Marie Hechtermans: A fresh perspective on sports medicine and freediving

You might expect a doctor to walk in wearing a crisp white coat, a slightly austere look, tortoiseshell glasses, and a stream of technical jargon. Instead, you meet Marie Hechtermans: a bright and unconventional figure in modern academia, driven by insatiable curiosity. A sharp mind, a great sense of humour, and a contagious passion for the mysteries of the human body underwater — as well as for sport and arts in all their forms.

A young sports physician specialising in diving and hyperbaric medicine, she teaches at the Haute École Libre de Bruxelles Ilya Prigogine (HELB) and at the Université libre de Bruxelles (ULB). She is one of the rare experts in Belgium able to bring a scientific, well-informed and nuanced perspective to both recreational and competitive freediving.

And when asked to introduce herself, she sets the tone immediately: one day, she will become a mermaid. Or better yet — Ursula. “I don’t know why everyone always wants to be a mermaid. I’d rather be Ursula. Tentacles — no one’s ever done that. That would be amazing.”

She laughs, then adds:

“I’d love to get my Level 1 in mermaiding, just so I can tell my patients: I’m a mermaid. If your sports doctor is a mermaid, that’s kind of badass. Mermaid Level 1.”

She recently discovered that some people even do “underwater pole dancing.” Her conclusion? “An octopus doing underwater pole dancing — that’s definitely missing.”

An unusual athletic journey

Her athletic résumé could easily fill a novel: competitive fencing, ten years as a professional ballerina, figure skating (“I was more skating than figure”), eight years of competitive powerlifting and Olympic weightlifting — and, more recently, boxing.

She bursts out laughing: “Maybe it’s time to slowly stop competing and just start doing things for fun. Competitive mermaid or octopus… that might be a bit complicated.”

From medical practice to a passion for freediving

Marie Hechtermans’ fascination with the underwater world goes back a long way.

“I got into diving medicine when I was very young because my uncle — Guy Vandenhoven — is a diving and hyperbaric physician.”

As a child, she would accompany him during his studies and “scribble exam results on a little piece of paper in the corner.”

After a few scuba try-dives and then freediving initiations, curiosity did the rest. What fascinates her most is the physiology of freediving: “Freediving makes me even more curious than scuba diving, because it’s less studied. It raises more questions about human physiology and its limits.”

She also admits, with a smile, that there was “a bit of a contradictory spirit” involved — a desire not to follow exactly in her uncle’s footsteps.

Marie is something of an anomaly in the Belgian medical landscape: hyperbaric sports physicians can be counted on one hand. In Brussels, there may be only two or three. Her patient base reflects this rarity: competitive athletes, recreational divers, and even mermaiding enthusiasts. “In the end, I actually have more freedivers than scuba divers in my practice. ”She sees two to three freedivers per week — between 120 and 150 per year.

The plans of a “baby doctor”

Despite her undeniable expertise, Marie still describes herself, modestly, as a “baby doctor.”

After ten years of practice — alongside building and managing a multidisciplinary medical centre — she feels she is reaching a turning point:

“My plan for 2026–2027 is to slow down a bit on the clinical side… to give myself more time to study, read, attend conferences, discover new things, spend time at competitions with athletes, and develop my own practice… so I can come back stronger afterwards. I think I’m at that turning point now.”

Her goal is clear: deepen her knowledge in respiratory exercise physiology — for freedivers, but also for runners — and develop research projects.

A guiding principle: “You have to do that from time to time as a doctor. Otherwise, in the end, you become a bad one.”

There is no shortage of topics to explore, particularly those that remain largely untouched: the link between freediving and menopause, or more broadly, female physiology in sport — an area where research is, in her words, severely lacking.

