Adaptive Sports Medicine: Helping Every Athlete Move – PediaCast 600

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Show Notes

Description

Dr. Jonathan Napolitano and Timothy McCullough visit the studio to explore adaptive sports medicine. The Winter Olympics are winding down, which means the Paralympic Games will be starting soon. These games feature athletes who rely on adaptive sports medicine to keep their bodies moving. We also have a student athlete and her track coach (and grandfather) joining us to share the impact of adaptive sports medicine from the family’s perspective. We hope you can tune in!

Topics

Adaptive Sports Medicine
Paralympic Games

Guests

Dr Jonathan Napolitano
Sports Medicine
Nationwide Children’s Hospital

Timothy McCullough
Physical Therapy
Nationwide Children’s Hospital

Julia Kuba
Student Athlete
Sled Hockey and Seated Track

Steve Whitaker
Coach and Grandfather

Links

The Adaptive Sports Medicine Program at Nationwide Children’s Hospital
So EveryBody Can Move
So EveryBody Can Move – Ohio
Columbus Blades Sled Hockey
Adapted Sports Institute at The Ohio State University
Craig H. Neilsen Foundation Scholarship Application (Ohio State)

Episode Transcript

[Dr Mike Patrick]
This episode of PediaCast is brought to you by the Sports Medicine Program at Nationwide Children's Hospital. 

[MUSIC]

[Dr Mike Patrick]
Hello, everyone, and welcome once again to PediaCast. We are a pediatric podcast for moms and dads.

This is Dr. Mike coming to you from the campus of Nationwide Children's Hospital. We're in Columbus, Ohio. It's episode 600.

We're calling this one Adaptive Sports Medicine Helping Every Athlete Move. I want to welcome all of you to the program. We are so happy to have you with us.

Adaptive Sports Medicine gives kids and teenagers who are physically challenged the opportunity to compete, connect, and thrive through sports and movement. In this episode of PediaCast, we will explore adaptive sports medicine, what it is, why it matters, and how families can access care, equipment, and community support. It's a timely topic because as the Winter Olympics wind down, the Paralympic Games will soon get started.

They are March 6th through the 15th in Milano, Cortina, Italy, where the Olympics are being held. It is at the Paralympic Games that adaptive sports medicine really, really shines at the top level. Of course, in our usual PediaCast fashion, we have a terrific panel of guests joining us in the studio to discuss the topic.

Dr. Jonathan Napolitano is a sports medicine physician at Nationwide Children's. Timothy McCullough is a physical therapist that works with the sports medicine program, and in particular, the adaptive sports medicine program. We also have a family joining us today.

Julia Kuba is a student athlete who plays sled hockey and seeded track. Steve Whitaker is also here. He is her track coach and grandfather, as they describe what it's like to be supported by an adaptive sports medicine program from the athlete and family perspective.

And then, in addition to our wonderful guests, we also have a guest host guiding the conversation this week, and that is Eric Leighton. He is an athletic trainer at Nationwide Children's Hospital, and he's been with us in past episodes of PediaCast where we've covered sports medicine topics. He does a great job with the interviews, and so he is going to be back today to conduct the conversation.

Before we get to all of them, I do want to remind you that the information presented in PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. If you're concerned about your child's health, be sure to call your health care provider.

Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at pediacast.org. So, let's take a quick break. We'll get our guests settled into the studio, and then we will be back to talk about adaptive sports medicine.

It's coming up right after this.

[MUSIC]

 Dr. Jonathan Napolitano is a sports medicine physician at Nationwide Children's Hospital and an assistant professor of pediatrics and physical medicine and rehabilitation at The Ohio State University College of Medicine. Timothy McCullough is a physical therapist who works with sports medicine at Nationwide Children's.

Julia Kuba is a student athlete who participates in sled hockey and seated track, which we will talk about in more detail, but later in the program. And Steve Whitaker is Julia's track coach and grandfather. Each of them has a passion for supporting student athletes who face physical challenges.

That's what we're talking about today, student athletes with physical challenges and the adaptive sports medicine program at Nationwide Children's Hospital. Before we dive into our topic, let's offer a warm PediaCast welcome to our guests. Thank you all so much for being here today.

It is really great to have you. Eric Leighton is also with us. You'll recall he has served as host during several past episodes of PediaCast, ones that focus on sports medicine topics.

He is an athletic trainer at Nationwide Children's. So, let's welcome him once again to the program. Eric, we are so glad you are here.

And with that, I will hand the reins over to you.

[Eric Leighton]
Thank you, Dr. Mike. And thank you so much for having us back. It is always great to be here with you guys on the show and to be with us.

And thank you to everyone, Dr. Napolitano, Tim, Holly and Steve, for joining us on today's show. So, as Dr. Mike mentioned, we are talking about the adaptive sports medicine program here at Nationwide Children's Hospital, but also adaptive sports, adaptive sports in general. And we are so lucky to have Steve and Julia with us today to offer the sort of the boots on the ground opinion and details of what the day-to-day is really like.

So, as we know right now, here in February, the Olympics, of course, going on in Milan and Cortina and coming up here soon during in March. So, as a matter of fact, opening March 6th in Italy and Milan and Cortina, March 6th or the 15th will be the Paralympics. So definitely some options and some opportunities to see some of these sports, some of these things that we're going to talk about firsthand and really, really be able to see what that world is like and what these athletes do outside of what we consider as some of the traditional stuff.

All right. Well, you know what? Diving right in, we want to kind of talk about, well, adaptive sports.

Not everybody knows necessarily what that is. So, let's go straight. I'm going to go straight to Dr. Napolitano first here. So, what do we mean when we're talking about adaptive sports?

[Dr Jonathan Napolitano]
What is that? Yeah, thanks, Eric. It's a great question.

