is riskier than the GS, and so on. That’s weirdly obvious to a layperson, but the slalom can be rough on knees, so it took some sussing out. Also: It took 20 years for researchers to prove that ski helmets reduce head injuries by 75 percent because the early adopters of helmets were more safety conscious than most skiers.

Heard: “Engineers are better than doctors because they fix problems, whereas doctors fix people hurt by problems.”

Endurance Sports

The medical brief for the Leadville 100 is 30 pages long, includes detailed descriptions about what to do in cases of acute mountain sickness and hyponatremia (too much water, too little salt), and helps responders know the client: Type A personality; fetish-like desire to finish.

Heard: “What happens when you tell a runner not to run? They find another practitioner.” (This joke killed it with the physical therapists.)

Olympic Ski and Snowboard Cross

At the Seoul Olympics, competitors suffered 14 season-ending injuries and four potential career-enders.

Heard: “I fixed the tar out of that clavicle.”

X Games

After a surgeon wired a freestyle snowboarder’s jaw shut, the athlete informed him that he was returning to competition. The problem? A subsequent crash could make him unable to breath. So the surgeon made him a necklace with miniature wire cutters as the pendant.

Heard: “These are not preferred postoperative management techniques.”

Seen: Video of motocross star Eli Tomac (the son of Mountain Bike Hall of Famer John) stuffing the front wheel of his machine so hard that the twisting action of the handlebars dislocated one shoulder to the anterior and the second to the posterior.

Heard: “Ooh.”

Mixed Martial Arts

“The main goal of MMA is to induce a head injury,” said a doc with mad jujitsu skills. On average, MMA fighters sustain 2.5 severe blows to the head—after they’ve been knocked out.

Field Management

A famed orthopedic surgeon with a background in wilderness medicine who has worked at Everest Base Camp once learned how to do a tooth extraction—via sat phone. “My Leatherman tool came in handy that day.”

Swimming with Naegleria fowleri

Head to a stagnant pool in Texas or Florida, drink the tepid water, and the brain-eating bacteria won’t bother you. Get a little of that water in your nasal passages, though, and you’re in trouble. That’s where the little amoeba passes through to the skull cavity and eats your brain. Symptoms show up one day to two weeks after exposure—and then you’re dead within three days. Naegleria fowleri has killed at least 300 Americans and is all over the otherwise deadly hot springs in Yellowstone. It’s also been found in Minnesota. “The CDC likes to say it’s rare, but it’s not,” says the doc who has helped raise awareness of the killer globally. “In Africa, thousands are dying from it, but the cause of death is misdiagnosed.”

Wilderness Medicine

Even the experts get it wrong. What one wilderness doc thought was a simple rash or possibly the shingles on the top of his foot was actually a horde of cutaneous larva picked up while playing beach volleyball on the banks of the Amazon.

Seen: An image of the little critters burrowing around.

Heard: “Eww.”


Forty-eight percent of yoga injuries happen to those under age 18. Teenagers and kids, Canadian researchers say, should not be doing yoga. So what then? Hockey?

First Aid

A new device called a REBOA holds the promise of saving lives from rapid blood loss. To use it in the field, simply insert a catheter into the femoral artery and up to the heart, where you occlude the aorta.

Seen: Full-screen image of a man with a stick as thick as a rattlesnake penetrating his neck.

BASE Jumping

Seventy-two percent of BASE jumpers have witnessed a death or a severe injury.

Heard: Reporter had to depart before the question “are BASE jumpers insane?” was resolved. But we’re going with “yeah.”

Lead Photo: James Brunker/TandemStock

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