CRPS and chronic pain sufferers excluded from disability sport

Double Paralympic archery champion, Danielle Brown, is probably the highest profile sportsperson with CRPS to be excluded from paralympic sport. After winning gold at both the Beijing and London Paralympics, Danielle was excluded from competing in Rio following a change in the sport’s classification rules.

Danielle, whose CRPS affects her lower extremities, participates whilst seated on a stool. Regarding the reclassification, in 2013 the governing body said “World Archery, in full agreement with the International Paralympic Committee, clearly states that the Paralympic Games and World Archery Para Championships should not be for anyone who has a physical disability, but for those athletes with a disability where the disability has a direct and important impact on the archery performance.”

Subsequently, in 2015 the International Paralympic Committee published their updated “International Standard of Eligible Impairments”, the stated purpose of which “is to ensure that International Federations adopt the same standards when they determine which Athletes are eligible to participate in the sports that they govern. These standards are that all Athletes who compete in a sport within the Paralympic Movement must have an Eligible Impairment and comply with the Minimum Impairment Criteria applicable to that sport.”

What stands out about this document is that despite its importance, at little more than 8 pages, it is surprisingly brief. For all its brevity, however, it succeeds in excluding from Paralympic sport pretty much everyone suffering chronic pain, unless they have an additional (and possibly related) limitation, for example being an amputee.

Indeed, not only is “pain” the first stated example of a “Non Eligible Impairment”, but as if to ensure the avoidance of any doubt whatsoever, top of a specific list of ineligible conditions appear Myofascial Pain Syndrome, Fibromyalgia and Complex Regional Pain Syndrome.

Those formulating the classifications say that the principal reason for the exclusion of pain is that there is no objective method of measuring it and therefore no way of accurately assessing the minimum level of impairment required for inclusion.

However, whilst that is arguably a fair point, what is surely being overlooked is that for the vast majority of people suffering chronic pain, the pain itself is only part of the picture. Take CRPS for example. For a sportsperson in any discipline suffering CRPS, factors such as fatigue and poor concentration are likely to present as much of an impairment as the pain itself.

Clearly, classification in disability sport is very far from straightforward. However, to rule out those suffering chronic pain entirely would at the very least seem to misunderstand the full extent of the limitations they face.