So, we know the benefits that we are perceived and obtained by participation in sports from physical benefits, social, mental health benefits. However, a lot of individuals with physical challenges or disabilities may be restricted or unable to participate in what we think of as mainstream athletics. And so adapted sports are sports that are adapted and changed in a way to increase access and inclusion.

So, when we think about the word adapted, it's a verb, and that is just referring to the sport itself that has been changed, altered, whether it's in the rules, whether it's in the equipment. And what the purpose of that modification is really to increase that inclusion and access. Our program is called the Adaptive Sports Medicine Program, IVE.

That's an adjective. And so rather than just the process of modifying it, but it's using that word to describe the behaviors, the skills, the strategies that individuals, programs, groups use to increase access and inclusion. And so that's why we have an adaptive sports medicine program here.

[Eric Leighton]
That's great. Yeah, it's a lot of good detail. And there's so many things that go into it, obviously, and we'll probably get into some more detail.

And as we go farther into the questions into the sports themselves. So, we all know how participating in other things outside of school and sports, obviously, it does so much for people in helping us. So, Tim, I'm going to come to you on this one.

Why are adaptive sports so important to kids and teens, for instance?

[Timothy McCullough]
I think it's maybe let's start with not adaptive sports in particular, but why are sports important for any kid or teen? Because there's a lot of overlap. I think this question is kind of like a Venn diagram where you have unique benefits and you have shared benefits.

So shared benefits, like it's important to engage in things that you're passionate about. And these athletes are really passionate about their respective sports, whether it's sled hockey, bokeh, wheelchair, rugby, whatever it is. There are for sport, emotional and mental health benefits that have been well researched.

There's definitely the importance of self-betterment. And again, that kind of ties into the emotional and mental health benefit, like, you know, being able to regulate higher intensity emotion. Also, like, you know, self-betterment from a physical standpoint, how can I improve my overall physical performance to get to a level higher than I'm currently at?

Learning life skills is huge. Off the top of my head, I can think of, like, if I'm a winner, how do I act like a good winner and respect my competition? If I'm a loser, how do I lose well, but still maintain that passion to self-better myself?

Yeah, then just learning general life skills and better overall quality of life. I think what's cool, though, about the adaptive sports in particular, particularly two pieces. The first is social engagement.

It's great to get in a room with people who, you know, share the same passion as you and that are at the same or similar ability level as you. And I think it gives you a little bit of an iron sharpens iron effect, where, like, when these athletes are in the same room doing the same thing, it just, there's a natural environment for self-betterment and to really push yourself and see what your ability allows. And then I think there's also a benefit for improved function.

Like, we're looking at things in the context of sport, but a lot of the skills that these athletes use in sport ends up being applicable in the real world when they're having to wheel around a shopping mall and have the appropriate endurance or just performing general activities of daily living. There's a lot of overlap there. So, what we do in sport can actually help in real world situation.

Yeah.

[Eric Leighton]
Yeah. That's some great points there. Going back to Dr. Napolitano. So, what kind of community resources exist for adaptive sports? What are some of the things that they can look forward to getting involved in?

[Dr Jonathan Napolitano]
Yeah. You know, this list really continues to grow. And I think that's been out of the extreme momentum and energy behind the Paralympic movement.

You know, you mentioned earlier the excitement for the Paralympics coming up, commercials we see on TV, increasing television coverage for the Paralympic Games, but more and more opportunities. We're especially lucky here in Columbus and Ohio specifically in all the opportunities that we have. That starts from individual based team programs, kind of like the Ohio sled hockey team that Julia participates with and her family's involved with as well, where they focus on one specific sport.

And then there's other groups in town who are more multi-sport organizations. Columbus Parks and Recreation have a robust para and adaptive programming options for different team sports from rugby to wheelchair basketball to individual sports like tennis or swimming. There are other groups in town, the Adaptive Sports Connection.

I sit on their board and help advise them on things to improve their organization. And that group is mainly involved in individual adventure-based sports like adaptive skiing, like we'll see in Milan Cortina here in a little bit, but also biking and other things. So, really, there's numerous programs, too many to mention, but I do want to highlight the fact, again, there are benefits of being here in Ohio.

As you heard in the introduction, Julia's involved in school-based sports, too. So, the Ohio High School Athletic Association in 2013 added seated track and field as an event. And so, it's been over a dozen years now that high school athletes have been competing at the seated level.

And it was 2020 that they were able to add para swimming as another opportunity for school students as well. A lot of adaptive recreation and PE classes in town offer adaptive programming. A lot of them use the Special Olympics model and resources for competitive inclusion and opportunity.

And then nationally and internationally, these opportunities are available everywhere. I know you've got a lot of abroad-based listeners here. So, using Move United is a great resource, as well as the U.S. Olympic and Paralympic Team, our two national organizations that can help you find local programs close to you.

[Eric Leighton]
Very good. And we had mentioned before, you know, we had talked, touched on, you know, what is adaptive sports? And you had mentioned, of course, the adaptive sports medicine program.

So, Dr. Napolitano, what, give us the details, what is the adaptive sports medicine and exercise program at Nationwide Children's Hospital?

[Dr Jonathan Napolitano]
Sure. Yeah, it's something we're really proud of. You know, we've had this program now, it's upwards of 10 years, 9 or 10 years that we've been in place.

And I think most importantly is to understand that it is a program which is truly different than a lot of other unique offerings here at Children's. So, it is not specifically just an adaptive clinic, but it's rather a program. And the reason why we use that term is really because of the broad breadth of all the collaboration that we have, right, with physical therapy and athletic training, strength and conditioning, lots of different opportunities.

But it's also in the model of sports medicine, too. You know, Tim used the description of the Venn diagram where you have the two circles that overlap. So, if we think of adaptive sports in one circle and sports medicine in the other, you know, in sports medicine, we want to promote health, we want to prevent injury.

But when an injury happens, we evaluate, diagnose, and treat with that emphasis being on return to play. So, the adaptive sports medicine program from a clinical side of things involves an opportunity to be evaluated by me and our team in clinic to identify, hey, I might have a disability, and I'm not even started with activity. I want to get more engaged.

