This article is the final piece in our three-part series on shallow water blackout that we have published to raise awareness of the issue and help prevent further tragedies from occurring. If you haven’t already done so, please read Part 1 and Part 2.
Education and awareness are the best ways to prevent pool-based shallow water blackout from happening in the first place. USA Swimming, Swimming Australia and organizations such as the American Red Cross, the YMCA, Shallow Water Blackout Prevention, and the Aquatic Safety Research Group have been proactive in their efforts to warn of the dangers of hyperventilation and prolonged breath holding. And yet, deaths from shallow water blackout still occur. What can the competitive swimming community do towards preventing shallow water blackout on a daily basis? And, given that hypoxic training is regularly practiced by swimming teams around the world, where should we draw the line?
Providing useful information is the first step towards prevention. Swimmers, parents, coaches and aquatic staff need to be aware of the dangers of hyperventilation and/or prolonged breath holding and the mechanics of how shallow water blackout occurs. Emphasis should be placed on prohibiting breath holding practices without guidance and direct supervision, including hypoxic training drills both above and under the surface of the water. Aquatics directors should provide sufficient education on shallow water blackout to their staff, and consider posting signage around the pool prohibiting voluntary hyperventilation and prolonged breath holding. Both aquatics staff and parents should discourage their swimmers from engaging in deceptively innocent breath-holding contests or sitting at the bottom of the pool for long periods of time, and be extra vigilant in their supervision of the pool.
In the competitive swimming arena, hypoxic training remains widely-practiced worldwide and, since swimming underwater does play an essential role in the sport, it would be difficult – and impractical – to ban the practice altogether. Instead, coaches might consider having their swimmers practice more conservative hypoxic training methods. For example, drills that are practiced on the surface of the water are less risky than those during which the swimmers are completely submerged. Indeed, USA Swimming’s recent Safety Training for Swim Coaches program advises that hypoxic training should only occur on the surface of the water. If the hypoxic training drills are underwater, they should be practiced without hyperventilation, with sufficient rest in between sets and swimmers should not be encouraged to resist the urge to breathe. Jack Fabian, head swimming and diving coach at Keene State College, indicated in a Skype interview that while he does use hypoxic training methods to develop his swimmers’ abilities underwater, he never penalizes the swimmers if they are unable to complete the set. This type of approach ensures that swimmers can develop their capacities as competitive swimmers in a controlled environment without pushing their limits to the point of danger.
Swimmers must be instructed to avoid practicing hypoxic training drills on their own, even if lifeguards are present. Practicing breath-holding exercises without direct supervision seems to have played a key role in the deaths of NBAC’s Louis Lowenthal or aspiring military hopefuls Bohdan Vitenko and Jonathan Proce, despite the presence of lifeguards. As Coach Shoulberg relates, “…a kid will, for example, brag after practice that they were able to hold their breath for 70 yards underwater. Another kid will try to match that by holding for 72 yards and will die after having just completed 48 yards. Swimmers should never, ever be unsupervised, whether practicing breath-holding exercises or not”.
Although the aquatics community has been increasingly proactive in terms of educating and informing of the dangers of shallow water blackout, that will never be enough so long as deaths continue to occur. The risks are very real. As coaches, swimmers, parents, lifeguards and even spectators, we need to do our part in raising awareness of and preventing shallow water blackout within our own spheres of influence. Coach Fabian proposed that one solution to decreasing the risks of shallow water blackout would be for the coaching community to join together in finding safer ways to increase swimmers’ breath-holding abilities without putting the swimmers at risk. “If coaches all knew about the risks, they could join forces and experiment with different ways to improve swimmers’ level of performance without putting their swimmers in danger”. This is indeed sage advice to be strongly considered going forward.
As Vasa’s Rob Sleamaker indicated in a recent interview on shallow water blackout featured on SwimSwam, “It’s clear that with proper education, and by making informed, positive shifts in current training methods, the tragedies associated with shallow water blackout can be reduced dramatically, if not eliminated completely. If these efforts manage to save lives, then we have achieved something of value that no words could ever describe.”
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