magazine - Century Orthotics & Medical Equipment LLC€¦ · life magazine 2015/25 CONTENTS A bright spot on the radar screen – p. 20 Reliable, durable, and effective – p. 28

Sports medicine: A bright spot on the radar screenDr. Daniel Levy Memorial Sports Medicine Clinic, Ontario Page 20

MOS Genu after an osteotomy: Joint replacement can waitFast post-operative rehabilitation with a stabilizing orthosis Page 18

Pelvic orthosis has a direct impact on the SI jointsExperimental computer-based study on the SacroLoc Page 22

Issue 2015 | 2

internationalmagazine

Keeping knee treatment in the family Practical test: GenuTrain/A3/P3/S Page 12

PROVEN EFFECT ON KNEE PAIN

Study confirms stabilizing effect:GenuTrain relieves the knee and improves gait.

For indications relating to the knee joint, you want to offer the best possible treatment to your patients from diagnosis through to completion of therapy. Your aim is to relieve pain, provide reliable support, and prevent recurrent injury. A scientific study on patients with osteoarthritis of the knee has shown that GenuTrain

• alleviates knee pain• relieves the knee• improves gait*

* Schween R., Gehring D., Gollhofer A. »Immediate effects of an elastic knee sleeve on frontal plane gait biomechanics in knee osteoarthritis«. PLoS One. 2015 Jan 26;10(1):e0115782. doi: 10.1371/journal.pone.0115782. eCollection 2015.

STABILIZES THE KNEE

Knee adduction torque in Nm/kgWearing the GenuTrain led to a significant reduction in the maximum knee adduction torque (9% on average).

with supportwithout support

-9%

0

0.2

0.4

0.6

0.8

1.0

Genu Train®KNEE SUPPORT

EN_genutrain_arztanzeige_210x280_4c_int_150810.indd 3 20.08.2015 11:41:24

life magazine 2015/2 3

EDITORIALEDITORIAL

Dear readers,

Pict

ures

: Bau

erfe

ind

The knee joint is the largest joint in the hu-man body and unfortunately it is very prone to problems. Fortunately there are many excellent treatment options available.

With the development of the GenuTrain ac-tive support , we have been setting standards in knee therapy for over 30 years. Apart from the classic sup-port that is constantly being enhanced, phy-sicians can now also choose from various special models from the GenuTrain family. In our latest feature article on page 12, four knee specialists from Germany and Austria tell us how the GenuTrain and GenuTrain P3, A3, and S can help, giving us an insight into their everyday practice by describing one of their current cases.

“Nothing works like your own joint. So you should try to preserve it for as long as pos-sible,” says Dutch physician Dr. W. Reinhout Brouwer. Therefore, wherever possible, he tries corrective osteotomy first for treating knee misalignments instead of opting im-mediately for joint replacement. He ensures the success of this treatment by using the

MOS Genu stabilizing orthosis. Read more on page 18f.

Knee injuries are a common occurrence in sport , and there is one man who knows more about sports injuries than most: when Canadian Dr. David Levy decided to set up

the first clinic for sports injuries in the province of Ontario over 30 years ago, not much attention was being paid to sports and rehabili-tation medicine in Canada. Read more

about how it has developed since then and Dr. Levy’s experiences on page 20.

Scientific studies show how effective medi-cal products are and provide unequivocal evidence of whether and how a product works. For a long time, the sacroiliac joints, which form the main link between the sacral and iliac bones, tended to be pushed to the sidelines of medical research. Only in the past few years they have begun to attract more and more scientific interest. A compre-hensive study on the effect of the SacroLoc reveals that it has a clear impact on the sacroiliac joints. Find out more on page 22.

This issue of life also has many other fascinating stories from across the globe in store for you: we spoke to a specialist in Singapore about treating foot and ankle injuries, a physician from Japan talks about the challenges of our aging society and what she believes is the key to a better quality of life, and we also hear from a shoulder specialist in Mexico.

We hope that you enjoy reading it.

Prof. Hans B. Bauerfeind

“With the development of the GenuTrain active support , we have been setting standards in knee therapy for over 30 years.”

PROVEN EFFECT ON KNEE PAIN

Study confirms stabilizing effect:GenuTrain relieves the knee and improves gait.

For indications relating to the knee joint, you want to offer the best possible treatment to your patients from diagnosis through to completion of therapy. Your aim is to relieve pain, provide reliable support, and prevent recurrent injury. A scientific study on patients with osteoarthritis of the knee has shown that GenuTrain

• alleviates knee pain• relieves the knee• improves gait*

* Schween R., Gehring D., Gollhofer A. »Immediate effects of an elastic knee sleeve on frontal plane gait biomechanics in knee osteoarthritis«. PLoS One. 2015 Jan 26;10(1):e0115782. doi: 10.1371/journal.pone.0115782. eCollection 2015.

STABILIZES THE KNEE

Knee adduction torque in Nm/kgWearing the GenuTrain led to a significant reduction in the maximum knee adduction torque (9% on average).

with supportwithout support

-9%

0

0.2

0.4

0.6

0.8

1.0

Genu Train®KNEE SUPPORT

EN_genutrain_arztanzeige_210x280_4c_int_150810.indd 3 20.08.2015 11:41:24

4 life magazine 2015/2

CONTENTS

Successful knee therapy with the GenuTrain family Bauerfeind’s GenuTrain is the gold standard in modern active supports. Four knee specialists tell Bauerfeind life about practical situations where they turned to the GenuTrain and GenuTrain P3, A3, and S for help.

Focus page 12

GenuTrain: Keeping knee treatment in the family – p. 12

IMPRINT:

Bauerfeind life Magazine International EditionPrinted on chlorine-free paper

Editor:

Bauerfeind AG Triebeser Straße 16 07937 Zeulenroda-Triebes, Germany Tel. +49(0)36628-66-1000 [email protected] www.bauerfeind.com Responsible: Simone Gebler

Publisher and editorial office:

mk publishing GmbH Döllgaststraße 7–9 86199 Augsburg, Germany Tel. +49(0)821-34457-0 [email protected] www.mkpublishing.de

Train active supports help you to be active despite knee problems: the GenuTrain S with lateral joint splints supports the knee joint for indications of slight instabi-lity, arthritis, or osteoarthritis of the knee.

Title image

Pict

ures

: Bau

erfe

ind,

Udo

Sch

önew

ald,

Ron

ald

Zijls

tra,

Ray

Chu

a/w

ww

.dha

ppyfi

sh.c

om, M

ike

Blac

k Ph

otow

orks

, pic

ture

alli

ance

/CIT

YPRE

SS24


CONTENTS

A bright spot on the radar screen – p. 20

Reliable, durable, and effective – p. 28 Athletic talent and endurance – p. 32

3 Editorial

4 Imprint

6 Moments

8 News

35 Service

Focus page 12

12 Practical test: GenuTrain/A3/P3/S knee supports Keeping knee treatment in the family

14 Case I, GenuTrain Symptom-free once again when playing basketball

15 Case II, GenuTrain P3 Permanent protection for the kneecap

16 Case III, GenuTrain A3 Reduced handicap

17 Case IV, GenuTrain S Valgus injury on the sand

Medical page 18

18 MOS Genu after an osteotomy Joint replacement can wait

20 Sports medicine in Ontario, Canada A bright spot on the radar screen

22 SacroLoc study Pelvic orthosis has a direct impact on the SI joints

24 PD Dr. med. habil. Nils Hammer “The orthosis can significantly change the movements in the SI joint”

26 Physician tackling the issues of an aging population “Body-work is the key”

27 Shoulder treatment with OmoTrain “A great sense of security”

28 Foot and ankle therapy with MalleoTrain and AchilloTrain “Reliable, durable, and effective”

30 “Skate for Science” & “Ride for Research” Two disciplines, one team, one goal

In motion page 32

32 Ice hockey Athletic talent and endurance

Joint replacement can wait – p. 18


MOMENTS

Bild

: Bau

erfe

ind

Bild

: Bau

erfe

ind

In April 2014, extreme sportswoman and sports model Angelika Allmann fell almost 800 meters during a photoshoot in Iceland. “My body was a mess. I was convinced that I wasn’t going to survive it,” recalls the qualified sports scientist. Her right knee was completely destroyed, the main artery in her right thigh was severed, the posterior cruciate liga-ment, medial collateral ligament, and medial meniscus in her left knee were torn, she had a comminuted fracture of her left shoulder ... the list was endless. But, by setting herself lots of little targets, Angelika Allmann fought her way back to life and back onto the mountains. She had some help along the way, including from Bauerfeind’s SecuTec Genu knee orthosis. With her incredible motivation, Angelika Allmann is the ideal face of the current Bauerfeind winter campaign, for which pictures have been taken in Austria (large image). You can find out more about Angelika Allmann and the Bauerfeind winter campaign at www.bauerfeind.com/en. †

Step by step to a new lease of life

Left: Angelika Allmann a few days after her accident in Reykjavik. Right: The extreme sportswoman in rehab.

Pict

ures

: Bau

erfe

ind,

Bas

chi B

ende

r


MOMENTS


NEWS

Pict

ures

: Bau

erfe

ind,

One

Wor

ld P

rodu

ctio

n, S

aman

tha

Shal

Compression Sock Performance sports stocking

The Compression Sock Performance sports stocking is now available in red, yellow, and green, and will pep up any run-ning outfit. The knee-high stocking’s noticeable compression improves circulation in the legs, reduces muscle vibrations, and speeds up recovery. The lightweight , breathable fabric feels comfortable against the skin, making this sports stocking an ideal companion for long distances, when running or cycling for example. The Compression Sock Performance is available in white, black, and “Rivera”, a shade of turquoise, as well as the new colors. †

A colorful companion

Three new colors for the Compression Sock Performance.

