Team USA Paralympic athletes' experiences with sport participation: a socioecological qualitative study.
Kossman MK, Triplett AN, Post EG, Anderson T, Blauwet C, Donaldson A et al. · BMJ open · 2026
Objectives: The
Purpose: of this study was to understand Paralympic athletes' positive and negative experiences associated with their participation in Paralympic sport.
Design: Phenomenological qualitative study contextualised using the socioecological framework SETTING: Online. Participants 19 Team USA Paralympic sport athletes (females, n=11; males, n=8; age, 31±9 y) representing 11 sports and 4 categories of eligible permanent medical conditions recognised by the International Paralympic Committee impairment classifications: (1) muscle and movement (impaired passive range of motion and impaired muscle power); (2) bone-related conditions (limb deficiency, short stature and leg-length discrepancy); (3) visual impairments and (4) central nervous system disorders (hypertonia and ataxia).
Results: The resulting codebook included three themes titled: (1) Journey to Becoming a Paralympic Athlete; (2) Challenges of Paralympic Sport Participation and (3) Advantages of Paralympic Sport Participation. Athletes described Paralympic participation as shaped by interconnected personal, social, organisational and policy-level influences. Inclusive sport environments, family/community support and rehabilitation experiences facilitated athletic identity development and participation pathways, although many participants reported delayed awareness of Paralympic opportunities. Challenges included financial strain, healthcare accessibility, travel demands, chronic injury management and balancing sport demands with employment, education and family responsibilities. Despite barriers, athletes described physical, psychological and social benefits including improved self-acceptance, resilience, belonging and professional growth.
Conclusions: This study highlights the dual reality of Paralympic sport participation: a journey characterised by resilience, achievement and community, yet marked by persistent inequities and systemic barriers. Inclusive sport environments, social support and increased institutional recognition contribute to athlete well-being and performance; however, addressing the identified challenges is essential for advancing equity and inclusion in high-performance sport. Future research should
Aim: to quantify the barriers and benefits experienced by Paralympic athletes in relation to their health and wellness.