The Challenges of Being a Challenged Athlete in Kona: Part II

October 6th 2011

I spoke with two athletes racing PC in Kona: Scott Rigsby and André Szücs

(Ed. note: Click to read the introduction to this series along with Part I: Wheelies)

Scott Rigsby, 43,was the first double amputee to complete an Ironman. During his first attempt, in Coeur d’Alene, he crashed on the bike. Despite a cracked vertebra, he made it through twelve miles of the marathon before the injury overwhelmed him. A year later, in 2007, he did the "unthinkable" (which is also the title of his book) right here in Kona, finishing with eighteen minutes left on the cutoff clock.

André Szücs, 31,was born with a malformation that required surgery at the age of nine months to allow the fitting of a prosthetic lower right leg. He’s also missing a couple of fingers and the first and second toes of his "good" left foot. Andre did Ironman Brazil in 2007 but this is his first trip to The Big One in Kona.

LG: I learned a whole new language talking to the wheelchair guys, and it looks like I have to learn another one for the PC division.

SCOTT: Oh, yeah: Singles vs. doubles, above-the-knee vs. below-the-knee…but unlike with wheelies, you can tell with one glance what the extent of the injury is.

LG: But only when you’re wearing shorts. If you’ve got long pants on, I often can’t see any sign at all that something’s missing.

SCOTT: Neither can I. A lot of that has to do with technology.

LG: André, was I hallucinating or did I see video of you surfing? And doing a lot better than I ever did?

ANDRÉ: That was me. I love the water. I was a competitive swimmer for eight years before I got into triathlon.

LG: You don’t wear a prosthetic in the water during a race, do you?

ANDRÉ: No. I leave my stump exposed or slip a liner over it.

LG: With one leg, aren’t you out of balance?

ANDRÉ: Yes, and that takes some getting used to. I also have to kick with my good leg but there’s no propulsion in it; I just do it to help me stay horizontal.

SCOTT: Propulsion is pretty much a non-issue for me, too. Even with four inches of leg below each knee, I don’t get anything out of kicking because it’s the foot that acts like a fin. So it’s just about minimizing drag by not letting your legs flail around the water.

LG: Can you wear any gear on your legs?

SCOTT: Depends on the rules of the race, but never anything that supplies propulsion. I’d like to wear something that will let me get out of the water and over to T1 more quickly but I don’t yet know what’s going to be allowed here. Part of the problem is that there’s a blanket rule against any kind of "add-on" at all. It was intended to prevent people from using things like flippers but it’s worded so broadly that it also covers things that could help you get out of the water but have no advantage while you’re still in it.

LG: Can you run or walk on your stumps?

SCOTT: Some people can but it’s tough for me, especially on a rough surface. I don’t want to start a 140.6-mile race on scratched up stumps. I also don’t want to risk tripping up athletes who might not notice me because I’m down so low.

ANDRÉ: First thing I check out at a new venue is what the water exit looks like and how far it is to T1. Are we talking stairs, ramp, sand? A cycling leg is really no good for walking but if it’s a relatively short, easy trip to transition, I can put it on right out of the water.

LG: How many legs do you have?

SCOTT: If you’re a triathlete, you’re going to have three sets: everyday walking, cycling and running.

ANDRÉ: And backups. Don’t forget those.

SCOTT: Right. One of the things I’m a little concerned about is how T1 is going to be set up for challenged athletes. We’ve got our own tent on the pier but Raj [triple-amputee Rajesh Durbal] and I alone have something like twelve legs. It’s going to look like a prosthetics factory in there on race morning.

LG: How difficult is it to get a leg on? I’m guessing you don’t just step into it like a ski boot, snap a couple of buckles and head off.

ANDRÉ: It’s a multi-step—

LG: Is that a pun?

ANDRÉ: Unavoidable. Happens all the time. Anyway, it’s a multi-step process involving silicon liners, fabric slip-ons, flexible carbon fiber, cups…

LG: So what is that actually keeps the leg attached firmly to the stump?

SCOTT: Suction. The urethane liner fits tight around the stump and up along the thigh. Then when you step into the prostheses and pull up an outer sleeve which creates a seal, the air is pumped out by an electric or mechanical pump, depending on the design, forming a vacuum seal that holds the whole thing on.

LG: What keeps the vacuum intact?

ANDRÉ: A one way valve. Every time you put pressure on your leg it forces air out through the valve but it can’t come back in.