Bodytronic 600 can also digitize foam imprints in 3D.

Bodytronic 600 measurement technology

Bauerfeind’s Bodytronic 600 measurement technology digitizes body shapes and dimensions. Now it also offers the possibility to export 3D data. Thanks to the latest software upgrade, up to 54 centime-ters of the foot and lower leg can be captured from the floor up. The software uses this data to generate a precise 3D model. Another new feature also enables medical retailers to digitize foam imprints in 3D to precisely model the plantar side of the foot. Finally, the data is merged to create a complete, anatomical 3D model of the foot using external software. This can be used for further applications such as modeling and manufacturing custom-made lasts, foot orthoses, or shoes. †

Export and continue processing 3D data

Győző Szolnoky, MD, PhD, receives the BPA from Jürgen Schmidt-Steinkühler, Bauerfeind, Global Marketing Phlebology.

Promoting research

Hungarian Győző Szolnoky, MD, PhD, was awarded the eighth Bauerfeind Phlebo-logy Award (BPA) during the chapter meeting of the International Union of Phle-bology (IUP) between August 27 and 29, 2015, in Seoul. The jury made the award in recognition of the study design devised by the physician from the University of Szeged in Hungary. He wants to investigate the influence of compression on the coronary vessels in healthy people as well as people with lymphedema and lipedema. Venous and lymphatic compression therapy is one of Győző Szolnoky’s main areas of research. He is a co-founder of the Balkan Venous Forum (BVF), an expert member of the International Compression Club (ICC), and is on the scientific advisory board of the Center of Interdisciplinary Research on Compres-sion (CIRC). Bauerfeind, in collaboration with the IUP, has been awarding the €20,000 BPA since 2001. The intention is to support pioneering medical research initiatives in the field of compression therapy. †

Bauerfeind Phlebology Award 2015


NEWS

Bauerfeind USA & NBATA

Bauerfeind USA relocated its headquarters to Atlanta on June 29, 2015 and celebrated the move by hosting an open-house event , where a new official partnership with the Na-tional Basketball Athletic Trainers Association (NBATA) was announced. NBATA is a professional organization of highly skilled certified athletic trainers who provide specialized health care and critical support services to the athletes and organizations of the National Basketball Association. “This is a natural , organic partnership, since the NBATA has been a Bauerfeind customer since 2003 when we started with one team buying the GenuTrain knee brace,” said Kevin Johnson, NBATA Chairman and Head Athletic Trainer for the Philadel-phia 76ers. “Today, 27 teams purchase a variety of Bauerfeind products and this formal partnership brings together two organizations which are dedicated to providing the best sports medical care solutions for professional basketball ath-letes.” As part of the multi-year partnership, Bauerfeind will be the Official Brace of NBATA and the NBATA will endorse Bauerfeind’s medical functional support , brace and compres-sion therapy products. “Bauerfeind’s medical and sports heritage aligns with the NBATA’s medical and sports athletic training and expertise,” said Gregory J. Vaughn, M.D., CEO at Bauerfeind USA. “NBATA trainers work with the best athletes in the world and this partnership allows us to bring their medical and athletic training, knowledge and expertise to our consumers.” For more information on the NBATA partner-ship, visit www.bauerfeind.com. †

“A natural , organic partnership“

Bauerfeind Academy

A great deal of specialist knowledge is required to provide sound expert advice and treat patients using orthopedic aids. The Bauerfeind Academy supports medical retailers all over the world with its customized training programs. Two international training courses are scheduled for 2016: a summer course from June 6 to 10, 2016, and a fall course from October 17 to 21, 2016. These training courses will be conducted in English and held at the Bauerfeind Academy, which is located at the company headquarters in Zeulenroda, Germany. They both last five days and are divided into two separate training modules. From Monday to Wednesday morning, the program will cover medical specialist knowledge, the principles of orthopedics, and the correct ways to use Bauerfeind supports to treat different indications. On Wednesday afternoon, the participants will learn about sales and marketing before being taken on a tour of the plant. On Thursday and Friday, participants can choose between the training sessions on “Orthopedic orthoses” or “Medical compression stockings”. In addition to imparting medical knowledge about individual treatment areas,

International training courses in 2016

International Training in 2015.

the Bauerfeind Academy also places a great deal of emphasis on workshops, where participants can undertake practical work in small groups and gain hands-on experience with products and patients. Your local Bauerfeind subsidiary or international distributor can tell you more about the program and how to register. You can also contact the Bauerfeind Academy by e-mailing [email protected]. †

Kevin Johnson (left), NBATA Chairman and Head Athletic Trainer for the Philadelphia 76ers, and Gregory J. Vaughn, M.D., CEO at Bauerfeind USA, announced the partnership between Bauerfeind USA and NBATA.


Pict

ures

: Bau

erfe

ind,

iSto

ckph

oto.

com

/Sea

n Pa

vone

NEWS

GenuTrain S and GenuTrain S Pro

The standard size system for the GenuTrain S and GenuTrain S Pro knee sup-ports has been extended to include size 7. Patients with a calf circumference of up to 49 centimeters and a thigh circumference of up to 59 centimeters can now also receive the medical care they need quickly. This particularly includes people with a larger stature and athletes with pronounced muscles who require additional support in the case of mild to moderate knee instabil-ity. GenuTrain S and S Pro provide active and passive stabilization for the knee joint. The therapeutic intermittent compression of the supports activates the stabilizing muscles during movement. Lateral joint splints and inelastic straps also provide external mechanical stability, which particularly supports the collateral ligaments in conditions involving friction. With the GenuTrain S Pro, it is also possible to gradually restrict the flexion and extension angle. †

New standard size 7 for strong knees

Triathlete Nicola Spirig

“It couldn’t have gone better,” says triathlete Nicola Spirig. The 33-year-old won gold at the inaugural edition of the European Games in June 2015 in Baku, Azerbaijan, becoming the first Swiss participant to secure her place at the Olympic Games in Rio de Ja-neiro. “Being selected early gives me time to optimize my preparations for Rio,” says the triathlete, who also triumphed at the 2012 London Olympics. The likeable elite athlete recently became a brand ambassador for Bauerfeind Switzerland. As Nicola Spirig explained, “Bauerfeind Switzerland has been winning over custom-ers for 30 years with its high-quality products that help to prevent injuries and speed up recovery. Bauerfeind delivers top performances in its field, as I do in mine. This makes us a perfect match.” †

Objective: Defend the titleOlympic triathlon champion Nicola Spirig.

Added support for the knee in XXL.

Bauerfeind USA: New online shop

Consumers in the U.S. can now learn all about Bauerfeind’s product line and buy directly from the newly revamped web store, www.bauerfeind.com. Along with informative and entertaining content that emphasizes how Bauerfeind can help you regain the confidence to move, the re-design allows users to easily search for what they need by categories that include parts of the body, product name and sport or activity. Customer support and expert advice is also now available through a real-time chat function, making it simpler and faster for consumers to identify what they need to return to an active lifestyle. †

Approaching consumers in a targeted way

User-friendly: the Bauerfeind USA online shop.

People with skew foot and flat foot or sensitive feet that are painful under pres-sure benefit from cushioning foot orthoses that provide long-lasting relief and shock absorption when walking. To achieve consis-tent cushioning that really lasts, Bauerfeind has developed a unique polyurethane-based material for the new ErgoPad Soft foot orthosis.The material is viscoelastic, which means your feet will mold the orthosis into a com-fortable shape while you wear it. Its main advantage, however, is its shape retention: the material will return to its original shape without manipulation, just like memory foam. Product tests confirm that after 700,000 steps, the foot orthosis still exhibits significantly better cushioning properties than a conventional soft cushioning foot orthosis. Wearers benefit from long-lasting soft cushioning and, as a result, a consistently high level of wearing comfort. An integrated reinforcement element inside the foot orthosis gently sup-

ports the longitudinal arch and helps to correct misalignments. The foot orthosis is thermo-formable, allowing it to be op-timally adapted to the foot. An orthotist can further modify the foot orthosis ac-cording to individual customer needs, for instance by fitting a pad, increasing the height of the outer or inner edge, evening out differences in leg lengths, or applying targeted pressure relief on the forefoot. The ErgoPad Soft orthotic blank is avail-able in a soft or firm version, and with or without a microfiber top cover. †

ErgoPad Soft cushioning foot orthosis

The ErgoPad Soft cushioning foot orthosis has been on the market since April. It is made from a new, viscoelastic material that retains its shape well for consistently effective cushion-ing.

Long-lasting cushioning

The ErgoPad Soft is easy to modify.

The ErgoPad Soft foot orthosis creates a com-fortably soft bed for your foot and provides durable cushioning.

DIARY DATES

TRADE FAIRS AND EVENTS

November 2015

November 12 – 15, 2015 29th ACP (American College of Phlebology) Annual Congress, Orlando, Florida, USA. Further information: http://www.acpcongress.org/

April 2016

April 9 – 11, 2016 Isokinetic Conference, London, England. Further information: www.isokinetic.com/en/

April 13 – 17, 2016 European Congress of Phlebology, Rome, Italy. Further information: www.uip2016.com/information.html

May 2016

May 3 – 6, 2016 OTWorld, Leipzig, Germany. Further information: http://ot-world.com/index_eng.html

May 4 – 7, 2016 17th ESSKA Congress (European Society for Sports Traumatology, Knee Surgery and Arthroscopy), Barcelona, Spain. Further information: http://esska-congress.org/

May 16 – 20, 2016 SpineWeek, Singapore. Further information: www.spineweek.org/



Pict

ure:

Bau

erfe

ind

FOCUS


FOCUS

Bauerfeind’s GenuTrain is the gold standard in modern active supports. “Therapy through move-ment” is the pioneering principle behind the GenuTrain, with physicians using the special models for a wide variety of applications. Four knee specialists tell Bauerfeind life about practical situations where they turned to the GenuTrain and GenuTrain P3, A3, and S for help.