And so, we can outline a plan for you for that versus someone like Julia, who is actively involved and may have a setback, whether it's an injury or pain, and we come up with a program for that. Then the rest of our program is, as I said, far beyond just the clinical roles. We're conducting research on gait analysis in those with limb differences and prosthetic users.

We look at mental health of the benefits of sport participation, and then a lot of that community collaboration as well with those groups that I mentioned above.

[Eric Leighton]
Yeah, yeah. There's definitely a lot that goes into it. And as you mentioned, it's not just the clinic.

So, one of the words we use, phrases we use is multidisciplinary. So, Tim, I'm going to come to you. How does that, the multidisciplinary care work in the world of adaptive sports medicine and what we do?

[Timothy McCullough]
I think when you talk about multidisciplinary care, the illustration I like to use is like a puzzle. And you have these individual pieces that make up the greater picture. But every individual piece of the puzzle is unique.

Like one cannot replace the other very easily, if at all. And just like that, multidisciplinary care works a lot like that, where it's not just one person handling it all. It's multiple people in multiple different specialties that help to make up the picture of care.

So, I obviously can talk most educatedly about being a PT, right? I'm supposed to be the movement specialist. And I work with clients and athletes to optimize their task performance while ensuring that they still have good ability to participate in those activities, not only that they need to do at home, but that they want to do in the field or in the environment of sport.

And so, you know, I can also be really heavily involved with equipment acquisition, but like that's never usually just me doing that. I rely on other pieces of the puzzle, again, to really develop that picture. So, if I'm helping something or somebody with equipment, I'm usually referring to either a physician or an orthotist, a prosthetist, an ADAPT or assistive technology professional.

So, decisions are made as a team. And, you know, when you need help, you rely on the other pieces of the puzzle. But like, it's even more than that.

Like, the team at NCH is, we've, you know, physicians, PTs, ATs, like Dr. Napolitano said, but it can even include like occupational therapists, dieticians, psychologists, strength and conditioning coaches, certainly surgeons. You know, we work as a team because we get the best outcomes.

[Eric Leighton]
Yeah, definitely. I mean, we definitely hold a lot of meetings. We talk about this.

We're always looking into it, but yeah, it is a growing world and there's definitely a lot of angles. Like you said, it's a pretty big team. Tim, I got another question for you.

So, Dr. Napolitano had mentioned before about, you know, we're very lucky around Central Ohio where we have some opportunities and some places where this can go on. Why are the local collaborations so important for these athletes, what they get out of this?

[Timothy McCullough]
Yeah, I mean, I feel like local collaborations are the absolute necessity for getting somebody into the adaptive sports world. Like, they are the absolute best places to learn the basics of a sport. They're the best places to get plugged in with a community of similar-minded people.

Like, again, you want that ironing, sharpening iron. You want to make an environment where people are striving for, you know, optimal physical performance, self-betterment, all of that. And, you know, like sometimes people just want that community and that's cool.

Do activity because you want community. And sometimes people want that community so that they can really push their limit and see, well, how far can I take this? Awesome.

Do it for that reason. There is really no bad reason to be involved in athletics and not everybody's going to have the same reason. But what matters is that you're doing something.

And there are genuinely unique opportunities to take advantage of, especially in the Columbus area. I know we had already mentioned like adaptive sports connection, recreation and parks, but like, you know, I don't know who's listening to this, but if you're spread out all over Ohio, there are opportunities all over Ohio. I think of like Southwest Ohio, Northern Kentucky, the bridge is doing phenomenal things down there.

If you're like in Northeast Ohio, adaptive sports Ohio is doing phenomenal things. Southeast Ohio has opportunities through like Southeast Ohio center for independent living. And if, as I know, we've got a facility up in Toledo area and Fort Wayne's not too far from you guys, you've got turnstone right there, which is one of the Olympic and Paralympic training centers.

So yeah, focus on your regional stuff, but know that likely when you're doing the regional stuff there, you're going to have competitions, tournaments, things that go outside and they give even better opportunities to connect, even better opportunities to build yourself up and really be the best athlete that you can.

[Eric Leighton]
Yeah. And as Tim mentioned that, I mean, there is, there is stuff everywhere. It's one of those things that, you know, you didn't realize to look for it maybe, but once you start looking out there, there's, there's probably more near you than you ever thought.

And, you know, locally, regionally, nationally, it is, it's, it is all over. All right. Reach out and other people can help you like us too.

I got one more question kind of going along this stuff. So, with Dr. Napolitano, so I think you and I are both in the same boat. I am definitely an Olympics addict.

I have watched so much coverage the past week and the winter games is always one of my favorites. I'm a skier myself. And I just, I, I love the winter games front to back, top to bottom.

So obviously a lot of families hear about those big events. Like you mentioned, we see the commercials like the Paralympics or special Olympics. How do those fit in?

What, what, what, what's the connection there?

[Dr Jonathan Napolitano]
Sure. Yeah, definitely a big Olympic addict. So, when I think about a special Olympics, first of all, you know, it's, it's very different than, than the Olympic movement.

And we think of it because they have the same name, but, but it's important to really differentiate the two. Special Olympics is going on year-round training and it's in their message and their motto is just opportunities and inclusion for recreation and fun. And so, while yes, they help individuals with physical disabilities, a lot of participants in special Olympics are also have intellectual disabilities too.

And so, it's, it's a less competitive, but really equally important and active avenue. And it's worldwide as well. You know, there's over 5 million participants here in the United States and over 170 different partner nations that have special Olympics programs.

So, so that's really important. But when I think about Paralympics, that's, that's where I really get excited just because of that competition. When you hear the word Paralympics, a lot of people first think about paralysis or paraplegia, but really the word Paralympics comes from the Greek root of that word being para or alongside.

