Cover Story: Expanding the Human Spirit

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January/February 2005

By Michelle Apuzzio, MSPT

John Register, manager of the US Paralympic Academy (left), coaches aspiring wheelchair athlete, Abby Farrell, during a one-on-one game of basketball.

The Paralympics have come a long way since 1960 when 400 athletes with spinal cord injuries competed in eight Olympic-style sports in Rome. Today, 22 summer and winter sports give individuals with a range of physical disabilities the chance to go for the gold. In September 2004, 4,000 athletes from around the world accepted that challenge in Athens, Greece.

As manager of the US Paralympic Academy, a new grassroots recruiting initiative, John Register wants to make sure those numbers continue to grow. It's just a matter of exposure.

Many potential Paralympians are accustomed to small turnouts in their community-based competitions. When Register took a handful of these future world athletes to Athens, they were awestruck. "When you come to the Paralympic games, you see 4,000 athletes marching in the opening ceremony, and you see the phenomenal competition that goes on. It's such a high level of athleticism. You say, 'Oh, my goodness, my world has just been blown open,'" says Register.

One of the young athletes to accompany him was a 16-year-old girl from Chicago, with a below-the-elbow amputation. "She sees [cyclist] Ron Williams fly around the track and she's hooked. She's saying, 'That is what I want to do. That is what I'm going to do,'" says Register.

When the young woman returned to Chicago, she was fitted for a modified bike that allows her to hold onto the handlebars, despite her physical disability. For many Paralympic athletes, adaptive equipment is the crucial link to their sports, and the gear is as specific to the sport as it is to the human being using it.

Gold medalist Susan Katz uses her height to her advantage as a member of the US Women's Basketball team, so her chair sits higher than many others. To compensate for incomplete trunk control, the backrest is taller for balance and support while shooting. And her knees are positioned higher to give her a flat lap, which is essential during push-off.

According to US Track and Field wheelchair coach Craig Hampel, customized fit is the biggest change he has seen over the last decade. "It's absolutely paramount if you want to be a fast racer to be more or less one with your chair...If you're flailing around in the chair, that's a ton of lost energy," he says.

The basic design for racing chairs - a T-frame with three wheels - has not changed, but some athletes are tinkering with aerodynamics on their own time. Staying within the rules governing chair design, which state that you cannot have a bearing unless it is a structural part of the chair, Hampel says, athletes have become clever by using carbon fiber to build aerodynamic shells around their bodies. "In the past 18 months, there are a couple of athletes out there who have built a chair completely from scratch from carbon fiber," he says.

An athlete and coach, Register became involved in the paralympics after his leg was amputated after severing his popliteal artery.

The problem with that, Hampel continues, is that the design needs to be flawless because carbon fiber lacks the malleability that has made aluminum such a popular material to get that customized fit with racing chairs. Still, that has not deterred the athletes from trying to improve the technology. And Hampel thinks that leaves chair manufacturers no choice but to copy those designs. "If 150 racers show up at a race, and you have three guys who are the [top] finishers, and they have these idealized chairs, everyone else is going to want them and they're going to start demanding them," says Hampel. "If the chair manufacturers have any business sense whatsoever, they'll start to look into it. And they should because they have the resources. The athletes are nickel and diming it and scraping and spending their own money to try to do this."

Hampel is optimistic that chair companies will catch on eventually. When he started coaching, the racing chairs' wheels had spokes, which were constantly bending under the everyday beatings they took. He had a background in cycling, and knew that carbon fiber wheels would be much more durable for his racers. But he did not get the same enthusiasm from the manufacturers when he suggested that they modify their wheels for wheelchairs. "The response I got from all of them was 'We don't want to do that. Our lawyers say that if you take a population that's already disabled and if they get more disabled using something that we built, then that's extra bad,'" he says. "It was ignorance on their part. You can't really fault them because they don't know better."

But eventually, a company in France did adapt the carbon fiber wheel for wheelchairs, and soon the other manufacturers followed suit.

Save for a few adventurous souls, the average person probably does not want a wheelchair that resembles a racing pod, but everyday chairs certainly resemble sports chairs more than the typical chrome wheelchairs. Everyday chairs weigh much less these days, thanks to sports chairs, which first experimented with lightweight materials like titanium and aluminum. Many wheelchairs also have advanced suspension systems to allow for curb-hopping as users demand more functionality from their chairs.

Just as sports chairs are influencing everyday design and technology, increased visibility of the Paralympics is having its own effect on society.

Although the Paralympics first got its name during the 1960 games in Rome, credit for its origins goes to neurologist Ludwig Guttman who organized competitions, as a means of motivation and movement, for World War II veterans with spinal cord injuries at an English hospital in 1948. In 1976, the Paralympics extended to other disability groups. Today the eligibility standards include amputations, visual impairments, cerebral palsy, multiple sclerosis, and dwarfism. Most important, the games have shifted from being a medical model of rehabilitation to a sports-centered focus on the elite athlete. "We have a phenomenal platform nationally and around the world," says Paralympics CEO Charlie Huebner. "We utilize that platform via our athletes to promote excellence, not just in sport but in life. When we talk about excellence, we're talking about excellence in the workplace, excellence in school, and excellence in the community. And I think Paralympic and Olympic athletes do that better than anybody."

Huebner considers the start of the Paralympics to be in 1988 when the games became integrated with the Olympics. They had always been held in the same year, but from that point forward, they were held in the same venue.