“Blue Health”: Prescribing nature, a modern paradox

“Blue health” refers to the physical and mental benefits of being near, immersed in, or simply observing natural bodies of water — seas, lakes, rivers. The concept is grounded in a simple reality: water soothes, regulates, heals. For Marie, there is no doubt:

“It’s scientifically well established that contact with water is good for us. And actually, I think it goes even further — it’s really about contact with nature.”

Yet she points out a striking modern paradox: “There’s something quite sad about the fact that nowadays, we have to prescribe things that are just basic human behaviours: going for a walk in the forest, breathing fresh air, dipping your toes in the sea.”

In her vision, prevention goes far beyond medical tests: “It’s not just about blood tests and ECGs. It’s also about offering people ways of living that help them stay physically and mentally healthy over time.” At a broader level, she sees a major political issue:

“We need to keep doing research, keep showing the benefits of contact with water and nature… to support public health policies, but also policy in general. To say: for a human being to thrive in their natural environment, they need this and that. And maybe right now, we’re not heading in the right direction.”

Towards a network of water-health professionals: The “Blue Book”

When the idea of creating a symbolic status for healthcare professionals within AIDA Belgium — a “Blue Book” to be presented to the INAMI — is mentioned, Marie immediately responds as a natural network builder:

“We should connect healthcare professionals who are interested in water and its benefits… That’s a weakness in Belgium: we’re not very well connected, because we’re often on the front line, but each working on our own.”

She envisions a collective dynamic: a roundtable, a working group bringing together healthcare professionals and water practitioners, a space to brainstorm, share, and evolve practices — and eventually bring these ideas into the political sphere.

When it comes to freediving specifically, she remains pragmatic: “In terms of prevention in freediving… I base myself on what’s recommended in scuba diving. We lack scientific evidence. It would be interesting to think about this together, because we’re smarter when there are more of us.”

Her message is clear: bring people together, share knowledge, structure the field.

“Could we throw all of this into a shaker, and see what comes out? Because it’s an emerging sport that genuinely benefits people — so we need to develop things.”

A vision perfectly aligned with what she sees as freediving’s greatest strength: “Its ability to create very strong communities.”

Women and research: A scientific void

When the topic of “freediving and women” comes up, her assessment is blunt:

“There aren’t even three and a half books on the subject. Research labs are extremely rare, and many recently shut down under Trump, which doesn’t help. It affects research in general, and especially research on sex and gender differences…”

The scientific gap is vast — while the physiological stakes are very real.

Belgian freediving: Less isolation, more knowledge sharing

Her organisational diagnosis is typically Belgian: “In the sports world, everyone does their own thing, and everyone keeps reinventing the wheel.”

She advocates for another approach: more communication, more connections, building federations, bringing practitioners together across related disciplines, sharing ideas, passing on best practices, and pooling training opportunities.

She rejects naïve uniformity, but wants to avoid repeating past mistakes:

“Avoid letting people fall into the same holes others have already fallen into.”

And she returns, once again, to the power of community: “Find out who’s doing what in Wallonia, Flanders, and Brussels — throw it all into a shaker and mix it.”

And this is exactly what AIDA Belgium is currently working on.

Let’s open the “Blue Book” together

In the coming years, you may well come across Marie at Belgian competitions, or visiting pools across the country — as a specialist physician, but also as a researcher.

Join the movement: let’s build the Blue Book of aquatic health together.

To everyone reading this: if you have health-related questions about freediving, ideas for prevention, research proposals, or simply the desire to take part in a “blue health” roundtable — reach out. This is where it begins.

Today, we are launching a collective initiative to create a Blue Book — a reference document that can carry the voices of mermaids, fish, and water-health professionals to the INAMI.

AIDA Belgium has created two membership categories:

• supporting members

• healthcare professionals

  
  

These categories exist for one simple reason: to bring us together.

Starting now, let’s combine our strengths to take things to the next level. Let’s draw inspiration from initiatives across Europe, share our practices, build bridges between regions and disciplines, and advance aquatic health across our territory.

Water creates strong communities. It’s up to us to turn that strength into action.