Amputee sports

Disabled athletes face many challenges in their efforts to participate in competitive sports. Playing with or against a physically challenged athlete adds a new dimension to sports.

Several years ago, I had the opportunity to golf with a gentleman who had lost his leg to cancer. The level of his amputation was in the pelvis so he could not wear a functional prosthesis. He played every shot while balanced on one leg, including getting out of sand traps. He shot an 84 on a course he’d never played before and never slowed the pace of the game.

The human body has a tremendous ability to adapt to conditions as they are presented. This function is much more efficient in people who are in good general health. In the case of a lower extremity amputation, the nervous system adapts by refining the neurologic network of the cerebellum, inner ear, and peripheral nerves to improve balance. Often the biggest obstacle is fear and a lack of confidence.

Dr. James Leonard, a physical medicine and rehabilitation specialist at the University of Michigan, works extensively with amputees. “Young amputees adapt quickly and those who were athletes before their amputation seem to have a better understanding of their body than non-athletes and thus fair better,” Leonard said.

Oscar Pistorius is a double amputee born without supporting leg bones between his knees and ankles. This year he will be allowed to compete in track events at the Beijing Olympics. Several protests have been registered, complaining that his prosthetic legs give him an unfair advantage over able-bodied runners. After completing tests at the MIT laboratories, no advantage was found.

Amputees are unfortunately growing in numbers as a result of the wars in Iraq and Afghanistan. Many were accomplished athletes before their injuries and have a tremendous desire to return to sports. The Wounded Warrior/Disabled Sports Project establishes programs for wounded veterans to get back to competition.

While we tend to focus our interests in sports on famous, well-paid athletes, it is comforting to know that the athletic spirit is alive and well at other levels of sports.

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital with a private practice at NeuroDiagnostics, LLC in Norwich. He can be emailed at You can listen to a podcast of this column at

Exercise is important for pregnant women

Throughout life, the human body undergoes various changes. These may be related to normal growth, aging, or illness. Among the most dramatic changes are those associated with pregnancy. Just as the body changes, the basic requirement of regular exercise also changes. Often the need for activity increases rather than decreases.

Many women do not feel like working out during pregnancy and may use that time as an excuse not to exercise. Studies have shown that regular exercise while pregnant is beneficial to both mother and child.

Dr. Stephen Briggs, an Ob/Gyn on The William W. Backus Hospital Medical Staff, has found that patients involved in a regular exercise program have “more efficient labor.” He defines this as requiring fewer pain medications, having shorter labor, with an overall better delivery.

After checking with your physician, an exercise plan can be implemented with the help of a personal trainer or local gym that sponsors fitness classes for pregnant women. Any program should be specific for the different stages of pregnancy. Contact sports, scuba diving, and vigorous weight training should be avoided. Any sports requiring balance such as skiing, skating, or cycling can lead to falls due to a shifting center of gravity and are also discouraged.

Exercise goals should not be set toward improving overall endurance and the “no pain, no gain” philosophy is the wrong approach. Heart rate, fluid intake, and body temperature should be monitored.

The best fitness program incorporates yoga and pilates-style exercises to improve flexibility. Walking is excellent and can easily be added to a swimming component. The buoyancy of a swimming pool alleviates the strain from additional weight in the last trimester. Regular use of a stationary bicycle is another outstanding way to stay fit.

Following an exercise program, along with proper nutritional requirements, is a great way to work through the life-changing experience of pregnancy. It may also be a good idea to get the coach involved in the program to make it a family affair.

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital and in private practice at NeuroDiagnostics, LLC, in Norwich. E-mail him at If you wish to learn more about healthy sports topics listen to the podcast or go to the Healthy Sports blog at

Exercise can help your memory

Among the most frequent human fears is the loss of memory. Whether it is the result of Alzheimer’s disease or its recently identified predecessor, Mild Cognitive Impairment (MCI), the inability to recognize loved ones and remember recent events vastly diminishes quality of life.

MCI represents a transition state between cognitive impairment from normal aging and Alzheimer’s disease. People with MCI are more likely to develop Alzheimer’s than the normal aging population.

There is now an expanding body of data indicating that moderate, regular exercise will help avoid this tragic situation.

At this year’s meeting of the American Academy of Neurology, several research presentations addressed Alzheimer’s and MCI.

One of the most intriguing reports was presented by researchers from the Mayo Clinic. They studied 868 individuals between the ages of 70 and 89. They looked at the exercise habits of these people during the ages of 50 through 65. The study found that those participants who exercised moderately (30 minutes or more) two to five times per week were less likely to develop MCI in later years.

Another proposed strategy for diminishing the likelihood of developing MCI emphasized the incorporation of an intellectually stimulating activity while exercising. This can be done by performing various mathematical problems while monitoring activity such as heart rate, miles, or steps per minute.

Other presentations dealt with the early onset of Alzheimer’s disease in heavy drinkers (more than two alcoholic beverages per day) and smokers. High cholesterol levels in 40 to 50 year olds were also cited as precursors to Alzheimer’s disease. It is unknown if exercise stimulates the emission of a protecting substance that reduces the incidence of Alzheimer’s, or if it is one element in an overall healthier lifestyle necessary for better cognitive outcomes.

Based on these studies we can conclude that the combination of moderate exercise, no tobacco, a healthy diet limiting fats and alcohol, and intellectually stimulating activities will diminish the risk of severe cognitive impairment and improve our quality of life in later years.

ACL tear highlights a problem but also true sportsmanship

In April, sports fans witnessed an event that warmed everyone’s hearts and highlighted the true meaning of sportsmanship. It also emphasized a common sports injury.

Western Oregon and Central Washington Universities are Division II NCAA schools. Sara Tucholsky, a Western Oregon senior, hit the first home run of her softball career. She over ran first base and had to reverse direction to step on the bag. That sudden movement caused her right leg to collapse and left her writhing in agony. The umpire ruled that if she could not complete her home run trot, her effort would be recorded as a single.

Two players then lifted Tucholsky and carried her to each base so the home run would be recorded. The inspiring part of this story is that they were members of the opposing team and performed this unselfish act without a second thought. Tucholsky’s injury was a torn anterior cruciate ligament (ACL), the most common serious injury in women’s athletics.

The ACL is one of four major ligaments in the knee joint. It limits movement of the lower leg and stabilizes the knee’s front-to-back movement. It is often injured when an athlete suddenly stops running or pivots on a planted foot, twisting or overextending the knee.

Dr. Thomas Trojian, team physician for UConn women’s basketball, recently published a medical review of injuries in women’s basketball and cites the reason for increased ACL tears in women as multifactorial. Proper landing techniques, imbalance between quadriceps and hamstring muscle development, and hormonal influences have all been cited as contributing causes.

Treatment is surgical for those who wish to return to activities which involve pivoting. Rehabilitation is demanding and involves strengthening hamstring muscles to avoid further injury.

New physical training and conditioning regimens will hopefully reduce the incidence of ACL tears in women’s sports. No physical program can prepare an athlete to demonstrate sportsmanship the way it was in April. That training comes from great role models and coaches who truly understand what sports are all about.

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital and in private practice at NeuroDiagnostics, LLC, in Norwich. E-mail him at If you wish to learn more about this column or other sports health topics – listen to the podcast or go to the Healthy Sports blog at