Disability in Pole Dance: Inclusivity and Accessibility for all

Pre-disclosure: Pole Physio Caitlin has previously worked with persons with disabilities within the Australian Defence Force, including the Invictus games and Adaptive sports programs, as well as the Australian Paralympic Shooting teams.

When most of us look at starting a sport or taking up a hobby, the focus might be on what we are interested in, or what might be a challenge. We have all had a time where we have thought ‘this is too hard’ or ‘I am not flexible enough’ or ‘I will never get it’. Then one day we do, an instructor shows us a different way to move into the trick, or we see an Instagram post, or we relax and let our bodies move and it just clicks. Our bodies are amazing with what they can achieve and none of us are the same. We are all different shapes and sizes; have varied strengths, weaknesses and challenges; and all of our bodies move in different ways.

With this in mind, at The Pole Physio we thought we might start a conversation around how individuals with disabilities face a few different challenges compared to abled bodied polers. This blog will be for instructors to build awareness around disabilities, but for anyone who is interested in learning more about what our bodies can do.

It is important to emphasise before we start that not all disabilities are easily seen or recognised. For example, not every poler with a disability has a limb amputation, which is often what is first thought of when the word disability is mentioned. There are many different types of disabilities in the community, and we are not able to cover all of them simply due to the vast number. Additionally, this blog does not provide medical advice and is focused on providing education and representation to the disability community rather than diagnosis and management.

So what will we cover? This blog will be covering vision and hearing impairments, diabetes, amputees, spinal cord injuries and other neurological conditions.

Disability and Pole – Background

According to the United Nations Disability Inclusion strategy, the word disability is an appropriate word to use when referring to persons with a disability. The context and phrasing when referring to disabilities is also important. It is encouraged when writing or speaking about individuals with disabilities to emphasise the person before the disability (otherwise known as first language). Examples include; persons with disabilities or students with spinal cord injuries. Throughout this blog we will primarily be using the term disability as an umbrella term, or refer to specific disabilities as able.

In a sporting environment - the term for an athlete with a disability that makes them eligible to compete in a para sport is ‘para-athlete’. Did you know The International Pole Sports Federation has a para pole category that was introduced in 2018? Athletes are classified based on the International Paralympic Committee classification system (used for all para sports).

There are three categories:

• Impaired muscle power (two groups – able to walk or wheelchair)

• Limb deficiency (based on below or above elbow/knee)

• Vision impaired

So with this background information, at The Pole Physio we decided that that rather than referring to persons with disabilities or para-athletes, we will be referring to our polers with disabilities as para-polers. We want to emphasise that a disability does not define an individual, and outside of this blog – we are all humans, with basic needs that have different challenges, experience levels, strengths and weaknesses.

Have you seen a para pole competition? If not – have a look at the Erin Clark’s video from the IPSF World Pole Sports Championships in 2018 where she won gold and set a world record with a score of 39.8.

What is the difference between a disability, disease and disorder?

Before we explain the different types of disabilities, it helps to have an understanding of what the definition of a disability is, and how that is different to a disease or disorder. There is currently no universally accepted definition of the term disability, which makes defining a challenge!

Disability is an umbrella term for impairments of the bodies' function or structure, that results in activity limitations or participation restrictions. It can impair a person's movements, senses or activities.

A disorder is a medical condition or illness that disrupts an individuals capacity to function. These are most commonly associated with psychological conditions.

A disease is a condition of a structure or function, that produces specific symptoms or affects a specific location, and is not simply a direct result of a physical injury.

Simple right?

Not quite. Long term disorders and diseases over time may result in a disability – for example some mental health conditions and infections. Trained health professionals are able to define when a specific condition become a disability, and within the pole community most individuals have a good understanding of their condition. It is important if you have a disability, disorder or disease, and are not sure how it fully affects you or may affect you in the future, speak with an appropriate health professional for further understanding.

Within the pole community, regardless of you having a disability, disease or disorder, there may be a way to participate in pole – the focus should be on HOW you can move your body.

Let’s get specific about some of the disabilities our para-polers may have.

Diabetes

Diabetes is a chronic disability that occurs when there is an issue with insulin within the body. Insulin is a hormone responsible for regulation of blood sugar (glucose) levels. There are two types:

Type 1: This type occurs when the pancreas (responsible for insulin production) is unable to produce insulin effectively, resulting in the need to administer daily insulin. It is not known the cause or how to prevent it from occurring. Thanks to advances in health technology, many individuals with this type of diabetes have glucose monitors and insulin pumps to help be independent in management.

Type 2: This type occurs when the pancreas is working, but not as effectively, resulting in the body building insulin resistance. It is often associated with excessive body weight and reduced physical activity. This type can initially be managed through diet and exercise with monitoring of blood glucose levels, however some individuals may need medication to help manage.

