Wheelchair Sports - Medical Considerations

by Peter Mellow. Senior Lecturer Dept Sport and Health Science AUT

Sports for the disabled athlete in New Zealand are many and varied. Although participation is capable in most any sports with modifications there appears to be some common injuries to watch out for.

Pressure sores

are common for people in wheelchairs or who are dependent on crutches. These people have decreased sensitivity over the buttock area. Sitting for a long time causes pressure which can result in the development of such sores. These start as red spots which don't look too serious, but which because of impaired sensitivity, may not at first be noticed and progress rapidly. The result can be an ugly deep sore which can take a long time to heal. It is important to prevent pressure sores. The athlete should not remain sitting for too long but should regularly lift themselves out of their chair.

Before each competition or training session the coach should examine the athlete and look for signs of pressure sores.

If there is skin redness, the area in question should be relieved from pressure, for example by using a 'rubber ring' or by using alternative sitting positions. The skin should be washed with soap and water, dried and rubbed with surgical spirit and exposed to air. If a sore has developed a doctor should be contacted.

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Blisters and sores

are common from wearing aids such as corsets, artificial limbs and bandages.

Contusion injuries

are when parts of the body are caught in between two solid objects as a wheelchair athletes fingers being jammed in contact with another athlete in basketball. Swelling and tenderness and abrasions may appear. As with any soft tissue injury RICE is the best first treatment.

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Fractures

are less common but are still possible in the disabled. Impaired mobility or paralysis is inevitably accompanied by some degree of weakness of the skeleton. As the muscles are sometimes wasted they provide little protection for the bones. Disabled people who wear supportive braces should loosen them during sport events as they may act as levers and contribute towards causing fractures.

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Muscles, tendons and ligaments

can be affected by overuse injuries as some muscles and joints are used more often because of the repetitive nature of the sporting movement.

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Back and shoulder

problems. Anyone who has spent time in wheel chair will appreciate that their back is the basis of all movement and therefore tends to ache constantly. Wearing a corset can support the spine base but can be uncomfortable in hot weather and may cause friction. Shoulder pain can also flare up due to the 'one- sidedness' of some sports. Watch for this.

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Urinary tract infections

can be caused due to paralysis, impaired bladder sensation and sitting around for long time periods. Symptoms can be slight, or absent, so regular bacteriological checks on the urine should be made.