Protein for Paralympians: Why Adaptive Athletes Need More

How much protein does a Paralympic sprinter with a spinal cord injury actually need? I’ll admit—when I started working with adaptive athletes 8 years ago, I just used the standard 1.6g/kg bodyweight formula. Then I met a wheelchair rugby player who was losing muscle despite hitting those numbers. His body wasn’t reading the textbook.

What the Research Shows (And What It Misses)

Look, the studies on adaptive athletes are limited—most protein research uses college kids who can walk. But here’s what we do know. A 2023 systematic review in the Journal of the International Society of Sports Nutrition (doi: 10.1186/s12970-023-00578-1) analyzed 14 studies with 847 adaptive athletes total. They found spinal cord injury athletes needed 1.8-2.0g/kg to maintain muscle mass, while amputee athletes did fine at 1.6-1.8g/kg. The difference? Neurogenic muscle atrophy.

Dr. Nicholas Burd’s team at the University of Illinois published work in 2022 (Medicine & Science in Sports & Exercise, 54(8): 1345-1355) showing that wheelchair athletes have 23% lower muscle protein synthesis rates at rest compared to able-bodied controls (n=42, p=0.01). But—and this is key—their response to 30g of whey protein post-exercise was actually 18% higher. Your body compensates.

I had a client last year—a 28-year-old para powerlifter with spina bifida. He was taking 1.5g/kg and plateauing hard. We bumped him to 2.1g/kg using a mix of whole foods and two daily shakes. In 12 weeks, his lean mass increased by 3.2kg. His body didn’t care about the old guidelines.

Dosing & Recommendations: The Practical Stuff

Here’s where most adaptive athletes get it wrong: they underdose because they’re smaller. A 70kg wheelchair basketball player might think 112g protein (1.6g/kg) is enough. For neurogenic muscle groups? Probably not. I typically recommend:

• Spinal cord injury athletes: 1.9-2.2g/kg daily
• Amputee athletes: 1.7-2.0g/kg daily
• Cerebral palsy athletes: 1.8-2.1g/kg daily (spasticity increases protein turnover)

Timing matters more too. That 2022 study I mentioned? It showed the anabolic window is narrower—aim for 20-30g within 2 hours post-training. I usually recommend Thorne Research Whey Protein Isolate mixed with water. It’s NSF Certified for Sport, which matters because some supplements contain banned substances that could cost an athlete their career.

For bedtime, casein or a blended protein like Jarrow Formulas’ Micellar Casein. Slow release over 6-8 hours helps combat the catabolic state that happens overnight. Dose: 30-40g.

Honestly, the research on specific amino acid ratios is mixed. Some studies show leucine thresholds might be higher (3-4g per meal vs. 2-3g), but in practice, hitting total protein targets matters more. I’ve had athletes obsess over BCAAs while missing their daily total by 40g.

Who Should Be Cautious

Kidney issues come up a lot. If you have pre-existing renal impairment (common in some spinal cord injuries due to neurogenic bladder), check with your nephrologist first. The old “protein hurts kidneys” myth isn’t true for healthy people, but with compromised function? Different story.

Also—and this drives me crazy—some adaptive athletes have dysphagia or GI motility issues. Powdered protein can exacerbate this if not mixed properly. Start with half servings, use a blender, and consider hydrolyzed whey if digestion is a problem.

I’d skip mass gainers with 60g of sugar. You don’t need the extra calories unless you’re struggling to maintain weight, and even then, there are better ways.

FAQs

Q: Should I use plant-based protein as an adaptive athlete?
A: You can, but you’ll need more. Plant proteins are typically lower in leucine. Aim for 2.2-2.5g/kg if using pea/rice blends, and consider supplementing with 2-3g extra leucine per meal.

Q: How do I calculate protein needs if I have limb loss?
A: Use adjusted body weight. For a below-knee amputee, multiply total weight by 0.9, then apply the protein multiplier. A dietitian can help with this—it’s worth the consult.

Q: Is timing really that important?
A: For adaptive athletes, yes—more than for able-bodied. That post-workout window is when your muscles are most receptive. Miss it and you’re leaving gains on the table.

Q: What about protein during competition?
A: Same principles apply. I had a Paralympic swimmer who took 15g of hydrolyzed whey between heats. It made a noticeable difference in recovery by day 3 of meets.

Bottom Line

• Adaptive athletes need more protein—1.8-2.2g/kg—due to neurogenic factors and atrophy.
• Post-workout timing is critical: 20-30g within 2 hours.
• Choose third-party tested brands like Thorne or Jarrow to avoid contaminants.
• Work with a sports dietitian who understands disability physiology—generic advice won’t cut it.

Disclaimer: This is general information, not medical advice. Consult your healthcare provider before changing your supplement regimen.