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Sunday, Aug. 12, 2012
Japan's Paralympians overcome adversity by leaps, bounds and innovative design
By TOMOKO OTAKE
When Oscar Pistorius made his dramatic debut in the men's 400-meter race in London last Saturday — becoming the first double amputee to compete alongside able-bodied athletes in Olympics history — some people might have wondered if the South African's artificial legs gave him a competitive edge over the other sprinters.
But if you ask the prosthetics-wearing athletes themselves what it takes to run with carbon-fiber feet, they'll tell you it's much tougher than you can imagine.
Perhaps the misconception arises from how effortless the top runners make their movements seem. Such skill is possible only after long, difficult training — not just physically, but mentally.
Take Saki Takakuwa, a Keio University sophomore who will compete in the 100 meters, 200 meters and long jump competitions at the London 2012 Paralympics, which begin Aug. 29.
The 20-year-old Saitama Prefecture native, who lost her left leg below the knee to bone cancer nine years ago, discovered her talent as a sprinter after joining her high school track club. At a 100-meter race in Tokyo last month, she placed first in the "T44" category (for single below-knee amputees), beating Japanese record holder Maya Nakanishi.
"I wasn't able to run immediately after losing my leg, though people get the wrong idea because it looks so easy," Takakuwa said during a recent practice at Keio's Hiyoshi Campus in Yokohama, where she trains every day with able-bodied college athletes. "We all begin by learning how to walk again."
Takakuwa says achieving top speed with prosthetics — which are made of several parts, including a sleek, shock-absorbing spring and a custom-crafted socket — is not easy. Artificial limbs lack the equivalent of human ankles, which have flexibility that helps able-bodied sprinters run fast.
Takakuwa's biggest challenge at the moment involves something basic: footwork. The "sole" of the prosthetic limb contains four rows of spikes, and she tries to land on the third row for each stride, followed by the second and the first.
"It's such delicate training that it makes my brain tired," she says.
When asked about Pistorius, Takukawa answers that although she admires his achievement, she doesn't think every amputee athlete shares the same dream.
"Oscar's accomplishment is not becoming the first Paralympian to compete in the Olympics," she said after finishing practice and swapping her prosthesis for a nonsports limb, which is almost indistinguishable from a real one. "It's the fact that his courage has made prosthetics familiar to people all over the world and showed that there are real athletes wearing these kind of limbs."
Indeed, amputee runners are a minority among minorities — especially in Japan. According to the health ministry, about 60,000 Japanese are missing at least part of their lower limbs, but probably fewer than 100 of them are active as athletes. Japan has only been sending prosthetics-wearing men and women to the Paralympics for a short period. For many years, participation in the event was limited to wheelchair users and the visually impaired.
That changed at the Sydney Games in 2000, when Japan was represented by below-knee amputee Toru Suzuki and above-knee amputee Akihiro Kojo. (Paralympic events are meticulously broken down by the degrees and types of disability.) Suzuki finished sixth in the men's high jump, and Kojo eighth in the 100 meters. Since then, Japanese amputee athletes have increased their profile at the world's most prestigious event for people with disabilities. In London, seven runners and jumpers will compete — the largest Japanese contingent ever.
That, of course, is a result of hard work and dedication, not only by athletes but also by people around them — including one man who has played a crucial role in nurturing Japan's community of amputee athletes.
Fumio Usui is a veteran prosthetist at Tokyo-based Gishi Sogu Sapoto Senta (Prosthetic and Orthotic Support Center), which was originally set up by welfare corporation Tetsudo Kosaikai to help disabled railway workers. The center now offers a full range of consultation and rehabilitation services to anyone who has gone through an amputation surgery. It's not an exaggeration to say that, without the time and effort volunteered by Usui at the center, most of the nation's prosthetics-wearing athletes would never have had a chance to compete in the Paralympics.
Usui said he came up with the idea of challenging his clients to run about 25 years ago, after seeing photographs of amputees in the U.S. wearing sports prosthetics. He had never encountered such equipment in Japan, nor had he seen any Japanese amputees attempt to run.
With grants from his employer, Usui ordered a set of parts from the United States — a hydraulic knee joint and a spring apparatus called "Flex-Foot" — and assembled them himself. He arranged for two young clients — a girl and a boy — to wear the gear, but soon discovered that just having the right equipment wasn't enough.
"I realized that I needed to teach them how to run," he said.
So he started doing just that, in evenings and on weekends, in the hallways of the support center and on the streets outside the building. Although he lacked expertise in sports medicine and in the theoretical aspects of running, he did have a smart strategy.
Usui first had a go with the girl, thinking that, if she succeeded, the boy would be motivated to follow. He fine-tuned the knee's hydraulic settings and made other adjustments as she progressed from walking fast, to skipping, then trotting. After several sessions, the girl managed to run about three meters in the corridors of the support center.
