From Rehab to the Paralympics

“Sport saved my life. If I wasn't up for it, I would have given up on everything.” W. Terto

From Rehab to the Paralympics

Overgoor, A., De Leeuw den Bouter, M.D., & Akkermans, L.D.

The Paralympics are booming! The 2016 Rio Paralympic games had 2.15 million spectators, more than twice as many viewers as the London 2012 edition, with amazing features of human performance on display. With popularity on the rise, the question of how to get to the elite Paralympic level also arises. An understudied field of research, even though serious money is to be made from a successful Paralympic campaign in the future, while simultaneously inspiring millions of able-bodied and disabled people around the world. But how can people who acquired a handicap in their life in a (most likely) traumatic way get back to sports again? And if they do, what is the best route to Paralympic excellence?

Sport plays an important role in the lives of people with a disability, promoting better rehabilitation outcomes as well as offering opportunities for recreation, social interaction, and the pursuit of athletic excellence.1 Competition is a defining feature of sport and one of several factors that sets sport apart from other physical activities such as exercise, activities of daily living or recreation. Moreover, competition is known to be a factor that motivates many thousands of people to play sport. (21)

Active people who acquire a handicap have great chances to keep performing and maybe even reach higher levels of competition than before. This is because the elite level in Paralympic Sports is, in most cases, more reachable than in able-bodied sports due to a smaller number of participants.5 Because this is such an understudied field, no rock-solid evidence about what's the best way to reach top level on Paralympics can be given. However, the scarcely available research does provide some recommendations that can be followed in order to positively influence the development of the Para-Athlete.

Studies have shown that talent can be transferred from one sport to another.(8,9,10,11) In the context of this article, what is understood by talent is something a person possesses that makes him or her more likely to succeed in a certain area. Based on talent transfer studies in able-bodied sports it is believed that the sport experiences someone has had while being able-bodied could also facilitate the participation in Paralympic sports after acquiring a handicap.(8,9,10,11) In addition to athletes with a physical impairment, athletes with a visual or intellectual impairment can also participate in the Paralympic Movement. However, they were not included in this study.

To gain insights into the experiences of mature athletes who faced the unfortunate events of acquiring a handicap and still want to be competitive in sports, two Para-Athletes were interviewed:

- Bruno Landgraf is a former professional football goalkeeper in Brazil who, after a car accident, became paraplegic and is now a Paralympic sailor.

- Wesley Terto is a Brazilian Jiu-Jitsu brown belt and above elbow amputee. Even after his motorcycle accident, he trains and plays against able-bodied people.

1. Experience as many sports as possible!

If we look into the talent development systems in able-bodied sports, we see the ever-present sampling/specialization debate.4,6 It is generally recommended that young athletes should sample multiple sports before specializing in one sport. Motor skill development is one of the many benefits of sampling many sports as a child, while early sampling also influences continued sport participation and elite performance positively.(4)

What recently handicapped people have in common with children is that they have to (re-)learn their bodies before they can perform at a higher level.5 For example, following an amputation, the biomechanics of your whole body change. This influences how much force your muscles have to exert in order to make a certain movement, especially if the movement is complex, as in many elite sports. The quickest way to re-learn your body is through re-entering the sampling years.5 Sampling many sports before specializing in one particular sport should have the same positive effects in Para-Athletes as it does in children. Once the athlete feels comfortable with his body it is time to choose a sport in which they want to perform, be that at a high level or recreational.

This is in line with the experiences of Wesley Terto. He states that being active in sports like football, parkour, boxing and skating let him develop necessary balance skills to be able to play Jiu-Jitsu on a competitive level after his accident. Furthermore, being active as a kid helped him to know his body better but also helped him to adjust more easily to his new physical condition after the amputation.

2. Find your (new) sport and class!

Once you find a new sport you are passionate about and want to compete in, go practice! If your impairment makes you eligible to play the sport of your choice according to the Paralympic Movement, you must be classified by the Sport's International Federation. Systems of classification are an important feature of Paralympic Sport as it makes sure there is a level playing field by ordering groups based on physical properties that they have in common and in this way promote participation.(2)

When competition is one-sided or predictable, the motivation to participate goes down, particularly among the unsuccessful. Proper classification ensures this is less the case. Importantly, not every physical impairment is eligible to every Paralympic Sport. For instance, someone with an amputated hand might not be eligible to compete in Para-Athletics, but might be able to participate in swimming, where the hand plays a more important role in performance. Table 1 provides an overview of the different eligible impairments for each Paralympic Sport.

The evaluation for classification varies with each federation. In general, the pathway for classification includes athlete presentation, verification of accreditation, physical assessment, technical assessment and observation assessment on training sessions. Finally, following athlete evaluation, a Sport Class and Sport Class Status are allocated to each athlete in accordance with the International Standard for Athlete Evaluation and he or she is officially allowed to participate in competitions. Further details about eligibility and classification can be checked at the website of the International Federation of the sport of interest.(4)

3. Transfer your Talent!

Is it possible to attain a high level in sports even after acquiring a handicap at a mature age? It is known that early beginnings and huge amounts of training since early ages help in talent development.6,7 However, when considering mature athletes who just faced the unfortunate events of acquiring a handicap, this pathway is hardly possible due to their age.

