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Issue 2013 | 1
magazine
international
Between illusion
and distortion
Injuries and
overloading of the foot
“This is the best thing
I’ve ever done”
“The strap is no wire rope,
but it works”
Shepherd Center, Atlanta:
Innovative use of MalleoLoc
LumboLoc Forte stabilizing orthosis
after intervertebral disk surgery Page 20
A clinical medical evaluation
of the new GenuTrain P3
Orthosis helps patients rehab
from Spinal Cord Injuries Page 28
Page 26
INSOLES
ErgoPad® weightﬂex
ONE
FITS
ALL.
Foot orthoses with the X factor.
Flexible synthetic foot orthoses with variable support.
The “weightflex-X” in the core of the synthetic foot orthosis offers variable support according
to individual foot conditions, therapeutic goals and body weight.
soft
flexible arch support
Motion is Life: www.bauerfeind.com
medium
semi-flexible arch support
weightflex ®
Technology
strong
rigid arch support
Editorial
Dear readers,
insight into the work of Wally Blase, athletic
coach of the Atlanta Hawks. He relies on the
GenuTrain knee support for the prevention
and rehabilitation of knee injuries.
And would you believe that the LumboTrain
back support is used in water sports? Brazil
ian athletes value its stabilizing effect
when windsurfing and stand up paddling, a
sport that is currently gaining in popularity
(page 6 f. & 27). Happy reading!
With warm regards,
Prof. Hans B. Bauerfeind
Pictures: Bauerfeind
ensured, for example, by two incorporated
The skeleton of an adult human comprises
pads and an individually adjustable correct
about 206 bones, with 26 in the foot alone.
ive strap.
Together with various joints, muscles,
tendons and ligaments, they form a real and
Our products help physicians and therapists
complete work of art in our feet.
to make sure that their treatment is success
Whether running, jumping, balancing, danc
ful and to support and possibly even acceler
ing, or even just standing and walking, we
ate the recovery process, thereby enhancing
demand top performance from our feet on
the patient’s quality of life. In this issue,
a daily basis, yet give them little attention
you can read more about the very differ
in return – at least until they start to cause
ent examples of how Bauerfeind products
problems. This is why our cover story shines
are used across the
the spotlight on
world. Dutch back
injuries and overload
“Our products help physicians
specialist Dr. Menno
ing of the foot. In our
and therapists to make sure that Iprenburg uses the
feature article, you
will be introduced to
their treatment is successful and LumboLoc Forte back
orthosis as a means
Associate Professor
to support and possibly even
of stabilization after
Dr. Martin Engelhardt,
accelerate the recovery process.” carrying out inter
Germany, and Prof.
vertebral disk surgery
Victor Valderrabano,
(see page 20). At the
Switzerland, two medi
Shepherd Center in Atlanta, one of America’s
cal experts who are very well versed in foot
leading rehabilitation clinics, patients with
problems and how to treat them. Find out
incomplete Spinal Cord Injuries benefit from
more on page 12.
using the MalleoLoc ankle orthosis. Find out
In this issue of the Bauerfeind life magazine, more on page 28.
Spectators at a fast-paced game can easily
we present the newly revised GenuTrain P3
vouch for the fact that basketball is an
(page 24 f.). P3 stands for “permanent
extremely demanding sport that causes
patella protection,” as the support protects
the kneecap during every movement. This is many injuries. life magazine offers you an
life magazine 2013/13
Contents
Focus
Imprint:
Bauerfeind life Magazine
International Edition
Printed 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, Christian Grimm
Publisher and editorial office:
mk publishing GmbH
Döllgaststraße 7–9
86199 Augsburg, Germany
Tel. +49(0)821-34457-0
[email protected]
www.mkpublishing.de
4
page 12
Between illusion and distortion
Aside from acute injuries, problems with
the feet often arise as a result of in
appropriate mechanical stress or over
loading, and diagnosing these problems
requires searching for clues. One of the
common and dreaded complications is
achillodynia. Treating foot problems,
which involves the use of conservative
functional methods, presents a challenge
in general. Associate Professor Dr. Martin
Engelhardt and Prof. Victor Valderrabano,
experts in this field, demonstrate ways of
tackling illusion and distortion.
Title image
The symbolic significance of
a footprint in the sand: we
pay very little attention to
our feet – yet we expect so
much from them.
Pictures: f1online/ableimages (Title); Stefan Durstewitz, Bauerfeind, Sherri Innis Photography, Giancarlo Botteri, Scott Griessel/Fotolia.com
Ankle injuries and achillodynia – p. 16
Contents
“The best thing I’ve ever done” – p. 20
Orthosis helps patients rehab from SCI – p. 28
Relief for the back – p. 27
Passion expressed through dance – p. 32
Moments page 6
Extraordinary support
Focus
page 12
12Injuries and overloading
of the foot
Between illusion and distortion
16Ankle injuries and achillodynia
“Chronic instability also affects
the Achilles tendon”
18MalleoTrain, MalleoTrain Plus,
MalleoLoc & CaligaLoc
Safety in functional therapy
Medical
page 19
19 VenoTrain impuls+
Deep action plus comfort
3Editorial
4Imprint
8News
35Service
20LumboLoc Forte stabilizing orthosis
after intervertebral disk surgery
I’ve ever done”
24 An observational study of the
use of the GenuTrain P3
Concentric muscle action
26A clinical medical evaluation
of the new GenuTrain P3
but it works”
27Unusual use of the LumboTrain
Relief for the back
28Shepherd Center, Atlanta
Innovative use of MalleoLoc helps
patients rehab from Spinal Cord
Injuries
30Foot orthosis care for plantar fasciitis
A significant reduction in
maximum pain
In Motion
page 32
32Argentine tango
Passion expressed through dance
22NBA insight
Player health and grunt work:
both part of the job
Moments
Extraordinary
support
Picture: Ronald Izoldi
It is certainly an extraordinary sight and not ex
actly a typical use: a windsurfer wearing an ortho
pedic back support while gliding over the waves.
Professional windsurfer Paulo dos Reis, 2012 Wind
surf Formula One Design South American and World
Champion and leader of the Formula Windsurfing
Class 2010, likes using the LumboTrain in the sea
as well. After all, the fast-paced watersport puts
huge pressure on the back and especially on the
lumbar spine. Several other windsurfers also rely
on the active support to stabilize the muscles in
the lumbar spine.
†
Read more on page 27.
6
Moments
NEWS
Eastern Europe
Bauerfeind Competence Center in Lublin
Under the watchful gaze of the local media, Ultra-Med sp. z o.o. opened a Bauerfeind Competence
Center in Galeria Zone, a shopping mall in Lublin, Poland, in January. Medical aids from all product
divisions are sold in this store which covers an area of over 100 square meters. To ensure products
fit perfectly, the sales personnel use a range of Bauerfeind measurement systems. What’s more,
the Competence Center is also able to modify individual foot orthoses – a grinding machine has
also been installed. Even if the level of reimbursement for patients in Poland is low, the self†
consciousness of the people is rising, and customers are looking for premium quality.
A popular interviewee at the opening: Mariusz Długosz, President of Ultra-Med.
Cannibal triathlon team, Mexico
Real MalleoTrain fans
No one can really remember which member of Mexico’s Cannibal
triathlon team was the first to become a MalleoTrain fan. One of
the athletes was given the ankle support and soon convinced his
teammates of the benefits of MalleoTrain. Take, for example, Gerardo
Franco, who first used the active support after injuring his ankle two
years ago. “It made the rehabilitation process much faster,” he says.
“The support provided stability and helped reduce pain. I just feel
much more secure when I wear it while I’m training.” Javier Rosas is
another member of the Cannibal team who relies on the ankle sup
port. The image here shows him at the finish line of the 2012 Iron
man competition in Hawaii. “I am convinced that I would not have
been able to prepare for my dream event without this ankle support
from Bauerfeind,” he insists. “The advice and support I received from
Ortoprotec (Bauerfeind’s local partner) was also fantastic.” In any
case, the MalleoTrain will help take Team Cannibal into the future. †
Javier Rosas at the finish line of the 2012 Ironman in Hawaii.
ErgoPad weightflex 2
The effective orthopedic ErgoPad weightflex 2 foot orthosis is particularly
flat and flexible, requires little preparatory work and is ideal for patients who
change their shoes regularly. As was the case with the first generation of
weightflex products, the centerpiece of the new foot orthosis is the synthetic
core with variable support. Depending on the individual foot conditions, the
therapeutic goal and body weight, it supports the feet with the flexibility levels
of soft, medium or strong. The new generation of weightflex products features
a core coated with high-quality polyurethane. The partial foam covering, based
on a unique technology for which a patent application has been filed, ensures
that the core remains visible and gives a contour on the foot and the shoe side
that requires very little preparatory work. The polyurethane foam coating has
long-lasting cushioning properties despite its reduced construction height
and it cushions sensitive areas of the foot. Slight sensorimotor spots in the PU
surface gently stimulate the musculature. This stabilizes the hindfoot and sup
ports the transverse arch. The core’s integrated hinges in the forefoot and heel
†
area allow the foot orthoses to adapt to different heel heights.
8
The internal “weightflex-X” offers variable support according
to individual foot conditions,
therapeutic goals and body
weight.
Pictures: Bauerfeind, Marathon picture: Image courtesy FinisherPix.com.
