Autonomic dysreflexia and boosting in disability sport: exploring the subjective meanings, management strategies, moral justifications, and perceptions of risk among male, spinal cord injured, wheelchair athletes.

Autonomic dysreflexia (AD) is a potentially life-threatening condition unique to individuals with spinal cord injury above the sixth thoracic spinal level. When this condition is induced by spinal cord injured athletes to enhance performance it is known as boosting. Given that little is known about this practice from the perspectives of the athletes themselves, we draw upon interview data with a sample of male, spinal cord injured, wheelchair athletes to explore their experiences of AD and boosting in relation to how they perceive and negotiate the fine line between the latter two conditions; how they experience positive benefits and manage unpredictability; how they conceptualize risk; and their moral justifications for boosting. Our thematic analysis suggests that our participants understand boosting via a process of experiential learning that involves them operating as ethnophysiologists within a boostogenic environment that can foster moral disengagement and encourage athletes to take dangerous health risks. The implications for policy and practice are considered.