To former Army Sgt. Ryan Major, there's no better feeling than banging into another player so hard during a game that he knocks them over.
It's an exhilaration sports have given him ever since he was a little boy — the more aggressive the sport, the better. But after an improvised explosive device blew off his right leg and some fingers in 2006 while he was on foot patrol in the Iraqi city of Ramadi, and his left leg was later amputated, Major wondered if he'd ever play sports again.
Now using a wheelchair, Major not only still plays rough sports, but they've become central to his life and key to his mental and physical rehabilitation. The 31-year-old former Towson High School football player now plays rugby, toppling others in wheelchairs with his hard hits. He also skis, kayaks and participates in numerous other activities.
Major is among many people with major limb injuries who found that sports made them feel like their old, more able-bodied selves again. Their increased athleticism is occurring at a time of growing recognition in the field of physical rehabilitation about the value of sports for recovery.
He credits sports with helping him overcome the severe depression he experienced after returning home from Iraq.
"I had lost my freedom," Major said. "And sports helped bring it back. I don't know where I'd be without it."
He competed in May in the Invictus Games competition for injured soldiers in Orlando, Fla., where he won gold medals for rugby and seated shot put and silver medals for indoor rowing and seated discus. Next up: the Department of Defense Warrior Games starting Wednesday in West Point, New York, where he will compete in shot put, discus, cycling, wheelchair racing and swimming.
The Invictus Games were established in London two years ago to showcase the recovery aspects of sports. The Olympics-like competition for injured and ill military personal and veterans gives them the opportunity to compete in sports such as rugby, track and field and swimming. The first Warrior Games, a similar competition, were held in 2010.
Various "adaptive sports" leagues have cropped up to provide recreational sports opportunities for the injured and disabled.
The University of Maryland Rehabilitation & Orthopaedic Institute has long used sports in its programming, and the institute's therapists say it helps patients cope with often-life-changing injuries and illnesses. The program started with golf 21 years ago and now includes basketball and scuba in its therapy program. The activities build muscles, endurance and balance but also give people a social outlet and improve self-esteem, confidence and quality of life, program counselors say.
"It makes people feel like they have a purpose in life again and it helps them stay healthy because you still need to be healthy in your new state," said Sheila Schaffer, outpatient therapy manager at the rehabilitation and orthopaedic institute.
At BlazeSports America, which provides athletic opportunities for people with disabilities, veterans participating in adaptive sports have reported an increase in quality of life, overall health and employability, said Cynthia Frisina, the group's executive director.
"Having the opportunity to participate in adaptive sports changes the lives of veterans, children and adults with physical disabilities, as well as their families," Frisina said. "We see it firsthand every day. There is an increased focus on the power of sport to transform lives and the power of the human spirit to overcome adversity and challenges in all forms."
Adaptive sports began gaining traction among veterans after the Vietnam War but have been slow to catch on, said Michael Cottingham, director of adaptive athletics at the University of Houston, who has conducted research on the issue. It can be cost-prohibitive for many veterans living on disability benefits, and not all areas of the country have programs. It may also be hard to convince some people that they can play sports after life-altering injuries.
In his research, Cottingham, also an assistant professor of sport and fitness administration, found that injured people who participate in sports are more likely to hold a job, and that for each year of participation in sports, the chances of a person finding work increased by 4 percent. Playing sports also develops skills such as team-building and makes injured people physically stronger.
"If you have a spinal cord injury and your body is just rattled, you're going to get physically stronger and in better shape when you play sports," Cottingham said. "You will be able to sit up for eight hours a day at work. You will be able to put your wheelchair in the car five days a week."
Players on a wheelchair rugby team sponsored by Maryland's Rehabilitation & Orthopaedic Institute credit the team with helping them adjust to life after their injuries. Team members include men injured in car and boat accidents. One was born with cerebral palsy. Major is the team's captain.
During a recent practice in Perry Hall, coach Mike Patria led the team through a series of drills designed to help them improve their skills. They wheeled sprints down the gym floor to work on speed. They spun in circles to work on turning quickly without falling over or stopping. Divided into teams and lined up with their wheelchairs on opposite sides, they competed to see which team could pass the ball faster.
"You never know what is going to happen in a game," Patria said to one player before grabbing the rugby ball from his lap, a lesson in anticipating the unexpected.
Some of the men could barely wheel across the floor when they first joined, but now they zipped along.
Randolph "Randy" Johnson loves rugby so much he got the team's name, Maryland Mayhem, tattooed across his chest. The Baltimore County resident broke his neck in car accident in 2013 and now uses a wheelchair. He has incomplete feeling from below his neck to his toes and doesn't have full function in his hands. The 6-foot-6 former semi-pro football player and once-promising basketball player thought sports were over for him, but rugby proved him wrong.
"This is my team," he said. "This is my family. These guys understand me. They understand what I have been through the way others do not."
Major lay in a coma for weeks after getting injured in Iraq. He received care in Germany, then at Walter Reed National Military Medical Center in Bethesda, where his left leg was amputated, before he was moved to the University of Maryland Shock Trauma Center in Baltimore to help treat infections in his wounds.
When Dr. Sharon Henry, a trauma surgery professor at the University of Maryland School of Medicine and Shock Trauma's director of wound healing, first met Major, she remembered he was withdrawn and "a man of few words."
His treatment was intense. Doctors took him to the operating room almost daily to check and clean his infections. He underwent several other procedures, including getting an external apparatus installed to hold his pelvis bones together and expanders under his skin to help replace skin missing from his wound sites. Doctors also removed the thumb on one hand and placed it where his index finger was blown off, giving him the ability to pinch and grasp.
Major said he was depressed when he arrived at Shock Trauma. He wondered if he would get better and how life would be after the amputations.
"At least two weeks into his hospital stay, he started to get used to the staff and started to see his condition was improving," Henry said. "Then he was just a nice kid."
Henry still treats Major when needed and said she saw a difference after he became involved in sports.
"He gets so excited when he talks about his next competition or game," she said.
Major needed to be convinced to play rugby at first. He had become an avid kayaker and didn't want to give that up. A small part of him also wasn't sure he would be able to play. A therapist at Maryland's Rehabilitation & Orthopaedic Institute convinced him to give it a try.
There was no turning back after his first practice. Rugby reminded him of his football days. And the team atmosphere, where people worked together to win, reminded him of his days in the Army.
These days the gregarious Major constantly prepares for the next competition. He plays with heart and passion that his rugby teammates say rubs off on them.
"It is," he said, "what I live for."