Practical test: GenuTrain/A3/P3/S knee supports

Keeping knee treat-ment in the family

The GenuTrain knee support meets the requirements of physicians and patients alike, facilitating secure movement as a means of combating pain and instability. Its winning combination of therapy-enhancing and user-friendly features has earned it the title of “The original modern knee support” and the reputation of a classic product.

The classic version and the special modelsA range of special models for treating different knee conditions build on the GenuTrain active principle of “therapy through movement.” For instance, the GenuTrain P3 focuses on relieving the patella, hold-ing it in the correct path to counteract instability. The GenuTrain A3 model tackles complex knee problems, such as those that occur in conjunction with osteoarthritis of the knee. The GenuTrain S provides increased stability for the ligaments and uses a combination of lateral joint splints and straps to provide additional guidance for the knee during movement.The knee supports in the GenuTrain product family are suitable for virtually all types of patients: whatever their age, weight , and activity levels, they can all benefit from its stabilizing and relieving effect on the knee. Four case studies show how specialists use the active sup-ports in practice to treat individual cases: >>>


Orthopedic specialist Dr. med. Christoph Lukas is a physician of the Baden-Württemberg basketball association and chairman of the German basketball physicians’ association (www.basketdocs.de). The sports physician currently looks after the Crailsheimer Merlins (1st Basketball Bundesliga) as their team physician. As a tourna-ment physician, he worked at the European Basketball Championship for Juniors. The 41-year-old works full-time as a senior physician at the Hess rehabilitation center in Bietigheim-Bissingen, where he runs a private orthopedic practice.

Sport means quality of life. This realization usually becomes painfully clear when you can no longer do it. This is what happened to a patient of Dr. med. Christoph Lukas, an orthopedic specialist in Bietigheim-Bissingen, Germany. The patient’s recent tale of woe began when he fell on his knee. However, he already had a history of knee problems: in 2004, the avid basketball player tore his anterior cruciate ligament. After reconstructive surgery, pain developed and had been increasing since summer 2014, particularly when walking downhill. The problem was gonarthrosis, a late conse-quence of the cruciate ligament tear. Then came the fall directly onto the knee joint. Due to the knee’s tendency to swell , basket-ball games without the use of aids were out of the question, as the case history showed.

Gonarthrosis, findings for 44-year-old patient as per Dr. Lukas’ case report Left knee that is free from irritation with mild effusion, ex/flex 0-3-130, stable liga-ments, negative meniscus test , retropatellar pain on pressure and pain on motion when the patella is centered, slight pain on pres-sure, medial joint cavity.

X-rays:Left knee in two planes: osteoarthritic changes with medial and lateral osteo-phyte formation and clear narrowing of

the joint space and increased subchondral sclerosis. Significant retropatellar changes were also evident.

Treatment:Short-term (10-day) oral course of diclof-enac for pain relief (NSAID), one intra-articular hyaluronic acid injection on the third day to reduce pain. Prescription of a Bauerfeind GenuTrain active support for sport and situations of significant stress in order to stabilize the joint and reduce swelling. Dr. Lukas explained: “Wearing the GenuTrain is also a good way to build up muscles to counteract osteoarthritis in the long-term through movement. This was combined with targeted knee exercises which were shown to the patient during his postoperative rehabilitation.”

Subsequent development:The acute irritation was successfully treated by the NSAIDs and the hyaluronic acid in-jection. According to Dr. Lukas, “The Genu-Train should provide support when the knee is subject to significant stress, and prevent the formation of new effusions.” From the point of view of the orthopedic specialist , this support has one particular advan-tage: “From my work as team physician for professional basketball players, I know that the GenuTrain is more durable and does not wear out as quickly as other supports.

It offers a good fit and is well made. The pressure-reduced edges ensure that it does not slip or roll up. The soft hollow of the knee is comfortable during use.”The slightly overweight patient was told that it is not advisable for him to play bas-ketball because of his knee. However, since his quality of life is strongly defined by this sport that he plays privately as a referee and a youth coach, he did not want to give it up. During a check-up six weeks after the fall , he told Dr. Lukas that he was currently able to play for an hour a week without any symptoms again – with his GenuTrain, which he found “very comfortable”. †

44-year-old patient , gonarthrosis.

The physician’s intention is for the GenuTrain to provide support when the knee is subject to significant stress.

Case I, GenuTrain: Symptom-free once again when playing basketball

FOCUS

Pict

ures

: Bau

erfe

ind,

Udo

Sch

önew

ald,

Dr.

Chri

stop

h Lu

kas,

Dr.

Casp

er G

rim

, pri

vate


FOCUS

Case II, GenuTrain P3: Permanent protection for the kneecap

Dr. med. Casper Grim, a specialist in orthopedics and trauma surgery, and senior physician at the Orthopedics, Trauma and Hand Surgery Clinic at Klinikum Osnabrück, was appointed as the chief physician for the German team at the Youth Olympic Games in 2014. Grim had already been to the first ever Youth Olympic Games in Singapore in 2010 in his role as the chief physician for the German team. The second Youth Olympic Games took place in Nanjing in China in August 2014.

Medical complaints of any kind always seem to occur at the wrong time, and knee instabilities are no exception. The young patient of Dr. med. Casper Grim, senior physician at the Orthopedics, Trauma and Hand Surgery Clinic at Klinikum Osnabrück, Germany, has personal experience of this bad timing: just before the start of her training, her patella began to slip out of place more frequently. What do you do in this situation? Having had no previous success with conservative treatment , the 20-year-old turned to Dr. Grim, a specialist in orthopedics and trauma surgery, which was the right thing to do. His findings were as follows:

Patellar instability, 20-year-old patient , as per Dr. Grim’s case report Diagnosis: Recurring patellar instability in the right knee, consultation with evaluation and as-sessment of the primary and secondary risk factors: TTTG 12 mm, patellar tilt 25°, Ca-ton Deschamps index < 1.2, mild trochlear dysplasia type A based on Dejour’s clas-sification, no significant axial or rotational misalignment , adequate muscular control , no relevant cartilage damage, positive apprehension test , significant lateraliz-ation/subluxation of the patella at 0-30°; increasingly better at 30-60°.

Subsequent development: Dr. Grim firmly believed that surgical treatment was indicated for this patient. However, as she was due to begin train-ing soon, the patient wanted to delay the

operation. This was when the orthopedic specialist introduced the GenuTrain P3: “It was intended to bridge the gap until the operation could be performed and protect the patella against lateral drifting.” The GenuTrain P3 (which stands for per-manent patella protection) relieves pain caused by misalignment of the kneecap (patellar lateralization), anterior knee pain (patello femoral pain syndrome) or pain associated with patellar tip syndrome. The active support , with its two integrated pads and an adjustable corrective strap, holds the kneecap in its natural , central position, and specifically counteracts the muscular imbal-ances that cause lateralization. “Through the GenuTrain P3’s stable patellar guidance, the patient was able to attend her profes-sional appointments,” said the physician. “The patient noticed a significant increase

in stability.” However, even after successful surgery, the story is not yet finished: the patient continues to wear the GenuTrain P3, particularly when playing sport because it “feels good,” reports Dr. Grim. †

20-year-old patient , patellar instability, MRI and X-ray results.

The GenuTrain P3, with its adjustable corrective strap, centers the kneecap and protects it from lateral drifting and tilting.


FOCUS

Case III, GenuTrain A3: Reduced handicap

Dr. med. Peter Ullmann, an orthopedic specialist , has been an orthopedic practitioner since September 1992 and is the founder of the “Zentrum für arthroskopische Chirurgie” (center for arthroscopic surgery) in Erfurt. In 2013, Dr. Ullmann relocated to the Erfurt Sports Clinic, where he and his colleagues apply themselves to the cross- sector treatment of joint diseases and injuries with a focus on surgical treatment. As well as his work as a golf medical coach, Dr. Ullmann is team physician for FC Rot-Weiß Erfurt. He is also an instructor at the working group for arthroscopy and joint surgery.

Flying balls are fascinating. Even more so when they land beautifully near the flag. This is what golf enthusiasts think, and this view is shared by the patient of Dr. med. Peter Ullmann from Erfurt, Germany. The problem: the patient’s handicap. Not her golf handicap, that’s for sure (HCP 9), but her knee. Her personal pain score was going up and up. Her balls were still flying, but only when she used aids to combat her gonarthrosis. For Dr. Ullmann, orthopedic specialist and golf medical coach, the case presented itself as follows:

Gonarthrosis, findings for 57-year-old patient , as per Dr. Ullmann’s case report Case history:Increasing loading restrictions in the left knee joint for the past two years, pain when moving after long periods of inactiv-ity/pain at night after prior heavy load-ing, instability when walking on uneven terrain and downhill , recurring effusions, two arthroscopic operations: partial medial meniscus resection in 2005, grade 3-4 cartilage damage in the medial compart-ment in 2010.

Sports case history:Years of playing competitive tennis and vol-leyball , Rennsteiglauf trail running event in 2005, golf: member of the golf regional league team, has not been able to tolerate the loading involved in running and jump-ing since 2012, progressive varus thrust in 2013.

Treatment:Regularly takes 100 mg of diclofenac when playing sport. Current treatment: cycle training, supply of special shoes, osteopathy, GenuTrain A3 during loading.