The foot orthosis for every shoe
NEWS
Compression Sock Training
Stability for the ankle during running
Insecurity in the ankle can soon spoil the fun of running. The
new Compression Sock Training has a noticeable stabilizing
effect on the ankle joint during light endurance training. To
do this, the stocking uses the same active principle of a tape
bandage. It is designed in a “figure of eight” formation, with
a “taping zone” wrapped around the instep and heel. The
strengthened knit gives the ankle joint more stability, supports
the ligaments and improves coordination. In the calf area, the
“muscle toning zone” exerts gentle compression to reduce tiring
muscle vibrations. The light, even pressure from the outside im
proves circulation in the tissue. The training stocking is made of
high-quality breathable material, which draws out moisture and
guarantees comfortable foot conditions. Integrated cushion
ing in the toe, forefoot and heel areas absorb impact, while also
protecting the feet from irritating rubbing and blistering. The
stocking is available in four different color combinations. For
†
more information, see www.bauerfeind.com/training. The Compression Sock Training is available in four attractive color combinations:
“Coal/Rivera,” “Silver/Rivera,” “Coal/Polar,” and “Silver/Polar.”
Bauerfeind Stores in Taiwan
East meets West
Bauerfeind Store in SHIN KONG MITSUKOSHI Kaohsiung Zuoying.
Bauerfeind continues to expand its international sales network:
in February 2012, the medical retailer WellCare Health Care
Supply opened the first Bauerfeind concept store in Kaohsiung,
the second biggest city in Taiwan. The Store is situated in a
big shopping mall, SHIN KONG MITSUKOSHI Kaohsiung Zuoying,
and offers its clients medical aids from all product divisions. A
second store opened in spring 2013 in the city of Tao Yuan.
The Taiwanese appreciate the high quality of the products which
Bauerfeind has been developing for more than 80 years. The
Bauerfeind commitment to sports and the growing number of
international design awards for Bauerfeind products contribute
†
to the good image of the brand.
Sales partner in Russia
Nikamed named “Start-up of the Year”
Exciting times at Nikamed in Moscow: from over 3,000 candidates, Bauerfeind’s
exclusive sales partner in Russia has been named start-up of the year for 2012.
Nikamed won over the judges from Russia’s biggest business magazine with its
Bauerfeind store, which opened in Moscow in April 2012. It features a “Motion
Laboratory” tailored specifically to athletes’ requirements. The “Motion Laboratory” is
located right on the popular “Prospekt Mira” shopping street. Customers are greeted
by products displayed over 120 square meters that help to prevent sports injuries and
provide support in the event of injury and during rehabilitation. The range includes
Bauerfeind’s supports and orthoses, medical compression stockings and orthopedic
†
foot orthoses. Analysis and measurement devices are also available.
Award ceremony held at the Ritz-Carlton hotel in Moscow: Sergey Shaitov, Anna Fedosova
and Igor Burchakov (from left to right) accepted the award on behalf of Nikamed.
News
Moscow Symposium on Sports Medicine and Rehabilitation
Intensive scientific exchange
Rehabilitation specialists, traumatologists and (sports) orthopedists from across Russia
gathered at the First Moscow State Medical University at the end of 2012 for a symposium
featuring a top-class list of participants.
The intense exchange between participants continued even during breaks in proceedings and at
fringe events.
The 150 or so attendees from all over the
country enjoyed an exciting program, which
was presented by the Chairman of the sym
posium’s steering committee and Deputy Di
rector of the “Priorova” Central Institute of
Traumatology and Orthopedics, Prof. Nikolai
Eskin. Prof. Markus Walther, Medical Director
and Consultant at the Schön Klinik’s Center
for Foot and Ankle Surgery in Munich, kicked
off this Bauerfeind-sponsored event with a
speech on the topic of “Treatment concepts
in foot and ankle problems.” Indication
appropriate orthotic care is usually an
integral part of this.
Dr. Homayun Gharavi, President of the
German Academy of Applied Sports Medicine
(GAASM), spoke about “the importance of
active and multifunctional braces in sports
rehabilitation.” In doing so, he compared a
simple tape bandage with treatment involv
ing the MalleoTrain ankle support.
While Ulf Harzmann, International Sales
Manager Eastern Europe at Bauerfeind,
presented the active principles of multi
functional orthoses, the Moscow-based
physicians at the symposium added their
own contributions based on their clinical
experiences of using Bauerfeind products.
Prof. Michael A. Eremushkin (MD and a
holder of numerous posts, including Profes
sor of Sports Medicine and Rehabilitation,
IOPS FMBA), talked about the use of orthoses
at various stages of outpatient treatment.
Oleg Nikolaevich Milenin (MD, PhD, Se
nior Researcher for the Russian Scientific
Research Institute of Physical Culture and
Sport, gave a presentation on the use of the
GenuTrain P3 knee support in the treatment
of patellofemoral pain syndrome.
At the accompanying exhibition, the sym
posium participants had the chance to find
out about Bauerfeind’s products and mea
surement technology, as well as the work car
ried out by local Bauerfeind partners Orteka
and Nikamed.
On several occasions during the event, the
hosts of the symposium explicitly empha
sized the importance of high-quality medical
aids for targeted patient care, citing this as
the reason why Bauerfeind products have
been so well-received in Russia. Based on
positive feedback from the participants, it
has been decided to hold the symposium on
†
an annual basis in future.
For improved contact with the floor
Bauerfeind’s MalleoTrain S ankle support is now also available with an open heel area: this
modification means that the MalleoTrain S open heel improves contact with the floor. The
support is thus particularly suitable for wearing during sports carried out in bare feet, such
as gymnastics, martial arts and dancing.
Both the MalleoTrain S and the MalleoTrain S open heel stabilize the foot thanks to the
3-level strap system. This protects against lateral twisting, improves proprioception during
movement and provides a feeling of security. They provide support for the foot without
†
restricting its mobility and are thus particularly suitable for use in sport.
MalleoTrain S open heel: particularly suitable for wearing
during sports carried out in bare feet.
10
Pictures: Bauerfeind, iStockphoto.com/erlucho, Corrina Mallon
MalleoTrain S open heel
Diary Dates
On course for expansion
Premiere: Chile’s first Bauerfeind store
Trade fairs and events
June 2013
June 5 – 8, 2013
14th EFORT Congress 2013 (European
Federation of National Associations
of Orthopaedics and Traumatology),
Istanbul, Turkey. Further information:
www.efort.org
June 6 – 8, 2013
Viña del Mar (meaning “Vineyard by the Sea”), is a city and commune on central Chile’s Pacific coast.
The Bauerfeind store in Viña del Mar is the second retail outlet in Latin America.
39th Congress of the European Society of
Lymphology, Valencia, Spain. Further
information: www.eurolymphology.org
June 27 – 30, 2013
Quality made in Germany is rated highly in Chile. This also applies in the area of medical
14th Annual Meeting of the European
aids. Chile’s first Bauerfeind store is now open in Viña del Mar, located in the greater
Venous Forum, Belgrade, Serbia. Further
Valparaíso area. It joins the store in São Paulo as the second retail outlet in Latin America.
information:
The store opened for business in February 2013, with the official opening planned for June
www.europeanvenousforum.org
2013. The focus is on high-quality orthopedic and phlebology products. “The economic
region surrounding Viña del Mar offers huge potential for the sale of supports, orthoses,
medical compression stockings and orthopedic foot orthoses,” says Alejandro Giletto,
September 2013
Bauerfeind’s International Sales Manager Latin America & Canada. Bauerfeind and its
local partner Artevascular are delighted to now be able to provide support to patients and
September 8 – 13, 2013
†
athletes in the company’s own dedicated store.
UIP XVII World Meeting
(Union Internationale de Phlébologie/
International Union of Phlebology),
Boston, USA. Further information:
Campaigns for vein health in Canada
www.uip2013.org
Leg health mission
September 16 – 20, 2013
Galien, Bauerfeind’s distribution partner
24th International Congress of Lymphology,
in Canada, has taken up the cause of vein
Rome, Italy. Further information:
health. Each year, over 100 events are held
www.lymphology2013.com
to inform various professional groups about
vein health and the provision of compression
September 19 – 21, 2013
stockings, some of them involving Galien
REHABILITACJA, Rehabilitation Fair,
alongside local partners. These “Healthy
Lodz, Poland. Further information:
Legs Days” often take place in clinics, but
http://rehabilitacja.interservis.pl
also at events such as the recent Greater
Edmonton Teachers’ Convention (see image).
Over 7,500 teachers were given the chance
November 2013
to find out how medical compression stock
ings work. After all, their job puts a lot of
November 20 – 23, 2013
pressure on the veins as a result of prolonged
MEDICA, International Trade Fair with
sitting and standing. Galien and its local
Congress, Düsseldorf, Germany. Further
partner Pulse Medical also carried out leg
information: www.medica.de
measurements directly on site. Many teach
ers took advantage of this opportunity and
even bought a pair of VenoTrain compression
December 2013
†
stockings at the event.
December 9 – 13, 2013
Exhibition booth at the Greater Edmonton
Teachers’ Convention.
Zdravookhraneniye’2013,
Moscow, Russia. Further information:
www.zdravo-expo.ru/en/
life
Picture: Fotolia/Kara
FoCus
12
FOCUS
Injuries and overloading of the foot
Between
illusion and
distortion
To sprint like Usain Bolt, or play football
like Lionel Messi – these are understandable dreams, but they are not without their hazards. After all, the foot, the
essential link in transforming desires
into reality, has its own rules to follow,
and these obey the laws of loading and
loading capacity. Aside from acute injuries, problems with the feet often arise
as a result of inappropriate mechanical
stress or overloading, and diagnosing
these problems requires searching for
clues. One of the common and dreaded
complications is achillodynia. Treating
foot problems, which involves the use
of conservative functional methods,
presents a challenge in general. Associate Professor Dr. Martin Engelhardt and
Prof. Victor Valderrabano, experts in this
field, demonstrate ways of tackling illu>>>
sion and distortion. life magazine 2013/113
FoCus
>>> Describing endurance sports as “mate
rial testing for the body” may sound some
what cynical, but that is essentially what
they are. The feet are subjected to enormous
loads. In long-distance running, for example,
they constantly have to absorb the repeated
impact of each tread, distribute the load
and convert the energy into new movement.