And so that's alongside of the Olympics. And so that's where they kind of move together in this expanse and exposure of athletics around the world. You know, the first Olympics were back in 1896, and it wasn't until 1960 that they had the first Paralympic games.

And, and even with that, it was 18 year, 28 years actually, after that, the Seoul, South Korea, where that became a combined bid, meaning that when you would put a bid in to host the Olympics as a city, right? Like they're in Milan, Cortina now or Paris in, in 24, where that would be a separate bid for the Paralympics and the Olympics. And so why that's so important is from since 1998, when these cities are building up to host such huge events, they are now building up with accessibility in mind.

And it's this universal design that their athletic facilities are accessible for Olympic athletes, as well as Paralympic athletes, Olympic spectators, as well as Paralympic spectators. So, it has really done amazing things for that accessibility and growth of these cities. We took a big jump here in the United States and in 2019, they renamed the U.S. Olympic committee to the U.S. OPC. So that's U.S. Olympic and Paralympic committee, where it is truly a one team mentality and there's, you know, additional access to training and resources and other things. So yeah, the Paralympics has really done a remarkable job of increasing availability, access, and just awareness that there is something out there for everyone.

[Eric Leighton]
Yeah, it's, it's amazing. And, and, and luckily, we get to, we get to experience it and see it. So, you know, for the get four- or five-weeks total of Olympic and Paralympic out of, out of Italy.

So, it's exciting and I can't wait to watch that too. So, a lot of good information, sort of the background of, you know, what is the adaptive sports, adaptive sports program, everything we do on our end. And all right, Steve and Julia, I didn't forget about you.

I'm coming at you now. So now we get, you know, now we want to, we want to hear about, you know, you, you deal with the real thing. So, throw this up.

This is sort of a toss-up either one of you, both of you can answer. So, Steve and Julia, how did your family get started with sled hockey and track? And I guess the second part of that question is then how is it sort of a family event?

It's a family affair, so to speak, where you're all involved.

[Julia Kuba]
For sled hockey. I heard about this through my friend, Lissa Zetfel, through our Spider-Lutheran Alliance. She started playing hockey and she wanted me to try it out.

And this, this is my 10th year playing hockey.

[Steve Whitaker]
Track has been a, something that's been really beneficial to Julia. She started that as an, actually through you guys actually, you know, pointed her that way in her possibility. And, and I think Jeremy was a little bit involved in that.

[Julia Kuba]
Jeremy was a little bit involved.

[Steve Whitaker]
And, you know, getting that going for her and getting her a chair and getting her started. And, you know, once she started middle school, she just really took off with it. And it's just been, it's been great for the family.

As far as a family thing, our families have always been very involved in all the stuff Julia does. She has a very large family. She only has one sibling, but she has a world of cousins all athletic.

And they come to her events, they support her. And one, one thing I'd like to mention about the family part of it is that she's well-recognized in the family as an athlete in what she does. And these kids are athletes.

I mean, they compete hard. One thing that I, I, I did at one point, you know, when you're on a high school team and there's not a lot of other athletes like Julia on the team, they tend to, it's easy for them to look at them and like, well, they're not really an athlete like we are. But then when, when you ask one of them to sit in her shot-put chair and throw that shot put, they find out that they can't throw as far as Julia.

It makes all the difference in the world. They begin to recognize this is some tough stuff. And, but it's just been great.

And it's, you know, the school's been wonderful in, in adapting for her and allowing me to be an actual coach on the team to take that special time and work with Julia. It's been a real blessing.

[Julia Kuba]
Yeah.

[Eric Leighton]
Yeah. It's, it's definitely fun. I actually had the, I actually had the honor to work with the sled hockey team where I met Julia first, a coach and just assist and just be there to help out.

So, I've seen them do it. When you, when you first sat in that sled, the first time you tried it out, was it for Julia, was it like, all right, what is this? What did I get myself into?

Or did you pretty much fall in love with it?

[Julia Kuba]
I pretty much fell in love with it. I immediately left. I immediately went to town on my sled.

[Eric Leighton]
Yes. But just say, I think I remember you digging the sticks in and taking Mach 5 half the time. Keeping up with you was always fun.

I got another one there for you, Julia. So, what, what does your day-to-day life look like with adaptive sports?

[Julia Kuba]
It's basically no different than, than a normal life with sports. It is basically.

[Steve Whitaker]
You're busy.

[Julia Kuba]
Yeah. Busy. So, Friday nights, I basically live at the ice rink.

[Steve Whitaker]
Yeah.

[Julia Kuba]
And then occasionally on weekends when we have tournaments.

[Steve Whitaker]
She does, you know, we start a few weeks early in the weight room before track season starts. And when she's at home, she, they have a circular driveway in one part. So, she can, she can practice in off season doing that.

[Julia Kuba]
And in the summer times I do laps around our driveway.

[Steve Whitaker]
And what do you do after school when you're waiting on your mom for an hour?

[Julia Kuba]
I do laps around the school for an hour after waiting on.

[Steve Whitaker]
And I'll tell you this year, when we started back in the gym, I really expected to see, you know, a point where she fell back a little as far as what she could do. No, she didn't. I was surprised for the whole off season.

She really kept her strength up. So, when we got back in the weight room, she was, she was cracking.

[Eric Leighton]
And like you said, Steve, I mean, you know, they're athletes just like every other athlete. And you see like, you see like these during the stories and of course all the interest pieces they do during the Olympics. And I'm sure they'll do, you know, here coming up in March with the Paralympics in Milan, you know, these athletes, it can be a full-time job, you know, skaters are at the rink skating for four hours, then they're off working for another four or five, 10 hours, you know, doing other things.

[Steve Whitaker]
A couple of players will watch her on the weight machines and they're like, the weight that she's pushing, and it really surprises them. She's a full athlete, like every athlete.

[Eric Leighton]
Definitely. So, Julia, how does, we're talking about training and how much you train. I mean, you're putting the extra hours in the laps, literally around the school, around the driveway.

