magazinecenturyorthotics.com/wp-content/uploads/2016/03/... · life magazine 2014/15 CONTENTS compensation 3 Editorial 4 Imprint Consolidated expertise 6 Moments 8 News 39 Arlberg

Issue 2014 | 1

internationalmagazine

“The system helps us stand out on the market”Perfectly fitting compression stock-ings with Bodytronic 600 Page 32

The foot – both a tool and a means of compensation Strains during sporting activities and treatment with foot orthoses Page 22

Olympic Winter Games 2014 in SochiAthletes are very grateful for Bauerfeind support Page 36

To shoulder the world

Protection to suit the indication

page 12

S U P P O R T S A N D O R T H O S E S

Motion is Life: www.bauerfeind.com

The shoulder in focus

OmoLoc®Stabilizing orthosis for immobilization of the shoulder joint

SecuTec® OmoFunctional stabilizing orthosis for immobilization of the shoulder joint

OmoTrain®Active support for early functional treatment of the shoulder joint

Schulterprodukte_Anzeige_4c_210x280+3_EN_140320.indd 1 20.03.2014 09:21:54

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EDITORIAL

You don’t have to have the weight of the world on your shoulders to develop shoulder problems. The structure of the shoulder joint makes it very susceptible to complex com-plaints. This is why we are currently focusing on the topic of shoulder problems and how to treat them in this magazine. From page 12 onward, you can read about the experiences physicians have had with our new shoulder products, SecuTec Omo and OmoLoc.

This issue of Bauerfeind life international will also take you on a world tour: find out

more about the use of PRP (platelet-rich plasma), a biostimulation method that uses autologous blood and the body’s own plasma, by a physician in the USA (p. 18). You can also discover how patellar instabilities are treated in an interview with a physician from England (p. 20), travel to this year’s football World Cup host nation Brazil with Bauerfeind life (p. 6), learn more about the use of Bauerfeind’s Bodytronic 600 mea-surement system in Switzerland (p. 32) and much more.

International events gather the whole world together in one small place – and the 22nd Winter Olympic Games in the Russian city of Sochi was no excep-tion. Bauerfeind AG served as a partner of an Olympic organizing committee for the third time and formed part of the central medi-cal care system at the Games. In 2014 we treated more athletes from various different countries than ever. Our orthotists on site received a great deal of gratitude from the athletes and recognition from the physicians and physiotherapists. This makes us all very proud, and rightly so. You can find out more

about our involvement in the Sochi Olympics from page 36 onward.

Having a good product available is one thing, but it can only be used to its full effect if an experienced orthotist explains how it should be applied and adapts it as required. Our Olympic experience once again underlined our quality concept: if you combine highly

effective products with orthotic ex-pertise, the result is top-quality care. And what applies to elite athletes goes for any other sports enthusi-

ast or patient too: if the manufacturer, the physician and the orthotist all work to the same high standard of medical care, together we can achieve maximum success in helping to restore people’s mobility and make them feel good again.

With warm regards,

Prof. Hans B. Bauerfeind

Dear Readers,

“If you combine highly effective products with orthotic expertise, the result is top-quality care.”

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CONTENTS

Shoulder therapyThe shape, method of control , and degree of freedom of the shoulder are fundamen-tally different from those of other major joints of the body, because the shoulder is mainly made up of soft tissue. How-ever, structures controlled by muscles are prone to complex complaints. A new stabilizing orthosis can help with modern shoulder treatment.

Focus page 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, 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

Shoulder therapy: Protection to suit the indication – p. 12

The full-size statue of Atlas shown in this photograph can be admired in its position on the top of Linderhof Palace in Bavaria, Germany.

Title image


CONTENTS

3 Editorial

4 Imprint

6 Moments

8 News

39 Service

Sporting activities and foot orthoses – p. 22

Measurement system Bodytronic 600 – p. 32 2014 Winter Olympics – p. 36

A one-stop shop for quality – p. 30

Focus page 12

12 Protection to suit the indication The weight of the world is on your shoulders

15 SecuTec Omo and OmoLoc For strong shoulders

16 Experiences of using the SecuTec Omo A look over the shoulder

Medical page 18

18 Orthohealing Center, Los Angeles Innovative, non-surgical orthopedic treatments accelerate recovery

20 Treating patella instability “The importance of getting it right from the beginning”

22 Strains during sporting activities and treatment with foot orthoses The foot – both a tool and a means of compensation

23 New ErgoPad foot orthoses for sport A powerful trio

24 Fisio 1 Fisioterapia, Rio de Janeiro A holistic approach

26 Compression stocking compliance Life insurance for legs

28 Treatment of lymphedema “There is still a lot of work to do”

30 FysioDanmark A one-stop shop for quality

35 Bauerfeind’s support for research International scientists honored

Trade & Technics page 32

32 Bodytronic 600 measurement system “The system helps us stand out on the market”

In Motion page 36

36 2014 Winter Olympics Bauerfeind’s service in high demand

37 First International Sports Medicine Conference Professional diversity

38 Orthopedic technology in Sochi Consolidated expertise

38 Bauerfeind Austria Theory and practice in the Arlberg region


MOMENTS

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MOMENTS

Football is practically a religion in Brazil. It is therefore no wonder that this South American country, whose men’s national team has won the World Cup five times (1958, 1962, 1970, 1994 and 2002), claims to be the most successful footballing nation in the world. At the forthcoming World Cup, which is due to take place from June 12 to July 13, 2014, spectators in the stadia and in front of TV screens can look forward to seeing not only some (hopefully) top-quality games, but also colorful , vibrant crowds of local fans – a familiar sight already from the 2010 World Cup in South Africa. The team from the Bauerfeind store in São Paulo is also gripped by World Cup fever and is eagerly anticipating the chance to provide sports enthusiasts from all over the world with Bauerfeind products. †

Football fever grips Brazil


NEWS

Zambrano Hellion Hospital , MexicoPatients benefit from Bauerfeind productsThe Zambrano Hellion Hospital is one of the most important and best-known hospitals, not only in the city of Monterrey, but throughout Mexico. 17 traumatologists and orthopedic surgeons with a wide range of specialties work in its Institute of Orthopedics and Traumatology. The physicians also treat a number of elite athletes, including some of Mexico’s Olympic team. The Institute has a close relationship with the Ignacio A. Santos School of Medicine, the medical school division of the Monterrey Institute of Technology and Higher Education (ITESM) in Monterrey, which is the most reputable private higher education system in Mexico. It also maintains a relation-ship with the Autonomous University of Nuevo León (UANL), the second biggest public university in Mexico. Since the start of the year, Endocat (Bauerfeind’s local partner) has been supplying the Institute of Orthopedics and Traumatol-ogy with Bauerfeind products. The aim is to support the reha-bilitation of patients and athletes, to relieve pain, and to enable early functional training. Currently, over 20 Bauerfeind products are already available from a sales center in the Institute, from compression stockings to supports and orthoses. † Zambrano Hellion Hospital in Monterrey, Mexico.

