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December/January 2001

By Andria Segedy

The Altruistic Edge

Mary Donahue, PT, ATC, and John Christiansen, PT, ATC, members of the USA Paralympic medical team, worked closely with swimmers at the aquatic center in Sydney.

Therapists, physicians, and athletic trainers volunteer their time to keep athletes competitive in the Paralympic Games

A crowd of 8,300 screaming fans watched the United States' wheelchair rugby team beat the home team of Australia during the game's debut as a medal sport in the 2000 Sydney Paralympic Games in October. There was only a one-point difference at the end of 32 minutes of play to give the US team the gold medal. Courtside were Anne Hart, PhD, PT, and Denise Anderson, PT, ATC, both volunteer international classifiers for the fastest growing wheelchair sport in the world.

Paralympic veteran Mary Donahue, PT, ATC, and first-timer John Christiansen, PT, ATC, spent most of their time at the aquatic center as volunteer members of the USA medical team. Ed Ryan, ATC, was the USA Medical Coordinator and works full time for the US Olympic Committee (USOC).

For most physicians, it takes 7 years from the time they submit an application to the time they are selected by the USOC. James Sterling, MD, a specialist in physical medicine and rehabilitation, applied in 1987 and was invited to the Olympic training center's 2-week orientation in 1994. At the Sydney Paralympics, he volunteered his time as the United States' head physician.

Classifiers

Being a classifier at a wheelchair rugby game is like being a sleuth in the game of Clue. It is not a popular position to hold, but for Hart and Anderson, it is a satisfying extension of their day-to-day work in physical therapy.

"How do they do it?" asks Hart, assistant professor at Northern Arizona University in Flagstaff. "Is it Colonel Mustard in the library? How can they throw the ball when they don't have the muscle to do it that way? It's like finding the solution to a puzzle."

"We do not have a popular job," says Anderson, who owns her own business specializing in neurologic and orthopedic rehabilitation in Bozeman, Mont. "Sometimes an athlete's classification is incorrect and all of a sudden he can't make a team or does not fit into the lineup."

"We have changed athletes' classification," Hart says. "Some went up, some went down. Going down is very popular; they like that!"

Hart and Anderson are two of three wheelchair rugby classifiers in the United States certified for international games. Classifiers in any sport determine what points to assign to an individual player based on the athlete's physical abilities. Before a game begins, classifiers determine what athletes can and cannot do. Then they watch players in action on the court.

"You evaluate the athletes' abilities," Hart says. "You look at their strength and you look at their function. How they push the chair; how they handle the ball."

In wheelchair rugby, player points range from 0.5 to 3.5, only four players are allowed on the court, and points can only add up to 8. In wheelchair basketball, the point range is 1.5 to 4.5 and the maximum number of points on the floor is 14.

"Classifiers have to be physicians, physical therapists, or occupational therapists," Hart adds, "someone who has had formal neuromuscular training. Each sport has its own system."

Hart started at a local university game in 1988. Her major clinical interest is spinal cord injury, which, along with her love of traveling, has made this volunteer work very fulfilling.

"A lot of time, the organizers pay your way to the event, but you do not get paid for your time," Hart explains. The same is true for her time in Sydney. The Sydney Paralympic Organizing Committee (SPOC) paid for travel, room, and board. The volunteers lived in the judges and officials section of the Paralympic Village, which also housed 3,824 athletes from 122 countries. "The Paralympics took me away from my job for 3 weeks, but it is a fabulous opportunity."

Anderson notes, "Because I am a PT and an ATC, I looked for a way to combine my neuro and sports background." She started classifying in wheelchair rugby in 1988 after a friend introduced her to the sport.

"I believe everyone needs to give back to the community in some way," she adds, "Volunteering for the Paralympics costs me my time. I budget a certain amount of money every year to this."

US Medical Staff

Donahue and Christiansen are part of the US medical staff assigned to the swim team. Their priority is to be with the team during competition and at all practices. Otherwise, they are in the US medical clinic in the Paralympic Village.

Donahue has been on the medical team since 1988, when the Paralympics were held in Seoul; she was on hand in 1992 in Barcelona, in 1996 in Atlanta, and finally in Sydney. She specializes in dance performing arts medicine at Henry Ford Hospital Center for Athletic Medicine in Detroit. She works with disabled athletes for the love of it, she says.

She advises to start with your local programs. "Start volunteering. There are so many different disabilities. Some awareness of disability is helpful, but not required. Once you get involved, you start to learn about it.

"I went in cold when I was interviewing for a job [in 1981] in cerebral palsy (CP) swimming," she says. She was a physical education teacher during the day and taught kids with CP how to swim at night. After becoming an ATC, she incorporated that knowledge into her night classes.

The USOC mandates that nonphysician medical staffers be athletic trainers, she says. "They are top heavy with dual credentials just because of the disability issues," she adds.

Christiansen opened his own clinic, Advanced Rehabilitation Clinic, in Westmont, Ill, in April 2000. While in Sydney, he has a friend seeing his patients back home.

This is the first time Christiansen has worked at the Paralympic Games even though he has worked for the past 6 years with the US rhythmic gymnastics team. He has already made contacts to volunteer his time with disabled athletes back in Illinois.

He applied to the USOC for a volunteer position and assisted at the World University Games in Spain in 1999, he then was assigned to the Sydney Paralympics.

"I thought it would be a good opportunity to help athletes compete at their highest level," he notes.

Ryan is the USOC's director of sports medicine and is the medical coordinator for the US Paralympic Team. He ensures that the medical care available to the US athletes meets the USOC's requirements. He is also the US liaison with SPOC's doping control efforts, ensuring that all US athletes are escorted through the process when they are randomly selected. Third, he works with athletes to identify their individual needs for any prohibited substances used during competition. He investigates whether the athlete's physician can prescribe an alternative drug.

"Most drugs used address pain and spasticity," he explains, "perhaps some are for cardiac problems, and some of those substances are prohibited. Once the athlete provides that information for us, we validate it, and send it to the Medication Advisory Panel of the International Paralympic Committee to try to justify an individual's use of the drugs."

His education as an athletic trainer has been the foundation of his 15 years with the USOC. "Athletic trainers are first and foremost people-oriented. You are in a service profession. I am specifically educated to work with athletes to contribute to the achievement of their athletic goals."

Finally, he is responsible for ensuring the best environment for the medical team. "Because we are in a competitive environment," he explains, "little things become big problems really quick. It is our job to see the little things before they become monumental."

Denise Anderson, PT, ATC and Anne Hart, PhD, PT, were classifiers for wheelchair rugby in the 2000 Sydney Paralympic Games

Sterling's first assignment was at the Olympic Festival in 1995, followed by the 1996 Atlanta Paralympics. In 1998, he was in Nagano for the Winter Olympics. In Sydney, he was responsible for four other physicians, 17 athletic trainers and two certified prosthetists, along with the 256 American athletes.

"The total number of days away from my practice is 27, plus 10 days in March for the team leaders meeting in Sydney," he says. "One of our partners was a head physician for the Barcelona games, and he is vice chair of the sports medicine committee of the USOC. In saying that, our group is very supportive of our involvement in the Olympic Games and the time spent as volunteers, so the group absorbs our workload when we are gone."

He would like to continue working with both Olympic and Paralympic athletes. "Paralympians are an incredibly special group of athletes," Sterling comments, "not because of their disabilities, but because they do not get the recognition they should or the validation they deserve. They are incredibly appreciative people. That is worth more than any money a physician can be paid."

Andria Segedy is a contributing writer for Rehab Management.

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December/January 2001

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The Altruistic Edge

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