Does your training or how does your training change during the season versus off season or between different seasons? Obviously, you know, you may work out one way for sled hockey and there's other things you do for track, right?

[Julia Kuba]
Yeah. During the season, I'm basically in the weight room every day.

[Steve Whitaker]
Except weekends.

[Julia Kuba]
Except weekends, I get a break. And then for hockey, I am, every Friday night I am at practice. And then on the off season, I don't, I keep my, I keep my body moving during the off season.

I don't sit around.

[Steve Whitaker]
She washes her diet.

[Julia Kuba]
Yeah, I wash my diet.

[Steve Whitaker]
And you know, we got to push her sometimes, I'll be honest. She gets, you know, but then, you know, she realizes, you know, she really wants to do it and that makes a difference. I remember our first couple of years in track, especially, we got into quite a bit of, she was angry with me a few times because I pushed her pretty hard because she didn't, she would want to quit.

[Julia Kuba]
But that's gotten better, hasn't it?

[Steve Whitaker]
Well, I mean, that's the whole point of what you guys were talking about with Tim and Jonathan were talking about with the competition and what it does. When these kids have a chance to get together in competition, whether she's at a school where there's a couple other seated athletes to race with, or especially at the if you guys ever go to the States, you will see these kids are competitive and I mean, they are sizing each other up from the get-go. The minute they get there waiting to race either in their track chairs or do shotput, these kids, the competitiveness comes out.

It's unbelievable and it's exciting to see.

[Eric Leighton]
Yeah. You mentioned, you know, you mentioned you guys got into it a little bit because you didn't want to stop, Julie. You kept pushing yourself or, you know, coaches pushing you a little bit in these two.

Do you find, do you find that your training for whichever season you're in, does it, does it affect your everyday life? Like with your school days, weekends, or, you know, your social stuff, hanging out with friends?

[Julia Kuba]
Not really. It's basically what I do my whole life.

[Steve Whitaker]
So, you know, she goes, the only difference in a typical day, I would say with you would be it after school, when all the kids are getting on a bus or getting in a car, Julie is wheeling over to the complex. And when I show up a half hour later, she's already been lifting for a half hour.

[Julia Kuba]
Yeah.

[Steve Whitaker]
And, and, and that's, that's every day of the week. And, uh, except when on Fridays, a lot of times she has to be at a hockey event. So, other than that, I don't think it changed as much.

[Julia Kuba]
No, it doesn't change much.

[Dr Jonathan Napolitano]
How about changing for the, the positive, Julia, thinking about the social aspect of being on the school track team or, or the relationships and, and other things you've built through your hockey teammates. You mentioned your friend who got you interested. How have sports contributed, these specific sports contributed to, to that social aspect?

[Julia Kuba]
My sports, my, my hockey team has been becoming pretty much like a family to me.

[Steve Whitaker]
They are.

[Julia Kuba]
They're family to me and the track team.

[Steve Whitaker]
And it's, if I may add to that, I know you were asking Julia, but if I could add to that, one thing that I've noticed, it's so exciting to see that she is an active part of her high school and she's an active part of her high school track team. And she's, there's that camaraderie that kids get when they're in sports together. You know, you see kids that, that are in, in a, in an adaptive way, but they, they maybe don't get involved in a lot of things that you just kind of sit back and watch everyone else.

This is, I, I so happy and appreciate what all of you have done and everyone that's worked to make this happen, because these kids are an active part of their high school experience where you didn't always see that in other cases. And I just, I really want to encourage any parents that may hear this, or, you know, of someone, if you have a kid, that's just been kind of a wallflower because they may be in a chair or something different and, you know, they just don't know what to do, encourage them to get into this, even at a small level, because once they catch fire, it's just one, it's wonderful to see what they can do and how it builds the self-esteem and, and camaraderie. I mean, Julia's had, had high school prom dates from her hockey team and, you know, those things. It's exciting, isn't it?

[Julia Kuba]
Yeah, it's exciting.

[Eric Leighton]
That's amazing. Hey, Julia, we were, right before we came into the studio, we were hanging out, you know, before we, before we went on the air here, we were talking about your, your, your track chair. You were mentioning some stuff to me and kind of, kind of goes together.

So how do you know? So how do you when, know when to back off and, you know, maybe seek help, whether it's, you need to talk to coach or you need to come see Tim or Dr. Napolitano or me, for instance, how do you know when?

[Julia Kuba]
So last season, I couldn't race at all in my track chair because I had, because I developed a pressure, a pressure, pressure sore. So, I couldn't be in my track chair for the whole season. So we went to the doctor, got checked out.

And yeah.

[Eric Leighton]
Are there other times where you, when you're working out, like when you're training, it sounds like you hit the weight room pretty hard. You put in the extra laps around the driveway, around the school. So, you know, again, are there other times where something pops up where you're like, okay, you know what?

I need to back off and give myself a break. Maybe I need an extra day of rest this week or, or something else.

[Julia Kuba]
When my muscles start to hurt, I'll be like, hey, I need a break for a second or the day off.

[Steve Whitaker]
Yeah. She called me just last week and said, hey, I'm done. Can we skip a day?

And we did. She needs to be able to do that because I can say this, that when she's in the gym, there's no quit with this kid.

[Julia Kuba]
No, there's no quit.

[Steve Whitaker]
It's just, it's not. Well, she tells me she needs a break.

[Eric Leighton]
She needs a break. Yeah. Yeah.

That's right. Yeah. If she's asking for time off, there's, you know, it's real.

[Julia Kuba]
I would never ask him for time off.

[Eric Leighton]
Yeah. Just like, you know, all athletes, you know, this is something we preach to all of our, all of our athletes. It doesn't matter what type of athletics you're doing.

I mean, yeah, you have to work hard. You got to put in the work, but rest is part of the whole workout. How you take care of your body, how you rest, how you fuel yourself, how you eat, how you get ready for your event or your practice, how you recover from it.