Above: Spinova Stabi Classic stabilizes and relieves the lumbar spine using the integrated corset stays.

Below: Spinova Support Plus Classic uses an anatomically contoured back pad to support the lumbar lordosis.

New lumbar orthoses with a classic strap systemThe name says it all: the Spinova Classic combines modern features with tried-and-tested design for stabilizing the lumbar spine. Each version of this product is based on the innovative support made from an elastic mesh material with integrated corset stays. The support lightly wraps around the center of the body and compresses the abdomen. Force is applied by means of a classic strap system, aided by Velcro straps. The new range includes four orthoses with different functional elements. Spinova Stabi Classic stabilizes and relieves the lum-bar spine using the integrated corset stays. The Spinova Unload Classic version reduces lordosis in the lumbar spine with a bridging frame, while the Spinova Support Plus Classic instead uses an anatomically contoured back pad to support the lumbar lordosis. Spinova Immo Plus Classic provides the greatest relief for the lumbar spine. It immobilizes the lumbar vertebra using a shell around the torso. The bridging frame, the pads or the shell can each be removed during the mobilization phase. For more information, see www.bauerfeind.com. †

Spinova Classic

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NEWS

Modern support stockings for preventive careHigh quality, an attractive look and maximum comfort – these characteristics are synony-mous with the VenoTrain brand and its range of medical compression stockings. With the new “VenoTrain act” line, this range now also includes over-the-counter support stock-ings for preventive care. Customers can choose between three different material quali-ties. Designed for health-conscious women, the “Sheer elegance” version is available as knee-high or thigh-high stockings or as pantyhose, with a fashionable 70 or 140 denier sheer finish and in seven sophisticated colors. The “Cotton active” version is a classic unisex knee-high stocking with a high cotton content and a distinctive ribbed look. This 280 denier stocking offers excellent support. The third version, “Microfiber active,” con-tains a high proportion of microfibers. This attractive knee-high stocking, which is suit-able for both men and women, offers a comfort feature that is also characteristic of many other VenoTrain products: even with its highly supportive 280 denier design, the stocking is exceptionally soft and gentle on the skin. In warmer weather, the breathable material feels pleasantly light and soothing.Recommended for people whose work involves spend-ing time on their feet or long journeys, VenoTrain act is presented by medical retailers as an attractive lifestyle product with modern, fresh-looking packaging. †

VenoTrain act

ManuTrain

For increased flexibility when gripping, the position of the ManuTrain’s seam has been changed. The wrist support’s joining seam is now on the bottom at the side and runs toward the ulna, along the volar hand splint. This means that the knitted fabric adapts more easily to the space between the thumb and the index finger, and the sensitive area is protected from irritation during gripping movements. The new seam position allows more freedom of movement and therefore more dexterity in everyday life. This makes the support more convenient to wear on a daily basis, which is a definite comfort in the treatment of osteoarthritis and irritation, and following injuries, because the ManuTrain’s circular compression stabilizes the painful wrist and protects it from overloading. †

Wrist support now features new seam position

Feel the differenceThe VenoTrain business knee-high stocking is now available in two ver-sions, Men and Women, with different foot lengths. The compression stock-ing with a classic ribbed look complements an understated business look perfectly and provides functional comfort throughout your working day. It stimulates the circulation, supporting you through long days. The stock-ing is comfortable to wear and keeps your feet fresh with its antimicrobial sole. Previously used primarily as a men’s or unisex stocking, the fit now also takes the small difference between the genders into account: the Men version is designed for shoe sizes from 41 to 49, while the Women version, with a shorter foot , is recommended for shoe sizes from 36 to 41. The two versions are distinguished by the packaging design with a masculine or feminine product image, the packaging label , and the sewn-in label on the stocking itself. †

VenoTrain business Men and Women

VenoTrain business in different foot lengths for men and women.

ManuTrain: more comfort with every movement of the hand.


NEWS

First Bodytronic 600 in South AmericaViña del Mar, Chile

In February 2013, the first ever Bauerfeind Boutique in Chile was opened in Viña del Mar, in Greater Valparaíso, and by the end of the year, the Bauer-feind Bodytronic 600 measurement system was already installed there, the first in the whole of South America. The Bodytronic 600 makes it possible to take digital body and volume measurements for tailor-made care using VenoTrain compression stockings and supports to treat the knee and ankle. “Products that fit perfectly are a fundamental requirement for providing the best possible treatment and ensuring a high level of patient and physician satisfaction. Thanks to modern measurement technology, the Bauerfeind Boutique in Viña del Mar is setting new standards in the quality of care,” says Alejandro Giletto, International Sales Manager Latin America and Canada at Bauerfeind. †

Sales Manager Alejandro Giletto and Dr. Gerd Ebert , Bauerfeind Measurement Technology, with Viviana Valle and Julio Chaparro

Abarca from the Bauerfeind Boutique in Viña del Mar (f. l.).

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The VenoTrain curaflow flat-knit compression products are now available in a bold blue “Navy” tone in addition to the existing colors of “cream,” “cara-mel” and “black.” The VenoTrain curaflow range offers tailor-made solu-tions for treating lymphedema and lipedema in the leg, toes, arm, hand and thorax. The extended color palette is not the only new feature, however; improvements have been made to the quality of the leg stockings too. The type of knit and elasticity have been modified to ensure that they fit perfectly and are easy to put on. The standard stockings now come with an “anatomically contoured knee,” a “soft toe” and, in the pantyhose version, a new gusset that feels more comfortable to wear. All of the compression products have an exceptionally high microfiber content , which makes them particularly soft and breathable. They are easy to put on and help reduce shearing forces, making them extremely gentle on sensitive skin. The new design of the VenoTrain curaflow products is intended to create a more pleasant therapeutic experience for patients and make it easier for them to wear compression products on a regular basis. †

VenoTrain curaflowLymph therapy takes on a new tone

VenoTrain curaflow is now available in “Navy”.