Given the forces at work on the muscles, liga
ments and bones of the foot, any athlete who
can withstand this material testing is already
demonstrating significant talent: jump
ing exerts a force of four to five times’ an
athlete’s body weight on the foot, while even
running can subject the foot to a load equal
to the body weight multiplied by three.
Any talented athlete who can endure this
torture on a lasting basis has solid found
ations to build on. Twenty-six bones make
up the basis of the foot, while an even
higher number of joints, capsules, tendons
14
and muscles form longitudinal and trans
versal arches. This structure is what makes
a healthy foot so flexible. The cushioning
properties of the body’s lowest extremity
are supported by fat pads. Normally, all the
absorbing and dynamic characteristics of
the foot architecture function with remark
ably few problems, but only up to a certain
limit, at which point the exposed position
of the foot makes it vulnerable, in spite of
its extraordinary flexibility: this can result
in problems associated with overloading –
including in the Achilles tendon.
Eighty kilometers per week
are enough
“The maximum load a foot can bear var
ies greatly depending on the individual,”
explains Associate Professor Dr. Martin
Engelhardt, Chief Orthopedic Physician
in the Orthopedics and Trauma and Hand
S urgery Clinic at Klinikum Osnabrück.
Being a specialist in sports medicine, Dr.
Engelhardt was the Chief Orthopedist for
the German Olympic team. It is clear what
he means by individual differences, but the
load-bearing limit of the foot is difficult to
determine in practice. What is the patient’s
level of fitness? What previous damage has
the foot suffered? Are there any anatomical
peculiarities? These questions have to be
answered not only with regard to determin
ing maximum loads, but also to obtain a
precise diagnosis of problems relating to
overloading. “The state of the patient’s
constitution is also important, and that’s
what I start with,” says the physician. “There
is the question of the starting level. Before I
started actively participating in sport, a low
load situation was enough to provoke an in
jury.” A dilemma of the modern age becomes
apparent here: we want to do s omething, but
Pictures: Stefan Durstewitz, doc-stock/3d4medical.com
Chief Physician and Associate Professor Dr. Martin Engelhardt is a triathlete himself.
FOCUS
we can’t, at least not straightaway. The situ
ation is different for elite athletes, however,
whose foot problems are caused by much
higher loading and load ranges. The sports
medicine specialist, who is a triathlete
himself, goes on to add that “Bones, tendons
and ligaments need time to adjust to higher
demands.” The lower blood circulation com
pared with muscle tissue and internal organs
is a factor here. Nevertheless, Dr. Engelhardt
is able to provide an approximate benchmark
value for loading: “Even elite athletes should
not exceed seventy to eighty kilometers of
running per week. Anything above this limit
is critical.”
Running involves accelerating the body
without the use of external sports equip
ment – an extremely strenuous activity. In
spite of this, acute injuries are rare in run
ning sports. Muscle strains or tears certainly
do occur, but the big issue when it comes
to running relates to problems associated
with overloading. It is estimated that fifty to
sixty percent of all sports injuries are caused
by this. However, regardless of all their indi
vidual characteristics, there is clear evidence
of “material damage” in certain sports.
The Achilles tendon often proves
problematic for runners
“Achilles tendon problems are common
among runners,” Dr. Engelhardt explains.
“They range from chronic tendinosis to
dorsal calcaneal spurs or bursitis, triggered
by Haglund’s deformity, and right through
to general inappropriate mechanical stress
situations.” He adds that plantar fasciitis,
which is caused by excessive strain on the
plantar fascia, is also quite common, and
that can lead to plantar calcaneal spurs.
In many cases, awkward heel-to-toe move
ments in the foot due to instabilities, pes
valgus or pes cavus also contribute toward
tendinopathies occurring in the Achilles
tendon. However, the physician is keen to
warn against generalizations: “Based on
movement analyses, for a long time it was
believed that problems were an inevitable
result of overpronation,” says Dr. Engelhardt,
“But that is not the case.” However, he does
not exclude the possibility of later problems
with these patients’ Achilles tendons or
skeletal systems. Yet he does believe there
are various treatment possibilities: “In the
case of unphysiological pressure distribution
loads on the foot, which we can record us
ing a pressure plate, we have a good option
available that involves the use of a special
orthosis, like those offered by Bauerfeind, to
make the load situation more bearable.”
An extremely thorough clinical examination
has to be carried out for all foot problems,
whether they are acute problems or symp
toms of overloading. In addition, an MRI
scan can detect edema formation on the
bone, which, according to Dr. Engelhardt, is
a clear diagnostic indication of overloading.
“In the types of sport in which I am involved,
such as long-distance running and triathlon,
as well as in other sports such as football,
we also have to bear stress fractures in mind
when dealing with problems to do with
overloading. These often occur in the meta
tarsal bone, and also in the heel bone and
the navicular bone.” Even stress fractures
can be treated conservatively. However, Dr.
Engelhardt thinks that an obvious field of
application for conservative early functional
therapy is treating tendinopathies of the
Achilles tendon, as well as ankle injuries.
Medical aids can stimulate
protective reflexes
“In principle, we have the entire range
of physiotherapy at our disposal to start
with. Then we can use supports such as the
AchilloTrain. A good use for this support
is to reduce swelling in areas around the
Achilles tendon that have been subjected
to excessive loads. The AchilloTrain can
effectively reduce swelling, and its proprio
ceptive effects are useful too.” In general,
Dr. Engelhardt thinks that it is important not
to disregard proprioception. “The proprio
ceptive protective reflex helps reduce the
risk of injury. This reflex can be trained
during therapy with the help of supports and
balance boards.” The orthopedic specialist
also regards heel cushions and orthoses as
suitable therapeutic aids: “Heel cushions
can be used for partial load relief, while the
relevant orthoses are ideal for optimizing
the positioning of the foot in the case of pes
valgus – bringing the heel toward a neutral
position.” Modern conservative therapy can
be used to help withstand “material testing
†
for the body.”
Reference: Valderrabano V., Engelhardt M., Küster H-H. (Ed.),
Fuß & Sprunggelenk und Sport (“Foot & ankle and sport”),
Deutscher Ärzte-Verlag 2009, 319–323.
The Achilles tendon is the
thickest and strongest tendon
in the human body. Men are
more commonly affected by
Achilles tendon problems
than women.
FoCus
Ankle injuries and achillodynia
“Chronic instability also affects
the Achilles tendon”
Specialists in sports medicine are finding themselves increasingly faced with problems in
volving one of the strongest tendons in the human body. Ankle injuries and misalignments
can make life difficult for the Achilles tendon in the long run, says Prof. Victor Valderrabano,
Chief Physician of the Orthopedic Clinic at Basel University Hospital. According to
Prof. Valderrabano, who is a foot and tendon specialist, a treatment package consisting
of physiotherapy and orthopedically effective orthoses and supports can provide the
key to dealing with pathologies concerning the hindfoot.
…and are these superseding knee problems
in medical practice?
Prof. Valderrabano: Certainly not. However,
it is true that particular successes regard
ing treatment for the knee, such as early
functional therapy, have contributed toward
a certain decline in the occurrence of knee
problems. Special preventive measures may
also play a role in this.
Can these successes be carried over to foot
treatment?
Prof. Valderrabano: The construction of the
foot is unique, and its structures consist of
extremely small components. If you make
even the slightest change to one compo
nent, this can have an impact on the inter
play of the entire structure. For example,
16
sprained ligaments in the hip or knee have
a less serious effect on the stability of the
joint in question than a sprained ligament
in the ankle. Here, even an elongation of
up to two millimeters is enough to cause
instability. An extra two millimeters quickly
increases the load on the ankle joint by 40
percent with every step, because the talus is
constantly subluxated. You can just imagine
what effect an extra three, four or five milli
meters would have.
the optimal line of tensile force in the Achil
les tendon to be thrown off balance – and
achillodynia occurs.
If you narrow down this pain to the Achilles
tendon – what is the most important factor
here?
