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Keeping Olympic wheelchair rugby players cool

Article reposted from ars technica
Author: CHRISTINE RO

Overheating is a problem for many athletes, but wheelchair athletes can face an even more extreme version of this challenge. Many of these athletes compete with spinal cord injuries and therefore “are unable to sweat and control their blood flow below the level of their lesion,” said Katy Griggs, who researches the thermoregulatory responses of wheelchair athletes. The ways that these Paralympians “can cool themselves by external sources are important,” she told Ars.

Due to these difficulties with thermal regulation, Team USA wheelchair rugby players (all but two of whom have spinal cord injuries) jokingly refer to themselves as “reptiles.” But their efforts to cool themselves during the 2016 Paralympic Games, beginning this week in Rio de Janeiro, are deadly serious.

Trainers generally pay close attention to athlete temperatures and the possibility of heat illness, but they have to be extra vigilant when it comes to wheelchair athletes because self-monitoring can be more difficult. For instance, wheelchair users can’t always see the color and amount of their own urine, making it more difficult to use it as a gauge to hydration. (And to be more alert to dehydration or overhydration, Team USA staff now use refractometers to measure the gravity in urine.)

Jim Murdock, the athletic trainer/medical coordinator for the US wheelchair rugby team, has tried just about every innovation around to keep his athletes cool. Ice vests have been one of the most effective cooling techniques for improving the performance of athletes with spinal cord injuries, but Murdock has found them to be of limited use for the rugby players he trains.

“The problem is the vests don’t fit them,” he explained to Ars. “[After all] each guy fits in their chair differently.” It would be labor-intensive to customize these types of garments for each athlete.

Another common strategy is localized cooling of body parts. It’s not always practical for wheelchair athletes to engage in whole-body water immersion (cryotherapy) as some able-bodied athletes do. Researchers have looked at immersing hands and feet into cold water or using cooling devices on specific body parts, though this may be more appropriate following exercise.

But again, this is a no-go for Team USA’s wheelchair rugby team. These athletes are typically wearing gloves or tape on their hands, and they can’t afford to let their hands go numb. It’s also cumbersome and time-consuming to remove shoes from feet that are typically tucked back in wheelchairs.

Trucking around an inflatable pool to use as a cooling tub can work—the Paralympic team has had to do it—but it’s also a pain. And that plan will be complicated in Rio by the fact that some athlete facilities lack ice machines, freezers, and air conditioning.

So what to do? Low-tech remedies are best at the moment. One mainstay for keeping rugby players cool is a cold beach towel, applied for 10–15 minutes during physical exertion. A spray bottle filled with cold water is another.

Still another is similarly no-frills: the humble slushie. “Everybody loves the slushies,” according to Murdock. Whether they’re made of Gatorade or something else, there is a strand of research that backs up the efficacy of this strategy. For example, this article in the journal Sports Medicinesuggesting that ice slurries may work to lower core temperatures and enhance performance through effects “on brain temperature, internal thermoreception, and sensory responses.”

The drive to optimize recovery and performance doesn’t mean that wheelchair athletes aren’t resilient and adaptable. But able-bodied athletes have plenty of resources, and comparatively little attention is paid to athletes with physical impairments. “There’s not a lot of things out there for athletes in wheelchairs,” Murdock noted. And among this small body of research, few studies take into account these athletes’ widely varied capacities and conditions.

Even if some of the cooling techniques haven’t changed much from when Murdock himself was an athlete, the monitoring today has to be sophisticated. Two members of the wheelchair rugby team representing the US in Rio have diabetes, and as Murdock noted, “huge thermal swings are not good for them.” So team trainers have implemented data collection systems to track the athletes’ status. This includes examining whether athletes with higher cardiovascular fitness levels are less prone to overheating.

The scientific evidence on how different cooling techniques affect core/skin temperature remains mixed. With so many variables—timing, duration, body part, temperature, device weight, type of activity, nature of impairment—doing research is complex, and previous studies on athletes with spinal cord injuries have tended to be small-scale. Translating findings from a research setting into practical application remains a hurdle.

Researchers, trainers, and athletes aren’t the only ones concerned about overheating; sporting bodies are aware of the issue as well. Eron Main, CEO of the International Wheelchair Rugby Federation, explained to Ars that a temperature of 66.2–71.6°F is required for matches.

“In fact, we typically require tournament organizers to ensure that there is a power supply at each bench so that teams can plug in fans,” he said. “A few teams have even brought small chest freezers to the bench to keep ice vests cold.”

Both on and off the field of play, athletes are allowed to wear cooling neck collars, vests, and other garments, as long as they match the uniform colors and don’t create a safety hazard.

Given the intensity of the sport first called “murderball,” let’s hope that temperatures aren’t an issue
in Rio.