People with Down’s syndrome will all have some degree of learning disability and many will have other physical health conditions which can limit participation in sport. Atlanto-Axial Instability (AAI) is a condition which is more prevalent in people with Down’s syndrome compared to people without. In people with Down’s syndrome the ligaments which stabilise the joints tend to be particularly lax and this, combined with low muscle tone, results in an unusually wide range of movement at some joints. This laxity can also affect the complex set of joints between the head and upper neck vertebrae. If there is excessive movement between the vertebrae this can result in an increased risk of damage to the spinal cord, which although is very rare can be potentially serious.
It is important that athletes, competition officials and coaches are aware of this, as prior screening before competition can identify those at risk of AAI before any issues occur. There must be a balance between encouraging people with Down’s syndrome to take part in and enjoy exercise whilst identifying those few individuals who may be at increased risk for dislocation so that timely investigation and if necessary, surgical intervention can be considered. Athlete’s with Down’s Syndrome competing in all England Athletics Championships must complete Atlanto-Axial screening before competition.