Prof. Valderrabano: Most tendon problems
are already present, such as problems with
the Achilles tendon attachment or tendin
opathies, but overloading aggravates the
symptoms. Tendinopathies can also be
You and your Basel-based team see more than caused by all kinds of intrinsic and extrinsic
1,000 feet every year. Is instability a major
factors: idiopathic misalignments of the
problem?
hindfoot, inappropriate footwear, inadequate
Prof. Valderrabano: Not exclusively in rela training methods, imbalances, a lack of mus
tion to feet. In the ankle, however, instabil cular flexibility, aging. Haglund’s deformity
or bursitis in the tendon attachment area are
ity following supination trauma, such as a
also common causes of tendon problems.
fibular ligament rupture – the most com
mon sports injury of all – can very quickly
become chronic. This is particularly the case How long can the Achilles tendon withstand
when the instability is not diagnosed or is
these problems?
treated incorrectly – with disastrous con
Prof. Valderrabano: The Achilles tendon can
sequences. Achilles tendon diseases are one suffer for a long time. And then suddenly
consequence, and osteoarthritis is poten
the tendon structure is so altered and the
tially another (Valderrabano et al., see ref.). tendon is so necrotic that just one careless
movement is enough to tear it! Ruptures
are rarely trauma-related, and they rarely
Are Achilles tendon problems directly conoccur in clean, healthy Achilles tendons. If
nected with foot or ankle injuries?
this happens, it is usually in the context of
Prof. Valderrabano: Yes, in fact there are
numerous cases in which both the ankle and professional sport or an accident. In three
quarters of all cases, however, the Achilles
the Achilles tendon present or become a
major problem. The reason for this is that, in tendon ruptures in diseased conditions.
the case of chronic instability, the move
How can you restore the Achilles tendon to a
ment axes are not optimally positioned,
healthy state?
which results in a misalignment. Instability
in the lateral upper ankle joint, for example, Prof. Valderrabano: When it comes to
often leads to a varus angulation of the
therapy, it is always important to consider
hindfoot. In turn, this misalignment causes
the whole picture. If achillodynia occurs in
Picture: Stefan Durstewitz
The foot is receiving a lot of attention at the
moment. Why is this?
Prof. Valderrabano: There is certainly a
noticeable increase in the level of medi
cal interest in the foot, but this has less
to do with us, the physicians, than with
patient behavior. Sports that involve put
ting strain on the feet – and there’s more
than just a few of these – are very popular.
Untrained participants in sport very often
overestimate their abilities. They want to
emulate Roger Federer on the tennis court,
even though they have the physical fitness
and neuromuscular skills of an office worker.
As a result, accidents happen. Furthermore,
people who are immobile and often over
weight have to be taken into account. Every
excess kilo these people carry multiplies the
continuous load on the foot. Those are the
main factors...
FOCUS
A proven foot specialist: Prof. Victor Valderrabano, Chief Physician of the Orthopedic Clinic at Basel University Hospital.
connection with chronic instability, one form
of treatment alone is not generally sufficient.
I usually provide such patients with a treat
ment package. Depending on the indication,
this may contain physiotherapeutic mea
sures and shockwave therapy, for example.
Added to this are orthoses and a support for
stabilizing the ankle, such as the MalleoTrain
or – in the most severe cases – the MalleoLoc
orthosis. Bauerfeind’s professional heel re
lieves the sensitive area under the heel. This
kind of “conservative package solution” with
orthoses has a proven track record. Patients
†
benefit greatly from this.
Reference: Valderrabano V., Hintermann B., Horisberger M.,
Fung T.S., Ligamentous posttraumatic ankle osteoarthritis,
Am J Sports Med (2006), 34, 612–620.
FOCUS
MalleoTrain, MalleoTrain Plus, MalleoLoc & CaligaLoc
Safety in functional therapy
Gradual mobilization is the key to the success of functional ankle therapy.
Depending on the severity of the injury, supports and orthoses can provide the
stabilization and restriction of movement needed to help improve the healing
of damaged structures.
MalleoTrain
MalleoTrain Plus
MalleoLoc
CaligaLoc
Increasing stabilization
MalleoTrain – for muscular stabilization
of the ankle
The MalleoTrain active support is used to
treat a sore ankle joint. Indications are post
operative and posttraumatic irritation (e.g.
after sprains), joint effusions and swellings
resulting from osteoarthritis and arthritis,
tendomyopathies and ligamental weaknesses.
MalleoTrain Plus – increased stability
and effective protection against lateral
twisting
The MalleoTrain Plus support is ideal for
providing conservative treatment for simple
ligament injuries (grade I)*, for chronic
ankle instability or for supination prophylaxis
(particularly during sporting activities). It is
based on the same mechanism as a functional
tape bandage. The semi-elastic strap system,
which is wrapped around the foot in a figure
of eight, enhances the stabilizing effect
of the support and protects the ankle from
lateral twisting. The tensile force can be in
dividually adjusted and determines the slight
degree to which the foot’s plantar flexion is
restricted.
18
MalleoLoc – stability for the ankle bone
The MalleoLoc offers a higher degree of stabi
lization. It is used for conservative and, par
ticularly, early functional therapy for simple
to severe ligament injuries (grades I and II)
and for chronic ligament insufficiency. This
anatomically self-molding orthosis is fixed
into place with straps to reduce the forward
displacement of the talus. It stabilizes the
upper ankle joint, even without wearing
sturdy shoes. The foot is held in a slightly
pronated position to ensure active protec
tion against lateral twisting. This protection
is boosted by the neuromuscular stimulation
provided by the ProprioPoint plantar guide.
Dorsal extension and plantar flexion are
restricted, but without affecting the normal
heel-to-toe movement of the foot.
CaligaLoc – partial immobilization
The newly revised CaligaLoc provides postoperative protection after ligament suturing/
reconstruction and conservative therapy fol
lowing complex ligament injuries (grades II
and III). The anatomically contoured, softly
padded plastic splint is held securely on the
foot by velour straps. This secures the upper
and lower ankle joint. The CaligaLoc reduces
the forward displacement of the talus more
strongly than the MalleoLoc, and the active
range of movement is considerably more
restricted. The integrated pronation wedge
under the heel raises the hindfoot slightly
and takes the strain off the exterior liga
ments. The CaligaLoc orthosis offers a high
degree of stabilization, but enables gradu
ated freedom of movement, which is essential
for the successful regeneration of injured
ligament structures in the ankle joint. This is
where the main difference lies compared to
using a walker or a plaster cast. The Caliga
Loc can also be worn in ordinary, ready-made
shoes and is easier to use on an everyday
basis. Partial immobilization is effective for
approximately four to six weeks. After this
a higher degree of mobilization is required,
which can be provided by the MalleoLoc or
†
MalleoTrain Plus.
*Classification of ligament injuries in grades I-III in
accordance with the simple classification system used by
the American Medical Association.
The required degree of stabilization and restriction of movement are decisive when it comes to choosing a product.
MEDICAL
VenoTrain impuls+
Deep action plus comfort
When treating advanced vein problems, it is important that compression is constant
and reaches the deep venous system of the leg. VenoTrain impuls+ combines effective
therapy with exceptional wearing comfort – not least as a result of the high microfiber content.
The wearing comfort of medical compression
stockings (MCS) is not usually the focus of
long-term treatment of advanced and deep
vein problems. But, when treating serious
symptoms, the patient’s commitment to the
therapy is a particularly important success
factor; therapy often fails because of discom
fort when wearing compression stockings.
VenoTrain impuls+ is used for moderate to
serious vein problems and in the treatment
of the initial stages of lymphedema. The
round-knit MCS in compression classes 2 and
3 is made from a hard-wearing, short-stretch
material. Thanks to its special stretching
properties, it is easy to put on and ensures
a high pressure with a therapeutic effect
that spreads right down to the deep venous
system of the leg, even with low levels of
muscle movement. The constant high pres
sure lasts as long as the compression stock
ing is worn.
Using microfiber to treat even severe
conditions is a unique feature
For a combination of maximum comfort and
efficient treatment, VenoTrain impuls+ has a
microfiber content of over 40 percent. Silky
soft microfiber filaments make the stocking
particularly comfortable, easy to look after
and also easier to put on.
The high microfiber content of the knitted
fabric has an additional benefit: it optimizes
the repelling of moisture and the tempera
ture control, so that the stocking is comfort
able to wear on both hot and cold days.
VenoTrain impuls+ is available as a standard
or made-to-measure product in a range of
styles, in the colors caramel and black, as
†
well as with open or closed toe.
Lycra knitted core
Double-covered in
microfibers
Lycra compression
core
High-quality materials and technical expertise
in manufacturing are the cornerstone for medical
efficacy and the excellent wearing comfort of
VenoTrain compression stockings.
Wrapped in
polyamide
Clear advantages
Dr. Hans-Jürgen
Thomä, Head of
the Phlebology
Department,
Bauerfeind AG.
Why does Bauerfeind insist on a high microfiber
content in many of its compression stockings?
Microfiber has clear advantages over
traditional fibers in terms of temperature
control and repelling of moisture. With most
manufacturers, MCS with a high microfiber
content are reserved for mild vein condi
tions. However, we set ourselves the chal
lenge of making the advantages of microfiber
available even to patients with severe vein
problems or lymphedema.
What effects does the use of microfiber
have on the stretching properties of shortstretch stockings like VenoTrain impuls+?
None at all – the compression strength is
created almost entirely by the elastic core
of the “weft” (inserted thread). The microfiber mainly serves as a wrapping material
for the knitting yarn and therefore has no
effect on the compression effect of the
†
knitted fabric.
MEDICAL
LumboLoc Forte stabilizing orthosis after intervertebral disk surgery
I’ve ever done”
Dr. Menno Iprenburg is a specialist in TESSYS (Transforaminal Endoscopic Surgical System).
Dr. Menno Iprenburg has previously been
stationed in Tanzania and Zambia as well
as in many countries in Asia. As a young
physician, he went wherever he was needed.
Today the world comes to him. “Apart from
20
Australia – no idea why – we have already
had people from all known nations here.” By
here, the orthopedist means a spot around
20 miles south of Assen. In the middle of the
green expanse of North Holland, by a canal
that goes on for miles, lies Veenhuizen. A few
pretty, well-kept little houses; that’s all there
is. At the end of the village, however, a col
lection of brick buildings emerges. “It is the
remains of an old state jail, renovated a few
Pictures: Stefan Durstewitz, Bauerfeind
In the small Dutch village of Veenhuizen, Dr. Menno Iprenburg performs surgery on
his back patients. The results of his endoscopic operations sometimes make patients
weep for joy. To ensure that this joy lasts, he uses a stabilizing orthosis as part of
post-surgical treatment.
