Sunday, February 25, 2024


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The number of physically impaired athletes, who includes wheelchair athletes, amputees, and athletes with cerebral palsy, visual impaired and intellectually impaired athletes has substantially increased over the years.

Physically challenged athletes have similar injury rates and patterns as their able bodied counterparts, however, some injuries and illnesses are more common in certain Disability types than others.

The most common cause of disability for wheelchair athletes is spinal cord injury (SCI). For such athletes, noxious stimulus commonly precipitated by distended bladder, fecal mass, contact with sharp objects can leads to uncontrolled nervous response, which presents with headache, higher blood pressure, flushing, sweating profusely and increased heart rates.

Athletes with SCI often have difficulty regulating body temperature during training or competition in both warm and cold environments, primarily because of paralysis of skeletal muscle and resulting loss of sensation.

The risk of hyperthermia is increased due to the Impairment of sweating and control of blood flow in the lower limps while risk of Hypothermia is heightened by reduced ability to generate body heat by shivering due to loss of skeletal muscle mass and activity

Pressure sores, commonly in the back of pelvis, can be a significant problem for wheelchair athlete. They arise due to prolonged pressure over the skin resulting in disruption in skin integrity. Use of sports wheelchairs designed to keep knees higher than the buttocks further increase the risk.

Vigilant skin care is essential and includes weight shifts to relieve pressure, use of padding and electrical stimulation to increase blood flow.

Bladder dysfunction due to poor sensation can predisposes athletes with spinal injury to urinary tract infections (UTI) from incomplete voiding, elevated pressure, causing increased malaise, lethargy, or a sense of unease.

Upper extremity injuries are the most common musculoskeletal injuries sustained by wheelchair athletes.

The shoulders tend to function as weight-bearing joints for wheelchair propulsion and transfer, resulting in an increased risk for overuse injuries.

Injuries to athletes with cerebral palsy, a condition caused by injury to brain during or immediately after birth, often affect both upper and lower extremities and depend greatly on ambulatory status. Knee injuries commonly results due secondary to spasm of muscle groups surrounding the joint.

Thigh muscles often have increased tightening, leading to increased tension across the joint. In addition, cerebral palsy athletes often have deformities of the ankle and foot that lead to increased risk for injuries, ankle instability, calluses and pressure sores.

Amputee athletes use a variety of prostheses to assist them in competition. Stump injuries are common because the stump is subjected to skin abrasions, pressure sores, blisters, and rashes.

Ensuring prostheses are fitted properly can prevent many complications. Appropriate skin care, including talcum powder and cool clothing to combat sweating, will reduce risks of stump irritation.

Cervical and Thoracic spine injuries are commonly seen in individuals with upper extremity amputations due to imbalance and unequal movements in the upper limbs during training and competition.

Proprioception in blind athletes tends to be worse than those with partial vision. Poor proprioception can, in turn, result in abnormal gait and biomechanics, resulting in increased incidence of overuse injuries of the lower extremities, especially ankle sprains and contusions to the shins.

Competing in unfamiliar environments with the lack of guides or assistive devices predispose these athletes to injury. Special attention should be taken to prevent injuries by familiarizing athletes with their environments and by providing adequate guidance and support.

Story by KAMAU KINYENJE | Sports Medicine

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