You know, it's a 24 seven cycle. Obviously, you're not competing or throwing the weights around 24 hours, but how you do your whole day. Yeah.

So always very important.

[Steve Whitaker]
When we started out this season in the weight room, I had to tell her, look, we're going to start with lower weights and less repetitions because I don't want you pulling a muscle right out of the gate and ruining your season. So, I had to kind of hold her back and then let her build up a little bit to where she is now because she was wanting to just throw all those weights on, she did last year and do 50 reps. And you know, you just can't do that.

So, it's a matter of listening to her and her listening to her coach and she's good at that.

[Eric Leighton]
Yeah. It's always, you know, I love it with my athletes too. And I work with them.

I mean, having the hard charges that want to go 110% is good. You want that motivation, but yeah, having to hold the reins just a little bit, you know, and unfortunately, you know, coach is right. You know, you have to listen once in a while.

So, hey, so we had mentioned, you know, injuries with the equipment, you had mentioned your chair. So, Tim, I got a question for you. You had mentioned, you know, working with a lot of equipment and some of the adaptive equipment and the chairs, et cetera.

So why does the equipment fit and access matter so much to these athletes?

[Timothy McCullough]
Yeah. I mean, in a lot of circumstances, the only way these athletes participate in their sport is with equipment. So, like wheelchair, rugby, wheelchair, basketball, power, soccer, track and field, it runs across many, many, many of those adaptive sports.

So, and like, again, off the top of my head, you need wheelchairs for rugby, basketball, power, soccer, track and field. Skiing doesn't necessarily have wheelchairs, but they have like seated skis that people can sit in. I tried that once and I ate snow and man, it's hard.

But I also learned that like having the right equipment, even for stuff like that is huge because when I sat in the seat, I felt wildly out of control because I was too big for it. Like it was one of those where you're really trying to squeeze in because that's just all they have. But for somebody who's like on a serious level, like they need that good fit.

And then you could even be thinking about like prosthetic limbs for like track and field, again, skiing and snowboarding. I know right now on the Olympics, there's a commercial with one of the U.S. Paralympic snowboarders, and you could see him wearing his prosthetic limb as he's doing some cool tricks. I am beyond excited for March to come.

But like beyond just generally like participating in sport, it can affect overall health. Like Julia, you were talking, you had a pressure sore, and it might have been because your equipment didn't fit appropriately. Also, if you're consistently sitting in a chair that does not meet your needs, you can develop musculoskeletal issues down the line.

Repeatedly sitting in the wrong position causes you to do things in the wrong position and doing things wrong leads, it's a domino effect. So, if you don't fix it at the point of the issue, it'll get worse and worse and worse over time. And then even beyond that, there's common sense of like, if I'm not sitting in a chair or if I don't have a limb that's appropriately fitting, I'm at a higher risk for injury.

I'm going to fall out of my chair. I'm going to drop on my knee. I'm going to do something that's going to put me in the emergency room for a checkup that I don't want.

And the lack of proper equipment also perpetuates the whole like social isolation, right? We want people to be participating in these activities and enjoying it and challenging themselves. And with the wrong equipment or no equipment at all, they're not able to do that.

They're not able to build community and camaraderie and things that matter.

[Eric Leighton]
Yeah. It's, it's, it's important. And, and I do remember, so you were mentioning the chair and how you ate snow on the mono-ski, Tim.

I had a, I had a story where, uh, we got to do the, uh, the sled hockey challenge that we've done from children's. Julia, I don't remember if, I don't know if you remember this one. I was there a few years ago and, you know, we're in the sleds for the first time.

I've, I've never piloted one of those and it takes some getting used to, and we were all stacked up to the side because we couldn't quite get off the ice. So ready for a line change and somebody goes, Hey Eric. And I looked to my right.

They're like, no over here. So, I looked quickly to my left and I was like the, the guy in the movie that walks outside and touches all the motorcycles at the bar and they all fall over. Yeah.

I knocked over 12 people. Just, we just stacked up. They're all trying to get up.

Meanwhile, the kids are out there on the ice, blowing past us, laughing at us. It was, it was fun. It was, it was pretty funny.

[Steve Whitaker]
You don't want to, you mentioned that Tim, you were mentioning that that, you know, the equipment and how important it is. And one thing that our school did last year, and I'm seeing the Ohio High School Athletic Association really being progressive when it comes to helping these athletes. And our school did this and we've encouraged other schools to do it.

When we, when we put the shot, new shot put rings in, we put tie downs for the, for the straps that hold the throwing chair, because there's nothing worse than going to a place, having to drive stakes in the ground, put straps on and hope and pray when this kid's rocking back and forth to throw a shot put that it doesn't pull out.

[Julia Kuba]
Yeah.

[Steve Whitaker]
So, when they put the anchors in, just things like that, that are simple, that we don't think about really affect them. But those are ways the schools can come alongside and say, what can we do? Another thing is when they go to the track and field events, do we have cement or blacktop that they can roll up to the thing or, or are they going to have to go across grass when it's muddy to get, and it's those things a lot of the schools have picked up on are saying, Hey, let's make this more adaptable for our athletes.

And I think that goes along with that equipment.

[Dr Jonathan Napolitano]
Yeah. I think it goes with the equipment as well as what I was talking about with the Paralympic development and really just improving access for everyone, right. That's going to help the spectators as well.

I wanted to chime in here guys with you, as far as the equipment goes, cause access is a huge challenge with this too. You dropped his name because he is famous and as well, but for those of you who don't know Jeremy, you know, Columbus parks and recreation does a great job of, of supporting athletes as well. And so, they have the opportunity to loan a track chair for a season.

And that's a great way to get experience and find a sport. And then, and I think adaptive sports Ohio does that in Northeast Ohio as well. Other ways to increase access because getting your own track chair or equipment really is a barrier.

