Wheelchair users and exercise

Magnus from Malmo, Sweden asks:

How do people in wheelchairs exercise?

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This sounds like a very simple question but the answer is probably more complicated than most people would expect.
The first major factor is whether the person usually uses a manual wheelchair or a power wheelchair. This is important because quite often (but not always), the person's ability level determines the type of wheelchair he/she uses. For example, if your spinal cord was damaged at the cervical (neck) area, you may have movement in the arms but perhaps impaired or little movement in the fingers or wrists – this person is more likely to use a power wheelchair to get around town than a manual one.

It is obvious why this makes a difference. Someone in a wheelchair that they have to push up a hill him/herself would get more exercise than someone who simply pushes a lever to do the same thing. That is why when I push myself up a hill, I have a 50% chance of someone mentioning something like, "You must have good cardio" or "You must have strong arms."

Does that mean people who use power wheelchairs cannot exercise? Of course not.

Notice how I said earlier that people with impaired hand/arm function may need a power wheelchair to "get around town." I said that on purpose because it is not the same as needing a power wheelchair to "get around." People with impaired hand/arm function may be able to use a manual wheelchair under certain situations that do not require racking up the miles, such as getting around the house or the neighborhood – or in sports.

Ah, sports. This is a topic that will be gaining momentum this summer as the Paralympic Games in London approach. Many able-bodied sports have been adapted over the years, providing an outlet for people with various disabilities to exercise. As the Paralympics show, some of them turn their exercise into actual athletic competitions.

There are also weight room exercises that wheelchair users can take advantage of. The recent TV series Push Girls shows several scenes of working out with weights. There are also adaptive weight rooms out there specially designed for wheelchair users.

These are also in addition to exercises that you might see in rehabilitation centers and therapy, which can give you quite the workout – many things that are taught in those places require a LOT of core strength (especially important if one does not have full use of his/her lower- to mid-body muscles).

Of course, this is all nice and everything but the hard truth sometimes is that it is not always affordable to take advantage of sports programs or exercise rooms. This is where the unfortunate stereotype of "using a wheelchair because you are fat" comes in.

If you cannot use all of your muscles vital for "normal" exercise (such as walking) and cannot afford exercise programs, it is much more likely that you will become overweight. When you become overweight, you may start having difficulties pushing your own chair (if you use a manual wheelchair). This may lead to shoulder injuries, which becomes a secondary obstacle to pushing your own chair and you may require a power wheelchair. When you use a power wheelchair, you're exercising even less and may get more overweight.

As you can see, it's a slippery slope and one that is difficult to escape from once it starts.

Another factor that may lead to that slippery slope may include prescription drugs, particularly steroids (which some people may need to get enough strength for some functions such as breathing). Steroids can make someone gain weight, which leads to the same situation. This is why I am not a fan of the stereotype of the "fat person using a wheelchair because he/she is fat" – often there is a reason for that and it would have nothing to do with one's eating habits.

As a manual wheelchair user, that is why I try to get as much exercise as possible, whether it be a casual stroll through the neighborhood or playing sports. I know some people with more limited hand/arm function who try to do the same if they can. Unfortunately there is still no simple solution that works for everyone but it is quite important to do what we can to stay in shape.

Do the Paralympics matter?

I have been meaning to answer this question for a while but procrastinated until the timing was right. Well, guess what. The timing is right!

My friend Jess from Vancouver, British Columbia asks:

You probably know that there was talk about whether the Paralympics should be merged with the Olympics... and whether the event has made an impact in disability awareness at all. What do you think?

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This question was submitted a few weeks ago and I was actually already planning to cover it in my other blog, Confined Abilities. But since a question has come in about this topic, I will answer it here instead!

With the Olympics and Paralympics coming up later this year in London, there has been talk about whether the two events should be merged. There have been some rather passionate arguments for and against this; those who are arguing for it are often drawing on the idea of equality while those against it are afraid that the Paralympics will be "swallowed up" by the much larger Olympics.

