Humans are predestined for movement – probably everybody knows the good feeling after having been physically active. This physical basic need doesn't change despite an SCI. It is therefore an important goal of first rehabilitation to avoid that people with SCI are less physically active and therefore suffer from reduced functioning, mobility and independence. Not getting enough exercise may not only influence the physical health and the well-being of a person but may also lead to an increase of mental issues – and this usually long after returning to everyday life after first rehabilitation. Studies have even shown that people who are less physically active tend to suffer more frequently from depression, anxiety and a decreased quality of life. Moreover, a fit and active body is less prone to co-morbidities. Due to breathing more deeply and an increased blood circulation during sports activities, the risk of urinary tract infections, respiratory diseases, increased spasticity and pressure sores is decreased – this applies for complete and incomplete paraplegia and tetraplegia. The physiological advantages for people with SCI of being physically active have been proven in numerous studies. Here are some examples:
Being physically active therefore does not only contribute to maintain and develop the physical skills but has also an important psychosocial component – not only for people with SCI. Regained passion and joy in physical activity may help to better cope with the new life situation. Enjoying physical activities is an important element for self-esteem and self-confidence and allows to not only test one's limits but also to increase them through training.
Furthermore, being actively involved in a sports club or an interest group promotes social interaction and integration. For many people, sports is a good opportunity to meet other people, not only with SCI but also pedestrians, and to make friendships. To keep moving does not only mean staying alone at home or in the gym and "grinding out kilometers" but is an interesting and communicative leisure activity, especially within a group.
The choice of disciplines for people with SCI is more diverse than one can imagine. The website of the Paralympic Committee gives a good idea of what may even be done as high-performance sports in competitions (www.paralympic.org). Which sport is most suitable, can be determined in a rehabilitation facility or together with a physiotherapist or sports therapist who is experienced with people with SCI.
As early as 1948, the physician Sir Ludwig Guttmann understood that sports play a very important role during first rehabilitation of people with SCI. His commitment resulted in the first Paralympic Games in 1960. Ever since, the repertoire of disciplines of the Paralympics has been increasing constantly. Some sports disciplines are still in their beginnings; however, many of them established themselves many years ago and are very popular within the community. Depending on lesion level and physical skills, the following sports disciplines may be an option (small selection):
This sport is popular with incomplete and complete paraplegics and tetraplegics (people with spina bifida and amputations are usually integrated into respective competition classes). During national and international sports events competitions regarding all common distances are held – from sprint to marathon.
The handbike is not only a very suitable means of transport but allows for a very gentle way of doing sports. Since the shoulders of most people with SCI are heavily used through the daily propelling, they often get problems with the tendons and muscle attachments. As shown in a study, handcycling is not only more efficient, but puts also less pressure on the shoulder girdle.
There are competitions in various classes over various distances.
The "bodiless" sport, as basketball is also called, is especially popular among people with paraplegia. Not only physical endurance and balance is required but also team spirit and the ability to overview. Wheelchair basketball has been played since 1945, when American veterans put their national sport on wheels.
Similar to basketball, rugby is a very active and fast-paced team sport that is mostly played by tetraplegics (Low Point Rugby). Specially designed wheelchairs protect the players from injuries, when the athletes crash against each other with their sports devices. Also here, endurance, skills, team spirit and strategy are important elements of the game.
Another ball sport that is played in over 100 countries and has also been a discipline of the Paralympics since 1992 is tennis. The rules of the game are identical with those for pedestrians – the only exception is that the ball may touch the ground twice before it needs to be hit. In order to be able to play tennis, the hands and arms need to be fully functioning. Tennis is therefore especially suitable for paraplegics with a low lesion level.
Even though skiing is not possible everywhere and also very time consuming and needs many resources, it is a very popular mass sport. One would assume that skiing is only possible for people with a low lesion level but also people that do not have a sitting balance can enjoy the sport on the slopes in the skibob. Depending on the independence of the person, an person assisting is needed.
The range of possible sports activities is much wider: Even fun sports such as surfing, climbing, wheelchair skating and motor sports (quad bike riding) but also dancing and yoga are possible depending on the physical prerequisites. Especially people with tetraplegia dedicate themselves to target shooting (archery among others) or e-hockey (hockey on electric wheelchairs for tetraplegics). As long as one enjoys exercise and it is good for body and mind, it does not matter which sport you choose. It is recommended to try out the various sports offered within the regional wheelchair clubs or associations after consulting a health professional. In Switzerland the sport consulting services and promotion offered by the Swiss Paraplegics Association (www.spv.ch) are very well organized. Especially the regional wheelchair clubs are an ideal meeting point to get in touch with other people and learn new things.
updated: December 2013