Injury Patterns in Elite Paralympic Track and Field and Swimming

During the past several years, we’ve been fortunate to help multiple Paralympic athletes in multiple sports, with an emphasis on the visually impaired.  We’ve documented some of these experiences on the site and also included a motivational talk from elite track and field athlete Tanner Gers in our video section. 

Unfortunately, specific research on this population is often lacking, as it’s a fairly narrow niche.  Recently though, two studies from Brazil have examined injury patterns in visually impaired athletes in both track and swimming. 

In the track and field study, Magano E Silva (2013) collected injury data from Brazilian athletes at five international competitions between 2004 and 2008.  Most notably, authors found no statistically significant differences between visual classes or between genders.  Track and field includes three visual classes, including completely blind and two separate categories of incomplete blindness but with different visual impairment severity. 

Authors made the following observations:

• 31 of the 40 athletes sampled reported at least one injury with an average 1.93 injuries per athlete.
• 82% of injuries were classified overuse, 18% acute
• Lower limbs (87%) were most commonly injured followed by spine (12%) and upper limbs (1%).
• The body regions most affected were the thighs (33.8%), lower legs (16.9%), and knees (9.1%). The most frequent diagnoses were spasms (26%), tendinopathies (23.4%), and strains (13%)

Theoretically, visual impairment may affect motor control, as we rely on vison for muscles to anticipate movement.  Despite vision’s paramount role, the human body is wonderfully adaptive.  Even those Paralympians with an acquired visual impairment (rather than inherited) can utilize other senses to facilitate movement.  It is possible that more detailed study on the mechanisms behind each visual impairment case may reveal differences.  Does how long someone has been visually impaired affect their injury risk?  Though the evidence does not support any injury differences based on impairment class, it is possible that the ability to re-learn motor skill after an acquired impairment may affect performance.

Similar injury trends in a related study on elite Paralympic swimmers with visual impairments (Silva 2013).  As with the track and field study, the swimmers represented all three visual classes.  Also like the track study, authors collected data from five international competitions from 2004 to 2008. 

In this study, 18 of the 28 swimmers reported injury, with a cumulative total of 41 injuries.  Overall findings were similar to track and field, though the distribution among body parts presented a few predictable differences.   

• No statistically significant difference between sexes or visual classes, though clinical prevalence did vary.
• Overuse injuries (80%) outnumbered traumatic injuries (20%).
• The highest proportion of injuries was in the trunk (46.34%), followed by the upper limbs (34.15%).
• The shoulders (29.27%) were most affected, followed by the thoracic (21.95%) and lumbar spine (17.07%).
• Spasm (36.59%) was the most frequent diagnosis, followed by tendinopathy (26.83%).

Not surprisingly, the upper body among Paralympic swimmers was the site of more injuries than in track and field, in which the lower body took a greater beating.  Neither of these findings is specific to Paralympic sports, but it does confirm that Paralympic athletes are subject to similar injury patterns as able bodied athletes.  It’s unclear from these particular studies whether injury risk is heightened, but it is worth noting that taken as a whole, the spine (thoracic and lumbar regions) suffered more injury than the shoulders in these swimmers.

Conclusion

In sum, it should be no surprise that track and field athletes suffered more lower body injuries, and swimmers more upper body injuries (to include the shoulders and spine).  As noted, future study could focus on mechanism of visual impairment (acquired vs. inherited) and the effect that vision therapy in conjunction with performance training and musculoskeletal therapy may have on injury prevention and rehabilitation in these populations.  

References

Silva MM, Bilzon J, Duarte E, Gorla J, Vital R.  Sport injuries in elite paralympic swimmers with visual impairment.  J Athl Train. 2013 Jul-Aug;48(4):493-8. doi: 10.4085/1062-6050-48.4.07. Epub 2013 Jun 14.

Magno E Silva MP, Winckler C, Costa E Silva AA, Bilzon J, Duarte E.  Sports injuries in paralympic track and field athletes with visual impairment.  Med Sci Sports Exerc. 2013 May;45(5):908-13. doi: 10.1249/MSS.0b013e31827f06f3.