Paralympic Military — Sport As Rehabilitation

Circa 2005

Who am I now? What do I do with my life? How do I become employed? How do I provide for my family? What will they think of me?

A veteran of the Gulf War and former Olympic and Paralympic athlete, John Register saw those questions flash across the faces of soldiers as he spoke at Brooke Army Medical Center (BAMC) in San Antonio, Texas. And he knew them all too well. He’d asked the same things himself 11 years ago while waiting for a prosthesis to be put on his left leg. BAMC is the place for military rehabilitation, he’d told himself, but the reassurances didn’t make his situation any easier.

Standing before a group of soldiers, all of whom had recently been injured or had undergone amputations because of combat, Register had a mission: to acknowledge any questions they may have about life after injury, and to promote sport as an answer.

Register was tapped this year by the United States Olympic Committee (USOC) to head its newest initiative—the Paralympic Military Program. By providing Paralympic sports as a part of the rehabilitation process, the project serves as an outlet for military members who have experienced service-related injuries. “We’re doing this to give back and show we are thankful for their service,” Register states. “It is imperative for the growth process to have a family structure. We hope we can provide that.”

Register spoke both at BAMC and at Walter Reed Army Medical Center in Washington DC, introducing the Paralympic Military Program to the Army’s two Amputee Care Centers. He explained to the soldiers that just because they’ve experienced a life-changing event doesn’t mean it has to change their lives.


The Paralympic Military Program is an opportunity for soldiers not only to try things they may have never tried before, but also to pursue goals that were nowhere on the radar prior to their injury. “For a person who may have never run a marathon on two legs, now maybe with a prosthesis he will run the Boston Marathon. For a person who has never skied before, all of a sudden he’s got one leg and he’s flying down a mountain on a ski. That’s freedom,” Register declares.

Register understands that transition. His goals have changed too.

A three-time All-American, Register ran track at the University of Arkansas and competed in the long jump and the 4×400-meter relay. He qualified for the 1988 Olympic Trials in the 110-meter hurdles the same year he joined the Army. His athleticism allowed him to become a member of the Army’s World Class Athletes Program, which provides military athletes two years to train for the Olympic Games. His eyes were focused on the 1992 Games, but the Gulf War interrupted his training and he was called to serve his country in the Middle East.

After returning from Saudi Arabia unscathed, he had a mere 10 months to prepare for the 1992 Games. He qualified for the Olympic Trials and finished 17th in the 400-meter hurdles. Then Register began thinking: If he shaved just half a second off his time each year, he would not only qualify for the 1996 Olympics, but he’d be in the finals. “I was aspiring to be in the finals,” Register recalls confidently. “Then the injury happened.”

On May 17, 1994, while Register was running hurdles as part of his Olympic training, he crossed a hurdle and landed wrong on his left leg. The jolt severed the popliteal artery in his leg, cutting off circulation. He was flown to BAMC to have his leg amputated above the knee. Later, he was fitted for a prosthesis. Register retired from the Army but was hired back as a civilian sports specialist with the World Class Athletes Program.

During his rehabilitation at BAMC, Register turned to the water to boost his stamina. But swimming for kicks wasn’t enough. His desire to compete again made the clock his opponent—and he won.

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He achieved his goal of making the 1996 Paralympic Games in Atlanta, competing as a swimmer and making it to the finals as a member of the 4×400-meter medley relay team. Four years later, he was back at the Paralympics, returning this time to the oval track. With a specially designed plastic running prosthesis that gave him better control over his leg motions, Register competed in the 100-meter dash and the long jump, where he won a silver medal.

Now he’s telling others how they can follow in his footsteps—or make their own.

Register recently returned to BAMC and spoke to rehabilitating soldiers. Accompanying him were other Paralympic athletes, who helped demonstrate sports many of the soldiers had never seen. “The guys watched closely,” says Michelle Cano, a former case manager at BAMC. “We had one guy who ran on a prosthesis for the first time. We had another who was an amputee and sat in a racing wheelchair for the first time. He loved it and now wants to compete. The guys are getting a better understanding that there are no limitations to what they can do.”

“Sport opens doors,” Register asserts. “It’s powerful.”

His subsequent visit to Walter Reed Medical Center had the same results. Soldiers walked into the medical center’s gymnasium and were in awe of two wheelchair fencers in full combat. By day’s end, several of the soldiers were also participating. Register explains, “We want to get across that we know you’ve had a tragic accident, but here’s how sport can help.”


Organized sports for people with disabilities have existed in some form for more than a century; sport for the deaf has been documented as early as 1888, according to reports from the International Paralympic Committee. But after World War II, the physical and mental rehabilitation sport provided for returning servicemen rocketed to international attention the notion of athletic competition for veterans with disabilities. It was soon recognized that civilians with disabilities held equally strong athletic desires.

The flagship sport became wheelchair basketball. In 1946, teams were formed in Asbury, England, thanks to Sir Ludwig Guttman, considered by many to be the father of wheelchair sports. Wheelchair basketball games in America began at approximately the same time, with the first teams formed by California and New England chapters of the Paralyzed Veterans of America.