MEDICAL
clinic, and we order more once a week.” Usu
ally, the patient’s back muscles are still so
weak and tense from the long period of pain
before surgery that immediate support after
surgery is a great help. Since the recovering
patients can stand up and take their first
few steps straight away, the LumboLoc Forte
has a stabilizing effect from the beginning.
This creates confidence. “People like it,”
says the orthopedist. It provides security
for those who are nervous, and the orthosis
reminds overconfident patients to hold back
with certain movements. It should be worn
during the first night after surgery and in
the daytime for the following fourteen days.
During the third to fourth week, the orthosis
years ago,” the physician explains. In one of
the buildings, which used to be the quaran
tine station, the ‘Rugkliniek Veenhuizen’, also
known as ‘Spineclinic Iprenburg’, set up home
three years ago. Today, in a place previously
used to prevent infection, intervertebral disk
surgery is performed.
TESSYS uses a natural keyhole
Patients who are plagued by pain after an
intervertebral disk prolapse undergo a special
method of surgery with Dr. Iprenburg. “In
Holland, we call it PTED (Percutaneous Trans
foraminal Endoscopic Discectomy),” explains
the physician, “Internationally it is known as
TESSYS (Transforaminal Endoscopic Surgi
cal System).” This refers to an endoscopic
procedure for removing the intervertebral
disk prolapse with minimal surgical inter
vention. The special feature of TESSYS is that
the surgeon can reach through the inter
vertebral foramen, a “natural keyhole,” with
his smallest instruments to the location of
the prolapse, where he can remove the press
ing tissue and free the trapped nerve. The
patient lies on their side, the incision is only
a few millimeters long, and there are few side
effects as a result. Patients who come into
the Rugkliniek stooping usually leave it a
few hours later walking upright.
“I have my life back!”
“When you see the relief on the patient’s
face it warms your heart.” Dr. Iprenburg puts
on a video that shows himself and a patient
immediately after surgery. Uncertain, but
with astonishment in her eyes, the patient
walks two or three steps. She stops in her
tracks. Then she cries. “I have my life back”,
she says, her voice breaking. Speechless. It
is understandable, when faced with these
kinds of images, that even the experienced
physician concluded: “This is the best thing
I’ve ever done.” Yet TESSYS has nothing to
do with miracle cures à la Lourdes, as the
physician made it sound. The procedure is
internationally established and validated.
In studies it has been described as “signi
ficantly superior” in comparison with the
standard method (e.g. with the patient in a
prone position). Apparently, around 10,000
intervertebral disk operations have been
Security and comfort: LumboLoc Forte.
carried out to date across the world using
the TESSYS method. Of those, and there is
evidence to prove it, 1,700 had taken place
in Veenhuizen alone as of the start of 2013.
Surgery is only carried out in the Rugkliniek
when the pain has not reduced six to eight
weeks after the intervertebral disk prolapse.
Dr. Iprenburg learnt the double keyhole
procedure in Germany and practiced it as an
orthopedist in Assen, before founding his
own private clinic in Veenhuizen. “Although
the procedure is more expensive than the
standard method, it is cheaper from a macro
economic perspective, because patients can
start work again sooner,” said the physician.
“In studies it has been described
as ‘significantly superior’ in
comparison with the standard
method.”
(Dr. Menno Iprenburg)
can be taken off. However, it should still be
used when driving afterward, to enforce a
straight posture when sitting. The pressure
that the regenerating intervertebral disks
must withstand while sitting can gener
ally be very high. The physician continues
by saying that a study by the University of
Amsterdam shows that compression of the
lower spinal column can prevent relapses.
“I can see an additional important function
of the LumboLoc Forte in this regard,” he
adds. “Relapses are often caused by physio
therapy being carried out too soon and too
Orthoses as a security and a reminder
intensively. The surgical wound between the
vertebral disks needs six to eight weeks to
Without exception, all patients receive the
heal,” stresses the physician. Then life can
LumboLoc Forte stabilizing orthosis after
†
surgery to optimize the spinal column statics start afresh.
and relieve the lumbar spine. Dr. Iprenburg
had already had positive experiences of us
Reference: Kai Uwe Lewandrowski, Sang-Ho Lee, Menno
ing this treatment during his time in Assen. Iprenburg: Endoscopic Spinal Surgery, JP Medical Publishers,
February 2013.
“We always have six orthoses here in the
For further information about:
Dr. Menno Iprenburg please visit www.herniakliniek.nl.
See page 35 for contact information for Bauerfeind Benelux.
MEDICAL
National Basketball Association (NBA) insight
Player health and grunt work:
both part of the job
Wally Blase has been an athletic trainer in the NBA for 17 years. In 2005, he was even
named the Professional Athletic Trainer of the year by the Southeast Athletic Trainers
Association (SEATA). It’s a job he loves, but it’s not what most people envision.
life reveals what it really takes to be an athletic trainer in the NBA.
Wally Blase, athletic trainer for the At
lanta Hawks, looks relaxed and dapper in
his blue suit and matching tie as he sits
courtside during an NBA game. From all
outward appearances, one would envision
the 42-year-old to have a prestigious and
relatively cushy job. Well … at least the first
impression is accurate; it is a prestigious
job. Only 30, including Wally Blase, hold such
a position in the NBA. But the cushy part?
He would probably break into an uproarious
laugh.
Managing a staff of three – one full-time
assistant trainer, an intern and a strength
training coach – is something one envi
sions an athletic trainer to do. Scheduling
player training, taping ankles, addressing
post-game injuries, icing, and massages –
these are all part of what one envisions an
athletic trainer to do. But who would think
that an NBA athletic trainer would be the
pivot point of the team? The shoulders on
which all team logistics rest – logistics like
scheduling plane flights and buses, in-flight
and hotel food, room assignments, tips for
bellboys and skycaps, ball kids, equipment
and luggage transportation, training venues,
and more?
“You do a lot of grunt work so you need to
swallow your ego and be able to do every
thing. Once the team departs from their
home base, the athletic trainer becomes the
22
You can’t treat the personality,
you have to treat the athlete
“I was lucky when I got this job because I
had been with the Chicago Bulls, so I wasn’t
green around veteran players. You have to
be able to discern what’s best for the ath
lete, even if they have strong personalities.
They need to trust you and know you have
their best health in mind. You can’t treat the
personality, you have to treat the athlete,”
said Wally Blase. Prevention of injuries is of
A typical timetable
For life Wally Blase provides an insight into a typical timetable:
Typical Practice Day
Game Day
8:00
Arrive at arena
8:00 Arrive at arena
9:00
Athletes arrive
9:00 Athletes arrive
10:00 - 11:00
Morning practice
11:00 - 12:00
Visiting team practice
12:00
Go home
9:00 - 11:00Pre-work-out sessions,
player development
and tape up players
11:00 - 1:00Practice
1:00 - 3:00Post practice treatments
3:00
Go home
because they have to handle all the logis
tics and anticipate demand. For instance,
if they are scheduling practice at an out of
town arena, they have to look ahead and
work around that venue’s concert schedule,
including pre and post-concert events.
Being a wiz at training and logistics isn’t
the only attribute an athletic trainer needs.
Dealing with different cultures, person
alities, and a wide age-range amongst play
ers requires wisdom and experience.
3:00Return and prepare
for game
11:00 - 12:00Go home (or fly out
to another city)
primary importance to him. He accomplishes
this through preventative modality treat
ments such as ice, heat, flexibility train
ing, preventative exercises and strength
exercises. By finding out where an athlete is
weak or deficient, he puts together a plan to
strengthen those areas of deficiency.
With 82 regular season games and possibly
as many as 94, including preseason and
playoffs, injuries are bound to occur. Typical
injuries include patellar (knee) tendonitis
Pictures: Sherri Innis Photography, Bauerfeind
Wally Blase,
athletic trainer
for the Atlanta
Hawks.
traveling secretary, tour manager, and travel
coordinator, until the team arrives back
home. Many teams employ assistant trainers
to help with these duties, and even have
their equipment managers help with the
work load, but ultimately the head athletic
trainer is responsible and oversees the whole
operation,” said Wally Blase. Unlike athletic
trainers in other sports who have staff to
handle these logistics, athletic trainers in
the NBA need to be good administrators
MEDICAL
Wally Blase uses Bauerfeind’s GenuTrain knee support as prehab, to prevent patellar injuries, and rehab, to treat patellar injuries.
and ankle sprains. Wally Blase refers to
these types of injuries as “chronic overuse”
injuries, and uses Bauerfeind’s GenuTrain
knee support as prehab, to prevent patellar
injuries, and rehab, to treat patellar injuries.
He said the product is cropping up in a
majority of the other teams as well. “The
technology and material give the athlete
the right amount of compression, stability
and strength. The brace lasts longer and is
more comfortable than others on the market, time. In fact, he hopes to cap off his career
and the players say it relieves their symp
by someday moving up into management.
For now, however, he’s most content to work
toms when they are playing,” he said.
with players he considers to be “the best
“It’s an incredible job”
athletes in the world.”
Aside from working with the players, Blase’s “It’s an incredible job and I love the cama
raderie of the team,” he said. “Being able
involvement with his professional organiz
to help the players perform at their highest
ation is something he cherishes as well.
level is very rewarding; it’s a great chal
He calls the NBA athletic trainers “incred
ible,” and is very proud of their charitable
lenge, but also a lot of fun. Of course, I hate
foundation and scholarships, a philanthropic that I have to be away from my family so
endeavor that often goes unnoticed.
much, especially now that I have a child.
