The Challenges of Injury and Disability

The Challenges of Injury and Disability

By: Kerry A. Wiley


After sustaining a back injury (herniated disc) in the spring of 2010 and dealing with the ramifications of the injury for more than 7 months, injury prevention has become a topic of interest and has raised a number of questions for me about how to advance my mobility and fitness goals.

Questions I wrestle with include: How do I advance my fitness and mobility goals while simultaneously preventing a new injury?

I started to cursorily peruse existing literature on this subject and came across an informative textbook published by the University of Alberta Press entitled "Adapted Physical Activity," edited by Robert Steadward and written by Garry D. Wheeler and E. Jane Watkinson.

The book includes research which indicates there are a "disproportionately higher number of back injuries among athletes with cerebral palsy." The authors of the book also deliver the message that "care needs of athletes with disabilities pose unique challenges due to physiology, psychology, and the underlying presence of their disability."

Another study from the Journal of the American Academy of Pediatrics notes that "data on injury patterns during sports and recreation are imperative for determining appropriate care of athletes with disabilities." Based upon this cursory literature review, I first shuddered at the statistic about the disproportionately higher level of back injuries among people with my diagnosis.

I also agree with presented findings that more information is needed for health and fitness professionals who provide support in injury recovery. I would assert the idea that the client / athlete with a disability also needs consistent reinforcement of education, information, and support to assist in injury recovery.

Over the last 7 months, I have dealt with the challenges of the herniated disc injury on top of the challenges that my disability generally presents (e.g., spasticity and rigidity). I have been fortunate to have the ongoing support of a skilled wellness specialist in my recovery process, yet despite this, I was fearful and felt overwhelmed. I wanted to return to maximum function and expand function as rapidly as possible and implement any needed strategies to hasten recovery. At the same time, I remain somewhat fearful that the injury will re-occur or that a new injury could develop.


So, with these existing worries, how do I, the athlete/client, avoid contradiction and "talking out of both sides of my mouth," and accomplish advancement of my fitness goals and avoid injury?

Examples of injury prevention strategies include:

  1. A gradual build -up of physical activity in both the length of time and intensity; and
  2. Changing the type of physical activity implemented so that different muscle groups are engaged.

2011 has ushered in changes to my fitness and mobility program, including key schedule adjustments as well as changes to the exercises performed.

Schedule changes have included moving from a 3-day-per-week schedule for a 30-minute block of time to a 2-day-per-week schedule for 1 hour per session. These changes were driven by several factors, including efforts to implement a more intensive program. More intensive exercises are implemented under the surveillance of the wellness specialist who works with me.

The new routines have been designed to enhance mobility and move me toward a more independent program. Since I am meeting with the wellness professional in a different time configuration, more responsibility falls to me to implement exercises and the designed fitness routines outside the fitness center. My solo routines focus on upper- and lower-extremity work on different days. For example, on Mondays and Wednesdays, exercises focus on my upper extremities (e.g., arms). On Tuesdays and Thursdays, exercises focus on my lower extremities (e.g., legs).


To expand my knowledge and skill base around injury prevention, I began to explore what resources exist to promote injury prevention and came across a series of factsheets and a toolkit (not disability-specific) from the American Orthopaedic Society for Sports Medicine.

The factsheets and toolkit are accessible here:


Athletes with disabilities and the professionals working with them need more information about potential causes of injury (e.g., from overuse). More information is needed for both the client and professional about injury prevention strategies and how to implement them, particularly about adaptations and how pre-existing disabilities can affect injury recovery.

R. D. Steadward, E. J. Watkinson, G. D. Wheeler (2003).
R. D. Steadward, E. J. Watkinson, G. D. Wheeler (2003).
Published online January 26, 2009. PEDIATRICS Vol. 123, No. 2, February 2009, 690-696 (doi:10.1542/peds.2008-0603).

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