Soft tissue injuries to USA paralympians at the 1996 Summer Games

Objective: To report the soft tissue injuries sustained by the members of f our disabled sports organizations (DSOs) who competed as the USA Team at th e 1996 Paralympic Games. Setting: 1996 Paralympic Games, Atlanta, Georgia. Methods: Soft tissue (strain, sprain, tendonitis, bursitis, or contusion) i njury frequencies sustained by Disabled Sports USA (DSUSA, n = 66), the Uni ted States Association for Blind Athletes (USABA, n = 53), the United State s Cerebral Palsy Athletic Association (USCPAA, n = 56), and Wheelchair Spor ts USA (WSUSA, n = 129) athletes were compared by body region with chi-squa re tests (p < .05) and standardized residual assessment. Results: A total of 254 soft tissue injuries (67% acute onset, 170/254) wer e sustained by the participant DSO members. Statistical design limitations and poor USCPAA athlete homogeneity prompted their exclusion from group com parisons (descriptive results are reported). The most common injury regions for specific DSOs were shoulder (26%), hip-thigh (14%), and ankle (12%) fo r DSUSA; hip-thigh (21%), cervicothoracic region (19%), and shoulder (17%) for USABA; lumbar region (14%), foot-toe (13%), and ankle (9%) for USCPAA; and shoulder (18%), arm-elbow (12%), forearm-wrist (12%), and lumbar region (9%) for USUSA. Chi-square residual analysis showed that the USABA. athlet es contributed more to cervicothoracic and lower leg region injury frequenc ies than DSUSA or WSUSA athletes. The WSUSA athletes contributed more to el bow-arm and forearm-wrist region injury frequencies than DSUSA or USABA ath letes. The DSUSA athletes contributed more to ankle region injury frequenci es than USABA or WSUSA athletes. Conclusions: Differences in soft tissue injury frequency among athletes of differing DSOs suggest that the competitive use of adaptive or assistive de vices, in combination with sport-specific stressors and the athletes' disab ilities, is related to the development of predictable soft tissue injury pa tterns. The decreased incidence of shoulder injury among WSUSA athletes sug gests that the injury prevention advice provided by previous studies is bei ng implemented among athletes at this competitive level. The increased inci dence of ankle injuries among DSUSA. athletes suggests lower extremity load imbalances (prosthetic vs uninvolved) during running. The increased incide nce of lower leg injuries among USABA athletes suggests "overuse" injury pa tterns typical of nondisabled runners, or inadvertent contacts (contused sh ins), whereas the increased incidence of cervicothoracic injuries suggests injuries related to falls, "near falls," or sudden directional changes prom pted by guidance aids.