Athletes competing at the highest, international, level need to maintain their bodies in peak condition by keeping healthy and eating the right foods. When it comes to Paralympic athletes, this effort becomes superhuman.
We saw how much of a challenge it was for our Olympic athletes competing in the heat in Tokyo, but for Paralympic athletes, it’s a whole other level.
Spinal cord injuries happen when you damage the nerve that runs down the spinal column. They are classified by the level of damage there is to either complete or incomplete injuries. Having the former means you have no function below the site of injury, whilst with incomplete there is some (but not total) loss of function.
The position of the injury will also affect function; damage near the neck may cause paralysis in all limbs, whereas one lower down may mean you still have use of your arms and upper body.
Of particular importance in Tokyo, is that it isn’t just the muscles that you can’t move below the site of injury; you also can’t sweat there, which would lower your temperature. There are some things that can help. Having tournaments in the morning or late afternoon/evening when it is not as hot, moving to the shade or cooler places, as well as having cold drinks are useful tactics.
Sport science has a lot to offer here too – we will probably see cooling jackets or other technology to help keep athletes cool. But this will be complicated by the rules of the sport, as many won’t let you use these throughout the competition.
There can also be a huge variation in disabilities, even within the same sport. To make a team for wheelchair rugby for instance, players can be male or female and are classified by a points system, according to their impairment. The points range from 0.5, which is the highest level of impairment, to 3.5, and the total points for teams must be no more than 8 or (if there is a female playing) 8.5.
The range of points in a team means a range of disabilities; athletes may have spinal cord injuries, amputations, neurological disorders or other medical conditions. Some athletes, such as amputees may compete in a wheelchair, but not use one when they’re not playing sport.
This range of disabilities means a range in nutritional needs; a much wider one than you’d see in an able-bodied basketball team.
The aim when working with all athletes is to give evidence-based sports nutrition advice. But in disability sports there is nowhere near the same amount of research as there is with able-bodied sports.
In practice, this means we need to make the best of what we have and adapt the guidelines for able-bodied athletes to fit para-athletes. Essentially, we use trial and error and make an educated guess. For some athletes, e.g. those with hearing or visual impairments, this is fine, as their nutrition requirements don’t really differ from those without the impairment. For others, even the basics of nutrition needs are hard to pinpoint.
Many of the calculations we use for working out how many calories an athlete needs are based on height or weight. An athlete who had both legs amputated early in life, won’t know what height they would have grown to, and you have to estimate it. Some may know their pre-amputation height, but not always.
Even if you can calculate energy (calorie) requirements using height there are still further complications. An amputee has less muscle mass than an able-bodied athlete, meaning they have a lower energy requirement. However, if the amputation means that the way that they move differently as a result, they may have higher energy requirements than their able-bodied counterpart would walking the same distance. The extent to which each of these two opposing factors impact on calorie need is very difficult to quantify.
On top of that there will be practical issues you need to consider. You may have seen able-bodied tennis players taking a swig from their water bottle during breaks in play. This is hugely important as how well-hydrated you are can affect how well you compete. However, some wheelchair tennis players need to tape the racquet to their hand if they’re not able to grip it. Rehydration is still important; you just need to be creative about how you do it. Straws may work and/or assistance may be needed.
While in able-bodied sports, food hygiene and immunity have an important role, in para-sports this is even more vital. And that’s even before the challenge of coronavirus. Having an assistance animal means frequent close contact with them, to allow you to get around. Self-propelled wheelchairs require you to put your hands on rims that have been close to the floor. Athletes may have a medical condition that makes them more susceptible to illness and infection. You have to be especially careful about handwashing at all times in para-sports, and especially before eating, to stay healthy.
Driving home from work in the UK, shortly after the 2012 Olympics, I saw billboards at the side of the road with the slogans “Thanks for the warm-up” and “Meet the superhumans”. These were to highlight that London 2012 was not yet over, and the Paralympics was yet to come. The more I learn about nutrition needs for para-sports, the more I think superhuman is an understatement.
