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How Red Tape Keeps Amputee Athletes Out of Sport

The high cost of prosthetics is prohibitive for many people who need them.

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To finish a triathlon, some basic gear is needed–at minimum, some swim goggles, a bike, and a pair of running shoes. Many new triathletes improvise, borrow, and buy used before deciding if they want to invest in the sport, but for some athletes, one piece of gear is essential, costly, and can’t be borrowed from the next-door neighbor.

According to the Amputee Coalition, only one-third people who have limb loss (such as amputation) or limb difference have a prosthesis. For lower-limb loss, most prosthetics are a basic foot-ankle assembly, which provides a base of support for walking and standing that is solid at the ankle joint. These devices are fine for basic movement, but running requires a specialized, dynamic athletic prosthesis known as a running blade–and those are even harder to come by.

For a below-the-knee amputee, a single running blade costs nearly $3,500. Above-the-knee running blades cost significantly more, going for upwards of $9,000. The cost goes up when factoring in a second running blade for a double-leg amputee, specialized prosthetic feet for running on certain surfaces or clipping into a bike pedal, and physical therapy to learn how to move safely and efficiently on the new prosthetic. None of this is covered by insurance.

“Cost is a significant challenge to obtaining a prosthetic for running or other active sports,” said Mary Richards, president and CEO of the Amputee Coalition. “Athletic prosthetics are usually not covered by insurance as they are not deemed by insurers to be medically necessary.”

Athletic prosthetic requests are often denied by insurance companies due to their designation as a “convenience item.” Yet there is a well-established body of evidence that shows sport should be included in an amputee rehabilitation program: in additional to the standard physical and mental health benefits of exercise that apply to all human beings, those with limb differences experience improved bone-mineral density (especially important in those with lower-limb loss), a reduction in phantom limb pain, increased self-confidence, and improved quality of life. 

“Physical health and mental well-being work hand in hand,” said Richards. “Athletes who experience limb loss or limb difference rely on their ability to perform at a certain level and, when that doesn’t happen, it can have an impact on their overall well-being.”

John Register, an All-American track athlete who lost part of his leg while training for the Olympic trials, said a running blade was a critical part of his recovery: “Everyone has a different goal for their own body—driving a car, dancing at a wedding, walking to the farmers market. I knew I achieved a big milestone in my new normal when I could get back to competitive running.”

Currently, the Amputee Coalition is working with senators and representatives to introduce bipartisan legislature known as the Triple A Study Act, which calls for the Government Accountability Office to conduct a comprehensive study of access and availability among all healthcare providers and insurers.

In the meantime, the non-profit sector is stepping in to bridge the gap. Fundraising website GoFundMe usually has several requests for financial support in obtaining a running blade. Several organizations, like the Challenged Athletes Foundation, offer grants for free or reduced-cost athletic prosthetics. The National Limb Loss Resource Center offers a list of resources and potential avenues for financial support so that athletes can pursue funding for specialized athletic devices.

For more on this topic, read The Science and Controversy of Running Blade Prosthetics.