Now available with micro Velcro fasteningsWith the advantages it offers, it is no wonder we stick with micro Velcro: not only are micro Velcro fastenings easy to open and close, but once they are closed they can also withstand a high level of force. Micro Velcro fastenings are also very flat and barely noticeable. Orthoses and supports with this kind of fastening can therefore be worn underneath your clothes without any problems. The LumboLoc and LordoLoc lumbar orthoses can now offer these advantages in wearing comfort too: like all other back products from Bauerfeind, the abdominal fastenings on both these products and the ten-sioning straps on the LordoLoc now feature micro Velcro. These two orthoses are made of elastic, breathable material that feels pleasant to wear. They stabilize and relieve the lumbar spine and alleviate pain. †

LumboLoc & LordoLoc

Lumbar orthosis LordoLoc with new micro Velcro fastenings.

DIARY DATES

TRADE FAIRS AND EVENTS

May 2014

May 12 – 14, 2014 18th European Vascular Course, Maastricht. Further information: www.vascular-course.com/european-vascular-course

May 13 – 16, 2014 OTworld, Leipzig, Germany. Further information: http://ot-world.com

May 14 – 17, 2014 16th ESSKA Congress, Amsterdam, The Netherlands. Further information: www.esska-congress.org

May 21 – 24, 2014 EXPOSANITA, Bologna, Italy. Further information: www.senaf.it/Expo-Sanita

June 2014

June 04 – 06, 2014 15th EFORT Congress, London, England. Further information: www.efort.org

June 26 – 28, 2014 15th Congress of the European Venous Forum, Paris, France. Further information: www.europeanvenousforum.org

September 2014

September 18 – 20, 2014 Rehabilitacja, Łódź, Poland. Further infor-mation: www.rehabilitacja.interservis.pl

September 25 – 27, 2014 40th Congress of the European Society of Lymphology, Genoa, Italy. Further information: www.esl2014.com

November 2014

November 12 – 15, 2014 MEDICA, Düsseldorf, Germany. Further information: www.medica-tradefair.com


When it comes to treatment and rehabilita-tion, Diane Quimet has been relying on Bau-erfeind products for around two years now. She is a Certified Athletic Therapist for the Halifax Mooseheads, a Canadian professional junior ice hockey team from Halifax, Nova Scotia, that currently plays in the Quebec Major Junior Hockey League (www.halifax-mooseheads.ca). She has already provided quite a few players with supports “Made in Germany.” “The players really like the ‘fit and feel’ of the Train knit , especially the GenuTrain, and GenuTrain S for the knee,” says Diane Quimet.

Halifax Mooseheads therapist relies on Bauerfeind

“ The players like the ’fit and feel‘ of the Train-knit”

“Compared to some other products we’ve tried in the past , they are not nearly as hot. The players don’t feel they sweat as much under the support – great breathability!” Yet how does wearing a GenuTrain support affect players’ freedom of movement during a game? “That’s been one of the larger benefits – it fits really well under their gear, and doesn’t ‘get in the way’ of their normal play,” says Diane Quimet. “That’s very important to players at this level!” Diane Quimet also has some per-sonal experience of using the SofTec Genu – she wears this orthosis for hiking and playing football. †

Ice hockey is all about being fast and physical. It is certainly not a sport for the faint-hearted, so it is no wonder that ice hockey players are constantly having to struggle with injuries.

Athletic therapist Diane Quimet is closely following a game of her team, the Halifax Mooseheads.

... that Canada is regarded as the home of modern ice hockey? It supposedly stems from the Scottish sport of shinty, which was introduced to Canada by British soldiers in the mid-19th century. In the wintry Canadian climate, the game was soon transferred onto ice. The first rules of ice hockey are said to have been developed by students from Mon-treal. Nowadays ice hockey is Canada’s national sport , attracting far more spectators than basketball or any other sport.

Did you know ...


FOCUS

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FOCUS

The shape, method of control , and degree of freedom of the shoulder are fundamentally different from those of other major joints of the body, because the shoulder is mainly made up of soft tissue. However, structures controlled by muscles are prone to complex complaints. A new stabilizing orthosis can help with modern shoulder treatment.

The weight of the world is on your shoulders

Protection to suit the indication

Atlas lifted the entire celestial sphere onto his shoulders. The myths do not mention whether he felt pain when doing this. Current evidence shows that present-day humans often complain of pain, sometimes after performing even small tasks above their heads such as painting the ceil-ing. This sensitivity is due to the complex architecture of the shoulder. Its structure and function are mainly determined by muscles. Whole bundles of strands give the joint movement radii unlike any other. “In principle, the shoulders allow the fingers to reach every part of the body,” says Profes-sor Dr. med. Peter Müller from the Munich university clinic in Großhadern. The shoul-der’s ability to rotate through a wide angle and the associated freedom of movement comes at a price, however. “The rotator cuff that controls it is prone to degeneration and injury,” says the Deputy Director of the clinic and polyclinic for orthopedics, physi-

cal medicine, and rehabilitation. “In the long run, the shoulder’s soft tissue frame can have an extremely detrimental effect on its function.” The muscle-controlled shoulder not only provides maximum freedom of movement , but also strength and stability for the arm and hand – for sliding, lifting, pulling, pushing, squeezing, and reaching. But what happens when these functions suffer, when muscles and tendons are worn? Or when injuries occur?

Tender muscles and irritated tendonsThe orthopedist from Munich links typical shoulder disorders to the age of the main patient groups. In younger people, the most common disorders are dislocated shoulders due to instability and sports injuries or damage such as SLAP* lesions of the biceps tendon (e.g. during ice hockey). Separated shoulders caused by accidents are also com-mon. In older patients, shoulder joint frac-tures due to osteoporosis are more frequent. However, the vast majority of complaints concern the soft tissue. The most common disorder is degenerative damage to the rotator cuff. The group of four large muscles is the stabilizer of the shoulder. It controls and centers the joint. And wears down. “Up to eighty percent of eighty-year-olds have rotator cuff tear,” says the physician from the Ludwig Maximilian University. >>>

Prof. Dr. Peter Müller, Ludwig Maximil-ian University, Munich, Germany.


