Incredible Athletes – Part 2

Part way through Inside Incredible Athletes the dulcet tones of the voiceover start over a stunning aerial of London, “Few injuries are more serious than a broken neck…

…but it seems no one told these guys.” Seconds later men in wheelchairs fill the screen and slam into each other at speed. Welcome to the wonderful world of Wheelchair Rugby

This phenomenal sport hales from Canada, and was originally called Murderball! It was started by those unable, or not strong enough, to play wheelchair basketball, and is played by quadriplegics; those with partial of complete paralysis and/or loss of sensation in all four limbs. It’s a vicious game but as 2012 hopeful Steve Brown explains grinning, “Nothing in life is perfectly safe. Trust us; we’ve all broken our necks!”

The men and women who play this sport are phenomenal; clichéd as it sounds, it was such a privilege to meet them, and an honour to spend time getting to know them during our time filming.

The programme focused on two 2012 hopefuls, Steve Brown and Manny Sehmi. Steve’s story, never fails to move me. “It was a really nice day so [my girlfriend and I] sat out on the balcony,” Steve explains in the programme, “And then, I fell off the balcony. It was as simple as that.” This freak accident snapped Steve’s neck, leaving him without any movement or sensation from the chest down.

Steve and Manny both ended up at Stoke Mandeville, home to one of the top specialist spinal injuries unit in the country. It is also the spiritual home of the Paralympic Games (explaining the name of the 2012 Paralympics mascot!). It was here that they both encountered Wheelchair Rugby, one of the sports used for rehabilitation at the hospital, which opened their eyes to what was possible in life after their injuries.

Wheelchair Rugby has phenomenal sports science support; working for a number of years with Brunel University in West London, and now with the Peter Harrison Centre for Disability Sport at Loughborough University. So, unlike Liz’s physiology, there was a lot more support from the literature for the rugby guys. However, their physiology is equally fascinating.

A measurement of a person’s cardiovascular fitness is called the VO2 max; that is the body’s maximum level oxygen uptake measured during maximal exercise. Wheelchair rugby athletes cannot reach high VO2 max levels and so by conventional definitions these athletes are not physically fit. However, they push what they have to physiological limits and repeatedly break their fitness ‘ceiling’.

A person is described as quadriplegic when the spinal cord at the level of the cranial “C” nerves in the neck is crush or severed. Depending on the level of the lesion, in a quadriplegic the areas of the body affected start roughly from the upper torso downwards as C nerves innervate the arms, neck and upper torso. The skeletal paralysis in the lower part of the body eliminates the muscular pump which pushes blood back up the body through the veins and back to the heart. This encourages oxygen depletion in some muscle groups and reduces a reflex called the Frank-Starling effect. Usually in exercise this effect results in a higher heart rate.

The respiratory system is also affected by the muscle paralysis. The intercostal muscles, found between your ribs, which lift and expand the chest wall to inflate the lungs, are affected. Therefore, even partial paralysis of these muscles can actually decrease the ability to breathe deeply. A person with a spinal lesion higher up in the neck will often only rely on the movement of their diaphragm to inhale and exhale.

On top of this, there are deficits caused from lack circulating hormones, which would have been released as a result of the nervous system. This is a dramatic and debilitating set of impairments; these athletes should not be fit.

But they are; they are phenomenal. Dr Vicky Tolfrey, director of the Peter Harrison Centre, mentioned during our time filming that the results these guys were getting in fitness tests just shouldn’t be possible if you look at current physiology text books. The muscle mass these athletes are able to use is highly trained, increasing the ability of the muscle to take up and use oxygen from the blood as well as increasing power production.

Greater knowledge of the physiology of quadriplegia and the demands of the sport on the athletes has allowed quadriplegic athletes to push what they have almost to physiological limits, breaking all preconceived expectations.  The testing we did with Steve Brown and Manny Sehmi showed how the wheelchair rugby athletes are dedicated to maximising what they have; both guys are getting fitter at every testing. Further research will reveal ways to keep pushing their physiological boundaries.

Their attitudes about life and dedication to their sport are incredible. Steve frequently mentions that it shouldn’t have taken him breaking my neck to do something worthwhile with his life but it did. Make the most of your life; you can do whatever you set your mind to.

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