Supporting people with disability to participate in sport

Taking part in sport offers more than just improved fitness or mental wellbeing for people with disability, it can also build confidence, independence and create a deeper sense of belonging in the community.

Despite well-known benefits, the participation of individuals with disability in sports remains low. Around 5.5 million people live with a disability in Australia, but only 14% participate in sport at least once a week, compared with about 67% of Australians without disability. 

So why are so many people with disability still being left out of sport?

There are numerous environmental, personal and policy-related barriers for their sport participation, including lack of accessibility and financial support, limited opportunities, and importantly health-related concerns. 

However, health concerns are often overlooked.

People with disability have a higher risk of medical complications during sport. These can be directly or indirectly related to the person’s disability or sport specific demands. For example, wheelchair athletes with spinal cord injury may develop pressure sores, while individuals with brain injury may experience seizures in sport activities. These health concerns can discourage participation or lead people to withdrawing from sporting activities. However, most of these complications can be minimised and managed by proper medical guidance.

Doctors can play an important role in managing health risks and supporting the safe, sustainable sport participation. They are the first point of contact for health advice as well as a trusted source of health information for individuals with disability and their families. Their guidance can either encourage or limit sport participation of this population. 

And yet, we know little about doctors’ practices or their level of knowledge when it comes to disability sport. 

Exploring doctor’s knowledge of sport and disability

Our recent study published in BMJ Open Sport and Exercise Medicine explored doctors’ knowledge, practices and perceptions related to sport participation for people with disability and associated medical risks. 

We conducted an online survey of 168 registered medical doctors from 16 high- and middle-income countries including Sri Lanka, Australia and the United Kingdom. All participants provided direct general or specialised medical care to people with disability, with most respondents working as general practitioners and rehabilitation physicians. 

Most doctors recognise the value of sport. About 91% of doctors recognised its benefits, and 77% agreed that doctors’ role in supporting sport participation for people with disability is important. This shows strong awareness of the positive impact of sport among doctors. 

However, the picture becomes more complex when it comes to confidence and practical knowledge.

While 70% of doctors identified medical complications as a potential barrier to participation in sport, about half (46%) reported low confidence in identifying these medical complications. This reflects a well-documented gap in doctors’ knowledge of disability-specific health issues. Many doctors (54%) also felt they had limited knowledge of disability sports organisations. 

This gap matters. If doctors feel uncertain about risk or lack of knowledge of disability sports, it may influence how they promote sport for people with disability. Previous research also showed that health issues combined with inappropriate medical advice was a common reason why people with disability stop participating in sport.

Encouragingly, 74% of doctors said that they have supported their patients to participate in sport, most commonly by encouraging them to get involved. But what that encouragement looks like in practice remains unclear. Is it a general, “It would be good for you”, or does it include tailored advice, risk management strategies, or referral to appropriate programs?

Due to the limitations of an online survey, we were unable to fully answer that question, but it highlights an important next step: an in-depth exploration of medical doctors’ practice in this context. 

To our knowledge, this is the first study to explore medical doctors’ knowledge, perceptions, and practices in this area. 

Where to from here

Our findings indicate a need to improve doctors’ knowledge and confidence about disability sport and associated health risks. However, any strategies must be culturally and economically appropriate to ensure they are effective across diverse communities. 

Doctors also need tools to guide their patients. One practical step would be the development of a comprehensive, accessible mapping of national and international disability sport organisations. This would make it easier for doctors to connect patients with safe, suitable opportunities.

Ultimately, strengthening the role of doctors could help remove one of the key barriers to sport participation, and open the door for more people with disability to experience everything that sport has to offer.

Dr Gowinnage is a medical doctor from Sri Lanka, currently doing her PhD in “Developing procedures to identify and manage medical risk for athletes with disability commencing sports” at The University of Queensland’s School of Human Movement and Nutrition Sciences.