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“When the muscles and tendons of the cuff can no longer center the shoulder reliably, it can lead to osteoarthritis of the shoulder,” says Prof. Müller.

A choice of any abduction angleThe variety and complexity of shoulder disorders require a wide range of therapeutic approaches. Recently, great advances have been made thanks to arthroscopy. “We have only been able to discover certain patholo-gies such as SLAP lesions using this techno-logy,” explains Prof. Müller. “When we repair the injured or torn biceps tendon, it is essen-tial to safeguard the surgical outcome imme-diately.” To avoid jeopardizing the healing process, the natural tension of the tendons and muscles must be significantly reduced. This also applies to rotator cuff surgery. In order to relieve the muscles, the arm must be held at a certain abduction angle with the aid of an orthosis. This angle differs depend-ing on the surgical procedure. A smaller abduction angle is required for single-row tendon treatment than for double-row treat-ment. The problem is that the angle can only rarely be adjusted precisely. Often relatively broad locking positions are provided. This

is not the case with the recently developed SecuTec Omo stabilizing orthosis from Bauer-feind. It provides the option of selecting any abduction angle up to 60 degrees. The arm support can also be rotated to any abduction angle at the touch of a button. The rota-tion can also be restricted as appropriate if required by the treatment program.

A line of treatment from the shoulder to the arm and handThe shoulder, and by extension the hand, especially require customized treatment. Bulky orthoses are often more of a hindrance than a help. This is another reason why Bauerfeind decided to launch an orthosis that provides treatment to suit the indica-tion, but also gives patients the freedom they require in everyday life. “The SecuTec Omo underwent clinical testing in our department ,” says Prof. Müller. For the clini-cian, the crucial factor was the ability to safeguard the surgical outcome without any compromise. “The option of selecting any abduction angle meant that individual pro-tection was ensured from the start ,” he says. According to the physician, the absence of a contralateral shoulder strap is another im-

portant advantage of the SecuTec Omo. “The arm rests on a frame that is supported by the pelvic girdle. The patient does not need to be moved to put it on, providing immediate security after surgery. Wearing it cannot cre-ate tension in the neck later on.”

Freedom in the treatment program and everyday life “The arm belongs to me again” – this type of personal experience was expressed by Prof. Müller’s patients who were already familiar with other shoulder products before trying out the SecuTec Omo. This came as no sur-prise to Prof. Müller: “The orthosis fits easily into everyday life, meaning that patients see it as a real help and not a foreign object.” It does not even need to be taken off for X-rays. In follow-up treatment , the rota-tion function enables physiotherapy to be carried out using the orthosis. The orthosis is relatively convenient to wear at night. All these features also satisfy the clinician: “A shoulder that has undergone soft tissue surgery needs its time to heal. It also needs an aid that is actually worn.” †

* SLAP = superior labral tear from anterior to posterior

The SecuTec Omo holds the arm securely in the abduction position.

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FOCUS

For strong shoulders Whether used post-operatively for shoulder injuries or post-traumatically after a dislocated shoulder, the new SecuTec Omo and OmoLoc stabilizing orthoses, which have been available since last fall , secure, relieve, and stabilize the injured joint.

SecuTec Omo and OmoLoc

Using the new SecuTec Omo stabilizing orthosis, the shoulder joint can be immo-bilized securely after surgery in accordance with indication. Holding the arm in an abduction position relieves the tendinous bands. Reducing the load on the tendons safeguards the surgical outcome, promotes healing, and relieves pain. A multifunctional joint enables two settings of the functional stabilizing orthosis to be adjusted so that the arm can be positioned appropriately. The abduction angle can be adjusted freely up to 60°. The arm can be rotated inward and/or outward regardless of the selected angle, and this rotation can be controlled at the touch of a button. The rotation can also be limited if necessary. The arm support has been detached to save space and increase comfort. The arm support rests firmly on the pelvic frame. The angle of the pelvic frame can be adjusted to fit the patient’s body shape. Resting the arm support on the pel-vic frame means that there is no need for a shoulder strap. This avoids incorrect posture and the related tension that occurs in the healthy shoulder.

Emergency arm slingAnother new addition to the Bauerfeind product range for the shoulder is the OmoLoc stabilizing orthosis. It is used for immobilizing the joint immediately after surgery or after resetting a dislo-cated shoulder. The orthosis, made up of a pelvic/abdominal strap and three arm loops, holds the arm in the zero-degree abduction position. The arm loops can be positioned freely along the abdominal

strap to suit the patient’s body size and forearm length. The elbow is kept bent at an angle of 90-100 degrees. Restrict-ing movement reduces pain and provides protection after surgery. The orthosis can be put on easily, both by the physi-cian after surgery and by patients them-selves, and it can also be worn at night. The OmoLoc’s construction ensures

OmoLoc: stabilizing orthosis for immobiliza-tion of the shoulder joint following surgery or dislocation.

SecuTec Omo: func-tional stabilizing orthosis for immobili-zation of the shoulder joint with two set-tings.

stability even without a contralateral shoulder strap. Its open design makes it easier to maintain personal hygiene, particularly around the wound. †

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For further information

on the shoulder products, visit www.bauerfeind.com.

OmoLoc indications• Immobilization following surgery• Shoulder dislocation

SecuTec Omo indications• Reconstruction following a rotator

cuff tear • Shoulder prosthesis implant • SLAP lesion• Subcapital humerus fracture• AC rupture• Shoulder dislocation


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A look over the shoulder Experiences of using the SecuTec Omo

The interplay of muscles and bones is what attracts him: Dr. med. Jaap Willems has dedicated himself entirely to the shoulder joint. The Dutch physician performs both arthroscopy and arthroplasty. A newcomer to his “biotope” recently began helping him with both categories of patients: the SecuTec Omo.

A typical orthopedist: when the photogra-pher hoists her heavy bag onto her shoulder, Dr. Willems points out the risks of carrying it on one side. He does so kindly, with a smile. For our discussion, we meet the physician at the café of the “Hotel American”, a magnifi-cent art nouveau building at the heart of Amsterdam. The DC Lairesse hospital where Dr. Willems works is not far from here. He has hurried over during his lunch break. Over Koffie und Poffertjes (coffee and traditional Dutch pancakes), we have a fascinating conversation about medical advances. The subject: “my biotope,” the orthopedist’s term for the field he works in – the shoulder. As we know, a wide range of inhabitants live in a biotope – even newcomers can find their place. A newcomer to the “shoulder habitat ,” the SecuTec Omo stabilizing orthosis from Bauerfeind, is the reason for this conversa-tion.