Wally Blase loves his association with the
I don’t like missing birthdays or events, but
NBA and the Hawks in particular and plans
I don’t punch a clock and the job is any
†
to stay with the franchise for a very long
thing but monotonous.”
Further information
The Bauerfeind GenuTrain is the original functional knee support.
Bauerfeind products in USA are distributed since
1985 by Bauerfeind USA, Inc. to retailers and medi
cal doctors. The International Sales Manager Ulrich
Reddig in Marietta is the main contact person. “Our
GenuTrain is a true classic that keeps improving:
The latest generation sits firmly on the knee with
out any compromises. It is highly effective in sen
sorimotor terms. The Omega pad delivers targeted
pain relief at the patella and front meniscus. These
are the reasons for a daily application of GenuTrain
by so many top athletes in the US professional
sports.” For further Information please contact
Bauerfeind USA (address, page 35).
Ulrich Reddig, International Sales Manager,
Bauerfeind.
MEDICAL
An observational study of the use of the GenuTrain P3
Concentric muscle action
Physiotherapist Alexander Verdonck during the observational study of the new GenuTrain P3.
Knee pain patient Magdalena Kremer.
The pain was almost unbearable. When going
down stairs, crouching, even when sitting
down. “It was a stabbing pain, directly
behind the kneecap,” says Magdalena Kramer,
describing her suffering. “Patellar chondro
pathy” – cartilage problems of the patella,
also known as anterior knee pain or patello
femoral pain syndrome – is more common in
women than in men, especially in teenagers
and young adults.
Potential causes of anterior knee pain are
malfunctions of the muscles and knee joint
ligaments. Thigh muscles that are weakened
on the inside can lead to pain, lateralization
New support for anterior knee pain
Magdalena Kremer could not bear it any
longer. Her consumption of painkillers
increased rapidly. “My physician told me that
my kneecap had moved out of the joint,”
reports Magdalena Kremer. The disability care
worker has suffered from pain since the age
of 18. She cannot think of a particular strain
that could have caused it. The pain came
and went. “In the end, I was considering
surgery,” said the 28-year-old. Until, that is,
her physician told her about an observational
study being organized at the Hellersen Sports
Clinic in Lüdenscheid. Under the medical
24
and the dreaded lateral subluxation or even
to luxation of the kneecap. Typical symptoms
of anterior knee pain are pain which occurs
after unusual straining of the knee or after
sitting down with sharply bent knees for long
periods of time. “In winter it even went to
sleep on me sometimes,” describes Magdalena
Kremer. “I would fall down suddenly.” Not a
good situation in her job as a disability care
worker. Her work on the farm at home also
suffered considerably as a result of the pain,
not to mention relaxing in the evenings. Her
knee was almost always swollen. It made no
difference if it was bent or extended.
Pictures: Stefan Durstewitz, Bauerfeind
If you want to get the symptoms of anterior knee pain under control, focusing on
the patella is essential. The variety of functional mechanisms in the new, redesigned
GenuTrain P3 active support push the kneecap towards the center – back to its natu
ral, painless position.
MEDICAL
supervision of Dr. Bernd Lasarzewski, a study
was to be carried out to determine whether a
new, redesigned knee support could get the
problems of anterior knee pain under control
(see also interview on p. 26). Physiothera
pist Alexander Verdonck was responsible for
the practical execution and evaluation of
every movement. For all-round protec
tion, various functional elements that are
integrated into the support work together.
A specially shaped pad, together with an
adjustable corrective strap, hold the patella
securely in a centered position and protect
it from lateral drifting. A patella cover also
lit y for
a
u
q
n
e
v
o
Pr
years !
0
2
n
a
h
t
more
“The patients have more stability.”
It is difficult to estimate how much the
corrective strap alone contributed to the
success of the observational study, due to
the interplay of all the functional ele
ments. One thing is certain: all probands
rated the new GenuTrain P3’s stabilizing
Indications for the
GenuTrain P3
• Patellofemoral pain syndrome
(chondropathy, chondromalacia)
• Patellar tip syndrome (patellar
tendonitis)
• Lateralization of the patella (dislo
cation tendency)
• High-riding patella (patella alta)
• Feeling of instability
• Anterior knee pain
• After lateral release surgery
Optimized fit, effective action: the new GenuTrain P3.
the observational study. Magdalena Kremer
did not take long to make up her mind. She
participated in the initial test with four
teen other probands. There were seven men
and eight women alltogether and a total of
eleven probands completed the study. The
age range was 17 to 46 years. The injured leg
was compared with the healthy leg. The tests
were carried out using the new GenuTrain P3
active support by Bauerfeind.
prevents medial tilting. A second, wedgeshaped pad on the outer thigh relaxes the
muscles and reduces the outward pull on the
patella. GenuTrain P3’s compressive knit ac
celerates the reabsorption of edema and effu
sions. The muscles that stabilize the joint are
activated and the feeling of stability returns.
All these characteristics made Dr. Lasarzewski
and Alexander Verdonck curious even before
the observational study. However, there was
one feature that particularly aroused their
Securing the kneecap
interest: the adjustable corrective strap.
P3 stands for “permanent patella protection”: “It makes it different from other supports,”
the GenuTrain P3 protects the kneecap d uring explains physiotherapist Alexander Verdonck.
and supporting effect on the knee joint
positively. After evaluating relevant knee
scores, a clear improvement in the pa
tients’ situations could also be objectively
documented. The outcome is clear for
Magdalena Kremer: “I feel almost no pain,”
she says, and her joy is audible. “Being able
to adjust the strap myself also gave me a
great feeling of security.” The orthopedist
Dr. Lasarzewski also has no doubts about
the support. “After an in-depth evalua
tion of all data, it can be said that there
is a measurable increase in stability for
†
patients using the GenuTrain P3.”
MEDICAL
A clinical medical evaluation of the GenuTrain P3 with its adjustable corrective strap
but it works”
In cases of patellar instability, luxation as the first manifestation must be avoided at all costs,
stresses Dr. Bernd Lasarzewski, Head Physician at the Knee, Shoulder and Elbow Surgery
Department at the Hellersen Sports Clinic in Lüdenscheid. The team physician for the national
women’s football team thinks a seemingly insignificant strap can help.
mented. Such as a certain function of the
GenuTrain P3, which played a significant role
in the observational study at our clinic ...
Anterior knee pain, patellar instability –
who does it affect?
Dr. Lasarzewski: Widespread anterior knee
pain can be caused by patellar instability. A
colleague once said that half of North Rhine
Westphalia is affected by this condition.
Anterior knee pain is certainly very common.
It mainly affects girls and young women.
You mean the corrective strap, that can be
adjusted ...
Dr. Lasarzewski: ... and by the patients
themselves – an inconspicuous strap, wound
around the patella in the right place. The
patella corrective strap is no wire rope, but
it works! Patients can adjust it to make it
tighter or looser, depending on the level of
instability or how it feels to them. In this
way, it can contribute to an improvement.
The pull of the corrective strap on the new
GenuTrain P3 can be adjusted.
the patella. One of the biggest challenges
is: how can I improve the situation by
strengthening the muscles? The central
muscle is the vastus medialis muscle, which
guides the patella by means of the tendon
attachments. Physiotherapy is required as
the first step. Suitable training in conjunc
With a tendency towards luxation?
Dr. Lasarzewski: There is a risk. Luxation
tion with supports that stabilize the patella
should be avoided at all costs, as bone struc can reduce the symptoms.
tures could become damaged too – a clear
Which characteristics must these supports
indication for surgery. In addition, after a
first luxation, the risk of a relapse is greatly have?
Dr. Lasarzewski: Focus on the patella is
increased.
important. Many supports have a ring to
center the kneecap. This does not have
How can you avoid luxation and what
enough effect however. To convince patients
can you do to treat anterior knee pain?
and orthopedists, wearing comfort and,
Dr. Lasarzewski: Conservative procedures
above all, effectiveness must be well docu
should always be tried first when treating
Dr. Bernd
Lasarzewski,
Hellersen Sports
Clinic, Lüdenscheid, Germany.
26
What do you think of the GenuTrain P3’s
other features, like the patella cover and the
muscle-relaxing pad?
Dr. Lasarzewski: You have to consider the
support as a whole. The combination of all
of the characteristics and functions should
be coherent. That includes the musclerelaxing pad. It can act as an antagonist
for the vastus medialis muscle by relaxing
its partner, the vastus lateralis muscle. This
can avoid a tipping or lateralization of the
patella.
What is your conclusion on the newly
redesigned GenuTrain P3?
Dr. Lasarzewski: Before the observational
study, I admit I was skeptical. However,
the medical-clinical evaluation surprised
me. The support can help to reduce pain
in cases of anterior knee pain and reduce
the risk of luxation of the kneecap. It is
especially important for young women,
who take great care with their appearance,
that their support is an effective treatment
and motivation aid – it helps them to help
†
themselves.
Pictures: mk, Bauerfeind, Fernando Pasqualin, Marilia Kim
What causes subluxation of the kneecap?
Dr. Lasarzewski: Subluxation occurs when
the patella can no longer move easily in its
natural trochlear groove. A valgus position
ing of the kneecap worsens the situation.
Instability is usually lateral. Overexertion
in sport can be a cause. Local overexertion
of the patellofemoral structures is often
caused by lateralization of the patella.
