AOTA Member, Paralympian Sarah Adam, Discusses the Importance Adaptive Sports for Women and the Value of Grit

AOTA Member Sarah L. Adam, Paralympian, OTD, OTR/L, CBIS, Assistant Professor, Academic Fieldwork Coordinator, Occupational Science and Occupational Therapy at St. Louis University followed a path to earning a silver medal for the American Paralympic Rugby Team this summer propelled by a series of mentors, coincidences, and sheer grit. Lately, her new role as a disability advocate fits in perfectly with her life and goals. And she’s always been goal-oriented, which all occupational therapy practitioners (OTPs) know is the crux of the profession.  

Road to the Paralympics 

Adam had conducted her Capstone on adaptive sports, where she had access to elite athletes in training. She studied at The Lakeshore Foundation, where the philosophy is “there is no limit to human achievement.” She fell in love with the exhilaration and joy exuded by the athletes. She loved the fierceness of the competition and the fact that so many women were playing at such a high level. At the time, she had no idea she’d end up training there herself and becoming one of its star athletes.  
 
When she received the invitation to try out for the USA Paralympic rugby team in 2022, she was thrilled and not overly worried about it, thinking “Nobody makes the team their first year trying.” She surpassed her expectations and made the team, and immediately had trials all over the world.  

Disability Advocate 

“For me to be in that elite space as a female in what is typically considered a male-dominated sport has been an interesting opportunity. I speak on how important the growth opportunity in sports is for women, because that's where you learn so many skills for life: leadership skills, communication skills, people skills, the grit to just keep going.”  
 
Adam had noticed through clinical practice that adaptive sports were most typically referred for males. She says, “I think it's the way people still think about adult women in sports. We do not have the same level of opportunity. But we have to change that mindset. Adaptive sports are for everyone and are life-changing. When I first got into it and saw what people could and would do in these incredible wheelchairs, it made me go and do things I never thought I could do... it opened up the world.”  
 
Diagnosed with multiple sclerosis (MS) in 2016, Adam was grateful for the many opportunities occupational therapy provides. She practiced in different settings and did research before finding her place in adaptive sports.  
 
The Lakeshore Foundation, where team USA trains was familiar of course, because of her Capstone research there. As Adam witnessed the thriving athletic community and the power of adaptive sports in their lives, she was inspired and transformed.   

Adaptive Sports 

Adam is happy to note that adaptive sports are growing exponentially. She says, “We saw that in droves for Paris. Before we left, we could feel this palpable difference. People who have competed in the Paralympics for 10 plus years were saying this felt different going into the games because it was trending on social media and television. It was a regular conversation on a lot of major networks like NBC and received high visibility through our partners and sponsors for Team USA.”  
 
While the average client is not a Paralympian, Adam is passionate about educating her peers and others in the rehab community about adaptive sports. She considers herself an athlete first, and a person with a disability as incidental. The OT in her ties it all together, hence her advocacy. “The biggest thing for me is getting more people with disabilities involved in adaptive sports. And that starts with an occupational therapist. I talk to other OTs, PTs, and rehab professionals to encourage them to introduce adaptive sports to their patients.”  

 
Adam emphasizes the other benefits of adaptive sports beyond the physical aspects. She says, “It’s not just physical improvement, it's socialization and peer support, it's mental health, it's everything that you see in able-body sports, but you see it tenfold when you're talking about adaptive sports.” 
 
Though the benefits of adaptive sports are well documented, Adam acknowledges that there are barriers. Access to a facility or the equipment can be a challenge. There is a wide range of equipment, and practitioners and researchers must actively seek funding to have it available for their clients. The wheelchair Adam uses costs $15,000.  Most are custom-made and not covered by insurance. Access to adaptive sports programs in the U.S. can be elusive, especially for those who live in rural communities.  
 
Additionally, Adam notes that adaptive sports are simply not top of mind, especially for an inpatient who needs to re-learn basic life skills. “When you're so focused on the basic life skills, it's easy to say that it seems inappropriate or they're not ready to be introduced to adaptive sports yet. But I think it's quite the opposite. I think adaptive sports can connect you with the community and hope.” 
 
Adam wants OTs to expose patients to adaptive sports as early as possible. She thinks it counteracts the “doom and gloom” nature that sometimes pervades inpatient care. “Every last one of us in the disability community is saying, no, we will figure out a way for you to do just about anything you want,” says Adam.  
 
Her favorite example of this is the story of one of her teammates, Mandy, who was injured at age 10 in a serious car accident. For the next ten years she was completely dependent on a caregiver and was using a power chair, which Adams notes is very limiting. While in inpatient rehab she was shown the documentary, “Murderball” and it changed her outlook. Her occupational therapist was not encouraging, but she ignored him and pursued different equipment.  

When she was finally introduced to a manual chair, she became nearly entirely independent. Her life changed. Adam wonders how different people’s lives could be if their OTs consider equipment and access to adaptive sports.

Adam says, "I hope that people in our profession and patients saw the Paralympics on social media and on TV and thought, ‘let me go check that out. How do I get involved? Is there a sport I can play?’”