SCOTT: The technology I use is an "elevated vacuum" system. The processor in the electric pumps sense changes in the vacuum level, and if it starts to weaken, the pump automatically restores the optimal vacuum level. The valve also expels sweat. Back in the old days—

LG: Old, like…

SCOTT: Four or five years ago. Sweat was a huge problem. In ’07 I was stopping every four miles on the run to take the leg off and pour cupfuls of sweat out. Blood, too.

LG: Blood?

SCOTT: Yep. The old style legs were pure hell on stumps. I had rings of flesh ripped off and was in agony the last three miles, and for five days afterward I was in a wheelchair.

ANDRÉ: Now there’s a whole wicking system and the valve expels sweat automatically, which was a tremendous advance. Of course, if the liner gets punctured for some reason, the vacuum is compromised and you wind up having to adjust things every few minutes.

LG: Are we talking bike or run now?

ANDRÉ: Both. Expelling sweat is as important on the bike as the run, because all of that moisture breaks down skin. By the time you get to the run you can be in real trouble.

LG: Now, is that the same system for both the cycling and running legs?

SCOTT: Yes, and walking, too. The interface between the stump and prosthetic is the same, but the prosthetic itself is completely different depending on the function. My cycling legs are an aerodynamic design. I don’t even bother with any kind of shoe. There’s just a pedal cleat at the bottom.

LG: How tough is it to get out of the pedal quickly if you need to?

ANDRÉ: A fall to my right side is a bit of a problem. It’s just not the same reflex to snap out.

LG: I imagine that the bike is much less traumatic for you than the run.

ANDRÉ: Far less. There’s a lot of rubbing but no pounding. But there’s also a balance issue for a single amputee, because one leg is working harder than the other and doing it on one side of the bike.

LG: Bike legs look relatively straightforward, but there seems to be some real intricacy to run legs.

ANDRÉ: There is, and getting everything locked in correctly is critical. I take a lot of time in T2 to make sure everything is exactly right.

LG: Looks like a lot of complex hardware there. Are you talking about adjusting all those screws and bolts?

ANDRÉ: No. There are three main section: foot, pylon and socket. You can pretty much figure out what each is.

LG: Got it.

ANDRÉ: So the most important is the socket, because that’s the "comfort point." It’s the part that every amputee struggles with in the beginning, not only because it’s new but because the stump changes a lot before it settles down. And if you’re an athlete, it changes in the middle of the race. It gets compressed from all the pressure and pounding, and it can swell from the trauma, so you have to make adjustments in the middle of the race.

LG: Adjustments like…?

ANDRÉ: Slipping liners on and off to vary the thickness. But over time you figure things out, and the technology keeps getting better. I used to get terrible blisters that took weeks to recover from. At IM Brazil I was down on the ground with the foot off after about six miles, and had no intention of getting back up. A friend came by and urged me back up and I was able to block out the pain for a while. But with a few miles left I lied to him, told him I was fine and that he should go on, but the pain came back ten times worse.

LG: And now?

ANDRÉ: This year I got a new socket and did a 20K run that was pure heaven. Now the only thing I’m worried about in the Ironman run is myself, because I think the leg is going to be just fine. Which isn’t to say it’s going to be smooth sailing. If the stump swells and I take off the leg to get a breather, I might not be able to get it back on. You need to decide on the right liner, too: If it’s too tight, sweat will hurt you. If it’s too loose, things move around and can rub you raw. But as long as you’re not too beat up, you can stop in the middle of the race and pull liners on and off.

SCOTT: I’ve had the same problems. That run in ’07 was just awful. The advantage of the new elevated vacuum technology is that the high levels of vacuum create a stable environment that minimizes all that shrinking and swelling and trauma. Now let’s face it, I’m doing an Ironman. Even abled body athletes can’t say that they feel great after 140.6 miles. But this time I’m looking forward to being able to concentrate on just running instead of struggling with the equipment and worrying about how badly my legs are getting trashed.

LG: Has the foot part advanced much?

SCOTT: Interesting topic. There hadn’t been a major advance over the C foot in thirteen years.

LG: "C" refers to the shape of the carbon fiber arc?

SCOTT: Right, as opposed to the J. What a lot of people don’t realize is that the fiber half-circle has only one purpose, and that is to cushion the shock of each step. Other than that, there’s no "spring" like you get from your back foot when walking or running. There’s no mechanical advantage at all, and in fact it’s a deficit.

LG: You’re referring to Oscar Pistorious.