Particular anatomical conditionsThe new orthosis is extremely well adapted to the unusual conditions in its environ-ment. It can securely immobilize the shoulder joint after surgery in accordance with the indication. Holding the arm in a fixed abduction position relieves the ten-dons. Reducing the tension on the tendons safeguards the surgical outcome, promotes healing, and relieves pain. However, before Dr. Willems describes his initial personal ob-servations about the newcomer, he roughly maps out the “shoulder habitat”, which is involved in constant medical changes. “The shoulder joint is the most mobile joint in the human body,” says the expert , introducing the topic. “Its extensive range of movement is due to particular anatomical conditions. Compared to the socket , the head of the humerus is very large at the scapula and the joint capsule is quite broad.” According to Dr. Willems, the surrounding ligaments only provide limited stability for the joint. It is the rotator cuff muscles that are primar-

2010, recognizes a high level of susceptibil-ity to dislocation in the shoulder’s extensive range of movement. Dislocation is primarily caused by forced abduction and outward rotation of the arm. “Prevention is important in this regard,” says the orthopedist , mainly thinking of a rare case that , as a specialist , he actually comes across quite often: “Pos-terior dislocation of the shoulder is often missed,” says the physician. “The head of the humerus slips through under the acromion and ends up in the infraspinous fossa. This type of dislocation is difficult to diagnose from an X-ray. If it remains unnoticed, I have to perform surgery. After six months, the tendons and capsule are overstretched. Following surgery, I require an orthosis that will enable the muscles to strengthen without moving the joint.” This is where the SecuTec Omo comes into play for Dr. Willems. “I tell the patients: ‘Exercise your muscles by rotating your arm. You don’t have to worry, the orthosis will prevent dislocation.’” The expert is convinced that when the muscles and capsule are strong again, a posterior dislocation will not recur.

Looking good makes it easier to find a partnerNot only in the shoulder biotope, but par-ticularly in that habitat , there is a rule that is applicable worldwide. Dr. Willems knows it well. His frequent trips to lectures and workshops on every continent have taught him that the design has to be right! Whether in India, to which the Dutch physician makes regular visits, in Japan, or in South Africa, it is crucial that people actually wear the medical aid. If patient compliance is poor, many of the other efforts are in vain. With the SecuTec Omo however, Dr. Willems has no concerns in this respect: “The orthosis looks good and is very convenient to use in everyday life,” he says, as a final verdict. In the biotope, looking good usually makes it easier to find a partner. †

ily responsible for stabilizing the shoulder. Failure of these tendons is a frequent cause of pain and loss of function in the older population.

A bone problemIn the past , the importance of the soft tis-sues in controlling the shoulder may have led physicians to neglect the role played by the bone structures in shoulder complaints. “We are currently reconsidering this,” says Dr. Willems. “We frequently have a bone problem in shoulder instability. We are now learning to reconstruct the bones in the joint , when either the head or the joint cavity has eroded due to recurrent disloca-tions.” Another frequent problem is osteoarthritis of the shoulder. “In addition to arthroscopic surgery on the shoulder, which makes up around 80 percent of procedures, I perform about 50 arthroplasty operations each year. However, the fact remains that shoulder dis-orders are usually muscle and tendon prob-lems.” Dr. Willems roughly assigns common shoulder disorders to different age groups: “In 20 to 40-year-olds, the most common disorder is instability, which can lead to dislocation. 40 to 60-year-olds mainly suffer from rotator cuff problems and the over 60s are primarily affected by osteoarthritis.”

Preventing dislocationDr. Willems now has a new medical aid at his disposal to treat many shoulder indications. “I spent a long time searching for an ortho-sis that supports patients in accordance with their particular requirements,” says Dr. Wil-lems. “After shoulder surgery, the arm usually needs to be abducted at a customized angle. The SecuTec Omo makes it possible to do just that , up to 60 degrees.” Which indica-tions does he see in practice? The shoulder specialist , who was President of the re-nowned European Society for Surgery of the Shoulder and Elbow (ESSSE) from 2008 to


FOCUS

Dr. med. Jaap Willems has dedicated himself entirely to the shoulder joint.


on the SecuTec Omo, visit www.bauerfeind.com.See page 39 for contact information for Bauerfeind Benelux.


Diplomate of the American Board of Physical Medicine and Rehabilitation, was among the first in the United States to publish research on healing with the use of platelet rich plasma (PRP) that continues to lay a foundation for further biologic-based therapies. He has also created educational and hands-on train-ing materials regarding musculoskeletal ultrasound that continues to educate thousands of physicians.

The Orthobiologic Institute (TOBI), launched by Dr. Sampson in 2009, pro-motes the development of best practice in the field of regenerative medicine. Attended by 50 doctors five years ago, 400 physicians now attend the institute that discusses biologic-based medicine. Veteri-narians, surgeons, plastic surgeons, Ph.Ds, and other doctors gather to network with biologics experts from around the world to learn the latest research, procedures and protocols. www.prpseminar.com.

Steven Sampson, D.O.,

Innovative, non-surgical orthopedic treatments accelerate recovery

Orthohealing Center, Los Angeles, USA

Maintaining an active lifestyle is key to the overall well-being of all of us. But when a rotator cuff tears while serving on a tennis court , or a knee inflames while jogging, that active lifestyle can come to a screeching halt. When that happens, many in the area of Los Angeles, California, pick up the phone and call Steven Sampson, D.O., of the Orthohealing Center, a comprehensive facility specializing in cutting-edge non-surgical orthopedics and sports medicine.

a whole host of injuries. From cartilage and tendon disorders to arthritis and nerve and spine issues, patients, some as young as 16 and others as mature as 103, all come with one purpose in mind – to heal and get back to being active as quickly as possible.

Redefine boundaries“We treat patients who are so active, they redefine the boundaries of what they should and shouldn’t be doing,” said Dr. Sampson.