MEDICAL
Unusual use of the LumboTrain
Relief for the back
Whether it is windsurfing or stand up paddle surfing, many watersports put a lot of strain on
the back. Some top Brazilian athletes are therefore using an active support to provide relief.
good windsurfing session. “When using the
Lumbo Train I feel comfortable about doing
every move, but most of all, it makes me stand
in the right position and really relaxes my
lower back.“ Top athlete Paulo dos Reis uses
the LumboTrain for stand up paddling (SUP)
as well as windsurfing (see page 6/7). In this
sport, athletes stand on a type of surfboard
and use a single blade paddle to propel
themselves along – a strenuous activity for
the back. The back support gives the winner
of the SUP Summer Opening Race on Sylt in
2012 (Class 14.0) stability when participating
in this popular sport and a comfortable feel
†
ing in the lumbar spine area.
Note: Bauerfeind products are not designed for use in the
swimming pool or in the sea. However, they can be washed in the
washing machine at 30 degrees. Please use a liquid detergent
and remove the pads from the support before washing it.
Windsurfer Ricardo Bimba Santos loves to speed.
The Brazilian coast offers numerous hot
spots for windsurfers. It is no wonder that a
country that has optimum geographic condi
tions, plenty of enthusiasm for sport and
exercise, speed and beauty also produces
many windsurfers who have achieved world
wide success. One of these is Ricardo Bimba
Santos, twice Youth World Windsurfing Cham
pion, World Champion in 2007 and winner of
the Jaguar NeilPryde Racing Series in 2012.
“My greatest ambition is to win a medal
at the Olympic Games in Rio in 2016,” he
revealed. The Brazilian windsurfs five times
each week, as well as doing fitness training
and aerobics twice a week and pilates once
a week.
Better posture, less pain
“Windsurfing is a sport that places heavy
demands on your back, especially the lum
bar spine,” says Ricardo Bimba Santos. “I
have always had back problems, especially
between L4 and L5. However, thanks to
intensive back training, I have managed to
remain one of the world’s top windsurfers.”
He has worn the LumboTrain active support
for two years to support his back. He does
not wear it during competitions, but likes to
wear it afterward as well as frequently during
his everyday life. “When I’m wearing it my
back feels stronger, I have better posture
and the pain is reduced,” said the athlete.
He also passed on this experience to his best
friend Fernando.
“LumboTrain – a good tip!”
Fernando Samara Pasqualin (photo on page 5)
took up windsurfing in 1994, when he was
seven years old; seven years later he won the
Junior South American Championship. He
also trains five times a week. “As most of the
board sports do, windsurfing certainly exposes
your body to injuries due to constant back
torsion and impact. After windsurfing, I often
have severe back pain and was pleased to
receive the tip about the back support.” He
has been wearing the LumboTrain for a year,
Paulo dos Reis uses the LumboTrain for stand up
paddling (SUP) as well as windsurfing.
mainly for preventative purposes and after a
Medical
Shepherd Center, Atlanta
Innovative use of MalleoLoc
helps patients rehab
from Spinal Cord Injuries
Rehabilitation is essential for those with Spinal Cord Injuries (SCI); but it’s not just the spine
that needs proper support during recovery, it’s also the ankles. Joy A. Bruce (MSPT, PhD, NCS),
full-time research scientist and manager of the Spinal Cord Injury Laboratory (SCIL) at
Shepherd Center in Atlanta, discovered that MalleoLoc provided additional support to the
ankles and allowed patients to progress faster during the rehabilitative process. Her interview
with life provides details on this innovative approach.
The Shepherd Center
How did you learn about the stabilizing
orthosis?
Joy A. Bruce: When I was in college I
played soccer and rugby and had multiple
inversion sprains. Others on my team were
using the product so I tried it. It worked
well to help control foot and ankle position
ing and prevent roll-over sprains.
How did Shepherd Center discover
this product?
Joy A. Bruce: I brought in a MalleoLoc
I had, and then I had the department
purchase the devices. I wanted to be able
to train people at higher levels without
sacrificing mobility or safety.
Given that you had been using MalleoLoc
for patients with impairments to their feet
and ankles, when did you start using the
product as part of your treatment protocol
for patients with SCI?
Joy A. Bruce: The first patient I used it with
was a young man with a very incomplete
SCI. He wanted to return to running and
playing tennis. He had lingering strength
and proprioceptive impairments. He was at
high risk of inversion sprains. I used the
device with him during training including
running and plyometrics. It was very suc
cessful in protecting him and positioning
him during these activities.
28
The Shepherd Center is a free-standing
rehabilitation hospital that serves
patients with Spinal Cord Injury (SCI),
Acquired Brain Injury (ABI), Multiple
Sclerosis (MS), and other neurological
diseases/disorders.
The center treats approximately 1,727
patients a year (382 inpatients, 1,345
outpatients) with an average stay in the
facility of 49 days. The mean age of their
patients is 37.6 years; 83 percent are
male, and 17 percent are female.
For further information please visit:
www.shepherd.org
How has using MalleoLoc affected SCI patient
recovery?
Joy A. Bruce: These patients are particularly
susceptible to catching their toes or rolling
into inversion. The MalleoLoc allows us to
minimally limit the degrees of freedom at
the ankle while still providing biomechanical
support. Providing flexible control of the
ankle enables us to focus on overall move
ment patterns and control of proximal
segments while advancing activity. It also
allows us to challenge our patients more
readily to perform faster walking/running on
varied surfaces and under varied conditions.
How often is the stabilizing orthosis
used as part of the treatment protocol?
Joy A. Bruce: Stabilizing orthoses are used
consistently with patients who are working
on high-level locomotor and balance activi
ties. These devices are used multiple times
per week by multiple patients.
How does MalleoLoc compare to other
devices on the market?
Joy A. Bruce: The advantage over other
lace-up devices is weight, malleability,
cleanability, and ease of use with the straps.
The device wasn’t cost-prohibitive, didn’t
require a prescription, and could be modi
fied/customized using a heat gun.
What kind of modifications do you make?
Joy A. Bruce: Portions of the MalleoLoc are
made of molded plastic. If we find a place
that rubs the patient, we heat the plastic
and mold it to fit their skeleton. It’s rare
Pictures: Sherri Innis Photography
How long has Shepherd Center been
using MalleoLoc?
Joy A. Bruce: I introduced it in outpatient
treatment in 2000.
Medical
that we have to do this, but it’s very easy
to do.
How have your patients reacted to wearing
MalleoLoc?
Joy A. Bruce: Patients love that the devices
are light weight, low profile, easily fit into
shoes they already own, are simple to use,
durable, washable, and not too expensive. One
of the reasons I use this device is that a lot
of folks with SCI have involvement in their
upper body and hands as well. They find it
Joy A. Bruce,
manager of
the Spinal Cord
Injury Laboratory
(SCIL).
difficult to use braces with laces, but a simple
strapping system works really well. It provides
minimal bracing while allowing independence
and maximum functioning.
Is the usage of ankle braces for SCI injury something commonly used by most rehab centers, or
is this something unique to Shepherd Center?
Joy A. Bruce: Bracing has always been a part
of SCI rehab, but using devices that were in
troduced for athletics is a novel concept that
has spread quite a bit recently.
Joy A. Bruce discovered
that MalleoLoc provided
additional support to the
ankles and allowed patients
to progress faster during
the rehabilitative process.
Do you recommend MalleoLoc after
a patient has been discharged?
Joy A. Bruce: We often recommend these
devices to our patients who are being dis
charged into the community or who will be
walking independently while still exhibiting
some strength or sensory deficits that put
them at risk of inversion sprains or mechani
cal issues. Combined with in-shoe orthoses,
the MalleoLocs may provide a biomechanically
stable platform that allows some patients with
neurological issues to push their functional
†
limits in a safe manner.
For further information please contact:
Bauerfeind USA (address, page 35).
MEDICAL
Foot orthosis care for plantar fasciitis
A significant reduction in
maximum pain
Use of a foot orthosis is part of the standard treatment for heel pain and talalgia on
the sole of the foot. Prof. Markus Walther, Medical Director and Head Physician at
the Center for Foot and Ankle Surgery at the Schön Klinik München Harlaching, led a
study* to investigate different foot orthosis concepts, including the professional heel
by Bauerfeind.
Professor Walther, what motivated you to
carry out this study?
Prof. Walther: Heel pain and talalgia is a
fairly major epidemiological problem. Among
50-60 year olds alone, we can assume that
almost half will experience heel pain once a
year – usually because of plantar fasciitis.
In this disorder, the band of connective tis
Prof. Markus
Walther, Medical
Director and Head
Physician, Schön
Klinik München
Harlaching.
was only possible with custom-made foot
orthoses. We now wanted to investigate the
extent to which industrially pre-fabricated
foot orthoses could achieve a similar effect.
How did you do this?
Prof. Walther: In our randomized pro
spective study we compared a thin cushion
foot orthosis made from PU foam available
online (A), and two branded products and
the professional heel by Bauerfeind (C). The
professional heel is a multi-layer, cushioned
orthotic blank with a self-supporting syn
thetic core and a central heel cut-out with
a plantar fan design. 30 patients from an
orthopedic traumatology practice in Middle
Microfiber top cover
30
Pictures: Conny Kurz, Bauerfeind
Cushion layer with
sue in the sole of the foot becomes inflamed
polyurethane cushion
at the site where the plantar fascia attaches
to the bone. This is because the fascia loses
elasticity over the course of a person’s life.