While there are logistical issues related to merging the two events (such as how to accommodate so many athletes in one city at the same time), I will try to analyze the social aspects of such an act.

Equality is a very relative concept. What is seen as equal to one person may not be seen as equal to another. Some can argue that merging the two events would be "equal" in the way that athletes with and without disabilities can get the same amount of exposure at the same time. Some also argue that due to differences in event size, magnitude and interest, it would be more reasonable to keep them separate in order for the Paralympics to have a chance of success (much like how some may argue that affirmative action has made it possible for previously neglected minorities to "catch up" to the majority).

The idea of equality can also range according to location and society. Having spent some time abroad, there are some instances of disability equality in other places that may be seen as grossly unequal here in North America. For example, I watched a news magazine show from China called "Guangdong Today" where they documented a school for children with developmental disabilities. They praised this school, which was created to keep students away from "regular" schools and in an environment where they are on academically equal footing. They saw it as providing them an equal opportunity to be educated. However in North America, that lack of mainstreaming may be seen as segregation instead of equality.

Equality is such a relative concept that it is difficult to say whether simply merging the Paralympics and Olympics would make things equal, or if separating them would be better. The truth is, your answer will depend on how you look at it and also on the disability culture in which you were raised.

Among all these arguments about how the Paralympics should be handled is the question of whether the Paralympics are effective at all. Certainly as an athletic competition, it is a world-class event and the pinnacle of adaptive sports. But like the Olympics, it is supposed to be a chance for the participants to shine in the public eye – images of athletes gracing the front of cereal boxes and giving pep speeches to gym-fulls of students come to mind. With the limited exposure of the Paralympics, can it truly make a difference in the "real world"?

People with disabilities face many issues in society, even in North America (which is often considered a global center for disability rights movements). These issues relate to employment, healthcare, education, standard of living, relationships and so on – in other words, they are things that people with disabilities cannot always obtain simply due to limitations beyond their control. Despite the social and regulatory advancements in the disability field, these continue to be sore spots.

Many people think that the Paralympics seek to contradict two things: the idea that a disability is a weakness and that glory is achieved through strength. Some may think, "If you can't walk, how can you be considered strong?" I think that is missing the point, and that the true objective of the Paralympics is to challenge the idea of "give/take" when it comes to people with disabilities.

What is the "give/take" idea? In the relationship between people with and without disabilities, there is a very powerful notion that those without disabilities "give" to those with disabilities, and those with disabilities are supposed "take" the help that is given. For example, it is common to see someone try to help someone in a wheelchair but when someone in a wheelchair tries to help others, it is often seen as strange.

With this in mind, I feel that the Paralympics give a chance for everyone to see that people with disabilities can "give" as much as they "take." It gives them the chance to produce something visible for people without disabilities and challenge the existing "give/take" notions. In other words, it can turn what was previously a one-way relationship to a mutual one.

So do the Paralympics make a difference in society? While progress has been slow, I believe it does. An example of this came recently when I was interviewed for a job in a very unlikely location – a car shop. Considering that I know next to nothing about cars, it was very surprising. The manager was interested in finding ways to sell cars and car parts on the internet but could not manage the technology. There were a few candidates and all of them had disabilities (recruited through a local job agency that specializes in finding workers like that). I was told that he was inspired to go this route because he saw a wheelchair basketball game at a community center and was impressed by what people with disabilities were capable of, and realized that this could be an untapped gold mine since many of those people had very marketable skills.

Simply hearing that was a welcome surprise and while not everyone who watches a Paralympic sport will think like this (or be in a position to hire people), there is no question that once in a while it can have an effect that can spill over to "real world" solutions.

The Paralympics definitely matter. But it is always easier to build ramps and elevators than it is to change people's perceptions. It may take a while for it to happen and it may not happen within our lifetimes but in the future it would not be surprising to see that things have improved drastically.