"She was always very cheerful but had never run since her leg was severed above the knee seven years earlier," Usui recalled. "She cried the first time she ran again — she probably thought she'd never be able to do it." The boy soon followed.
Running with artificial limbs — or even jogging — requires overcoming the fear of falling. Prosthetics users can be tripped up by tiny gaps in the pavement or in the crack between train cars and platforms. "If they can't use their muscles well, the artificial knees will unexpectedly bend, causing them to lose balance and fall," Usui said.
After seeing the initial pair succeed, Usui became convinced that the benefits of running outweighed the risks of falling, even if his clients didn't go on to become competitive athletes.
"Running trains them to be both physically and mentally tough," he says. "It fosters a sense of independence and builds up stamina and immunity against illnesses. Sports have such positive effects on people with disabilities — perhaps even more so than on able-bodied people."
Usui would go on to set up a running club that came to be known as Health Angels (a pun on the name of the U.S. motorcycle gang Hells Angels). It now has 60 members and holds monthly practices at a sports facility for people with disabilities in Kita Ward, Tokyo.
At one session on a Sunday afternoon in June, Usui, clad in an orange T-shirt, could be seen among his 20-odd athletes. Some were accompanied by family members and friends, and some had traveled to the practice from outside Tokyo. The atmosphere was cheerful and relaxed, with many of the members chatting while waiting for their turn on the track — the same track where Keio's Takakuwa, back in high school, met the older athletes who would inspire her to start running. It's also where Sayaka Murakami, a company worker in Tokyo, found encouragement after the tragic experience that befell her three years ago.
Murakami, 28, competes in 200-meter and 400-meter races in Japan and abroad, and she hopes to participate in the 2016 Paralympics in Rio de Janeiro. But when she came to see a Health Angels practice for the first time in late 2009, she was on crutches. Earlier that year, Murakami, who suffers from anemia, was run over by a train after losing her balance and falling off a platform in Yokohama. She survived — miraculously — but her right leg was partially severed above the knee.
"When I was hospitalized, I was in such shock I couldn't tell anyone," recalled Murakami, who wore a constant smile while sprinting along the track. "I canceled my cell-phone plan and shut off all communication with everyone except my family."
Her despondency continued until she happened to see an amputee runner on TV. "I felt there was nothing I could do after losing my leg," she said. "But after seeing someone running with an amputated leg, I thought I could try that."
Visiting her first Health Angels practice, Murakami was stunned by the members' upbeat attitude. "One of them came up to me and said, 'Everyone's just beaming, aren't they? It's because all of us have at one point hovered between life and death, and we've experienced some of the worst things that can happen to people. Yet we've come out here hoping to change things.' I wanted to be like them."
Murakami, still on crutches, returned to the practices over the next several months just to watch. She was eager to learn how to run right away, but Usui urged caution.
"He said I should be patient for about a year, that I should learn how to walk 'beautifully' first." That meant walking in a straight line without one shoulder tilting toward the ground — a common tendency of people who are learning to use prosthetics.
Finally, around two years ago, she tried on a carbon-fiber spring that a senior athlete let her borrow. "The first time I put it on, I felt I had been deceived," she said. "I couldn't even stand up, let alone run. I didn't know which muscles to use. So I started all over again, learning how to walk — this time with the spring."
As I watched the athletes, I felt compelled to ask: What is it that makes you run? Norikatsu Mizutani, a 41-year-old club member who competes as an amputee sprinter, smiled when hearing the question. "With an elastic foot, you can feel the joy of running in ways you never will with normal-use prosthetics," he said.
Indeed, carbon-fiber feet have undergone rapid advances in terms of flexibility and durability. Mizutani explained that each "spring" in the blade-like foot is made of several carbon plates glued together, and as the quality of the glue has improved, the springs have become more durable; previously, they tended to easily crack.
Durability is important, because sports prosthetics don't come cheap: they cost anywhere from ¥100,000 to ¥500,000, depending on the manufacturer and model. Usui has used research grants from the health ministry to outfit 30 Health Angels members with the equipment, and many of the runners share their gear. Beginners often start by using their normal-use prosthetics, then switch to secondhand feet donated by more experienced members.
"Not every amputee gets into sports," Usui says, noting that only 10 percent of his hundreds of clients have shown an interest in running. "Not everyone has to become a competitive runner. But if they learn how to jog, even lightly, it really helps improve the quality of their lives."
Maybe a few years down the road, a future generation of top athletes will emerge out of this growing network of "Blade Runners," as they are called — perhaps even the next Oscar Pistorius.
"Running is such a simple and basic sport," Takakuwa says. "Even though I lost my leg, I can still use my whole body thanks to prosthetics. That's what gives me the biggest joy — and what keeps me running."