Subsequent development:“Five training sessions a week are toler-ated with the GenuTrain A3,” and both the patient and her physician, Dr. Ullmann, are delighted. The GenuTrain A3 (which stands for Anti Arthros Algos) counteracts complex knee complaints. Its specially shaped pad with integrated friction zones massages typical areas of pain and offers increased stimulation of receptors and nerve endings at the muscle-tendon transition with every movement. This activates the joint-stabiliz-ing muscles, particularly the vastus medialis muscle, and relieves pain, primarily in the

medial capsule-ligament area. Despite the radiology results showing that the disease has progressed significantly, Dr. Ullmann’s patient took part in the entire competition throughout the 2013/2014 season, and was even promoted into the regional league. After all , a handicap in golf can always be worked on. †

57-year-old patient , gonarthrosis, X-rays taken in two planes.

The GenuTrain A3’s special friction pad mas-sages the typical pain points in the knee and improves sensorimotor function.

Pict

ures

: Bau

erfe

ind,

Dr.

Pete

r Ullm

ann,

Dr.

Luka

s Br

andn

er


FOCUS

Case IV, GenuTrain S: Valgus injury on the sand

Dr. Lukas Brandner is a specialist in trauma surgery in Vienna and a former elite athlete. He specializes in minimally invasive surgical treatment of sports and joint injuries. Since April 2012, Dr. Brandner has been responsible for the surgical and conservative treatment of injured professional and elite athletes, as well as amateur athletes and those who are not involved in sports, at the Südstadt Olympic Centre. He works, amongst other things, as team physician for the Austrian skiing association and the Vienna Capitals, an ice hockey team in the Austrian Bundesliga.

There is always a certain risk of injury when playing sports on the beach or on specially created areas of sand in the city. Deep, energy-sapping sand can ultimately cause people to make incorrect movements. This can then result in serious knee injuries, particularly in the case of beach volleyball players, who move with a great deal of power. This is what happened to a patient of Viennese sports physician Dr. Lukas Brandner. The professional sportsman suffered a torn medial ligament after a major abduction movement of the lower leg while the thigh was anchored, a classic valgus injury. The findings with regard to the injured professional volleyball player revealed:

Torn medial ligament , 27-year-old pa-tient , as per Dr. Brandner’s case reportDiagnosis: Lesion of the left medial collateral ligament of the knee, no other associated injuries; cause of accident: valgus injury to the left knee joint (talus) during the competition; clarification: X-ray, MRI.

Treatment: Conservative treatment with a knee support for 6 weeks, pain management ,

treatment to reduce swelling, intensive physiotherapy.

Subsequent development: In terms of conservative therapy, Dr. Brand-ner decided on treatment with the Genu-Train S. The active support from Bauerfeind has lateral joint splints and straps on the thigh and lower leg. This combination of splints and straps gives the knee external mechanical support , providing increased stability, particularly during movement. In addition, the intermittent compression of the knitted fabric and the integrated pad massage the tissue during movement , which promotes the healing process and activates the surrounding muscles.Six weeks after the accident , the patient’s knee was free from pain and irritation, and the collateral ligament stability at 0° and 30° was once again the same on both sides. There was no pain during varus or valgus motion. “The patient got on well with the support ,” summarized Dr. Brandner. So well , that the patient even wore the GenuTrain S after his return to sport. Eight weeks after the injury, he began training and competing again, and wore the support for a further four weeks. It gave him a full range of motion with a corresponding feeling of security.

At the same time, intensive coordination training was carried out. According to Dr. Brandner: “Many of my patients con-tinue to wear the GenuTrain S when they begin to play competitive sport again.” †

27-year-old patient , torn medial ligament , MRI

The GenuTrain S provides additional support as it stabilizes the knee externally with a combin-ation of splints and straps as well as activating muscles during movement.


MEDICAL

Pict

ures

: Ron

ald

Zijls

tra

MOS Genu after an osteotomy

Joint replacement can waitIn the case of malalignment of the knee, a corrective osteotomy can relieve pain and improve joint function. The Dutch orthopedic specialist Dr. W. Reinoud Brouwer performs successful operations with the closing wedge method. He safeguards the successful outcome with the MOS Genu stabilizing orthosis.

You can bend and stretch it how you want: nothing is as good as your own knee – at least when you are younger. “The aim is therefore to help the joint to return to its earlier condition and offer the patient a sensible long-term alternative to joint replacement ,” says Dr. W. Reinoud Brouwer, orthopedic surgeon at the Martini Hospital in Groningen. However, this is not the case with elderly patients. At the age of sixty, patients generally experience more discomfort and their urge to move about is lower, says the physician, so the more radical solution of an endoprosthesis is often considered.

We are talking about gonarthrosis and the different ways of treating complaints with orthopedic surgery. In this context , realign-ment surgery is a method that is frequently underestimated. Osteotomies can offer long-term temporary relief from the severe osteoarthritic pain caused by misalignments. Dr. W. Reinoud Brouwer is a pragmatist. His theory is that: “Nothing works like your own joint. So you should try to preserve it for as long as possible.” And that is exactly what he does. The physician carries out 80 corrective osteotomies on knees each year. With a num-ber like this, he can be considered as being at the top of his profession – and not just in the Netherlands.

Evening out a malalignment of the leg axis An osteotomy, or corrective osteotomy, is an orthopedic surgical treatment method

used in the case of joint damage. Valgus or varus malalignments are usually the cause of the osteoarthritic symptoms in the knee joint. The surgery evens out the leg axis. The surgical procedure relieves the joint and stops the damage progressing. The corrective osteotomy brings the leg axis back into an anatomically correct alignment. Dr. Brouwer

treats varus gonarthrosis with a high tibial valgus osteotomy (HTO). In this case, the orthopedic surgeon uses what is known as the closing wedge method. After removing a wedge of bone just below the knee, the wedge is closed and fixed with staples. This surgical method is characterized by early postoperative loading of the knee, combined

“Nothing works like your own joint. So you should try to preserve it for as long as possible.“

(Dr. W. Reinoud Brouwer)

Osteotomy expert and top surgeon: orthopedic surgeon Dr. W. Reinoud Brouwer.


MEDICAL

with a comparatively short rehabilitation period for the patient. The general aim of the osteotomy is to relieve pain and slow down the osteoarthritis process in the knee.

Correction means preservationHigh numbers of operations demonstrate that a surgeon has extensive experience of a particular procedure. Word has also got around in Dr. Brouwer’s case. His osteotomy patients come from all over the Netherlands to see him in Groningen. “My oldest patient was a 68-year-old farmer from here in the north who still did a lot of walking,” says the

physician. “This is really amazing, because at this age most people who suffer from gonarthrosis opt for arthroplasty, i.e. an endo- or partial endoprosthesis, not a correc-tive osteotomy.” Typical osteotomy patients are around 40 years old. This age group gains the most benefit from delaying replacement surgery. “If these patients have ten more active, pain-free years with their own joint , then they have really benefitted,” stresses the physician. The patients are grateful. The endoprosthesis can wait.

Fast post-operative rehabilitation with MOS GenuIn order to safeguard the surgical outcome of the corrective osteotomy, Dr. Brouwer uses the MOS Genu stabilizing orthosis. The orthosis consists of an aluminum frame with adjustable joints, straps, and condylar pads of varying thickness, which compensate for swelling in the knee joint region. The orthosis is also available in a short and a long version. It stabilizes and relieves pressure on the knee joint. Its anatomically contoured frame has adjustable axes and joints. This special design provides external support for the knee, holding it in the correct axis. De-pending on the varus or valgus angle setting, it relieves different compartments of the knee. With their physiologically optimized pivot points, the joints of the MOS Genu

protectively limit flexion and extension in 10 degree increments. “With the long version of the fixed MOS Genu, around 90 percent of patients are able to put weight on the joint that has been operated on just one day after the operation,” explains Dr. Brouwer. “One week after the procedure, the orthosis joints no longer have to remain fixed in place, provided the patients are free of pain. The total rehabilitation time with the MOS Genu is about six weeks.”

MOS Genu can also be used after anterior cruciate ligament reconstructionMany patients do not want to do without the feeling of security offered by the MOS Genu even after the rehabilitation phase. In individual cases, Dr. Brouwer also uses the stabilizing orthosis after collateral ligament

and posterior cruciate ligament reconstruc-tion. The orthosis’ range of adjustment options provides assistance once again: MOS Genu stabilizes the knee joint according to the 4-point principle and counteracts the anterior drawer effect. To protect the knee, flexion and extension are limited, and, if necessary, the affected knee compartments can be individually relieved by adjusting the varus/valgus setting. For the knee special-ist who also works as team physician for FC Groningen, a soccer club in the Dutch top di-vision, this reliable stabilizing effect offered by the orthosis plays a crucial role for an obvious reason: “When I perform a complex operation, which I can offer to the patient with a clear conscience and with statistically proven success, I do not want the outcome to be compromised in any way.” †

“If these patients have ten more active, pain-free years with their own joint , then they have really benefitted.“

(Dr. W. Reinoud Brouwer)

Dr. Brouwer lends a hand: MOS Genu at the Martini Hospital in Groningen.


MEDICAL

Sports medicine in Ontario, Canada

A bright spot on the radar screenAlthough considered something of a joke at first , it is now accepted: orthopedic surgery and sports medicine in Canada pioneered advances in arthroscopic techniques and rehabilitation, bracing and orthotics.

“Yes, now it fits in well,” says Dr. Levy. He has just got back from his morning walk with his dogs. A bit of exercise in the fresh air be-fore starting his working day does him good. After all , he is a sports physician and has to lead by example. It is 8 a.m. in Burlington, a city in southern Ontario very close to the US border where the Levys live, while it is early afternoon in Germany. Dr. David Levy, a fam ous name among physicians and ath-letes, takes calls at home. Very handy. When Dr. Levy made the decision to establish the first clinic for primary care sports injuries in the province of Ontario over 30 years ago, sports and rehabilitation medicine in Canada still had what he describes as a shadowy existence. If, that is, you can say that it existed at all.

