After the Fall: Symptoms in Bungee Jumpers

Craig C. Young, MD; William G. Raasch, MD; Melbourne D. Boynton, MD

THE PHYSICIAN AND SPORTSMEDICINE - VOL 26 - NO. 5 - MAY 98

In Brief: A survey of 100 professionally supervised bungee jumpers who used an ankle harness in a single leap from a platform reveals that 42 jumpers had a total of 59 minor medical complaints or symptoms after their jumps. Immediate symptoms included musculoskeletal pain in the ankle, neck, back, and chest, neurologic complaints such as dizziness and headache, and blurred vision. Dizziness was the most common symptom, and neurologic complaints outnumbered musculoskeletal symptoms. All complaints resolved within 1 week of the jump except for lacerations sustained by one person who tried to grab the platform as he was jumping.

The inhabitants of Pentecost Island in the Pacific and members of some tribes in South America used to perform an initiation rite by wrapping vines around their ankles and leaping from towers (1). The modern version of this rite is performed by bungee jumpers tethered by an ankle or chest harness to elastic cords for leaps from cranes, balloons, bridges, water and radio towers, or other platforms. In the last decade, the popularity of bungee jumping has soared, and current estimates put the number of past and present jumpers at over 2 million (2).

Although a few fatalities have been reported in the popular press (3-7), the medical literature on bungee jumping consists primarily of case studies of ocular injuries (8-13) and two case reports of neurologic injuries (14,15). The purpose of this study was to determine the type and frequency of injuries reported by participants who used an ankle harness and jumped from a platform.

Methods

The study was conducted at the Wisconsin State Fair Park in Milwaukee in August 1994. The jump site was run by a professional bungee jumping company. Participants paid $59 to jump from a specially designed arch that had a jumping platform 130 ft from the ground. An attendant weighed each participant on two different scales and adjusted the length of the bungee cords accordingly. The cords were attached to an ankle harness worn by the participant, who then jumped from the platform positioned over a safety net. A private, fully staffed medical aid station on the fairgrounds provided healthcare for all fair events, including the bungee jumping.

A single observer, present for about 25 of the 100 hours available for jumping during the fair, recorded each jumper's body habitus, direction and style of jump from the platform, number of flips during the jump, and terminal angle. The terminal angle—low, moderate, high, or extreme (figure 1)—was defined as the participant's body position relative to the cord when the cord had straightened out but had not yet begun to stretch. Jumpers who had extreme or high terminal angles were whipped into a vertical position as they decelerated during cord stretching; those whose jumps ended in a low terminal angle had gradual deceleration forces in a single plane.

Each jumper was approached after completing his or her jump and was asked to participate in the survey. Those who agreed were asked to report any headache; visual problems; neck, back, chest, foot, or ankle pain; and bruises or any other medical problems resulting from the jump. Other data included the participant's age, gender, height, weight, number of previous jumps, amount of alcohol consumed before the jump, and reason for jumping. Each subject was contacted by phone 2 and 7 days after jumping to determine whether the reported symptoms had resolved or new symptoms had developed.

Results

A total of 354 individuals were observed to bungee jump; 154 were not interviewed because they finished their jumps while the observer was interviewing other jumpers. Of the 200 individuals who were asked to participate in the study, 100 agreed and completed all of the follow-up interviews.

Jumpers' characteristics. By body habitus, the jumpers included 24 ectomorphs, 66 mesomorphs, and 10 endomorphs. The average age of the subjects (74 men and 26 women) was 25.8 ± 9.4 years (range, 10 to 69 years). Their average height was 68.4 ± 3.8 in. (range, 59 to 76 in.), and average weight was 164.3 ± 34.1 lb (range, 95 to 235 lb). Eighteen had jumped previously—14 once and 4 twice. Forty-five had drunk alcohol prior to jumping; the average number of drinks was 2.8 (range, 1 to 9). Reasons given for jumping were excitement (78), dares (8), bets (2), and miscellaneous (13); some jumpers gave multiple answers and others none.

A forward head-first dive was the launching technique of 83 individuals, while 10 did a feet-first forward jump, and 7 did a head-first back dive by facing the platform and diving backward in an arc. Midplunge flips were performed by 7 people. The terminal angle was low in 31 jumpers, moderate in 34, high in 23, and extreme in 12.

Injuries. Forty-two jumpers reported a total of 59 medical complaints (table 1). Forty-nine complaints were reported in the immediate postjump period. All but 3 of the complaints had resolved by the second-day phone interview, but there were 10 new reports of musculoskeletal pain at that time. Dizziness was the most commonly reported symptom overall, and neurologic symptoms outnumbered musculoskeletal complaints. Dizziness accounted for 21 of the 28 reported neurologic symptoms, while ankle pain was the most common musculoskeletal symptom (12 out of 21). The only medical condition that had not fully resolved by the seventh-day phone call was the lacerations of one jumper who tried to grab the platform as he was jumping off it.