As a Physiatrist , Dr. Sampson is a Physician who focuses on the body’s musculoskeletal system, which includes bones, joints, muscles, ligaments, tendons, and nerves. His holistic approach to healing focuses on treating the entire patient , not just the symptoms, and includes minimally invasive procedures that provide alternatives to surgery. Patient treat-ment emphasizes enhancement of the body’s natural ability to heal itself by combining time-tested treatments, state-of-the-art

technology, with the use of Bauerfeind sup-ports. Dr. Sampson finds this combination leads to exceptional patient compliance, resulting in faster healing.With a medical practice that treats about 1,000 patients a month, many of them elite athletes – NBA basketball players, Olympic athletes, major league baseball players and more – as well as a bunch of former profes-sional champions and accomplished amateur and recreational athletes, Dr. Sampson sees

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Dr. Sampson founded the Orthohealing Center in Los Angeles, California, a comprehensive state-of-the-art facility specializing solely in non-surgical orthopedics and sports medi-cine. He created The Orthobiologic Institute (TOBI), and chairs and moderates a world-class annual regenerative medicine symposium, featuring the foremost experts in tendon and cartilage disease. For more information, visit: www.orthohealing.com.

The Orthohealing Center, Los Angeles, California

“We’ve got senior surfers, drag racers, wom-en’s basketball players, even a 70-year-old senior Olympic pole-vaulter. Take away their activity and they get agitated. They need motion to stay balanced and healthy. That’s why it’s important that their treatment is as minimally invasive as possible, so they can get back in the game.”The doctors at Orthohealing Center co-ordinate a team that may include other physicians and health professionals such as neurologists, rheumatologists, physical therapists, acupuncturists and orthopedic surgeons. Together, they decide what treat-ment is best for the patient and how it will be delivered.

Great results with PRP and BMCAlong with conventional treatments, innova-tive treatments, such as platelet rich plasma (PRP) and bone marrow concentrate (BMC), are now becoming more mainstream. In fact , many savvy patients who do their own research actually ask for it , even though it is considered experimental and not covered by insurance.“We’re finding great results with PRP and BMC throughout the body. Ankle injuries and rotator cuff injuries of the shoulder do exceptionally well with this treatment. Knee meniscus tears combined with rehab also do well. The most challeng-ing regions to improve are hip joints with arthritis,” said Dr. Sampson.

Knee brace was a game changerDr. Sampson values the feedback of his “pio-neering patients,” who often share informa-tion they have read about in the community regarding new therapies. In fact , he first learned about the benefit of Bauerfeind braces from one of his patients. “He came in wearing a Bauerfeind knee brace and told me how much it had helped him. He said it was a game changer. We had the company dem-onstrate the product and then tried it with several patients. We got great feedback,” said Dr. Sampson.Today, Bauerfeind supports and braces play a big role in the treatment of Dr. Samp-son’s patients, with about 25 percent using them. The GenuTrain knee brace is the most frequently used, followed by the MalleoTrain

ankle brace. Dr. Sampson says that the prod-uct’s workmanship, support , soft feel , precise fit , and light weight are especially attractive to his patients. “They also like the fact that

the braces reduce swelling, provide support , and allow them to heal faster. That’s what they want , to be able to return to their active lifestyle,” said Dr. Sampson. †

MalleoTrain and GenuTrain are the Bauerfeind products Dr. Sampson uses the most frequently. The supports are designed to restore mobility and improve performance. They are made from an anatomically knitted, breathable fabric with visco-elastic pads. As the joint moves, they provide a therapeutic massage and support. This stimulates the circulation and promotes the healing process.

Further information

See page 39 for contact information for Bauerfeind USA.

MEDICAL


MEDICAL

Treating patella instability

Dr. Chinmay M. Gupte is a Consultant Knee Surgeon at the Wellington Knee Unit and Imperial College, London. He is also director of training for North West London Ortho-paedics. For life magazine, Orthopaedic Registrar Philip Pastides, one of his trainees and who is working with him in the Knee Reconstruction Unit at Imperial College, talked to the knee specialist about patella instability.

Mr. Pastides: Mr. Gupte, why is patella instability such a problem for patients?Dr. Chim Gupte: The patella, or kneecap, ‘glides’ over the thigh bone during knee bending and straightening. If this mo-tion is not in a straight line or leads to an increased pressure on the kneecap, pain and sensation of instability can be the result. There are many potential causes of this and hence determining the correct treatment can be a challenge.

Mr. Pastides: How do patients know if they have patella related pain or instability?Dr. Chim Gupte: Classically a patient will complain of pain in the front of the knee or under the kneecap. This is commonly re-ferred to as ‘anterior knee pain’ and this can be associated with a catching sensation. Patients may experience pain when running or biking, going up or down stairs, squatting and getting up from a kneeling position. They may also feel that the kneecap is un-stable and in danger of dislocating.

Mr. Pastides: What are the causes of patella instability?Dr. Chim Gupte: Patella instability can arise from an acute traumatic injury, such as a patella dislocation due to a direct blow or abnormal twisting movement , or from a chronic problem. Underlying causes that may predispose to this include: bony problems such as knock knees (increased “Q angle”) or abnormal kneecap or thigh bone architecture (patel-lofemoral dysplasia), or kneecap ligament injury (medial patellofemoral ligament [MPFL] injury). Another very important contributing cause is poor muscle strength and conditioning (buttock and thigh muscles).

is determined and treatment planned. This can range from bracing, to specialist physio-therapy to operation.

Mr. Pastides: What non-operative options are available?Dr. Chim Gupte: Bracing can prevent further dislocation of the kneecap, but this must be balanced with over stiffening the knee and weakening muscles due to prolonged bracing in rigid frame constructions without any elastic knitting. Physiotherapy consists of initial swelling and pain management , followed by gradual bend-ing of the knee and buttock and quadriceps muscle strengthening exercises. In chronic cases patellar taping has been shown to be of value.

Mr. Pastides: If the medial patellofemoral ligament is injured, can this be treated opera-tively?

Mr. Pastides: How is the diagnosis of patella instability made?Dr. Chim Gupte: The diagnosis is made with a combination of a detailed history and a thorough knee examination. Sometimes im-aging of the joint , in the form of radiographs (X-rays), MRI scans and occasionally CT scans are also required.If a patient thinks that they are suffering from patella instability, they should consult a specialist orthopedic knee surgeon.

