Para Rowing Injuries – Part 3 on the Rowing Sports Medicine and Science Conference

This is part 3 of a 3 part series on what I’ve learned at the 2018 Rowing Sports Medicine and Science Conference.   Post one was about Low Back Pain in Rowers, the second on Rib Stress Injuries and Fractures in Rowers, and this post will focus on the Para Sport with regards to safeguarding and injuries. Dr Yetsa Tuakli-Wosornu was the main speaker on this topic and these are my notes from the session:

Safeguarding athletes from intentional injury/harm

This was a very important subject at the conference.  Intentional injury or harm and includes psychological, physical, and sexual abuse.  A power differential anchors every form of harassment and abuse in sport. Everybody on the athlete support team, including the medical professionals, should form part of the safeguarding process.  

Safeguarding and para athletes:

  • Athletes with impairments have up to 4 times higher risk of harassment and abuse in sport compared to able-bodied athletes
  • The risk is increased when an athlete needs assistance with daily self-care activities, this includes communication, travel and logistics
  • Disability is a predictor in all forms of abuse
  • Risk factors and effectiveness of current prevention strategies are still unknown
  • Cyberbullying is common in athletes with a disability and tolerated for social inclusion/friendship according to this article: McHugh MC, Howard DE. Friendship at Any Cost: Parent Perspectives on Cyberbullying Children With Intellectual and Developmental Disabilities. Journal of Mental Health Research in Intellectual Disabilities. 2017 Oct 2;10(4):288-308.

Read more about Safeguarding

Injuries in Paralympic athletes

Epidemiology of injuries in para athletes

Risk factors for shoulder injuries in para athletes (recreational to elite)

  • Increased age
  • Spinal cord injury
  • Imbalance in the shoulder muscles
  • Highest injury rate at the summer paralympic games was in Football 5-a-side and at the winter games in skiing and snowboarding
  • Seated athletes:
    • The shoulder becomes a weight-bearing joint leading to a high risk of overuse injuries
    • Most sports are also upper extremity dominant
    • Daily wheelchair users also use the upper extremities for mobility, transfers and pressure relief
    • Influence decision making regarding treatment and diagnostics as the athlete needs to use the upper extremity


  • Pre- rehabilitation exercises
  • Pre-participation physical exam with a focus on looking for imbalances in the shoulder girdle muscles including a PPE ultrasound in high-risk Para-athletes
  • It is important to consider the demographics of para athletes in injury prevention because the average age of para athletes is 45
  • Equipment regulation might be important in preventing injuries

Resources on shoulder injury prevention and treatment:

  • This study evaluated a 6-week intervention including strengthening and stretching and found that this intervention may decrease risk factors for shoulder injury in wheelchair basketball athletes. The participants did a 5-minute injury prevention program 3 times a week for 6 weeks.    Other studies have shown that improving range of motion is linked to a decrease in shoulder pain an injury because of better scapula kinematics.
    Wilroy J, Hibberd E.
    Evaluation of a shoulder injury prevention program in wheelchair basketball. Journal of sport rehabilitation. 2017:1-21.


  • This study explored an 8-week exercise program that consisted of stretching and strengthening the muscles around the scapula to determine the effect on people with spinal cord injuries with shoulder impingement symptoms. Stretches included the following muscles: upper trapezius, Pectoralis, Long head of Biceps, and the posterior capsule.  Strengthening exercises focussed on the following muscles: Middle and Lower Trapezius, Serratus Anterior, and Shoulder External Rotators. (See images and descriptions in the article) Nawoczenski DA, Ritter-Soronen JM, Wilson CM, Howe BA, Ludewig PM. Clinical trial of exercise for shoulder pain in chronic spinal injury. Physical therapy. 2006 Dec 1;86(12):1604-18.

Resources on Injuries and Illness in Para Sport

Read the first post in this series: Low Back Pain in Rowers – Part 1 on the Rowing Sports Medicine and Science Conference

Read the second post in this series: Rib Stress Injuries in Rowers – Part 2 on the Rowing Sports Medicine and Science Conference