Most diabetics can independently manage their condition, yet there are some situations where their insulin levels change resulting in a situation requiring assistance. One condition is Hypoglycaemia – occurring when blood glucose levels drop too low. Reasons for this drop can be variable; from too much insulin, missing a meal, unplanned physical activity, or more strenuous exercise than usual. Symptoms of Hypoglycaemia that may be seen when exercising include:

• Shaking, trembling or weakness

• Sweating

• Paleness

• Hunger

• Light-headedness

• Headache

• Dizziness

Those with diabetes will have a plan for treating hypoglycaemic events that most commonly includes having a fast-acting carbohydrate (jellybeans, soft drink, fruit juice). It is important for instructors and studio first aid officers to be aware of how to help an individual a hypoglycaemic event. Some may even have an assistance dog trained in recognising hypoglycaemic events. It is important to note if you ever see a dog in a studio to not assume they are there as someone’s pet – check first as they may be an assistance dog!

Diabetes does not stop our para-polers – but it is important that instructors and studios are informed. This is to not only be aware of hypoglycaemic events (especially if trying a new style of pole that may be more demanding), but for awareness if they have a continuous glucose monitor on their arm or stomach, or need to wear a pump – certain tricks may not be achievable in that class as the monitor can get in the way.

Vision impairment

Vision impairment occurs when an individual’s eyesight cannot be corrected to normal. It can be due to a loss of visual acuity (not able to see objects as clearly) or loss of a visual field (cannot see as wide an area without moving the eyes or head). Conditions may affect one or both eyes, a specific visual field or multiple areas.

Vision can be impaired for many different reasons, but the main reasons as defined by the World Health Organisation (WHO) are:

• Impairment to the eye structure

• Impairment to the optic nerve

• Impairment to the pathways that link the brain and the eye structures

• Impairment within the visual cortex of the brain

According to the WHO, the majority of people affected are over the age of 50, however it can affect younger people. Not all visually impaired persons require a white mobility cane or a seeing eye dog, corrective glasses can also help!

Visually impaired persons should not be discouraged from participating in pole. Often those with visual impairments have other enhanced senses, including increased proprioceptive awareness. We have a great blog on the different styles of learning, and this is a situation where having a good understanding of learning styles, and be able to explain tricks in different ways can help.

As an instructor of a para-poler with a visual impairment, it is important to be aware of what the student needs (do not be afraid to ask!). Do they need to be positioned at a specific pole to see the class? Do they need different cues or hands on assistance when learning tricks? The most important aspect is constant communication and feedback – especially in learning a new skill. And for our para-polers – speak to your instructor about what helps you, but also experiment to find out what works!

Hearing Impairment

Hearing loss is defined as an individual’s difficulty or inability to hear speech and other sounds compared to someone with normal hearing (WHO). There are different types of hearing loss:

• Auditory processing disorders: brain unable to process sound

• Conductive hearing loss: problem with the outer or middle ear so sound cannot pass through (most conditions associated with this type hearing loss can be treated)

• Sensorineural hearing loss: Cochlea or auditory nerve are damaged/malfunction and are unable to send electrical information to the brain

Some people may have tinnitus as well – ringing or strange noises in their ears that can last from seconds to days, which can be more of an annoyance. Individuals with permanent hearing loss may be able to manage with hearing aids, cochlear implants or surgery.

As a para-poler with a hearing impairment, this should not prevent you from participating. Most individuals with hearing loss can lip read to help with understanding cues and skill acquisition, and when it comes to music for routines are more aware of the vibration – thanks to enhanced senses. As an instructor – communication is key, and figuring out a communication style that works!

Amputations

When most of us think of disabilities, the first thing that comes to mind is an individual with a limb missing, an amputee. There can be many reasons why an individual is an amputee, including:

• Disease requiring removal of a limb (e.g infections resulting in extensive tissue damage, gangrene, diabetes, peripheral artery disease)

• Traumatic accident or injury removing or requiring surgical removal of a limb

• Congenital limb abnormalities - when an individual is born without a limb or deformed limb

Amputations can be at different levels, and in keeping it simple, the level of classification of amputations is in relation to the closest joint – for example above or below elbow or knee joint. Some people may be classed as a double amputee (two limbs) or may only have a single digit (finger/toe) or smaller part (part of hand/foot). The picture below goes into further depth for those that are interested.

Para-polers with an amputee’s or congenital limb abnormalities are able to participate in pole with modifications. An example of this is using elbow grip rather than hand grip in below elbow amputations or hand deformities. There are many para-polers out there who are continuing to challenge their own bodies and modifying tricks to suit how they can move their body. For instructors – it is about being flexible and finding ways for para-polers to do the tricks and combos, think about how you could modify it.

Spinal Cord impairments

Spinal cord impairments can result in disability in different body parts dependent on the area of impairment. These impairments can occur due to trauma, disease or degeneration. The extent of the impairment will determine where in the body limitations occur.

The most commonly recognised spinal cord impairment are:

• Paraplegic – spinal cord damage below the neck. Impairment can be at any level of the middle or lower back, and dependent on the level will depend on the level of function in the trunk and legs.

