Handle with care

Sunday 14 February 2010, 17:30 GMT

The Volvo Ocean Race is extremely tough - tough on the boats, tough on the shore crew and physically tough on the race crews.

I have been medical advisor to the race for 20 years, initially when it was the Whitbread and now in its most exciting guise in 70-foot weapons. Always the question needs to be asked: does the race impose unnecessarily harsh conditions on the crew?

The race organisers are always trying to tread the fine line of regulating safety without dumbing-down the race, but there is also a part to be played by the designers, skippers, and the teams themselves.

On the medical side, we have always maintained that the human performance aspect is an untapped edge that crews have not grasped. Correct decisions during the race are vital for success, and injury prevention needs to be combined with good nutrition and prevention of fatigue.

They sit alongside good weather information and design input to the sail wardrobe.

The teams seem to insist on regulation and rules to ensure that obvious safety and functional features on the boat are in place before installing them.

Designers and skippers need encouragement to understand the human cost if injury occurs. One key helmsman down out of only three in heavy air, and performance is compromised for hours.

And, what do we mean by injury? This covers the more obvious physical damage from being thrown around the boat, to aspects including elbow bursitis (painful swelling on the tip of the elbow) caused by having to crawl along a narrow space using knees and elbows to reach the navigation station; dehydration and abdominal pain because the toilet is not ergonomically friendly and too awkward to use; and chronic fatigue because sleeping is not comfortable enough in cot berths which may not be matched to an individual's height.

On deck, the crews are clearly even more exposed to the force of the elements - in particular the green walls of water sweeping over the deck.

We know very well how much back pain features in most of the crews due to a survey following the 2001-02 race, where we sent all the crews a questionnaire.

Back pain was the second most common medical complaint. It is hard to measure the value of a physio, but we need to make it clear to all the benefit of team medical support.

This measure alone for back pain should make the case. A further message relates to training for the medic. For the next race a more formal education programme for the medics is envisaged, but there is no substitute for practical experience.

Should the boats be more protected, such as with a canopy over the hatch as seen on the Open 60s? A difficult question, but the gauntlet should be thrown down to challenge the designers to improve human performance and minimise injury.

Stop the knee injuries resulting from being wrapped round the knife-edge of the dagger boards, stop the elbow injuries from crawling, stop the pain from fighting the steering wheel when there are not enough spokes to hold onto, and reduce the fatigue from being repeatedly washed into something hard. These are some of the challenges.

 The monocoque construction of the Formula One racing car was a huge innovation when developed. It may have been resisted, but now crashes at 180 mph are a walk-away phenomenon.

 This medical team has spent many post-race hours assessing the lessons learned and these will form the basis for future observations from the consulting room.

 Tim Spalding is a consultant orthopaedic surgeon and former chief medical advisor.

Full story published in the latest issue of Life At The Extreme magazine.