Keeping Adaptive Sports Athletes At Their Best Performance

Adaptive sports can be a hobby with loved ones, a casual neighborhood team or even national or international competition. Just as in traditional sports, it's essential for adaptive sports athletes to keep up with their health on and off the field.

Franciscan Health sports medicine physician Andrew Hills, DO, and physical medicine and rehabilitation specialist Binnan Ong, DO, explains what it takes for athletes to navigate adaptive sports at their best.

What Are Adaptive Sports?

Adaptive sports as similar to traditional sports, with rules and conditions designed to give athletes more comfort and an even playing field when competing with others facing similar health conditions.

"They're kind of like our sports for able-bodied people but modified to promote inclusion for individuals with disability," Dr. Hills said. "We want everybody to be able to participate in the sport. It promotes inclusion, physical fitness and improves quality of life when they participate."

Dr. Hills explained that adaptive sports include certain equipment and rules, but they can be played at various levels, similar to typical sports.

"PE Classic can range from anywhere from like recreational league to something very competitive, or even internationally like the Olympics, for example," Dr. Hills said.

Are There Barriers To Getting Into Adaptive Sports?

While adaptive sports give many people the opportunity to engage in casual and competitive sporting events, some barriers can depend on the athlete’s overall health.

"There are a lot of barriers to getting into adaptive sports such as getting the athletes comfortable in their daily life and proceeding from there," Dr. Ong said.

Dr. Ong explained that if people aren't comfortable with their medical conditions and managing them, they may not want to leave their homes to participate in a sports event with others. They also could encounter potential travel complications involving their condition, such as handling a wheelchair during a trip.

"There might be special equipment needs that they'll have to navigate to participate in their sport," Dr. Ong said.

He explained that some people may also put off opportunities to participate in these sports because obtaining additional equipment can be expensive.

"Still, there are resources to help people with these problems," Dr. Ong said.  "We're familiar with those resources whether that be grant programs or equipment that might be better suited for budgets."

Dr. Ong explained that some barriers aren't necessarily the patient's condition but rather the lack of information on helpful resources and knowledge about making adaptive sports a reality in their lifestyle.

Are There Unique Risks Related To Playing Adaptive Sports?

"Regarding risks in adaptive sports, I would say there can be some similar to able body sports," Dr. Hills said. "Still, injuries are somewhat unique based off the sport that's being played."

Like traditional sports, athletes participating in adaptive sports should prioritize their physical health on and off the court, such as positioning and range of motion.

Overuse Injuries

Dr. Hills explained that there is a slight trend towards overuse injuries due to physical barriers from the athletes. For example, an amputee tends to prioritize their upper body, which can result in more stress on joints throughout the upper body.

"There tend to be a little bit more overuse injuries in adaptive sports, but the sport that they're participating in definitely matters," Dr. Hill said. "When you get to some of these more competitive leagues it’s very much a like contact sport with some ramming and even tipping, which has the potential risk of fractures, concussions or other acute injuries."

Injuries Impacted By Disease And Disabilities

Dr. Ong explained that while there are a lot of unique forces on a patient depending on the sport they're playing, their disease or disability can also be at an increased risk of having specific problems compared to other athletes.

"If you have someone who's a paraplegic who uses a wheelchair and hasn't walked in a year, their bones can develop osteoporosis," Dr. Ong said. "Their bones can become brittle and soft. Things that normally wouldn't cause a fracture to an able-bodied person, will cause a fracture to one with a disability."

He explained that even situations where an athlete catches their arm in a jersey or falls from a wheelchair could cause fractures due to brittle bones.

"When you're clearing people for sports, most regular sports physicals don't include a bone density scan to determine your risks and get it treated before you participate in a sport," Dr. Ong said.

Disability-Impacted Injuries That Cause Difficulty in Adaptive Sports

Dr. Ong also explained other more common symptoms with similar implications to disability-impacted injuries, such as numbness.

"People that have numbness may not be able to feel their skin," Dr. Ong said. "They may also have wounds and bedsores. So, when these patients participate in a sporting event with a lot of friction and pressure, that may increase their risk of developing sores or worsen ones that they already have."

He explained how it's crucial to consider these unique situations that can quickly occur during the sport and find the best ways to address those concerns, making rules that can distribute forces that impact the athletes differently.

"For example, if patients are trying to compete at a competitive level in a throwing sport, they're not going be able to throw in the most optimal manner, and that can limit their competitive edge," Dr. Ong said. "Doctors like Dr. Hills and I, try find ways to overcome each of these unique barriers and how normalize people's body mechanics and function as much as possible."

How Do Sports Medicine and Physical Medicine Rehabilitation Optimize Performance And Prevent Injuries?

It's essential for any adaptive sports athlete to be at their best performance on and off the field. Sports medicine and physical medicine rehabilitation work together to make the path to performance a safe and confident experience.

Dr. Hills explained that even though the term adaptive sports is used to differentiate it from traditional sports, he has the same goal as a physician, which includes caring for his patients and providing risk-preventing solutions.

Preventing Injuries In Adaptive Sports

"If we can prevent the injury from even happening, that's the goal," Dr. Hills said. "If you do have an injury, you know they already have these impairments, so adding an additional injury or condition to it can change their quality of life and ability to independently complete their activities of daily living."

Dr. Hills gave the example that athletes in wheelchair basketball will need to optimize their chair positioning to reduce forces across their shoulder joints.

"So, one example of reducing force in a wheelchair is to place the rear axle of the chair slightly behind the athlete's center gravity," Dr. Hill said. "It allows the athlete to have better grasp and propulsion to make mechanics more efficient. The wheelchairs have a more of an angle at the base where it's wider and narrower at the top."

Dr. Hills explained that this method has a biomechanical term called camber. It increases the responsiveness of the hands when turning, provides better stability and allows some distance between the athlete and their opponents. He also explained how it's crucial for those with prosthetics to have a perfect fit with enough flexibility to participate in their sport and avoid any wounds or pain during use.

"Those with prosthetics may need to add an extra layer or sock to their limb to recreate a snug fit throughout the competition to prevent some extra movement," Dr. Hills said. "That's the key thing especially in this population. It's all about preventing the injury before it happens."

What Does A Team Approach With A Sports Medicine Specialist And A Physical Medicine Physician Look Like?

Sports medicine specialists and physical medicine physicians work together to address the barriers that patients face during sports and at home.

"If there's special equipment that a patient needs, it has to consider what those needs are inside the home and what those needs are in that specific sport," Dr. Ong said. "Likewise, sometimes if a patient has a sports injury, that injury may carry over into how they're going to function at home. If they fracture a leg, yes they can't participate in a sport, but we also have to consider how they'll need to get out of bed, in their wheelchair and downstairs."

No matter which adaptive sport an athlete decides to participate in or the level of competition, it’s essential to maintain good health on the field during official games or training at home. A team of dedicated professionals can guide you and your closest supporters through your athletic journey.