Rapidly advancing technology blurs the line of equality in competition.
|South Africa’s Oscar Pistorius (left) competes next to Italy’s Marco Moraglio in a mens 400m race. Pistorius has magnified the debate about whether or not technological advances in prosthetics have provided disabled athletes an unfair advantage over whole-bodied athletes. ALBERTO PIZZOLI/AFP/Getty Images.|
Months after his leg was literally torn away from his body, Brian Bartlett took his first steps with a new prosthesis. Though he still had open wounds and was connected to a morphine drip, Bartlett wanted to get back on his feet and pressured his prosthetist to get him into a socket as quickly as possible. About 20 feet into his planned walk around the block, blood was dripping down the prosthesis, and Bartlett thought he might pass out.
“I was in so much pain,” says Bartlett, who in 1998 was struck by a car and pinned against another, an accident that took his leg. “I’ll never forget that. It was horrible, and to go from my own leg into this prosthesis was such a letdown.”
Bartlett, inventor of the Bartlett Tendon after the accident and a professional freeskier before it, put himself through the excruciating process in an effort to get back to his aggressively active lifestyle and some sense of normalcy.
(Editor’s Note: See sidebar “The Bartlett Tendon“)
In the year following his accident, Bartlett was flying down the slopes at 70 mph, catching 150 feet of air, and skiing off 40-foot drops into the powder below. Impressive, for sure, but Bartlett was doing all of this on one leg, with one ski and a set of poles. “Yeah, but the able-body guys were going about 80 mph,” Bartlett says nonchalantly.
Necessity dictated Bartlett design his own prosthesis. There was nothing on the market that could withstand the rigors of his jaw-dropping, high-flying, hard-impact aerial stunts, whether on snow or the rock and dirt tracks carved out for downhill mountain bike racing. However, even as the eighth prototype of his namesake tendon allows him to compete against and beat some of the top whole-bodied downhill racers in the world, he says it is certainly no advantage.
A top-notch athlete before the accident and after, Bartlett takes umbrage at the theory that today’s rapidly advancing prostheses provide an edge for disabled athletes competing in the whole-bodied arena. “It takes so much physical strength and balance just to walk with a prosthesis; that supersedes any benefit,” Bartlett says. “For people to say you have an advantage, I just don’t buy it.”
|Brian Bartlett takes a break from downhill riding to show off the Bartlett Tendon. Photo by Timmy Corkery.|
Bartlett’s friend and fellow athlete Jason Lalla, CP, Next Step Orthotics & Prosthetics Inc., Manchester, New Hampshire, offers a proposal to anyone who believes in the growing debate about sophisticated prostheses turning athletes from disabled into too-abled.
“My initial sarcastic comment to this notion of someone being too-abled was, if anyone wants to sign up for an amputation to test the theory, here’s my card,” says Lalla, a transfemoral amputee like Bartlett. “I just don’t see any legitimacy to it yet.”
Yet might be the key word. The debate about “techno-doping,” which South African sprinter Oscar Pistorius recently brought to the spotlight, could be heating up now in order to avoid a meltdown in the near future. The International Association of Athletics Federation (IAAF) is in the process of testing Pistorius’ Cheetah® Flex-Foot® running legs to determine if he can compete against whole-bodied athletes at the 2008 Olympics in Beijing, China.
It should be noted that the IAAF is not obligated to examine the Pistorius matter.
Science vs. Emotion
Pistorius, a sprinter who owns three world records for disabled athletes, is the poster boy for the “trans-human” debate. The IAAF said his prostheses might provide an unfair advantage over sprinters with natural limbs, pointing to lesser wind resistance as one possible factor. The federation is currently testing Pistorious’ legs and will soon decide if he will be allowed to compete. Public opinion seems to favor Pistorius, as 68 percent of respondents to a recent WashingtonPost.com poll said he should be permitted to compete against whole-bodied athletes. But science is not a party to emotion, and therein lies the rub.
“Where do you draw the line?” asks Randy Alley, BSc, CP, FAAOP, CFT, president of biodesigns inc., Thousand Oaks, California. “Common sense says that people with a below-the-knee amputation will actually be able to, at some point in the future, surpass the world records of able-bodied athletes. With energy storage and lighter limbs, it seems more than possible.”
As for now, however, most of the O&P professionals who were asked agreed that the technology isn’t there. “As much as we would like to think that our systems are superior to what we are born with, we simply are not there yet,” says Kevin Carroll, MS, CP, FAAOP, vice president of prosthetics for Hanger Orthopedic Group Inc., Bethesda, Maryland. “The modern prosthetic system of today has the ability to store and release energy, but it’s not like your natural leg.”
Not even close, according to athletes and as described by an expert in the field. In Pistorius’ case, he can’t push out of the blocks like a whole-bodied sprinter would. Instead, he uses his hip muscles to pull himself forward. The Flex-Foot provides an 80 percent to 85 percent return of energy. The natural human leg offers an energy return as high as 250 percent; however, these numbers have been disputed by some scientists (
Expending Extra Energy
|Mark Eberhart, a transfemoral amputee, rides the rapids in his kayak, one of many extreme sports in which he competes.|
Those who actually use a prosthesis in competition tend to agree that an artificial limb-even a lightweight, highly advanced carbon fiber model-doesn’t propel a runner forward or reduce the amount of energy expended, as some have contended.
“Did you know that it takes more energy for an amputee to do a race? We use 40 percent more energy and twice the oxygen,” says Sarah Reinertsen, a transfemoral amputee who competes in Ironman events and other competitions. “My doing the Ironman in Kona, [Hawaii], in 2005, it took more energy than an able-bodied athlete-it was as though I did it twice. How can anyone have an advantage when they are missing a leg?”
Rather than looking at a technologically advanced prosthesis as an advantage over whole-bodied athletes, Reinertsen and others said prostheses merely give amputees and those with limb loss a chance to compete on a nearly level playing field. There is no added benefit when the amputee athlete’s starting point is taken into account.
“You literally have to learn to walk again,” Lalla says. “You have to retrain muscles that have been bisected. You have to learn how to fire those muscles in a different manner. Depending on the situation, there is other trauma to deal with, like skin grafting or calcium overgrowth.”
The Bartlett Tendon
Simon Lawton first met Brian Bartlett, fittingly enough, on a mountain bike trail. Lawton, a professional downhill rider, quickly realized that Bartlett couldn’t stand up on his bicycle. A transfemoral amputee, Bartlett’s prosthesis limited him to the saddle-not an ideal situation in the daring and dangerous sport.