SCOTT: Sort of. I don’t really know that much about the specifics of his legs but I do know that it’s not like running on a set of springs. It’s more complicated than that. People with one good leg use the momentum it generates to swing the prosthetic leg through. If you’re missing both legs, you can’t get it that smooth.

LG: Rudy Garcia-Tolson doesn’t swing them through at all.

SCOTT: Right. He kicks his legs out in a wide arc to clear the ground. But a little while back I got a call from a company called Freedom Innovations that came up with a new idea to return a little energy to more closely mimic an able-bodied pushoff from the rear foot. They put a strip of carbon fiber across the "C" arc. It acts like a crossbow: When you step onto the foot, the strip bends and stores energy; when you release pressure, it snaps back into shape and provides a little pushoff. [see photo: "Scott-Rigsby-Catapult"]

LG: How effective is it?

SCOTT: Well, at first I kept breaking them one right after another! Took a lot of trial and error to get the right size strip for my weight and running style but I think we have it nailed now.

ANDRÉ: Stuff breaking is an issue, by the way. The foot takes a terrific beating and carbon fiber weakens and even delaminates over time. You’ve got to pay a lot of attention to make sure you spot it before it happens in a race.

SCOTT: I still don’t know if we’re even allowed to make repairs or replacements during the race. I’m hoping we find out at the race meeting.

LG: Just thought of something: Where did you guys qualify?

ANDRÉ: Interesting topic.

SCOTT: We didn’t. There’s no qualifying for PC. It’s all done by lottery.

LG: Curious. The wheelchair people have two qualifying races. Is it because the range of possible amputations is so wide? It wouldn’t really be fair to pit a double above-the-knee against a single below-the-knee with an Ironman slot hanging in the balance.

SCOTT: That’s got a lot to do with it. You’d need a whole lot of categories to make it completely fair, and that’s not practical. Not yet, anyway. But there are other ideas being discussed, like qualifying races where you can compete against people in similar condition even though you might still lump the whole category together once you get to Kona.

LG: You would need a lot of categories to cover everybody.

ANDRÉ: Compromises are inevitable. In my case, I’m missing some fingers, which makes it hard for me to brake on downhills, so I train with a time trial bike.

LG: What about shifting?

ANDRÉ: Not a problem.

SCOTT: The lottery system isn’t an unreasonable idea, but it’s frustrating because it’s so random. Everybody else can work harder and race their hearts out trying to win a slot. With us, you just roll the dice and hope.

ANDRÉ: Of course, that’s unique to Ironman. There are all kinds of other races that you can plan for in advance.

SCOTT: And don’t think I’m complaining. We’ve come a long way, baby.

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A personal note:

When I first began speaking with challenged athletes in preparation for this piece, I thought I detected a little undercurrent of grumbling. There were thinly veiled references to inequities involving degrees of disability, race course rules that might not have been thought through fully, the frustrations of qualifying. It was nothing compared to the litany of complaints you get from able-bodied competitors, but it was there, and it was surprising, at least to me. I’d always thought that being allowed to compete alongside mainstream athletes was the acme of the challenged athlete’s ambition, and once you made it to Kona all you had to do is finish and you could ride off into the sunset, your life now complete.

Boy, was I stupid.

I’ve now done a complete one-eighty, and if you were to ask me what I thought was the single brightest indicator of the advances made by these remarkable athletes, I’d say it was the grousing, hands down. Why?

Because it says that they’ve moved beyond the Hallmark moment and into the rarefied territory of the genuine athlete. Carlos Moleda, Scott Rigsby, Sarah Reinertsen, Rudy Garcia-Tolson and other pioneers have already proven that it can be done. Step 1 (as André said…you can’t avoid leg puns) is over and is, like, so last year. They’ve moved beyond breaking ground and are now into breaking records. Scott came in with eighteen minutes on the clock last time. This year? He wants to finish, take a shower and return to the pier in enough time to cheer the rest of the racers in. Andre Kajlich wants to crack eleven hours, and so does Geoff Kennedy. (Guess which race-within-a-race I’ll be following.) So the griping is a sign of health, of acceptance not only by the larger community but by themselves. The morph from anomaly to athlete occurs when the question changes from "Can I finish?" to "How fast can I go?" to "Can I be the best?" And anything that gets in the way, whether it’s a qualifying inequity or an ill-considered rule, is just another obstacle to be overcome in a lifetime of overcome obstacles.

Let the games begin…

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