Physical training of combat diving candidates: implications for the prevention of musculoskeletal injuries.

Physical training (PT) is a significant component in the operational preparation for Canadian Forces (CF) combat divers. However, in developing the various components of a PT program, consideration must be given to the potential for increasing the risk of injury. Indeed, all PT programs should incorporate components that minimize risks of injury, thereby attempting to prevent injury. This report identifies high-risk activities associated with PT during a CF Combat Diving Course and contains recommendations for PT modifications. Major high-risk activities identified were: inappropriate exercises, errors in exercise prescription, particularly in intensity and duration and incorrect lifting methods. From a specificity of training perspective, there is little support for the incorporation of 'dry land flutter kick' (i.e., repetitive, unsupported alternating straight leg raises), or high repetitions of push-ups, sit-ups and chin-ups in the training of CF combat diving candidates. Excessive use of these exercises, as performed during training, pose a high-risk for injury and are not recommended.