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Disabled athletes have specific medical needs

October 26, 1999

BY DR. JAMES BRAGMAN

An important revolution has taken place for physically challenged athletes.

In the past 20 years, equipment, medical care and opportunities to participate have all improved for these unique athletes.

About 12 percent of the school-age population in the United States is physically challenged, and there are 3 million disabled adults who regularly participate in recreational and competitive sports.

In the past, the medical treatment of athletes with disabilities emphasized the biological, physical and psychological impediments that, in turn, accentuated a passive approach to exercise. In contrast, the new model stresses that those with disabilities are simply different and not unequal to able-bodied athletes.

The most common musculoskeletal injuries in physically challenged athletes involve the shoulder, pelvis and thigh. Next in frequency are injuries to the wrist and hand, ankles, neck, arm and elbow.

Medical conditions affecting these athletes include ears, nose and throat infections, followed in frequency by upper respiratory infections, skin rashes and gastrointestinal, neurological, genitourinary, eye and cardiovascular inflammations.

The means of caring for disabled athletes are often as unique as the individuals:

Difficulty in regulating extremes in temperature can be particularly troublesome to athletes with spinal cord injuries. Hypothermia or hyperthermia can best be prevented by adequate hydration and proper clothing.

In addition, athletes with spinal cord injuries are at risk for pressure sores that can lead to a local infection or a systemic infection. As a result, any early signs of skin breakdown must be promptly treated.

A phenomenon known as autonomic dysreflexia can occur in athletes with spinal cord injuries. Its symptoms are an increase in blood pressure and decrease in pulse. Autonomic dysreflexia is most commonly caused by distended organs such as the rectum or bladder, an ingrown toenail or appendicitis.

Many disabled athletes have difficulty with bladder control, and they are at risk for bladder infections and possible bladder ruptures. Regular breaks and careful monitoring of fluid intake are essential to allowing these athletes to perform their best. When an infection occurs, prompt consultation with a physician is necessary.

Athletes in wheelchairs can develop severe osteoporosis of the lower extremities because of lack of use and, as a result, can develop fractures from minor trauma or even a muscle spasm. These breaks can be prevented with proper padding and adequate nutrition. Also, stretching, regular conditioning, protective equipment, padding, and the proper size and type of wheelchair is of paramount importance for each athlete.

Overall, the best thing families and others can do for the physically challenged athlete is to become an educated source of encouragement and advocacy, being ever mindful of the unique health care needs of these gifted individuals.




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