Currently in the Ohio house, there's a house bill 564, and it's part of a national movement called so everybody can move. And it's basically a, it's a bill that is increasing access to sport specific prosthetic usage so that people can get the necessary equipment from their insurance providers to, to pursue their goals from a prosthetic standpoint. So yeah, I think we can put that in our show notes as well, but looking into so everybody can move, they're going to do an advocacy day here in a couple of weeks.

And, and there's lots that you can do if this interests you to, to get involved.

[Eric Leighton]
Yeah, definitely. It's all kinds of great information. We will definitely have a links to a lot of the things we talked about in the show notes, Dr. Michael cover here. We've covered a lot of great ground here. And I think a lot of terrific information, of course, having, having Julian and Steve with us helps. I do have, I've got, I've got one more question on my list here, and this is a, I'm going to kind of go through the, the list of people.

Cause I, I want to hear everybody's perspective on this. Steve coach, I'm coming to you first as a family member of someone with physical limitations, or, you know, if they, some, some phrase it as a disability, how do you think about identity?

[Steve Whitaker]
Her identity as a family member, you know, and I can say this across the whole, all of these programs have been mentioned today. It helps the identity of the, of the students so much. I even look at COSPA on Central Iowa Spina Bifida Association.

It's been a huge help to any time that we get together with athletics, with all those things, we haven't done the best job in the past with recognizing that our, our, our athletes or para-athletes are, are, that are just like everyone else. I mean, there's, there's really, they are true, honest athletes. And I think that what it does with everything that, how this has happened, and Julia has been such a good example of this, it opens people's eyes that they are.

I know at our school, at Algen local schools, we didn't have any athletes seated. And, you know, with Julia, it has opened up the, you know, we're, we're wanting to encourage more kids to do it. They're wanting to make the facilities available for kids that come along after Julia.

And that is, is so inclusive. And I think that as a family member and what I see, see the inclusiveness is, is, is great. She's not just off by herself.

She's with a group of kids is what she does. When her cousins talk about going to a wrestling tournament and then their friends, they meet there or they talk about, you know, going to a football playoff. Julia can, has the same experience with going to the straight state track.

And she can, they have something to relate to. So it is, it's huge.

[Julia Kuba]
Yes, it is.

[Eric Leighton]
It just really is. Yeah. Julia, I mean, it sounds like, yeah, obviously a lot of things that grandpa just said, obviously you agree with, but I mean, what do you, what do you think?

What, how does, how does it affect your thought of your identity as an athlete, as family, whatever you want to.

[Julia Kuba]
I think it affects me. Like, I don't really know how to answer that completely.

[Eric Leighton]
Well, I mean, how, so, you know, being, being an athlete and participating in what you do is you got a track and like, like grandpa was just saying, I mean, all the things and the friends and like that, but how do you feel it's, how do you feel it's changed your world? You know, like you said, you, you first started when your friend said, hey, you know what, come on, join sled hockey, try this out. And then of course you got into track.

And so how do you think it's, how do you think it's changed your world since you started?

[Julia Kuba]
I think it's changed my world. Like our, our.

[Steve Whitaker]
I know one way. And that is that, you know, like I said, we're a very large family and a very athletic. And in a wide range of sports right now, she has a cousin that is one of the top bowlers in Ohio.

But the point is when, when, when any of them talk and they get together in a group, we all get together every Sunday, our entire family for lunch, we've always done that. And they'll, when they brag about what they're doing in a sport, guess what? This one gets right along with.

Yeah.

[Eric Leighton]
Yeah. The tournament you just did.

[Steve Whitaker]
Right there. She's not just sitting off thinking, boy, I wish I could do some of that stuff. She is doing that.

And she's doing a marvelous job at it.

[Eric Leighton]
Yeah. We just talked about the tournament you were just at over this past weekend, you know, couple of wins, a couple, a couple that weren't, but Hey, you were in there and you're in the mix. And so, you're doing stuff.

[Steve Whitaker]
Last year in shot, but yeah.

[Eric Leighton]
And she's going to be first this year, right?

[Julia Kuba]
Yes.

[Eric Leighton]
There you go. Of course. So, you know, I'd like, you know, the same kind of question, I think, you know, those of us that work from the medical end in this world.

So, Dr. Napolitano, you know, what's your, what's your perspective on the identity and how it, how it affects some of the kids you've gotten to work with in the families?

[Dr Jonathan Napolitano]
Yeah, this has been so interesting for us to kind of uncover and discover, you know, Steve, as you had mentioned, you know, I think any of us, you know, if I am walking through the grocery store and I see an individual in a wheelchair, my first thought is not athlete, right. That may not be an identity I associate with an individual from the outside looking in. And this is part of my life, right?

This is part of my practice and something I am very well-versed in compared to a lot of individuals in our society. We did a study here where we were looking at barriers and facilitators of sport participation. And we just asked the simple question to athletes like Julia said, are you an athlete?

And overwhelmingly over 90% of them said, yeah, I'm an athlete. And so, I think that really clues us into the opportunity that, that we need to change our perspective of truly evaluating this individual as an athlete first, right? Our identity gets to be shaped, and it's chosen as to what we relate to, right?

We can use our identity as our, our career or our study of field or, or whatever it might be, but to identify as an athlete is really powerful. And I think it's specifically powerful for individuals with, with disability because oftentimes that disability is forced as an identity, right? As to, I am the, the kid at school who uses the wheelchair.

I am the, the person who uses a prosthesis or who needs extra assistance with one thing or the other. So, to have your identity in something elective and selective that you can pursue like athletics is extremely powerful for self-development and, and it's been fascinating to see how it affects individuals here.

[Eric Leighton]
Yeah. Tim, I know, like I said, you, you and I, we both get to work with it. You see probably even more than I do.

So yeah, same kind of question. What, what are some of the perspectives you've seen or, or learned in identity that you deal with?

