Ensuring a level playing field at the Paralympic Games

Ensuring a level playing field at the Paralympic Games

Canadian spinal cord research is clarifying what disability means for athletes with spinal cord injuries
August 24, 2012

The world watched in awe as Oscar Pistorius, or “Blade Runner” as he was deemed by the international press, competed in the Men’s 400M race at the London Olympics.  Pistorius may have lost the race, but his story forced the world to confront tough questions of what it means to be disabled and how we define ability in modern sports.

These questions will likely be on the minds of officials in London during the Paralympic Games that run from August 29 to September 9. Dr. Andrei Krassioukov at the University of British Columbia’s ICORD institute is working to make sure that athletes with spinal cord injuries are able to compete on equal footing.

Up to 90% of people with injuries between the cervical and high thoracic vertebrae suffer from autonomic dysfunction, a condition that limits their ability to regulate heart rate and blood pressure. For top-level athletes, this can be a huge competitive disadvantage.

The Paralympic Committee has designed a classification process where athletes are grouped based on the degree of their disability. The committee’s website states:  “Classification is simply a structure for competition. Not unlike wrestling, boxing and weightlifting, where athletes are categorized by weight classes, athletes with a disability are grouped in classes defined by the degree of function presented by the disability.”

In other words, the goal is to make sure that disabled athletes are competing against people of similar abilities, thus leveling the playing field and ensuring that judging is done based on excellence alone.

This classification system does not, however, include an assessment of autonomic function. Dr. Krassioukov’s work has shown that for athletes with spinal cord injuries, this is an important short-coming.  

Facing the pressure of top-level international competition, Paralympic athletes with reduced autonomic function have found creative ways to boost their blood pressure. This includes purposely inflicting pain or discomfort on themselves to cause huge spikes in their blood pressure.

“As a clinician, I can understand why these athletes are feeling the need to boost their blood pressure artificially” said Dr. Krassioukov. “Imagine waking up with low blood pressure and not being able to increase it through the normal means. You can’t simply exercise or have a cup of coffee to feel better. It’s a huge disadvantage.”

These spikes from boosting can cause serious damage to an athlete’s health and even lead to death. The inability to control blood pressure causes serious damage to the cardiovascular system. In fact, cardiovascular issues are the leading cause of death among people with spinal cord injuries.

“In the clinic, in a controlled situation, we use blood pressure boosting as a treatment for patients suffering from autonomic dysfunction” said Dr. Krassioukov. “But at the games this practice is both dangerous and banned – it is considered a form of performance enhancement.”

The Paralympic committee has charged Dr. Krassioukov with finding a solution to this problem by adding assessments of cardiovascular function to the system of classification for Paralympic athletes.

This move won’t happen overnight, but Dr. Krassioukov has been making important progress. He has collected data from athletes at the Paralympics in Beijing and Vancouver and he’ll be in London to conduct assessments and offer education to athletes on the risks of blood pressure boosting.

He’ll be on a plane to London later this month and is bringing along advanced testing equipment funded through the Canada Foundation for Innovation to help him and his five graduate students conduct their research.