Long rehabilitation periods following injuries“Sports medicine wasn’t on anyone’s radar,” says Dr. Levy. Arthroscopic surgery techniques that are commonplace today were fairly uncommon then, even in other

surgical disciplines. At that time, most physiotherapy clinics treated patients who had been injured at work or in motor vehicle accidents. Their aim was just to get these patients back to work or just able to func-tion in basic daily activities. Often their first reaction was simply to immobilize the limb. They were not used to dealing with athletes whose goal it was to return to competition and a strenuous level of activity. These athletes needed to attend a clinic that un-derstood these goals. “A friend of mine, who is a physiotherapist and frequently worked with athletes, convinced me to start such a clinic,” explains Dr. Levy. This friend was preaching to the converted. The physician wasted no time in opening his own clinic. “I have always been fascinated by sport and medicine, so I felt that we could combine the two.”

On the sideline for the Tiger-Cats, Rock, and BulldogsFathers often act as role models, not just in sport, but in careers too. David first found

himself in a Canadian football stadium as a tiny tot on his father Daniel’s lap, en-tranced by the games of his home team, the Hamilton Tiger-Cats. Then his father, a physician, introduced him to medicine. The first primary care sports clinic in southern Ontario goes by the name of “Dr. Daniel Levy Memorial Sports Medicine Clinic.” It was founded by Daniel Levy’s son in Hamilton in 1983.

Together with a physiotherapist , he still treats amateur and professional athletes there today. His wife Kathy also works with him at the clinic as a nurse. Dr. Levy has been the team physician of the Hamilton Tiger-Cats, one of the top teams in the Canadian Football League (CFL), for over 40 years. The professional players from Toronto Rock in the National Lacrosse League and the Hamilton Bulldogs, a professional team from the American Hockey League, also benefit from the experience of the sports physician, who is now in his sixties. Anyone who practices medicine for 60 hours a week, not to mention his work on the sideline, also gains a wealth of practical knowledge about supports and orthoses. To see these aids as the only sign of the maturation of sports medicine in Canada would be going too far. However, they were essential companions for early functional rehabilitation.

Functional and stylishAlthough early functional treatment strat-egies, which brought sports rehabilitation to the fore, were rare or non-existent when the clinic was founded, they are now more firmly established as a “role model” for general rehabilitation clinics. Dr. Levy feels that this more aggressive and effec-

“I have always been fascinated by sport and medicine, so I felt that we could combine the two.“

(Dr. David Levy)

Even tough guys need care. Pict

ures

: Mik

e Bl

ack

Phot

owor

ks


MEDICAL

Further information

Hamilton Tiger-Cats: www.ticats.caHamilton Bulldogs: www.hamiltonbulldogs.comToronto Rock: www.torontorock.com

tive treatment strategy, which is a common approach for the athlete patient , has influenced injury rehabilitation in general. “This approach often utilizes supports and orthotics which give patients functional-ity, but also provide protection,” says Dr. Levy as he describes his experience. “The fact that they improve mobility and help to prevent further injury has led to the use of these aids extending beyond the field of sports medicine into the realm of everyday life in rehabilitation clinics.”His own contribution must certainly be acknowledged. However, as a team player, Dr. Levy also recognizes another player on the field: “If companies like Bauerfeind continue to develop orthoses and supports with a range of functions that have a styl-ish appearance and are user friendly, our patients will be easily convinced of their benefits and continue to keep their compli-ance levels up.”

“Exercise is medicine” or “Motion is Life”The sports physician sees the active supports of the GenuTrain range and the Manu Train as successful examples of aids with high compliance levels, and says that both physi-cian and patient can express their “creativ-ity” with them, as the active supports enable an unprecedented degree of mobility . In this respect at least , Dr. Levy’s “exercise is medicine” philosophy overlaps with Bauer-feind’s “Motion is Life” motto. According to Dr. Levy, the sport-loving Canadians are more

than happy to invest in aids that keep them moving. In most provinces of the world’s second-largest country, these expenses are not covered by the state insurance scheme. However, many citizens can obtain suitable aids for free via their private insurance poli-cies, sports clubs, or employers. The high-quality German manufacturer’s products are currently extremely popular in Canada in general. According to an experienced sports physician, the popularity of these products is expected to grow even more. †

In addition to working at his clinic, Dr. David Levy is team physician for sports clubs such as the Tiger-Cats.


MEDICAL

Pict

ures

: Dr.

Ham

mer

, Bau

erfe

ind

For a long time, the sacroiliac (SI) joints, which form the main link between the sacral and iliac bones, tended to be pushed to the sidelines of medical research. They have begun to attract more and more scientific interest only in the past few years. Until now, however, relatively little was known about the exact anatomical conditions of the ligament structures around the SI joints, as conventional measurement techniques did not offer enough scope for investigating this area. For researchers at Leipzig University and Chemnitz University of Technology, this was reason enough to attempt to close this gap in research and, using state-of-the-art investigation methods, to get to the bottom of the effect of the SacroLoc orthosis on the SI joints and the pelvis.

Rotation of the sacral bone reduced by more than 40 percentThe study was carried out at the Institute of Anatomy at Leipzig University and led by anatomist Dr. Niels Hammer. As well as looking into anatomical and biomechanical

Figures A and B show the in vivo measurement setup. Fig. C shows the resulting measured forces in the finite element pelvic model (red arrows correspond to the force vectors).

A B

Data was collected on the compressive effect of the SacroLoc on a 26-year-old man using a Pedar pressure measuring system.

C

Graphical representation of the front view of the pelvic model created using the finite element method. The geometric data for bones and cartilage come from the computer tomography data for a healthy 29-year-old man. Both hip bones, the sacrum and coccyx, the fifth lumbar vertebra , the proximal sections of the femora, and the connecting articular surfaces were integrated into the model. The geometric and mechanical data for the ligaments comes from studies carried out by the group comprising Hammer et al., also involved in researching the SI joint.

SacroLoc study

A comprehensive study on the effect of the SacroLoc has revealed that it has a clear impact on the sacroiliac (SI) joints. Computer simulations have also shed some light on fundamental questions regarding the anatomy and biomechanics of the ligaments in this area.

Pelvic orthosis has a direct impact on the SI joints


MEDICAL

aspects, the study examined clinical issues re-garding the stability and mobility of the pel-vic ring under the influence of the SacroLoc. Using the finite element method (FEM), a computer model was developed into which geometric and mechanical data relating to the anatomy of the pelvis was incorporated. This made it possible to measure slight movements of the SI joints in simulations.One of the groundbreaking results from this study was that, overall, the movements of the SI joints turned out to be significantly smaller than previously assumed. Another important finding was that use of the pelvic orthosis altered the nutation of the SI joints considerably. In numerical terms, the rotational components were reduced by more than 40 percent. The transverse tilt of the iliac bone part of the hip bone increased by 65 percent, leading to a slight straightening of the pelvis. According to the researchers involved in the study, this sophisticated effect of the pelvic orthosis, which alters the range of movement in a complex way rather than restricting it in isolation, is a new finding for the scientific community (see also the interview on page 24).

and nerves. During movement, the pads in the orthosis also have a targeted effect on trigger points and †

The SacroLoc stabilizes the pelvis and relieves pressure on the sacroiliac joints.

The computer simulation demonstrates the movement of the SI joint when the pelvic orthosis is applied. In a weight-bearing position standing on both legs , a movement of the SI joint in the sagittal (z) axis and transverse (x) axis was observed. When the pelvic orthosis is fitted, this reduces the SI joint’s movement in the transverse axis and increases it in the sagittal axis. The SI joint’s total scope of rotation is reduced. The majority of the SI joint’s ligaments are relaxed.

with SacroLoc

without SacroLoc0,05

0,04

0,03

0,02

0,01

0,00

rota

tion

[°]

transvers (x-) axis sagittal (z-) axis

Movement (Compression)

Ref.: Soisson O, Lube J, Germano A, Hammer K-H, Josten C, Sich ting F, Winkler D, Milani T , Hammer N. PLOS ONE 10.1371/journal.pone.0116739. published 17 Mar 2015. Pelvic belt effects on pelvic morphometry, muscle activity and body balance in patients with sacroiliac joint dysfunction.(www.plosone.org)

Innervation of the SI joint ligaments Thanks to the complex way in which it changes the range of movement of the SI joints, the SacroLoc relieves the strain on the local ligament structures to a measurable extent – especially the ligaments inside the SI joints and the sacrospinous and sacrotuberous ligaments. This influences the kinematics of the pelvis, has a stabilizing effect, and in most cases helps to relieve pain. In fact, in the clinical part of the study, some of the patients with chronic SI joint symptoms reported immediate relief from pain when wearing an orthosis. There is also a direct link between this and the innervation conditions in the SI joint area. One of the findings shown by anatomical studies using plastinated specimens, which formed the basis for the computer simulations, was that the SI joint region is densely innervated up to the joint space. This means that applying the SacroLoc so that it encircles the pelvic ring not only relieves pressure on the ligaments, but also has an impact on the interaction between the ligaments


Pict

ures

: Bau

erfe

ind

Pict

ures

: Chr

isti

ne A

uste

, Bau

erfe

ind

What particular challenges were involved in investigating the effect of the SacroLoc on the sacroiliac (SI joints) and its ligaments?Dr. Hammer: Although the SI joint is one of the largest in the human body, key questions concerning its biomechanics still haven’t been answered, such as the effect of the ligament structures inside the joint. Up until a few years ago, all we knew was that there are some strong ligaments there. We didn’t know how precisely the ligament structures control the mobility of the SI joint. The ligaments are the joint’s stabilizers and, thanks to their nerve fibers, they also act as a kind of sensing element in a control circuit. The muscles in the back, abdominal wall, and pelvic ring seem to be the control elements in this circuit.

