Sport for Athletes with Spinal Cord Injuries: Medical Issues and Sports Injuries.

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Transcript of Sport for Athletes with Spinal Cord Injuries: Medical Issues and Sports Injuries.

Sport for Athletes with Spinal Cord Injuries: Medical Issues and

Sports Injuries

At BlazeSports America, our mission is…

to advance the

lives of youth

and adults

with physical

disability through

sport and

healthy lifestyles

This presentation is meant as a

summary review of the information

presented in the BlazeSports manual:

Sport for Athletes with Physical Disabilities: Injuries and Medical Issues

Athletes with Diabetes

Concerns:

Possibility of hypoglycemia or hyperglycemia occurring during exercise

Vulnerability to excessive heat

Athletes with Diabetes

Precautions:

Always carry easily accessible glucose and medical alert info

Increase consumption of carbohydrates based on intensity and duration of exercise

Thermoregulation

Ability to control or regulate internal body temperature.

The higher the level of the SCI and the more complete the lesion the more severe the inability of the body to cool itself.

Thermoregulation

Prevention: Stay well hydrated before,

during and after exercise Wear lightweight clothes Use fans, air conditioners, stay indoors in extreme heat and humidity Use spray bottle to cool exposed skin Use wet cloth, headbands or neck bands

Thermoregulation

Heat stroke

Early signs: mental confusion Be unable to drink fluids Sweating generally ceases, skin is hot and dry Athlete may feel faint May lose consciousness or be incoherent Body temperatures rises to dangerous levels

If an athlete is experiencing any of the above begin cooling and seek Emergency Medical treatment.

Thermoregulation: Medications Certain medications can increase a

person’s vulnerability to heat:

anticholinergics sympathomimetics diuretics certain muscle relaxers

Athletes should consult their doctor if on any of

these types of medications.

Thermoregulation

Coaches and athletes should have concern for hypothermia when athletes are exposed to cold temperatures over a period of time.

Autonomic Dysreflexia (AD) Marked elevation in blood

pressure Affects athletes with SCI at the

T6 level or above Research suggests that between

48-90 % of individuals with SCI may experience AD.

Autonomic Dysreflexia (AD)Most Common Causes:

Obstructed urinary catheter/distended bladder

Pressure sores Rectal impaction

Autonomic Dysreflexia (AD)Other Causes:

Ingrown toenails Fractures Body position Tight clothes Passage Range of Motion Deep Vein Thrombosis

Autonomic Dysreflexia (AD)

Symptoms:

Hypertension Sweating Headache Shivering Rapid heart rate

Autonomic Dysreflexia (AD)Treatment:

Identify the cause and remove it

If symptoms continue, medical attention may be necessary especially if high blood pressure continues

Pressure Sores (Decubitus Ulcers)

Definition:

An area of unrelieved pressure over a defined area, usually over a bony prominence, resulting in ischemia, cell death and tissue necrosis.

National Pressure Ulcer Advisory Panel

(O’Connor and Kirshblum, 1998, p.1057)

Pressure Sores (Decubitus Ulcers)Causes: Prolong sitting in one position Worn wheelchair cushions Continued sitting on hard surfaces Skin moisture from sweating Use of improper fitting wheelchairs

or other adapted equipment Falls

Pressure Sores (Decubitus Ulcers)

Most common sites:

Sacrum Buttocks Hip Heel

Pressure Sores (Decubitus Ulcers)

#1 Treatment is Prevention

Use well padded cushions Wear absorbent clothing to absorb sweat Good Nutrition Proper hygiene practices Check wheelchairs and adapted equipment

for proper fit Perform pressure releases (arm push ups)

every 20- 30 minutes

Spasticity

Spasticity normally occurs in some athletes with disabilities. Temporary increases in muscle tone may occur due to intense sport, aggressive exercise or strength training.

Spasticity

Experience and research has shown that sport training tends to lessen the impact of spasticity.

Spasticity

Treatment/prevention: Regular participation in a stretching

program No bouncing or ballistic stretching For the upper extremities, strength

training should focus primarily on extension and reduces the number of flexion exercises when flexion dominates over extension.

Venous Pooling

Cause

Lack of sympathetic activity and loss of active muscle function in the legs and trunk muscles.

Venous Pooling

Treatment/Prevention

Wearing an abdominal binder during exercise.

Common Overuse Injuries Musculoskeletal Injuries Shoulder Strain or Injury Blisters, Abrasions & Lacerations Carpal Tunnel Syndrome

Treatment: Musculoskeletal Injuries Blisters, Abrasions & Lacerations

Treat as standard athletic injury and attempt to identify and eliminate

cause to prevent recurring injuries.

Proper pre and post exercise warm and cool down can also be a helpful.

Carpal Tunnel Syndrome

Caused by a number of contributing factors including years of transfers, propelling a wheelchair, performing pressure release exercises where the wrist is at maximum extension and the forearm is in supination.

Carpal Tunnel Syndrome

Occurrence increases with the time a person has been using a

wheelchair.

27% of users 1-10 years from onset

54% of users 11-20 years from onset

54% of users 21-30 years from onset

90% of users 31+ years from onset

Carpal Tunnel Syndrome

TREATMENT

Best treatment is prevention:

•Good body mechanics

•Wrist flexibility and strengthening exercises

•Use of padded gloves

•ICE: 20 minutes at the end of each day

Carpal Tunnel Syndrome

TREATMENT

Severe Cases:

Rest

Immobilization

Anti-inflammatories

Surgery

Shoulder Strain or Injury

Contributing factors:•Wheelchair use

•Number of years after SCI

•Age

•Overweight or obesity

•Not starting shoulder exercises within 2 weeks of injury

•Low levels of recreation and physical activity

Shoulder Strain or Injury

TREATMENT:

•Standard therapeutic modalities

•Strengthening of shoulder internal and external rotators and adductors

•Arm and shoulder flexibility exercises

Shoulder Strain or Injury

Suggested Exercises:

Arm swings

Shoulder rolls

Arm circles

Chest fly

Bicep curl

Tricep extension

References:BlazeSports America

Sport for Athletes with Physical Disabilities:

Injuries and Medical Issues

Ben Johnson, Carol Mushett, Grant Peacock

and Ken Richter

National Center of Physical Activity and Disability

Introduction to Common Overuse Injuries

in Wheelchair Users

Patricia M. McClintock

Additional Resources:National Center of Physical Activity and Disability

NCPAD.org

Exercise Program for Individuals with

Spinal Cord Injuries: Paraplegia

&

Exercise Guide for Individuals with SCI

Exercise Program for Individuals with Spinal Cord Injuries: Tetraplegia

&

Exercise Guide for Persons with Tetraplegia

QUESTIONS?

jjones@blazesports.org

770-850-9095

www.blazesports.org