[Timothy McCullough]
Yeah. I, so before I worked at Nationwide, I worked at Turnstone, which is in Fort Wayne. And I remember one of the first things I got during my training there was like a pamphlet on like person first language, which is like almost identical to what Dr. Napolitano was just saying right now. Like when you refer to somebody, you want to like, not, you know, I guess a wheelchair athlete, but more like an athlete who use a wheelchair. And so, you see how you flip the narrative a little bit, like the priority isn't that they're in the wheelchair. The priority is they're the athlete first.

And I just, that was so groundbreaking for me, not only for that opportunity, but for the current opportunity where I'm at here at Nationwide to be able to look through that lens and, and treat anybody I see or anybody who walks through the door first as a person and then as meeting the needs that they have that they just happen to have. And I think what's really important is that like people know that I get, or a disability is going to come for everybody at some point in time. Like nobody is immune from that.

It's just, when will it come? Will it come earlier in your lifetime, or will it come later? So, like, you know, creating a world where we have the ability to, to, to meet the needs that are there, whether for people who have disability come earlier on or for people who have disability come later is just huge.

Yeah. Just kind of that person first mindset.

[Eric Leighton]
Yeah. And I will say one, one experience I've had in working with athletes, you know, like I said, not only trying to keep up with Julia on the ice, but every athlete I've worked with at the, uh, the building I'm in, as we say in the military, they have zero quid in them. Every athlete I've gotten to work with, I mean, it is.

Yeah. So, I can do that. And it's the attitude of, yeah, watch me.

And I love that. And, you know, we encourage it obviously, but you know, I never really had to try to encourage them or pull them out of the shell. And I got them in there probably a little bit more like you coach.

I almost had to hold the reins a little bit here and there because the, the motivation, just like, just like any other athlete, you know, they're going for it and going for their best. So, I want to thank everybody. That was, I think this was a really great topic and we got to talk about a lot of great stuff here.

So, for myself, Julie and Steve, thank you so much for joining in with us. And obviously, uh, you know, my coworkers, Dr. Napolitano and Tim, and this point I'm going to throw it back to Dr. Mike.

[Dr Mike Patrick]
Yeah, this was a really fantastic conversation. Just so interesting. And, uh, Julia in particular, I want to thank you for sharing your story, brave and a great athlete.

And it makes me want to go watch sled hockey. I don't know that I'm brave enough to get on the sled, but it really, it sounds like fun, but I can imagine that it is very, very difficult. But again, I really appreciate everybody stopping by.

We are going to have lots of resources available for you in the show notes. So, if you head over to pdacast.org, this is episode 600, and we will have a link to the adaptive sports medicine program at Nationwide Children's Hospital. So, you can see more about all the great things that they're doing.

Dr. Napolitano had mentioned so everybody can move, we'll have a link to their organization. They also have an Ohio specific section of their website, and we'll put a link to that as well. But if you're not in Ohio nationally, and so I would encourage you to check them out.

And then we'll also have a link to the Columbus Blades sled hockey association. And I would assume, Julia, is that who you play for? With, through?

Yeah. So, if you want to learn more about what they're about and what they do and how you might be able to support them, we'll have a link to the Columbus Blades sled hockey site in the show notes as well. And then the adapted sports institute at Ohio state, we didn't get to talk about that.

Dr. Napolitano, do you have more information about the adapted sports institute?

[Dr Jonathan Napolitano]
Yeah. So, the, the colleagues of mine, both at Ohio state and, and nationwide here, we work together. So, it's, it's a similar program, but if you're listening or tuning in and you're not a pediatric patient or a youth, we have equal programming over on the adult side through their adaptive sports institute.

So similar to what we're doing just on the adult side.

[Dr Mike Patrick]
Great. And there is a scholarship, the Craig H. Nielsen foundation scholarship.

So, you know, these things can get expensive and that's financial support. Is that right?

[Dr Jonathan Napolitano]
Correct. Yeah. It's, it's a collegiate scholarship and Julia had something definitely to explore those with spinal cord injuries that Nielsen family has, has provided excellent resources.

So, something for anybody to look into.

[Dr Mike Patrick]
Great. And we'll put a link to, to that as well in the show notes. So, lots of resources for folks.

Once again, thank you so much to Jonathan Napolitano, sports medicine physician at Nationwide Children's, Timothy McCullough, a physical therapist at our hospital. And of course, Julia Kuba, student athlete and her coach and grandfather, Steve Whitaker. And thanks so much, Eric, for hosting this one. Great job as usual. We really, really appreciate all of you for being here today. 

[Eric Leighton]
Thank you, Dr. Mike. 

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[Dr Mike Patrick]
We are back with just enough time to say thanks once again, to all of you for taking time out of your day and making PediaCast a part of it. We really do appreciate your support. And again, thanks to our many guests this week.

They all did a fantastic job. Dr. Jonathan Napolitano with sports medicine, Timothy McCullough, physical therapist. And of course, Eric Leighton with athletic training.

We also had Julia Kuba, our student athlete and her coach and grandfather, Steve Whitaker. So, thanks again to all of them for contributing to the conversation and teaching us so much. Don't forget, you can find PediaCast wherever podcasts are found or in the Apple podcast app, Spotify, iHeartRadio, Amazon Music, Audible, YouTube, and most other podcast apps for iOS and Android.

Our landing site is pediacast.org. You will find our entire archive of past programs there, along with show notes for each of the episodes, our terms of use agreement, and that handy contact page if you would like to suggest a future topic for the program. Reviews are also helpful wherever you get your podcasts.

We always appreciate when you share your thoughts about the show. And we love connecting with you on social media. You'll find us on Facebook, Instagram threads, LinkedIn, X, and Blue Sky.

Simply search for PediaCast. Thanks again for stopping by. And until next time, this is Dr. Mike saying, stay safe, stay healthy, and stay involved with your kids. So long, everybody.

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