Shipboard Medicine for the Sailor

Cruising and racing have different concerns

Over the years, many cruisers (both sailors and power boaters) have reported their experience with medicine aboard ship in remote oceans of the earth. Although acute injury from trauma and lack of fitness is possible on any boat, the primary concerns for cruisers tend be focused on being in exotic locations far from help especially when cruising short-handed. For racers, the situation is more sports medicine based, with real risk of trauma under extreme conditions where the boat and crew are being pushed to the max.

Recently, there has been growing interest in the rigors of racing and the injuries that can result. Who can forget the solo sailor who performed surgery on himself on the high seas? But what about the racer who doesn’t go offshore? Until now, these issues were mainly taken up by healthcare professionals who happen to be sailors. A new review paper in the British Journal of Sports Medicine summarizes what has been studied and published to date.

Racing-related health concerns

Not surprisingly, injuries are not uncommon among racing sailors. They can happen as a result of lack of fitness, overuse, overtraining or trauma. Interestingly, the types of injuries most commonly sustained vary with the type of boat that’s being sailed along with a host of other factors, including the crew position. Unlike a sport played in a consistent environment like tennis or baseball, sailing also takes place under a variety of disparate circumstances – from inshore dinghy racing to offshore circumnavigations – and varying weather conditions making it difficult to characterize the risks.

Some generalities about risks to racing sailors can be made, however:

• On big boats, grinders and bowmen have the highest rates of injury, with back strain due to lifting sails or booms and repetitive position and motion while winching being most often at fault
• On small boats, knee, shoulder and back problems associated with hiking, sheet handling, and trapeze work take the greatest toll
• Fitness training is essential to maintain performance and reduce risk of injury, but overzealous sailing-related fitness training can also lead to off-water injuries
• Physiologic stresses are common, including erratic weight management, hydration, and nutrition
• Viral illnesses are common, spreading among teams members and competitors; other sailing related illnesses are those expected of outdoor water-borne activities including hyper- and hypo-thermia, sea sickness, sun overexposure
• Trauma (cuts and bruises) are three times more common in male sailors than in female sailors and far more common among dinghy sailors than keelboat racers.
• Mental health can affect any sailor, especially after-race recovery and exposure to extreme conditions for distance racers

The bottom line is that there are risks in racing. To reduce those risks, sailors need to assess their boats, their crew positions, and their physiologic needs and develop a reasonable training program that will develop the body strength, agility and physiology to reduce the risks and enhance performance. And they have to stay on the boat and avoid the boom!

To read the full review by JB Allen and MR De Jong (Br. J. Sports Med. 2006; 40:587-593), please download the pdf here.

Cruising-related health concerns

Several wilderness medical specialists have written guides to medicine for the cruiser; after all the ocean is the ultimate wilderness. Anyone who crosses an ocean needs to understand that there are inherent risks involved. The primary risk is being far away from help when illness and injury occurs, so the primary emphasis is on prevention and self-sufficiency at sea. To assist, multiple services that provide radio and internet based medical advice from qualified shore-based physicians have become available. These are highly regarded and are in use by the shipping and cruise industries, as well as long-distance racers and cruisers.

Obviously, cruising in local waters is not as dangerous as crossing oceans, but you still may be a long time away from medical assistance if an acute illness or injury occurs. Many of us often sail short-handed which comes with its own set of variables, including lifting and boat handling issues in challenging weather conditions. That’s when it pays to have some first aid training. Every sailor should take a Red Cross First Aid and CPR course. At least you’ll be able to provide immediate assistance and relay the nature of the problem to authorities when you call for help. There are some things that we all should be prepared to handle:

• Recognize signs of hyper- and hypothermia and know what to do
• Clean and bandage a wound
• Support a broken limb
• Assess an unconscious victim
• Deal with seasickness, sunburn, and heat stroke

At least the physiologic and psychological stresses may be minimal (on most boats that is). Cruisers tend to relax a little more than racers. Nevertheless, on long passages a different set of psychological variables sets in and you may discover just how well you and your crew really get along.

A few years ago, Beth Leonard wrote about the experiences that she and her partner had with illness and injury during a circumnavigation. She wrote in Cruising World, “The medical log from our three-year circumnavigation shows that, while we were almost completely untroubled by colds and flus, we faced a much higher incidence of infections and allergic reactions.” Beth worked with a physician to assemble a medical kit for her chosen itinerary.

Download The Ship’s Medicine Chest and Medial Aid At Sea

Daria and Alex Blackwell are the authors of “Happy Hooking – The Art of Anchoring.” It covers every aspect of anchors and anchoring in a fun and easy to read format with lots of photos and illustrations. It is available from good chandleries, Amazon & CoastalBoating.net in print and Kindle format.