Pad
It is easiest to picture it like this: you swap
an elastic bungee rope for a steel rope and
jump. When the rope is fully unwound, there
is a loud bang, because the tension is built
Synthetic core
up suddenly and there is no soft cushioning.
In affected patients, there is a massive strain
on the attachment site of the fascia to the
Durable
bone and it begins to tear away or become
polyurethane cushion
inflamed.
Pressure on this structure can be relieved by
using a foot orthosis. Simple foot orthosis
Bottom coating
concepts only aim to cushion the hindfoot
to reduce the maximum pressure during the
heel strike. However, with a hindfoot frame
and medial support, combined with a spe
cially designed recess for the affected struc
tures, supplementary mechanical pressure
relief can be achieved. For a long time, this
The professional heel’s particular characteristic is its construction and its special orthotic core.
MEDICAL
Franconia took part in the study. The pa
tients’ average age was slightly over 50. All
patients had a diagnosis of plantar fasciitis
with no other form of foot disease. In addi
tion, the probands had not yet undergone
any treatment. During the 3-week period
of observation, use of a foot orthosis was
the only treatment method used. The foot
orthoses were allocated at random.
What was the main focus of the study?
Prof. Walther: The pain parameter, because
this determines the affected patients’ qual
ity of life.
The study documented the development
of maximum pain, the average pain level
during the treatment period, the daily pain
duration and the length of time that the
foot orthoses were worn. The daily walking
activity and the subjective wearing comfort
were also recorded. The patients used the
visual analog scale (VAS) for all subjective
assessments.
What were the most important results?
Prof. Walther: During the observation peri
od, maximum pain was significantly reduced
in Group B (patients wearing the soft foam
foot orthosis) and in Group C (professional
heel). This reduction in pain was detectable
for Group B after two weeks, but after only
one week for Group C. We had not expected
such a clear difference.
How do you explain the professional heel’s
rapid pain relief?
Prof. Walther: The firm core means that
patients can hold their hindfoot in a better
posture. This reduces the peak loads on the
attachment site between the fascia and the
bone.
The average pain level was also significantly
reduced in Group B and Group C. As expect
ed, the difference between foot orthoses B
and C was not as marked here, because it
is the cushioning that plays an important
role here, and this was equally good in both
branded products.
The two branded products were also rated
much higher than the (Internet) foot ortho
sis A in the subjective assessment of wear
ing comfort. The professional heel was rated
slightly higher than foot orthosis B.
Overall, the Internet foot orthosis did not
show any statistically significant effect
on pain intensity and duration of pain in
the wearing test, and for some patients it
was also extremely tattered after the three
weeks.
One more thing is important to me: use of
a foot orthosis, even when it is as good as
this one, should never be the only element
of treatment. It is also important to work on
the elasticity of the fascia with stretching
†
exercises as well.
* Prof. Walther presented the study in a lecture at the
ORTHOPÄDIE + REHA-TECHNIK 2012 world congress and trade
show in Leipzig.
Internet orthosis (A)
soft foam foot orthosis (B)
professional heel (C)
start
1st week
2nd week
3rd week
With the professional
heel, there was a significant reduction in maximum pain. Pain relief was
achieved much earlier
than with the other foot
orthoses.
Maximum pain [VAS] (0 = no pain, 100 = maximum pain)
professional heel
Relieves pressure with every step
The orthotic core of the professional heel
is specially designed to leave MTP joints I
and V free, thus keeping pressure on these
joints to a minimum. Further pressure
relief for the foot is achieved by lowering
the base of the fifth metatarsal bone. The
special shape of the hole notches and the
intelligent fan design of the synthetic orthotic core ensure that
the professional heel does not
form any uncomfortable edges.
In addition, pressure relief
is achieved for a larger
area.
The self-supporting
synthetic core supports
the arch of the foot and relieves
pressure on the heel area.
In Motion
Argentine tango
Passion expressed
through dance
Aggressive and emotional, comforting and yet full of
longing, melancholy and expressive – all of these words
can be used to describe the tango. The dance that
originated in the nightclubs of Buenos Aires is now
universally popular. Inscribed onto the UNESCO List of
Intangible Cultural Heritage in September 2009, the
tango still combines emotion and spirit, as well as vitality
and enjoyment of movement.
Picture: Shutterstock.com/Jose AS Reyes
With purposeful strides, heads touching and upper bodies perfectly in line,
the couples glide and revolve skillfully around the floor. A leg hook in the
air, a pause, a rapid rotation, a gentle touch.
>>>
32
In Motion
In Motion
A
Tango festival in Buenos Aires in 2012.
Tango demonstration in La Boca, the most famous of the 48 districts in Buenos Aires.
>>> Elegance, melancholy, eroticism – this
dance expresses them all: the Argentine
tango involves a breathtaking variety of
figures, tremendous versatility and lots of
feeling. When watching couples dancing the
tango, you can see their radiance – that is
the belief of Colombian psychologist Cynthia
Quiroga Murcia, who has found that dancing
the tango leads to a reduction in the stress
hormone cortisol while increased quanti
ties of the sex hormone testosterone course
through the dancers’ bodies. Tango is good
for the health and triggers all sorts of plea
surable feelings!
The tango was born in Buenos Aires and
Montevideo between 1850 and 1880. At that
time, the capitals of Argentina and Uruguay
were both desirable places to live and the
final stop for many European immigrants in
search of a better life. In the cafés and clubs
of the working-class neighborhoods, they
sought a distraction from the daily grind of
slaughterhouses, tanneries and warehouses,
from unemployment, crime and their primi
tive lives. Their songs express despair, wist
fulness and longing. “Tango is a sad thought
that can be danced,” explains E nrique Santos
Discépolo (1901–1951), one of the most
famous tango composers. The dance steps
are accompanied by African Candombe
drums. The compositions mix elements of
Spanish flamenco, Italian opera and the
Milonga songs of the Argentine gauchos. The
bandoneón, a handheld instrument similar to
the accordion that was brought to Argentina
in 1870 by German immigrants, became the
characteristic instrument of the tango thanks
to its melancholy tone.
A selection of the tango festivals being held in 2013
• Tangoamadeus in Vienna, May 8 to 12,
www.tangoamadeus.com
• 13th International Tango Festival in Berlin,
May 17 to 20, www.tangofestivalberlin.de
• 9th Toronto Tango Festival, June 6 to 9,
www.torontotangofestival.com
• Tangocamp Festival in Tylösand, Sweden,
June 14 to 17, www.tangocamp.se
• 10th International Istanbul Tango
Festival, July 3 to 7,
34
www.istanbultangofestival.com
• Seinäjoki Tango Festival, Finland,
July 10 to 14, www.tangomarkkinat.fi
• Tango Buenos Aires Festival and World
Cup, August 13 to 27,
www.tangobuenosaires.gob.ar
• 4th Innsbruck Tango Festival, October 24
to 27, www.tangofestivalinnsbruck.at
Other dates are also available at:
https://tango.info/festivals
A vibrant tango scene
The bandoneón has given the Argentine
tango new popularity. There is now a vibrant
tango scene with numerous events held
around the world: every year, tango enthus
iasts gather in Seinäjoki in the first week of
July (see the infobox). Over 150,000 people
can now be found dancing on the streets of
the small Finnish town during the course of
this week. “Tango is our national music,” says
Finnish filmmaker Aki Kaurismäki, comment
ing on the significance of the genre, which
has inspired many of the country’s composers
and performers.
Although the Argentine tango can be per
formed with any desired combination of rota
tions, steps and figures, the sequence of steps
in the standard tango, as has been taught as
part of the World Dance Program since 1963,
is significantly more regimented. Where a
continuous flow of dance in harmony with
the music is typical of the Argentine tango,
abrupt changes of pace and movement domi
nate in standard tango – long, prowling steps
are followed by small, jagged, staccato move
ments. The standard tango is nowhere near as
passionate and tender as the Argentine tango
– a conscious change implemented by British
choreographers to suit social conventions. †
Pictures: Tango BA Festival y Mundial 2012, Corbis/Jose Fuste Raga
Tango as national music
From the beginning of the 20th century, the
tango became a cult dance in Europe and
was acceptable in all sections of society
after upper-class young Argentinians made it
popular in the salons and bars of Paris. This
marked the start of the tango’s golden age,
which lasted until the mid-1950s.
Service
Bauerfeind worldwide
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Phone +49 (0) 36628-66-10 00
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Adresses:
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Phone +39 039 6 08 12 52
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ul. Postepu 15C
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Singapore
Bauerfeind Singapore Pte Ltd.
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#01-21 Singapore 210041
Phone +65 6396 3497
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Slovenia
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Spain
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Phone +34 96 385 66 33
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Bauerfeind AG
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Phone +41 (0) 56 485 82 42
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United Arab Emirates
Bauerfeind Middle East FZ-LLC
Dubai Healthcare City
P.O. Box 505116, UAE-Dubai
Phone +971 4 4335 685
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+971 4 4370 344
[email protected]
United Kingdom
Bauerfeind UK
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Phone +44 (0) 121 446 53 53
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USA
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Suite 700
Marietta, GA 30066
Phone 1 800 423 34 05
Phone (770) 429 83 30
Fax
(770) 429 84 77
[email protected]
ORTHOSES
Sof Tec® Genu
The intelligent knee orthosis.
Study demonstrates that knee stability increases
signiﬁcantly by wearing SofTec Genu
(reference: Int J Sports Med 2012; 33: 934–939)
A reprint of the study “Effect of Brace Design on
Patients with ACL-Ruptures” from Strutzenberger G.
et al. can be obtained at [email protected].
Motion is Life: www.bauerfeind.com

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