What did you do to deal with these challenges in the study design? Dr. Hammer: The first step we took was to describe the ligaments and their paths in precise terms. This was made possible

by using modern processes like CT and MRI scans and combining them with anatomical methods, such as frozen section and plastination procedures. We studied the anatomy of over 100 donor bodies and used the findings from this to create computer-based simulations. We deliberately chose to focus exclusively on the bones and ligaments of the pelvic ring in order to gain a deeper insight into how this “passive” partner of the SI joint works.

What findings regarding the SI joints are connected with the results from the study?Dr. Hammer: The results showed that, in general, the movements of the SI joint are very slight, much more so than previously thought. This concerns both the overall movement, the nutation, and sub-movements within this. However, in terms of the development of pain in the SI joint region, the small range of movement does not mean that pain and motion receptors are not triggered. In fact, slight movements like these require very precise control of the pain receptors.

What did you find out about the SacroLoc’s biomechanical mode of action?Dr. Hammer: Using this special aid altered the movement in the SI joint significantly. The rotation of the sacral bone is reduced by almost 42 percent. The movement of the iliac bones toward the fifth lumbar vertebra was actually increased, which

could be interpreted as an improvement in the physiological movement of the local ligaments. In most cases the strain on the ligaments was relieved, which of course has an indirect effect on the pain receptors.

Is it possible to draw any conclusions from this regarding the SacroLoc’s therapeutic effect?Dr. Hammer: Our data clearly indicates that pelvic orthoses change the overall movement in the posterior pelvic region. The extent of this change varies from one sub-component of the movement to the next and facilitates the overall movement of the SI joint on a physiological level. As well as the relief of the ligaments and the reduced stimulation of pain receptors associated with this, the components of the active locomotor apparatus probably also have a role to play here.

Can you offer any recommendations in terms of diagnosing and treating SI joint syndrome based on this?Dr. Hammer: The fact that the pelvic orthosis alters the range of movement in a complex way rather than restricting it in isolation is a new finding for the scientific community. Our data clearly shows that we need to take other parameters into consideration as well as isolated compression. There is already a wide range of suitable investigative methods available for diagnosis and treatment. The important thing is not to disregard differential diagnoses. These show “red flags” for diseases of the lumbar spine and hip joint in particular, as well as for conditions in the lower abdomen. Problems in the anterior pelvic ring and the pubic symphysis can also be the cause of SI joint syndrome… †

Dr. Niels Hammer, a specialist in anatomy at Leipzig University’s Institute of Anatomy, comments on the key findings from the SacroLoc study in an interview with life.

“The orthosis can significantly change the movements in the SI joint”

Putting questions to the leader of the SacroLoc study

Dr. Niels Ham-mer, Institute of Anatomy at Leipzig University.

The amount of pressure relief provided by the orthosis can be controlled individually using the tensioning straps.

Ref.: Sichting F, Rossol J, Soisson O, Klima S, Milani T , Ham-mer N. Pain Physician. 2014 Jan–Feb; 17(1): 43–51. Pelvic belt effects on sacroiliac joint ligaments: a computational approach to understand therapeutic effects of pelvic belts.

24 life magazin 2/2015

MEDICAL

BAUERFEIND.COM

GREAT COMFORT FOR AN ACTIVE DAILY ROUTINE

VenoTrain® microMEDICAL COMPRESSION STOCKINGS

PLEASANTLY SOFT THANKS TO MICROFIBERS

FOR BETTER COMPLIANCE

VenoTrain micro – the compression stocking in classes 1 and 2 for mild vein problems – is exceptionally comfortable to wear. With a microfi ber content of over 50 percent, it is pleasantly soft, breathable and very gentle on the skin.

Microfi ber content of over

50 percent

venotrain_micro_arzt_anzeige_EN_4c_210x280_final_150303.indd 1 03.03.2015 13:38:52


Pict

ures

: Sho

hei H

igas

hiha

ra, B

auer

fein

d, J

ose

Adri

an R

ojas

Ibar

ra

MEDICAL

Physician tackling the issues of an aging population

The population aging rate in Japan is the highest in the industrialized world, with a quarter of the population already aged 65 years or more. And this makes it all the more important to keep moving, according to Dr. Kakuko Nakamura.

“ Body-work is the key”

“I dedicate myself to the task of teaching the value of healthy living,” says orthope-dic surgeon and sports doctor, Dr. Kakuko Nakamura, who worked for a number of years at the Japan Institute of Sports Sciences (JISS) and as a Japan national team medical staff delegate providing support for various Japanese national teams in fields such as speed skating and rhythmic gymnastics.In April 2014, she opened her own sports clinic in Tokyo where she focuses on a forward-looking approach that combines exercise and medical care. One key area is the treatment of the elderly. “Chronic joint pain due to aging and dif-ficulty in accomplishing everyday activities are the main problems facing our elderly patients,” says Dr. Kakuko. The problems are

frequently caused by poor posture and the failure to use muscles and joints correctly. “Mobility-related falls and lifestyle-induced diseases often mean that the elderly become bedridden, thereby impairing their quality of life and increasing the cost to society. Body-work is the key. Everyday functional exercise can enhance proprioception and consequently stop such situations from com-ing about ,” Dr. Kakuko emphasizes. When patients enroll at the Dr. Kakuko Sports Clinic, they first of all receive an in-

depth check-up which includes an assess-ment of their medical history and posture, functional tests and, if necessary, further examinations such as ultrasound and X-ray diagnostics. Key elements in the treatment provided by Dr. Kakuko and her team include movement and body workouts.

Improved proprioceptionSupports and insoles from Bauerfeind also help increase her patients’ mobility both dur-ing and after the body-work program. Most of her senior patients suffer from arthritic disorders, especially in the foot , knee and hip joints. “These patients need to feel at ease once more with the biotensegrity of their bodies. Here Bauerfeind products, which in-clude supports, stockings and foot orthoses, can help. The prod-ucts boost the efficiency of proprioception while

For further information

please visit: www.dk-sc.com (japanese) or www.dr-kakuko.com/en/bio/ (english)

the body is being exercised, and the overall beneficial effect of the program is enhanced as a result ,” explains Dr. Kakuko. And she adds: “Insoles are also very effective during everyday activities, such as commuting to work, shopping and traveling.” A favorite for her and her patients alike is the orthopedic foot orthosis, the ErgoPad weightflex 2. “It is very well-designed and made from carefully selected materials which give it the struc-ture and shape to function perfectly at the practical and therapeutic levels. Patients like wearing it because it is so comfortable.” †

There are a many foreign business people in the area and therefore also among Dr. Kakuko’s patients.

Functional test during the check-up.

The orthopedic ErgoPad weightflex 2 foot orthosis is

particularly flat and flexible, and is ideal for patients who change their shoes regularly.

MEDICAL

Dr. Carlos Cisneros from Mexico relishes a complex challenge. It is therefore no surprise that treating shoulder complaints is one of the orthopedic surgeon’s specialist areas. He uses the OmoTrain active support to help treat a number of problems associated with this complex joint.

“A great sense of security”Shoulder treatment with OmoTrain

OmoTrain stabilizes and guides the movement of the shoulder.

The main shoulder joint is the most mobile joint in the human body. Its ball-and-socket design allows the arm to move in all three planes and axes. The control and security of the shoulder joint is primarily ensured by the rotator cuff. “The joint is simply fas-cinating. However, the complex structures, the ability to rotate through a wide angle, and the consequent mobility of the shoul-der also make it significantly more prone to injuries and wear,” says Dr. Carlos Cisneros, who works in a private practice at the Zam-brano Hellion Medical Center in Monterrey, Mexico, amongst others.“The biggest challenge is to find the best treatment option for my shoulder patients in

each case, and to enable them to continue their daily activities and sports as soon as possible.” He often encounters patients with impingement syndrome, rotator cuff injuries, bicep injuries or joint instabilities. “My typical shoulder patients subject the joint to heavy loads through their sporting or professional activities. These patients generally have functional deficits, frequent-ly experience pain during the night , and their strength and mobility are significantly restricted,” says the orthopedic surgeon. “Another group of patients experiences a feeling of instability and a range of impair-ments in movement , particularly when playing sport.”

Guides the joint securelyShoulder problems can be treated conserva-tively or surgically, depending on the nature and severity of the injury. In most cases, orthopedic aids are used to supplement therapy, primarily to stabilize the shoulder, and prevent or reduce swelling. “OmoTrain is one of the supports that I prefer to use for arthritis of the shoulder joint and in the case of some other diagnoses that include swelling and instability,” explains Dr. Cisne-ros. “The support has proved to be outstand-ingly successful.”

OmoTrain stabilizes and guides the move-ment of the shoulder. Its special strap sys-tem and compression knit center the joint. The knitted fabric massages the soft tissue during movement , and pain is relieved. A viscoelastic pad with frictional nubs can also be used if necessary to increase this massage effect. “Fortunately, the Mexican insurance companies will pay the cost of the support as part of the medical treatment. The patients benefit from a high-quality product that offers them stability, comfort , and a great sense of security.” †

Dr. Carlos Cisneros works in a private practice at the Zambrano

Hellion Medical Center in Monter-

rey, Mexico.

“The patients benefit from a high-quality product that offers them stability, comfort , and a great sense of security.”

