Recommendations for Coaches
Evaluate your athletes for injury
- Pre participation physical exams
- Keep medical histories on file
- Use extraordinary judgment determining when injured athletes should not participate
- Get to know your athletes. Many will not disclose pain/injury for fear of not getting to play
- Get both medical and parental approval for return to participation
- When collecting athlete information, be sure to record the athlete’s primary and secondary disability
Important Factors for Injury Prevention
- Teaching proper mechanics
- Proper fitting equipment
- Slowly increase training time and intensity
- A good warm up and cool down
- Educating the athlete on taking care of their body
Common Issues to be Aware of
- Overuse injuries
- Dehydration
- Heat illness
- Cold injury
- Acclimatization
- Seizures
- Pressure Ulcers
- Prosthetics and Orthotics
- Multiple Sclerosis
- Brittle Bones
- Concussions
Athletes who use Sports Chairs
- Most common injuries are strains and muscular injuries of upper extremities
- Overuse injuries
- Fractures of hands from falls and collisions
- Overdevelopment of anterior muscles, weakness of posterior muscles
Autonomic Disreflexia: a sudden onset of excessively high blood pressure. It is very common in athletes with spinal cord injuries.
Causes Include:
- Full bladder
- Urinary tract infection
- Constipation
- Sores, cuts, burns
- Ingrown toe nail
- Points of contact with hard/sharp object
Symptoms Include:
- High blood pressure
- Low heart rate
- Anxiety or agitation
- Severe pounding headache
- Sweating above the level of injury
- Nasal stuffiness
- Flushing of skin
- Bradycardia
Prevention Strategies:
- Once pain stimulus is removed, symptoms typically resolve
Pressure Ulcers: an open wound on the skin. Most common in athletes with paralysis or athletes unable to move themselves
Prevention Strategies:
- Clean, dry clothes
- Repositioning, skin checks
- Balanced, nutritional diet
- Proper breaks during activity
Cold Injury: inability to adapt to the cold
- Less sensitive to the sensation of cold on the skin surface
- Diminished perception of skin temperature change
- Diminished capability to stabilize core temperature
- Unable to induce shiver response
Prevention Strategies:
- Educate athletes and coaches on recognition and treatment
- Provide rewarming opportunities
- maintain proper hydration and food intake; wear proper clothing
Athletes with Amputations
Concerns: Risk for skin irritation or breakdown with prosthetics
Prevention: Use appropriate padding and friction eliminating material
Traumatic Brain Injury (TBI) & Cognitive Impairments
- May fatigue more quickly
- Injuries related to not being able to process instruction
- Unpredictable behaviors (known triggers)
Prevention Strategies:
- Wear protective equipment
- Ensure all equipment is maintained
- Deliver instruction broken down into more steps (one at a time)
- Provide schedule and other key instructions in writing wherever possible
- Allow time out’s, but frequently check in with athlete and try and re-engage
- KNOW YOUR ATHLETE
Osteogenesis Imperfecta: fractures/breaks
Prevention Strategies: Low impact exercise improves bone density
Athletes with Cerebral Palsy
- Seizures relatively common in this population
- Increase in lactic acid production leads to muscle fatigue
- Wheelchair users have higher upper extremity strains, sprains, overuse
- Ambulatory athletes have more knee injuries
Athletes with Visual Impairment
- No visual cues
- May have different biomechanics
- May expend more energy because of lack of visual cues (watch for earlier fatigue and overuse injuries)
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