Another way to look at becoming a high-competitive athlete is through transferring from one sport to another at mature age.(8) According to this relatively new concept and current evidence,

(5) this pathway seems promising for mature athletes still aspiring to be successful in another sport.

For example, in talent transfer for the able-bodied, someone with a history in sprinting made it to the winter Olympics in skeleton within just 14 months of intensive training!(9) A substantial overlap between the old and the new sport seems beneficial and could speed up the transfer process. However, there is also evidence of successful transfers between sports where there is no obvious overlap of physiological or technical abilities.(10)

In examining the factors that underlie successful transfers between sports, other factors besides the overlap also seem beneficial. A supported claim is that psychosocial factors are maybe of more importance for a successful transfer than an overlap of physiological and technical abilities.8,10,11 These psychosocial skills of experienced and mature athletes cover the necessary mental factors such as effort and self-regulation. Furthermore, being highly motivated, having a good work ethic, having confidence and being committed to a goal are cited to be the important components for achieving a high level after a talent transfer.(8,10,11)

For those reasons, it is believed that talent transfer from able-bodied sports to Paralympic Sports following the acquisition of a handicap is realistic.

This is in line with the experiences of Bruno Landgraf. He states that although soccer (old sport) and sailing (new sport) do not seem to have any physiological/physical overlap, there were psychosocial components that he developed in soccer that let him achieve the Paralympic level in sailing. For instance, performing at a high level in soccer taught him the discipline needed to perform in a high- pressure environment. Also his high intrinsic motivation was beneficial when competing at a high level in sailing.

Conclusion (Go for it!)

There is definitely hope for competitive athletes who still want to be active on a high level in any sport after acquiring a handicap. Sampling as many sports as possible during and after your rehabilitation program is the first step to take. This will help you get used to your new physical condition. When you are finally confident with your body, find a sport that you are highly motivated for and where you want to play for fun or try to attain a competitive level. When choosing a new sport, a certain similarity between the old and new sport seems beneficial but not necessary.

Even though acquiring a handicap is a life-changing event, there is no reason to stop performing or playing sports. Through hard work and determination, obstacles can be overwon and goals can be achieved. Think about what you can do, focus on the abilities that remain!(7)

“Don't give up! Sport will help you find new objectives and to realize that you still can do whatever you want. Moreover, it allows you to get to know people and make friends. It is a good guideline for a restart in life’’ Bruno Landgraf

“Everybody is capable of playing sport and it will help you to find a way when you are lost in bad thoughts after the accident. It gave me some direction in life. Times were hard after the accident, but then I went training and got back home willing to make a new story’’ Wesley Terto


1. Vanlandewijck Y.C., Chappel R.J. (1996). Integration and classification issues in competitive sports for athletes with disabilities. Sport Science Review, 5(1), 65-88.

2. Tweedy, S.M., Vanlandewijck, Y.C. (2011). International paralympic committee position stand background and scientific principles of classification in paralympic sport. British Journal Sports Medicine, 45(4), 259-269.

3. International Paralympic Committee. IPC classification code and international standards. 2007.

4. Côté, J., Lidor, R., & Hackfort, D. (2009). ISSP position stand: To sample or to specialize? Seven postulates about youth sport activities that lead to continued participation and elite performance. International Journal of Sport and Exercise Psychology, 7(1), 7-17.

5. Gudrun Doll-Tepper, S.R. (2014). A cross-cultural comparison of talent identification and development in Paralympic sports.

6. Baker, J. (2003). Early specialization in youth sport: A requirement for adult expertise? High Ability Studies, 14(1), 85-94.

7. Ericsson, K. A., Krampe, R. T., & Tesch-Römer, C. (1993). The role of deliberate practice in the acquisition of expert performance. Psychological Review, 100(3), 363-406.


8. MacNamara, Á, & Collins, D. (2015). Second chances: Investigating athletes' experiences of talent transfer. PloS One, 10(11), e0143592.

9. Bullock, N., Gulbin, J. P., Martin, D. T., Ross, A., Holland, T., & Marino, F. (2009). Talent identification and deliberate programming in skeleton: Ice novice to winter olympian in 14 months. Journal of Sports Sciences, 27(4), 397-404.

10. Collins, R., Collins, D., MacNamara, Á., & Jones, M. I. (2014). Change of plans: An evaluation of the effectiveness and underlying mechanisms of successful talent transfer. Journal of Sports Sciences, 32(17), 1621-1630.

11. Rea, T., & Lavallee, D. (2015). An examination of athletes' experiences of the talent transfer process. Talent Development and Excellence, (1), 41-67.