Mr. Pastides: In the acute cases, what should be done?Dr. Chim Gupte: It is important to ensure that if the patella does dislocate, that it is promptly put back into place. If there is a large swelling, blood in the joint can be drained with a needle and syringe under lo-cal anaesthetic. The knee can be placed in a brace for comfort and to restrict movement. Then the underlying cause of the dislocation

“ The importance of getting it right from the beginning”

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Dr. Chim Gupte: Yes it can. There are several procedures that can be done. Using an arthroscope, the tighter structures on the lateral aspect of the knee cap can be partially released to allow the knee cap to lie more medially. Alternatively, if the MPFL is badly injured and beyond repair, this can be reconstructed using the patient’s own tendons. The orthopedic surgeon will decide which procedure is best or if a combination of procedures is required.

Mr. Pastides: What are the causes of non-traumatic or chronic patella instability?Dr. Chim Gupte: These are slightly more complex and depend on the surgeon performing a thorough examination and imaging studies. Causes can include the knee cap lying too high or too low in front of the femur, a mismatch in the shape of the undersurface of the patella and the front of the femur, a malalignment of the knee cap in relation to the pull of the tendons it lies in or even arthritis within the patellofemoral joint.

Mr. Pastides: How can these be treated?Dr. Chim Gupte: Treatment depends very much on the diagnosis and hence the impor-

tance of getting it right from the beginning! If the patella is lying too high or too low or in a malaligned position in relation to the pull of the tendons, the bone on which the patella ligament attaches to on the tibia can be moved to correct for this. If the problem is due to arthritis within the joint or a mismatch between the bony geometry, then a type of kneecap replacement can be performed. If the problem is due to an injury to the MPFL then this can be reconstructed as described above.

Mr. Pastides: Does a patient have to have surgery for chronic problems?Dr. Chim Gupte: Of course not. Retraining and building the muscle around the knee cap with the help of physiotherapy is a vital treatment option. Surgery is usually offered to those patients who fail to make a satisfac-tory recovery with non-operative methods.

Mr. Pastides: What is the role of bracing?Dr. Chim Gupte: Bracing can be used imme-diately after a patellar dislocation to provide comfort and restrict the bend of the knee.In longer term, chronic cases need a differ-ent type of brace that allows mobilization for example the Bauerfeind Genutrain P3. This brace is made of elastic knitting and stabilizing elements. It can be used in motion to provide resistance to the patella moving out of position and to aid muscle function and joint position sense when play-ing sport.

Mr. Pastides: This all sounds very complex and difficult to treat.Dr. Chim Gupte: It is complex surgery and for that reason it should be performed by orthopedic knee surgeons who have an inter-est and expertise in doing these types of procedures. †

Dr. Chinmay M. Gupte is especially interested in the management of early osteoarthritis, sports knee injuries, knee ligament and meniscal biomechanics.


about Dr. Gupte please visit: www1.imperial.ac.uk/medicine/people/c.gupte00/See page 39 for contact information for Bauerfeind UK.


MEDICAL

Strains during sporting activities and treatment with foot orthoses

In many sports, very specific strains are exerted on the feet. life magazine spoke to Dr. Frank-Detlef Stanek, medical practitioner and specialist in physical and rehabili-tation medicine, sports medicine and manual therapy in Jena, Germany, about these strains and the best ways to support the feet using sports foot orthoses such as the new ErgoPad sports range.

The foot – both a tool and a means of compensation

Dr. Stanek, what role does the foot play in processing the strains generally exerted on the body when playing sport?Dr. Stanek: As our primary mode of trans-port , our feet provide us with the power required to move, while, on the other hand, they also serve as our main point of contact with the ground and sports equipment in most cases. This means that they have to do both the work and compensate for it in equal measures. The athlete must work to minimize the impact exerted on them during movement. They must absorb and

The athlete has a range of options to choose from – subject to restrictions – and can listen to advice from specialist sales staff on which materials are best suited to their individual physical characteristics. In this regard, however, they must also always accept the relevant material constants for what they are. This means there will almost always be issues not fully resolved – the position of the foot inside the shoe, for example, still requires improvement or indi-vidual foot defects and static problems with the shoes require correction. Those who do not want to use their own muscle power or active forces to achieve these improvements need to take an adaptive approach – simply by using a foot orthosis, for example. With injured feet that have static problems, it is often symptoms relating to the knee, hip or lumbar spine that we notice first and it is only afterwards that we realize that the foot is actually the root cause. Adaption by means of a foot orthosis can help even in these cases. †

deflect the impact and convert it into a form of energy that does not damage the body, but benefits it by pre-tensioning and pre-stretching the muscles, ligaments and tendons to achieve good propulsion. In this sense, the foot must always be consid-ered in relation to the entire body. When making claims regarding the foot , we must also always consider whether the knee joint or hip joint are in the correct position or whether the body statics are correct in rela-tion to the foot. The foot is the first point of contact and gives off proprioceptive signals. The foot is therefore also the one carrying out the work – always in conjunction with sensorimotor controlled muscle chains that ultimately determine performance.

In your experience, does it make sense to support perfectly healthy feet with appro-priate foot orthoses during sports?Dr. Stanek: We have an excellent array of shoes and other equipment available that are especially suited to recreational sports.

Dr. Frank-Detlef Stanek, Jena, Germany.

Quick stops and turns are typical of indoor and ball sports. The ErgoPad ball & racket provides relief for this: its heel cup stabilizes the hindfoot and ankle.

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A powerful trioNew ErgoPad foot orthoses for sport

Bauerfeind has developed three new sports foot orthoses based on patented weightflex technology: ErgoPad ski & skate for winter sports, ErgoPad ball & racket for indoor and ball sports and ErgoPad run & walk for running and walking.

contact surface between the foot and the shoe for better control. The ErgoPad ball & racket gives the feet optimum stability for the stops and turns characteristic of indoor and ball sports. The heel cup surrounds the hindfoot , thereby also stabilizing the ankle. Proprioceptive spots send stimuli to the foot muscles and thus improve motor skills. The slightly raised section under the small toes stretches them to prevent cramp and increase the contact surface between the foot and the shoe. The ErgoPad run & walk for running and walking guides and stabilizes the feet during movement thanks to the low heel cup. With their cushioning in the forefoot and hindfoot areas, they effectively absorb the constant impact of the heel hitting the ground and the toes pushing off. The top cover on all three types of foot or-thosis has also been specifically designed for the intended area of use: the top cover on the ErgoPad ball & racket and on the ErgoPad run & walk kills bacteria and inhibits odors, while the thermoregulating top cover on the Ergo-Pad ski & skate protects the winter athlete’s feet from the cold. †

All three of the new ErgoPad foot orthoses come with an innovative synthetic core, made up of two plastics with different levels of firmness, which supports the foot arches. The internal weightflex-X promotes the natu-ral mobility of the feet and loosens block-ages in the midfoot area. The flexible plastic provides optimum cushioning against the strong forces which occur during sport. The orthotic core is coated in a skin-friendly soft foam polyurethane for long-lasting cushion-ing for the feet and joints. All three foot orthoses use sensorimotor spots to stimulate and strengthen the foot muscles.