(Dr. Carlos Cisneros)



Pict

ures

: Ray

Chu

a/w

ww

.dha

ppyfi

sh.c

om, B

auer

fein

d

MEDICAL

What is the major challenge in the treatment of foot and ankle injuries? Dr. Tan: The foot and ankle is a fascinat-ing part of the human body. They are a complex arrangement of multiple – more than 20 – joints and bones that have the flexibility to adapt to different surfaces and also provide stability and durability to bear our weight over a lifetime. At the same time, this complexity makes accurate diagnosis and treatment particularly challenging. The other challenging aspect is our constant need to use both our feet/ankles in our gait. We are unable to suitably compensate when one foot/ankle is painful or injured because both sides are always needed to walk.

What are the most common foot & ankle problems you see in your daily work?Dr. Tan: I think the commonest problems that I see in the clinic are probably over-use type of injuries. These include heel pain from Achilles tendinopathy or plan-tar fasciitis as well as metatarsalgia and stress injuries/fractures. The most frequent problems we treat in the operating room would be ankle ligament injuries, cartilage disorders and ankle impingement , usually with ankle arthroscopy. Ankle injuries during sports is getting increasingly frequent in Asia and in Singapore, as our population is becoming more and more active in sports. Popular sports here include football , basket-ball , badminton, frisbee and running, to name a few. In many ball sports, the players are concentrating on the ball and pay less attention to where they place their feet. If the sport is played on an uneven pitch and involves jumping, the risk of ankle injury is even higher.

When do you use braces for treating the foot and ankle? Dr. Tan: An ankle guard or brace is an impor-tant part of management in any ankle injury.

Foot and ankle therapy with MalleoTrain and AchilloTrain

“Our philosophy of treatment is always to focus on rehabilitation and non-surgical options first and to incorporate minimally invasive treatments only when necessary,” says foot and ankle specialist Dr. Tan Ken Jin. Hence, Bauerfeind products are often used at his workplace, the Orthosports Foot and Ankle Clinic at Mount Elizabeth Novena Hospital , Singapore.

“ Reliable, durable, and effective”

Dr. Tan has dedicated his career to the treatment and advancement of foot and ankle disorders.


MEDICAL

In the acute phase, it can be used to provide compression and dynamic support. In later phases, continued use can be part of a return to sports rehabilitation program. In some pa-tients who have surgery for persistent ankle instability, use of an ankle guard or brace can also be recommended when they are first returning to sports after an ankle ligament repair/reconstruction. And in yet another group, these braces can be used longer term as part of management of a chronic injury.

What do you appreciate about MalleoTrain and AchilloTrain? Dr. Tan: I have been using the MalleoTrain and AchilloTrain for many years now. Despite other available alternatives, I have found them to be reliable, durable and effec-tive. When properly fitted, the amount of


please visit http://footandankledoctor.com.sg/

Dr. Tan Ken Jin

is an internationally known orthopedic surgeon with a sub-specialty interest in foot and ankle disorders and sports injuries. In addition to his studies and his work in Singapore, he completed a fellow-ship at the University Hospital Carl Gustav Carus in Germany under the renowned Prof. Dr. Hans Zwipp and a second fellow-ship at the Institute for Foot and Ankle Reconstruction in the USA with Dr. Mark Myerson, a world leader and pioneer in foot and ankle surgery.

compression helps with swelling and gives comfort and proprioceptive feedback. The elasticity in the material is also a good balance in providing support but not overly limiting movement.MalleoTrain can be used for acute ankle injuries and chronic ankle pain. It provides dynamic support and compression, allowing the patient to stay mobile. In addition, the lateral and medial pads in the MalleoTrain provide additional compression over the common areas of pain and swelling. The AchilloTrain is mostly used for heel pain from Achilles tendinopathy. We use it for insertional tendinopathy or non-insertional tendinopathy. The pad that is running along the Achilles tendon gives dynamic compression and relief as well as supporting the tendon. I have noticed that insertional tendinopathy is very common in Asians and AchilloTrain has been a very useful tool in treating patients with mild to moderate symptoms. My patients tolerate the Malleo-Train and AchilloTrain very well. The material is comfortable and gives uniform compres-sion. They are also relatively easy to put on. The knitting is of good quality so the braces are durable and do not fray easily as well.

What further medical aids from Bauerfeind do you use in foot therapy?Dr. Tan: The ViscoPed and ViscoPed S foot orthoses are also useful for management of foot and heel pain. I have found the full-length cushioning to be very helpful in patients with metatarsalgia. Being a full-length insert , when they are fitted well into the shoe, they do not slide easily in the shoe and are thus well tolerated and can also be used for sports.

How did you come into contact with Bauer-feind products? Dr. Tan: Bauerfeind products have a wide distribution network in Singapore. I am glad that the company has taken the effort to make their products available here. I have noticed that the products are of good quality and are well designed. Patients who have used the products have also given very posi-tive feedback, hence making me confident of using them.For most patients, the products are not re-funded by the health system. So they would have to pay for them. This makes it particu-larly important for the product to be a good one, so that patients can see the value. †

MalleoTrain (left) is an active support for muscular stabilization of the ankle. AchilloTrain helps to relieve the Achilles tendon without restricting mobility.


Pict

ures

: Ast

rid

Mul

der,

Team

Tra

umap

latf

orm

“Skate for Science” & “Ride for Research”

MEDICAL

Two disciplines, one team, one goal

injuries and fractures. Sports events at which the team members wear the special team top and promote the Traumaplatform’s goals – joint fundraising for joint PhD Research Fellows – are also on the program, however.

Edinburgh International Trauma Symposium 2016 “We aimed to cover two hundred kilometers in the Finland Ice Marathon the start of the year,” says Dr. Doornberg, describing the last

major sports event. The slogan was ”Skate for Science.” But if you assume that the only thing on the program was ice skating, you would be wrong: “It began on the plane,” he says, outlining the “in-flight program.” “Instead of watching films, we gave presenta-tions.” The overarching theme was “orthope-dic sports & trauma injuries.” They are won-derfully efficient, these traumatologists. “In August 2016, we will travel to the Interna-tional Trauma Symposium in Edinburgh with

The Dutch ”Team Traumaplatform” cultivates an interdisciplinary approach. Young orthopedic and trauma surgeons are united by a similar pool of patients – and by the love of sport. Scientific discus-sions are carried out in the bicycle saddle and on ice.

You cannot help but notice the red racing bike. Other physicians have art, ankles or knee joints in their rooms. Dr. Job Doornberg has these too; after all, he is an orthopedic resident trainee. His racing bike leaning against the bookcase adds a finishing touch to the furnishings. The racing bike is a must, however, if only to keep up with his boss. But more on that later. The young physician at the Amsterdam Medi-cal Center (AMC) is not the only one with a passion for sports. When Dr. Doornberg lists his colleagues’ qualifications, you could be fooled into thinking that if you do not have particular skills in rowing, ice skating or cy-cling, you will not make it into Team Trauma-platform. Of course, the medical qualification is what matters most of all.

Exchange of expertise between orthopedic and trauma surgeonsThe members of Team Traumaplatform, which was established in 2013, all work at differ-ent hospitals around the country. The aim is to improve the exchange of expertise between trauma surgeons and orthopedic surgeons, because both specialist medical teams care for patients with sports injuries and fractures, and both carry out operations on them too. It is in their common interest to exchange views on issues such as the ap-propriate way to treat ankle fractures, based, of course, on the latest scientific findings. As trauma specialists and orthopedic surgeons often only meet in grand rounds, the people who set up Team Traumaplatform wanted to create an informal setting where these groups could exchange knowledge. So the team travels to conventions together, and uses this time to discuss scientific works, prepare joint presentations or generally exchange views on issues relating to sports

Red and white: Dr. Job Doornberg from Team Traumaplatform with a racing bike.


specialists is another central objective for Team Traumaplatform. Doctoral scholar-ships and fellowships enable talented young physicians and their supervisors to work as residents or doctoral supervisors. But inter-ested students should also be introduced by their professors to the traumatological con-nections of both disciplines via a relevant network at an early stage. The improved visualization and interpretation of X-ray images are one such topic. What is known as a DICOM viewer could, as is currently being discussed, improve contrast or maybe allow users to scroll through magnetic resonance imaging (MRI) and computerized tomogra-phy (CT) in online observer studies. “Science is formal curiosity,” says Dr. Doornberg. The

young orthopedic surgeon now seems a little restless. “I’m sorry, but my boss, Professor Kerkhoffs, is waiting for me.” Prof. Dr. Gino Kerkhoffs is Head of the Department for Orthopedics and Sports Traumatology at AMC and the Chef d’Equipe of Team Traumaplat-form, of sorts. “I’ve arranged to go for a bike ride with him today,” explains Dr. Doorn-berg. Oh, that’s nice, it’s important to have some down time. Job smiles enigmatically and points to a long and detailed e-mail on his computer, in which thirteen points are listed. Yes, and? His answer is surprising: “That is the agenda for our bike ride!” †

around 100 surgeons,” says Dr. Doornberg, co-initiator and the team’s “tour leader.” “We will take the ferry from Amsterdam to New-castle and then continue to Edinburgh on our racing bikes. We will begin with the scientific work as soon as we get on board the ferry.”

Bauerfeind Benelux as a sponsorWhether on ice skates or racing bikes, this unconventional way of practicing science is intended as a fundraiser: raising money for


please visit www.traumaplatform.org

MEDICAL

Green and white: Team Traumaplatform in front of the airplane in Finland in February 2015.

