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Metabolic risks of completing Giro, Tour, and Vuelta in the same season
G Lippi and G Guidi Br. J. Sports Med. 2004;38;103doi:10.1136/bjsm.2003.010009

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102 Br J Sports Med 2004;38:102–104

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Figure 2 (A) Radiograph of a diver with a large plastic tube (40 mm diameter) inserted in the mouth. (B) The same diver with a standard mouthpiece inserted. and wide open (submaximal opening). The aim was to see if duringscuba diving the TMJ is maintained in a stressed position leading to pathology (myalgia, headaches, discal subluxations) under certain conditions. The different angles calculated for the whole samples were computed for statistical analysis by standard procedures including mean, standard deviation, median, and analysis of variance after the Kolmogorov Smirnoff test for normality. Post-discriminanttests included Tukey-Kramer and Bonferroni.

Scuba diving can induce stress of the temporomandibular joint leading to headache
In ordinary recreational scuba diving, many anatomical parts can be involved in disorders of cranial regions: ears and eyes are involved but also sinuses. Dental problems are generally involved in barotraumas because of bad dental fillings or other matters of interest tothe general dental practitioner.1 Very few papers have looked at the articular and periarticular problems of the temporomandibular joint (TMJ).2 Local factors such as joint laxity, anatomical factors, capsular or muscular inflammation, and articular stress of long duration resulting from holding the regulator mouthpiece in scuba diving or the snorkel mouthpiece in skin diving can lead to TMJdisorders including headaches and myalgic symptoms.3 We examined the biomechanics of the TMJ (fig 1) in relation to diving, particularly looking at the disc-condylar position during mouthpiece biting and with the mouth closed

Methods
To measure condylar and discal displacement in divers, we studied 30 TMJs in a population of 15 divers aged 18–55, including six women. None had symptoms of TMJdisorder such as joint noise, pain, or luxations. All were fully informed about the experimental paradigm and agreed to have magnetic resonance imaging (MRI) of both TMJs. MRI was used so that the intra-articular disc and condyle body could be viewed in the same image and scale to allow angular measurements. Six sagittal and parasagittal slices were viewed on each side (T1 weighted sequences,...