• Tetraplegia (Quadraplegia) - spinal cord injury in the neck resulting in paralysis of the arms, trunk and legs.

Some spinal cord impairments can be unilateral, meaning only one side of the body is affected and are often restricted to one limb. The level of impairment and subsequent reduced function will be very specific to the individual.

When commencing pole, the level of impairment that a para-poler has will determine how they are able to participate. For example:

• An injury isolated L4 nerve (responsible for ankle dorsiflexion, the action of bringing our foot up) will be able to participate in pole. However, for some tricks (e.g. brass monkey) the foot position may need to be modified

• A complete tetraplegia would not be able to participate in pole as the level of impairment results in loss of function of the arms, trunk and legs.

• An impairment at T6 or below would be able participate in pole with modifications, as they have adequate upper body strength, but will have reduced trunk control. Some T3-5 impairments may be able to participate, however back and trunk muscles are significantly affected.

One important condition that affects those with a spinal cord injury higher than T6 is Autonomic Dysreflexia, a condition of the autonomic nervous system that can affect the heart rate and blood pressure. It is important if you are a para-poler with this condition, or an instructor of a student with a spinal cord injury at this level, to be aware of the symptoms and develop a management plan.

For those who are interested in starting pole, you may not know what you are able to do unless you try! It is important to be engaged with appropriate health professionals before you start to be aware of your own limitations, but also be prepared to practice different moves with an instructor – often just starting to move around the pole will bring you inspiration and awareness.

As a studio, it is important to consider if you are accessible for para-polers with a spinal cord injury. Do you have wheelchair friendly facilities and access? Would your pole instructors have the knowledge and skillset to choose and/or modify tricks for those with spinal cord impairments? If not, would you know who to speak to for further understanding?

Neurological conditions

Neurological conditions are dysfunctions of the central nervous system (brain/spinal cord) and peripheral nervous system (nerves and where nerves innovate muscle). Neurological conditions are not always a disability you can visually see, until someone moves or speaks. Some can be short term, associated with inflections or immune response of the nervous system that resolves over time – we will not cover these.

There are many different conditions that can be classified as neurological, but the most common that we can see in pole include (but are not limited to):

• Epilepsy

• Migraines

• Multiple sclerosis (MS)

• Early onset Parkinson disease

• Traumatic brain injuries

• Motor neuron disease

• Stroke

Of the conditions listed above – there are many ways persons with these conditions can be affected. A person with multiple sclerosis may be primarily affected by fatigue, or persons with Parkinson’s may have a resting tremor that is not noticeable during activity.

If you have a neurological condition, it will challenge your ability to participate in pole to some extent (and every person will be different), however it should not stop you from trying. Ensuring instructors are aware of any conditions, allowing certain exercises to be modified, or additional support for spotting when learning more challenging skills.

What about some other disabilities?

Earlier in the blog we spoke about the differences between disease, disorder and disability, and how it is not as black and white as it seems. There are a number of disorders that can be classed as a disability that students may have, but are not as noticeable unless a student tells you. These may affect a poler if they are having a flair up, or have other stressors going on that means they are not managing as well as the usually do.

We will not go into depth around them, but some include:

• Ehlers Danlos Syndrome (EDS) (we do have a blog focusing on this found here!)

• Dysautonomia conditions – dysfunction of the nerves that regulate non-voluntary body functions, including Postural Orthostatic Tachycardic Syndrome (POTs)

• Auto-immune diseases – there are over 80 different types of autoimmune diseases, with some of the most common including Rheumatoid Arthritis, Lupus and Inflammatory Bowel disease.

Key Points:

A disability should not discourage you from starting or continuing to participate at pole. There may be limitations and challenges, but through creative thinking and practice, you can find the movements that suit your body.

@Cortdoesscience on Instagram summarised some key points regarding disabilities that are important to remember:

• Never assume people are faking – just don’t.

• Disability is not a bad word – it IS ok to say it

• Do more than the bare minimum – just meeting legal requirements is not enough – provide a supportive environment!

• Don’t compare yourself and your disability to others – every person is different. Regardless of your disability, you still deserve the support

We hope that in reading this blog, persons with disabilities who have been hesitant in trying pole reach out to a local studio and start to move their bodies in the ways then can. For those para-polers who have already been poling, continue to move your bodies and challenge what you can do!

Until next time, train safe.

The Pole Physio

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Websites for further information:

http://www.polesports.org/world-pole-aerial/disciplines/para-pole/

https://www.paralympic.org/classification

https://www.who.int/ - World Health Organisation

https://www.diabetesaustralia.com.au/

https://www.ungeneva.org/sites/default/files/2021-01/Disability-Inclusive-Language-Guidelines.pdf

https://www.spinalinjury101.org/details/levels-of-injury

https://www.cdc.gov/ncbddd/disabilityandhealth/disability.html

https://thedysautonomiaproject.org/