Golden Hoop Dreams

Born with spina bifida, Susan Katz was ambulatory until a tethered cord release surgery at age 10. With incomplete paralysis resulting, Katz was fitted for braces and crutches and encouraged to walk. But it was arduous, so she switched to a wheelchair to keep up with her friends. Less than a year later, Katz started participating in a wheelchair junior sports program near her home in the San Francisco Bay area. Although she had played softball previously, she took to the track and field events immediately. “Gettin involved in wheelchair sports was just tremendous. It was like I had a level playing field with everybody,” she says.

Katz’s first trip to the Paralympics was in 1996 where she competed in javelin, discus, and shotput, but did not take home any medals. Still, she was happy to have competed. At the University of Illinois, where she matriculated immediately after the ’96 games, Katz joined the Women’s Wheelchair Basketball team, which was the only one of its kind on the college circuit.

Katz played on the US national team, which won a silver medal in Sydney in 1998, but declined a spot as an alternate on the 2000 Olympic team. She could not stay away for long though, and eventually joined a club team in Orlando, Fla, in 2002. The idea was to play for fun, never to try out for another national team. “In 2003, about 30 seconds before our first game, I thought, ‘I want to try out for the national team. I don’t know where it came from or why it popped into my head,” she says.

Katz made the national team that year and went on to make the Paralympic team in 2004. A grueling training schedule ensued as life consisted of work, training, and getting together with the team for basketball camp.

Competition was tough, and the women lost the first game to Australia. But they rallied to victories in the remaining games—defeating Australia in the finals rematch—to win the gold medal. The feeling was indescribable, says Katz. “It’s not like every second of every day you think, ‘I’m a gold medalist,’” she laughs. “But it does change something about you…. Everything just seems like, no matter what, I’ll be able to accomplish it.”

—M.A.

To elevate the status of the Paralympics, the US Olympic Committee (USOC) centralized operations 3 years ago. The nine employees dedicated to the US Paralympics are located in Colorado Springs, Colo, in the US Olympic Training Center alongside the USOC. With that move came a new focus on supporting the athletes, enhancing revenues, and raising awareness of the Paralympic movement in the United States. According to Huebner, the United States is the only country that does not accept government funding for its teams, and the nonprofit group looks to the USOC and private corporate funds for its money.

On the surface, it may not seem possible for the Paralympics to ever reach the echelon of the Olympics. More than 11,000 athletes turned out for the Olympic games in Athens, which were broadcast continually for 2 weeks. By comparison, only highlights of the Paralympic games aired on a cable channel, Outdoor Life, 2 months after the games ended. But Huebner points out that the Paralympics are still young. "It's taken the Olympic Games more than 108 years to get to the level they're at. This year is the first that TV has covered every Olympic sport," he says.

Register said it was his perceived injustices within the Paralympic movement that brought him into the fold. He has been on both sides of the fence. Register was Olympic-bound until an ill-fated trip over a hurdle severed his popliteal artery. After an above-the-knee amputation, he went on to compete in the Paralympics in swimming and track and field. But he kept asking why Paralympics was not at the same level as the Olympics. "Why am I now treated differently as a Paralympian than an Olympic athlete because I have one leg? And a year ago, [look at] how you treated me when I had two legs. Why is there a difference here?" he remembers asking. "Am I not a world-class athlete any longer?"

Perhaps it is his background in the military that makes Register so pleased to see a high level of discipline coming to the Paralympic games. A few years ago, he says, the judges were more lenient in terms of the number of false starts they allowed the athletes to have. Also, it was not unusual for athletes to compete in classifications - competition classes based on level of disability - in which they did not belong. That has all changed.

And that means that Paralympic coaches have to take a tough love approach with athletes. Which is why Register discourages the perception that just competing is good enough - a viewpoint expressed by many of the Paralympics volunteers who come from rehabilitation backgrounds but do not have any experience in athletics. "Through no fault of their own, they have their own limited thinking about what is possible and [believe] that the participation alone is what's so great," he says. "But it's not just about participating. These young athletes want to win gold, silver, and bronze medals. And they want to compete against the best in the world. If you don't have that behind you, how can you share that with somebody?"

But that is not to say that rehab professionals cannot play a role in encouraging young athletes. Through the Paralympic Academy, Register has the opportunity to keep pumping lifeblood into the games. Starting with youngsters around age 12, the academy, via state-based hosts, works with disability sports organizations, rehabilitation professional associations, coaches' associations, school districts, and hospitals to build a network. Last year, five pilot programs began, but the ultimate goal is to have one in place in every state that can identify athletes and recommend them to regional sport-specific training facilities. Register encourages therapists to sign up for the quarterly newsletter so that when they see a potential athlete, they will know whom to contact.

Most important, Register wants to show young athletes that almost anything is possible. He talks about a 13-year-old girl, just starting out in sports, who accompanied the group to Athens. For her, the biggest influence was when she saw Paralympians in wheelchairs using escalators. "The Paralympics really expand the human spirit. It's more than just sport. This is saying, 'I can accomplish whatever I set my mind to,'" says Register.

And although the Paralympics may always be the Olympics' younger sibling, NBC television has already committed to running the Paralympic games in 2010 and 2012, a huge step in the organization's visibility campaign. "Our job is to really focus on enhancing awareness at the grassroots level, regionally and nationally in the United States, to make the Paralympics relevant so when there is a broadcast opportunity, people are watching it," said Huebner. "Because one of the worst things that could happen is we do create coverage - national and international - and nobody watches. That would hurt the Paralympic movement more than anything."

Michelle Apuzzio, MSPT, is a contributing writer for Rehab Management.

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January/February 2005