Table 1. Symptoms Reported After Bungee Jumping by 42 of 100 Jumpers Surveyed (58 Asymptomatic)
	Immediate Complaints		Complaints
Symptom	Total	Persisting >2 days	New on Day 2	Total
Musculoskeletal Pain
Neck	2	0	0	2
Back	2	1	1	3
Chest	1	0	0	1
Abdominal	0	0	3	3
Ankle	6	0	6	12
Neurologic
Headache	6	1	0	6
Dizziness	21	0	0	21
Leg numbness	1	0	0	1
Other
Blurred vision	7	0	0	7
Bruising	1	0	0	1
Anxiety	1	0	0	1
Lacerations	1	1	0	1
Totals	49	3	10	59

Each of the 12 types of medical complaints was statistically analyzed with a chi-square test with respect to jump style and direction, terminal angle, and body type. No statistically significant associations between any of the symptoms and variables were found. The feet-first forward jumping technique was associated with a slightly greater risk of injury, but too few individuals used this technique to determine if the association was significant.

Discussion

Although bungee jumping may seem like a death-defying act with high injury potential, this study shows that a jump, if performed under carefully controlled conditions, appears to be relatively safe and causes only minor, transient medical complaints. In many other activities that involve landing from heights, such as parachuting, pole vaulting, and diving, the participant is subjected to impact forces that can cause injury (16). However, the forces affecting a bungee jumper are minimized by the elastic restraining cords, which gradually absorb the gravitational forces on the jumper, thus reducing the risk of injury.

In previous reports, the majority of injuries have been ocular, most often transient ocular hemorrhage (8-10,12). Such injuries are thought to be caused primarily by intraocular fluid shifts that occur in response to directional changes and the resulting acceleration and deceleration forces (2). Serious neurologic injuries, including cases of quadriplegia and peroneal nerve injury, also have been reported (14,15). Another report (17) documents a bilateral nasal fracture and a left orbital floor fracture in a jumper who plunged from a bridge over a river and hit the water face first. Our study reflects previous reports in that it reveals several transient visual disturbances and one case of transient numbness in the leg.

Despite the absence of serious injuries in our survey, such injuries can occur at any of several points in a bungee jump. The launch platform can be dangerous if the person fails to clear the edge. Striking objects in midflight and entanglement in the tether during the fall or in the recoil are other potential causes of injury. Attaching or adjusting a harness incorrectly may cause serious injury, permanent paralysis, or death. In fact, the reported bungee jumping-related fatalities were due to improper harness connection or improper adjustment of the bungee cords (3-6).

The most important factor for a safe bungee jump is supervision by well-qualified professionals who are conscientious about their customers' well-being and the proper use and maintenance of equipment. Although this study shows that a single jump under such supervision is relatively safe, the effects of multiple or frequent jumping are unknown. Further study is needed to determine whether cumulative jumping increases the risk of injuries or chronic medical problems.

References

1. Harris M: The ups and downs of bungee jumping editorial. BMJ 1992;305(6868):1520
2. Vanderford L, Meyers M: Injuries and bungee jumping. Sports Med 1995;20(6):369-374
3. Cord too long in bungee jump. New York Times, July 2, 1993:A-11
4. Rohter L: Bungee jumping death in Michigan leads to ban and a fight in Florida. New York Times, July 18, 1992:A-5
5. Lim P: Bungee jumping's unencumbered cord gets tangled. Wall Street Journal, Aug 11, 1992:B-2
6. Canadian, 19, killed in bungee test jump. Boston Globe, Aug 3, 1992:12-1
7. Halftime bungee-jumper killed at rehearsal. The Arizona Republic, Jan 25, 1997:C-14
8. Habib N, Malik T: Visual loss from bungee jumping, letter. Lancet 1994;343(8895):487
9. Chan J: Ophthalmic complications after bungee jumping. Br J Ophthalmol 1994;78(3):239
10. David DB, Mears T, Quinlan MP: Ocular complications associated with bungee jumping. Br J Ophthalmol 1994;78(3):234-235
11. Hanbury PH: Bungy jumping, letter. Aust NZ J Ophthalmol 1990;18(2):229
12. Jain BK, Talbolt EM: Bungee jumping and intraocular haemorrhage. Br J Ophthalmol 1994;78(3):236-237
13. Simons R, Krol J: Visual loss from bungee jumping, letter. Lancet 1994;343(8901):853
14. Torre PR, Williams GG, Blackwell T, et al: Bungee jumper's foot drop peroneal nerve palsy caused by bungee cord jumping. Ann Med 1993;22(11):143-144
15. Hite PR, Greene KA, Levy DI, et al: Injuries resulting from bungee-cord jumping. Ann Emer Med 1993;22(6):1060-1063
16. Mellen PF, Shon SS: Military parachute mishap fatalities: a retrospective study. Av Space Environ Med 1990;61(12):1149-1152
17. Kmucha ST: Blunt facial trauma from a bungee jump. Phys Sportsmed 1996;24(5):70-73

The authors thank Lisa Van Dyken for collecting the data and Chris McLauglin for reviewing and editing the manuscript.

Dr Young is an assistant professor of orthopedic surgery and community and family medicine and Drs Raasch and Boynton are assistant professors of orthopedic surgery at the Medical College of Wisconsin in Milwaukee. Address correspondence to Craig C. Young, MD, Medical College of Wisconsin, 9200 W Wisconsin Ave, Box 26099, Milwaukee, WI 53226.

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