Red and white: Dr. Job Doornberg from Team Traumaplatform with a racing bike.

a PhD Research Fellow. Attracting sponsors and patrons is one of the essential ele-ments of the team’s work. And it is not easy. Dr. Doornberg is aware that “it is easier for people fundraising for children’s cancer or HIV than it is for us. But injuries need a lobby too.” For example, fractures that are treated appropriately have high socio-economic value for the public. You only have to think of disabling osteoarthritis, which can be a long-term complication of the many protracted ankle fractures in the young.“Fortunately, many companies see the social benefits of our initiative,” says Dr. Doorn-berg happily. So it was not difficult to get Bauerfeind on board. “After all, we know the products that they make from our work. We

have had particularly good experiences with the MalleoTrain, the active ankle support,” explains the orthopedic specialist. “We often prescribe it when someone has sprained their ankle.” Another highly-valued product used in the AMC’s affiliated hospitals is the OmoLoc, the strapless orthosis for immobi-lizing the shoulder. For the Team Trauma-platform fundraisers, it was most welcome that Bauerfeind Benelux has now opened its doors to their cause in return. The company did not need to be asked twice before lend-ing its support to the team.

From student to professorProviding joint traumatological training for young orthopedic surgeons and trauma


IN MOTION


IN MOTION

Six players per team battling hard for the puck on the ice and noisy, enthu-siastic supporters in the stands: ice hockey delights fans all over the world, who remain steadfastly loyal to their teams even in tough times. The speed at which players and puck sweep over the ice has increasingly become a decisive element of the game over the past few years. >>>

Bild

: pic

ture

alli

ance

/Hel

mut

Foh

ring

er/A

PA

Athletic talent and endurance


Pict

ures

: Hoc

key

Cana

da Im

ages

, Cit

y-Pr

ess,

IIH

F

IN MOTION

playing between the ages of four and six. “A good ice hockey player needs broad-based athletic training, particularly in coordina-tion skills – including off the ice,” says the expert Bakos. A highly stable torso axis is particularly important when playing the sport. This is the only way for the athletes to turn their upper body to correctly guide the puck while ice skating.

Protective equipment is compulsory“Apart from athletic talent , a certain ability to endure suffering is required, because ice

hockey can be painful ,” says Bakos, speaking from experience. As ice hockey is a highly aggressive sport , protective equipment is compulsory, but injuries are still a common occurrence. “These primarily affect the knee, hand, and face,” explains Christian Hofstetter. The IIHF is trying to limit the number of head injuries in particular by in-troducing tougher penalties or rule changes. These measures are proving highly suc-cessful: “There were no registered cases of concussion at all at the 2015 world champi-onships,” says Hofstetter proudly. Let’s hope that this will also be true of the 2016 Ice Hockey World Championship.Incidentally, the mascot for the men’s world championships in Russia in 2016 has already been chosen: maybe the dog Laika will help the Russians win back the world title. †

Speed is a crucial factor in ice hockey: Canada took the lead against arch-rival Rus-sia in the final of the 2015 IIHF Ice Hockey World Championship with four goals in eleven minutes. After two more goals scored and one conceded, the Canadian men were crowned world champions and found themselves at the top of the world rankings, just like the women’s team. Together with Russia, Sweden, Finland, the Czech Republic, and Slovakia, Canada is one of the world’s top ice hockey nations. In Canada, ice hockey is considered a national sport. The games of the youth and women’s national teams also attract a great deal of attention, and not only because the 2016 women’s world championships are due to be held on home soil. The level of enthusiasm is not surpris-ing, considering Canada played a signifi-cant role in the sport’s development: the first indoor ice hockey game took place in Montreal in 1875 and the puck was also invented in Canada. Canadian students at McGill University also introduced referees, goalkeepers, and some of the rules in the 1870s. For example, the rules stating that sticks must not be raised above shoulder height and that play is started and resumed from the center at the beginning of a game and after a goal still apply today.

However, keen ice hockey fans are not only to be found in Canada: “At major events such as the world championships, spectator re-cords are constantly being broken. This hap-pened most recently at the world champion-ships in the Czech Republic. Thousands of Slovaks and Latvians came to support their teams in person,” says Christian Hofstetter, Marketing Director of the International Ice Hockey Federation (IIHF, www.iihf.com). The Germans are also avid ice hockey fans: “Ice hockey is probably the sport with the widest fan base in Germany after football. German ice hockey fans are also passionately com-

mitted to the sport and stay loyal to their clubs, even in tough times,” reveals Michael Bakos, a former national player and admin-istrative organizer of the national teams for the German ice hockey federation Deutscher Eishockey-Bund (DEB, www.deb-online.de).

Speed is the keyThe sport of ice hockey has become quicker and quicker over the past few years. “The rapid switching between attack and defense means that several goals can be scored by both sides within a few minutes. This speed is down to high-tech materials such as carbon, which has made equipment increasingly lighter. But it is also due to the development of the elite sport itself and the demands placed on the players,” explains Bakos. Most professionals started

Speed, passion, and action are what make ice hockey games so exciting. The women’s world championships will be held in Canada in 2016.

>>>

World championships in 2016

• 17th Ice Hockey Women’s World Championship: March 28 to April 4, 2016 in Kamloops, Canada, www.worldwomen2016.com

• 80th Ice Hockey Men’s World Championship: May 6 to 12, 2016 in Moscow and St. Petersburg, Russia, www.iihfworlds2016.com

Christian Hofstetter, Marketing Director of the International Ice Hockey Federation.

Michael Bakos, former national player and administrative organizer of the national teams for the German ice hockey federation.


SERVICE

Bauerfeind worldwideBauerfeind AG

Triebeser Straße 16 07937 Zeulenroda-TriebesGermanyP + 49 (0) 36628 66-10 00 F + 49 (0) 36628 66-19 [email protected]

Austria

Bauerfeind Ges.m.b.H.Hainburger Straße 331030 WIENP + 43 (0) 800 4430-130 F + 43 (0) 800 [email protected]

Benelux

Bauerfeind Benelux B.V.Waarderveldweg 12031 BK HAARLEM

The Netherlands

P + 31 (0) 23 531-9427F + 31 (0) 23 [email protected]

Belgium

P + 32 (0) 2 527-4060F + 32 (0) 2 [email protected]

Bosnia and Herzegovina

Bauerfeind d.o.o. BIHACEl Gazalija 777000 BIHACP + 387 (0) 37 313-198F + 387 (0) 37 [email protected]

Croatia

Bauerfeind d.o.o.Goleška 2010020 ZAGREBP + 385 (0) 1 6542 -855F + 385 (0) 1 [email protected]

France

Bauerfeind France S.A.R.L.B.P. 5025895957 ROISSY CDG CEDEXP + 33 (0) 1 4863-2896F + 33 (0) 1 [email protected]

Italy

Bauerfeind AGFiliale ItalianaPiazza Don Enrico Mapelli 7520099 SESTO SAN GIOVANNI (MI) P + 39 02 8977 6310F + 39 02 8977 [email protected]

Nordic

Bauerfeind Nordic ABKungsholmstorg 811221 STOCKHOLMP + 46 (0) 774 100-020F + 46 (0) 774 [email protected]

Republic of Macedonia

Bauerfeind Dooel Skopje50 Divizija 24 a1000 SKOPJEP + 389 (0) 2 3179-002F + 389 (0) 2 [email protected]

Serbia

Bauerfeind d.o.o.102 Omladinskih brigada 11070 NOVI BEOGRADP + 381 (0) 11 2287-050F + 381 (0) 11 [email protected]

Singapore

Bauerfeind Singapore Pte Ltd.Blk 41 Cambridge Road #01-21 SINGAPORE 210041P + 65 6396-3497F + 65 [email protected]

Slovenia

Bauerfeind d.o.o. Dolenjska cesta 242 b 1000 LJUBLJANA P + 386 (0) 1 4272-941F + 386 (0) 1 [email protected]

Spain

Bauerfeind Ibérica, S.A.Historiador Diago, 1346007 VALENCIAP + 34 96 385-6633F + 34 96 [email protected]

Switzerland

Bauerfeind AGVorderi Böde 55452 OBERROHRDORFP + 41 (0) 56 485-8242F + 41 (0) 56 [email protected]

United Arab Emirates

Bauerfeind Middle East FZ-LLCGF-09, District 1, 71 MPC BuildingDubai Healthcare CityP.O. Box 505116DUBAIP + 971 4 4335-685F + 971 4 [email protected]

United Kingdom

Bauerfeind UKPhyllis House229 Bristol RoadBIRMINGHAMB5 7UBP + 44 (0) 121 446-5353F + 44 (0) 121 [email protected]

USA

Bauerfeind USA, Inc.1230 Peachtree St NE, Suite 1000ATLANTA, GA 30309 P + 1 800 423-3405 P + 1 404 201-7800 F + 1 404 [email protected]


Pict

ures

: Bau

erfe

ind

BAUERFEIND.COM

PLEASANTLY SOFT WITH EVERY STEP

RELIEVE THE PRESSURECONSISTENT CUSHIONING THANKS TO

THE NEW UNIQUE SOFT FOAM

ErgoPad® SoftFOOT ORTHOSES

The ErgoPad Soft foot orthosis provides lasting cushioning for the feet and reduces excessive pressure in the long term. This is thanks to the viscoelasticity of the new material and its excellent shape retention. While it is worn, your feet will mold the orthosis into a soft bed. It will return to its original shape without any manipulation.

100

80

60

40

20

Foot

ort

hose

s th

ickn

ess

in %

200,000 700,000

Steps

ErgoPad Soft conventional soft foam foot orthosis

After 700,000 steps and with a load of 100 kg, the ErgoPad Soft foot orthosis still clearly offers better cushioning than a conventional soft cushioning orthosis. An adult takes an average of 4,000 steps a day.

ergopad_soft_anzeige_210x280_3_4c_en_150824.indd 1 24.08.2015 12:17:55

Documents

magazine - Century Orthotics & Medical Equipment LLC€¦ · life magazine 2015/25 CONTENTS A bright spot on the radar screen – p. 20 Reliable, durable, and effective – p. 28