Sport for people with disabilities spread nationally and globally. Participation surged in 1948, when the first multi-sport games for people with disabilities were organized in Stoke Mandeville, England. Following the 1960 Olympics in Rome, the world witnessed the first Paralympic Games, with approximately 400 athletes participating. This premier competition has since grown exponentially, with the 2004 Paralympic Games in Athens hosting 3,837 athletes, including representatives from all five branches of the U.S. military. Most military athletes were former soldiers, but there was one active military competitor: U.S. Navy Petty Officer 2nd Class Casey Tibbs. On leave from his assignment in Afghanistan, Tibbs became the first active-duty soldier to compete in the Paralympic Games. Tibbs, who has used a prosthesis on his right leg since a motorcycle accident resulted in a below-knee amputation, won a gold medal in the 4×100-meter relay and a silver in his division of the pentathlon.

In addition to the increasing number of athletic opportunities in the Paralympic Games, there are just as many sport programs specifically for soldiers, Register says. The problem has been tracking what programs soldiers participate in and where they go when those programs are over. But the comprehensive amputee rehabilitation programs at Walter Reed and BAMC have centralized the outreach for initiatives such as the new Paralympic Military Program. “We want to take a leadership role in reaching out to athletes,” Register says. “We’re putting them into a system so they can stay involved and so we don’t lose track of them.”

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Army Amputee Care Centers at Walter Reed Medical Center and BAMC are staying busy as the present conflict in the Middle East continues. In previous wars that resulted in large numbers of soldiers with disabilities or amputations, rehabilitation was in the hands of Veterans Affairs. This conflict is the first in which the active military has taken full responsibility for veteran rehabilitation, says Captain Shane Koppenhaver, physical therapist and officer in charge of the amputee program at BAMC. “The military has invested a lot of money and a lot of care into these soldiers’ rehabilitation,” he says. “And a lot of them—although not the majority— are staying active in the military.”

The center at Walter Reed opened in 2004, and BAMC’s center opened in January of 2005. Currently there are about 45 soldiers in the amputee program at BAMC (eight inpatient and the rest outpatient), says Koppenhaver. Most of them are enlisted in the Army and Marines, but two come from the Navy and one from the Air Force.

For soldiers undergoing an amputation, rehabilitation begins two days following surgery. Two weeks later, they get their prostheses and workouts intensify. In uncomplicated amputations, soldiers can often achieve rehabilitation within a month. Those with multiple injuries may need longer to heal.

“We help them, but they really help each other more than anything,” says Mark Heniser, a physical therapist at BAMC. “These guys aren’t patients; they’re a team. They all have different levels of injury and different rehabilitation needs, but most are in the same age group and all come from a military background. They lean on each other, compete against each other and share experiences with each other.”

At BAMC the occupational therapists understand that integrating back into everyday activities is a cautious process, so they take group trips to Sea World, downtown San Antonio, golf outings and bowling competitions. If pursued alone, says Koppenhaver, re-integration can be difficult. But initiatives like the Paralympic Military Program make it easier. “Our goal is to expose people and let them know what is out there for them to do,” Koppenhaver says. “It’s important for them to see guys who are further along in their rehab, guys who can run or walk with their prostheses. They can talk with those guys and share information about things we in the healthcare industry may forget to explain. They can also see people who have been discharged from rehab and have fully integrated into a normal life with their disability.”

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Integration back into a previously known lifestyle is the ultimate goal of the Paralympic Military Program, using sport in the process.

The USOC has supported ongoing sport clinics for rehabilitating military members at Walter Reed and BAMC. The clinics started with running programs. “Running is a big part of rehabilitation,” says Troy Hopkins, a physical therapist technician at BAMC. “When the soldiers arrive here, we ask them what their goals are. The majority of them say they want to get back to running.” Additionally, the clinics introduce sports like wheelchair fencing, sitting volleyball, archery and tennis. Soldiers are not forced to enroll in sport programs to rehabilitate their injuries, but it does help. Programs can be tailored to fit each soldier’s specific interest.

“When we get soldiers walking and moving, even if they’re playing seated tennis, they’re stretching their trunks, their backs and their shoulders by turning in different directions,” Heniser explains. “Building muscles in the trunk really helps them with their balance. It’s teaching them to adapt so they can catch themselves if they fall.”

Anybody who fits into a Paralympic class can compete in the Paralympic Military Program, including athletes with brain injuries, spinal cord injuries, vision impairments and amputations. Men overwhelmingly outnumber the women participants, but competition is open to all. “Even if they don’t compete, we encourage them to come and watch,” Cano says.

The regularly held clinics lead up to the climax of the USOC Paralympic Military Program: two multi-day military sports summits scheduled for Colorado Springs, Colorado, and Chula Vista, California, with as many as 100 veterans with disabilities competing.

“It’s not a substitute for total rehabilitation, where we work with building muscles and learning to walk on a prosthesis,” Koppenhaver says of the program. “But it is a very important part of the progress these guys are making.”

Questions abound after an initial injury. The adjustment to a new life can take its toll on the morale of soldiers who have experienced wartime injuries. Family support is crucial. A good rehabilitation system allows proper recovery. And sport, Register points out, is also an option—and he knows.

“I’m able to give these athletes what I was given,” he says. “I can tell them, ‘Hey, I was in your position. I was right there.’ It’s like a divine order. It’s what was meant to be. The goal is not to be a Paralympic athlete. The goal is to lead a productive life.”

by Josh Pate

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