Tailor-made solutionsIn terms of their surface shapes, however, all three types of foot orthoses have been specifically designed for their individual area of use. The ErgoPad ski & skate relieves the feet and joints during the tilting motions and changing pressure loads typical of winter sports. The orthosis surrounds the hindfoot with its heel cup and stabilizes the ankle. The slightly raised section under the small toes stretches them, thereby increasing the

ErgoPad ski & skate

ErgoPad ball & racket

ErgoPad run & walk


see www.bauerfeind.com/footorthoses.


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A holistic approachFisio 1 Fisioterapia, Rio de Janeiro

The Brazilian healthcare system provides citizens with free primary healthcare. Orthope-dic aids are not included. Physiotherapist André Luiz Lauria Faria, joint founder of Fisio 1, a center of excellence for health and rehabilitation in Rio de Janeiro, explains that people’s awareness of their health and willingness to be proactive has still increased.

38,000 times. This shows us that we’ve got our concept right.

Which type of customer do you treat most often?André Lauria: Most of our customers are amateur athletes, but we also treat some professional athletes. For example, we col-laborate with an institute for Paralympic athletes. Customers are usually sent to us by

Your company has been operating since 2006. Are you satisfied with its development?André Lauria: After studying under one of the country’s most notable physiothera-pists, Dr. Nilton Petrone, we started our own company, still called Plexus Physiotherapy at the time. It all started in a 60 square-meter room in a conventional fitness studio in Barra da Tijuca, Rio de Janeiro. Back then, we only offered physiotherapy and training with

the Power Plate vibration platform. In 2011, we moved to a different location nearby that was more than twice the size and founded Fisio 1. There we were able to establish a broader infrastructure and expand our range, to include baropodometric analyses or pilates, for example. We also set up a wide range of courses for patients and therapists. Since our company started operating, our services have been requested more than

André Luiz Lauria Faria (left) and Pedro Koellreutter from Fisio1. The physiotherapists, have postgraduate qualifications in fields such as trauma orthopedics, sports rehabilitation, and osteopathy.


MEDICAL

or ligament surgery or are suffering from cartilage problems. The most frequent spine disorders are intervertebral disk prolapses and problems caused by instability or muscu-lar imbalance.

What do you do when treating patients?André Lauria: First we conduct a physical and functional assessment of the patient. We think it is very important to spot biome-chanical changes. If surgical treatment is required, we send the patient to an orthope-dic surgeon. If we can treat them conserva-tively, we start as soon as possible. During treatment , we always look at the person as a whole and not just the isolated problem, because an impairment or injury in one part of the body always affects other areas too. Depending on the individual case, we can then use a combination of different thera-peutic approaches, such as conventional physiotherapy, RPG (Global Postural Re-Education), osteopathy, electrotherapy, manual therapy, or training on the vibra-tion platform. The combination of different methods often makes rehabilitation quicker and more effective. We also sometimes re-commend the use of supports and orthoses. However, as with physiotherapy, the success

orthopedic surgeons who admire our work philosophy. People who have come to us before like to come again because they have already experienced firsthand how we can help them.

Do you think that physiotherapy is more highly regarded in Rio today than it was a few years ago?André Lauria: Definitely, and I think I can safely say that sport has played a major part in this change of attitude. When people hear from the media that this or that athlete has been injured and needs to undergo a rehabilitation process, or that a top athlete has recovered in record time thanks to phys-iotherapy, it also makes all those who have not yet recognized the importance of our profession change their minds.These days, people are generally more aware of their health. We now see a large number of people aged 55 or 60 who do sport. This was a rare occurrence in the past. Of course, the upcoming major sporting events such as the 2014 Football World Cup in Brazil or the 2016 Olympic Games in Rio de Janeiro also help increase people’s enthusiasm for sport. Wherever people do sport , physiotherapists are also needed to prevent or treat injuries.

What are the most common problems amongst your patients?André Lauria: They usually have knee, back, or shoulder injuries or problems. Patients with knee disorders have often had meniscus

of treatment depends on the quality. This is why we particularly like Bauerfeind products. Incidentally, patients are not reimbursed for supports and orthoses in Brazil. If you have to pay for it yourself, you naturally also want to have a good product.

How are recommendations for supports and orthoses received?André Lauria: Well , because patients have faith in our work and our recommendations. However, I think it is important to stress that these products provide support , but cannot replace physiotherapeutic treatment. Both aspects work together to help the patient. The supports and orthoses can also be used between treatments to preserve what has been achieved. Thanks to their stabilizing and proprioceptive effects, the supports also give patients more security when working and doing sport.

Have you already had personal experience of using supports?André Lauria: Yes. I play tennis and have a meniscus injury that didn’t need surgery. I do muscle strengthening exercises and wear a support while doing them to help stabilize the injury. †

Physiotherapeutical treatment at Fisio 1.Fisio 1 is situated in Barra da Tijuca, Rio de Janeiro.


please visit www.fisio1.com.br.


MEDICAL

What are your experiences in relation to compliance in compression therapy?Dr. Reich-Schupke: A variety of factors play a role in this issue. One key factor is how well informed patients are about how compression stockings work, and the other is how much they are suffering. Acceptance is high among patients with a life-threatening thrombosis. It is also high among patients who are wearing compression stockings for a short period of time to treat acute inflam-mation of the veins, after surgery, or in particular situations such as when traveling or spending long periods of time sitting or standing at work. However, when stock-ings are to be worn as prophylaxis for less severe venous disorders, such as pronounced varicose veins or vein inflammation, or to prevent thrombosis, it is often challenging to motivate patients to wear them. Age and gender also play a role: it is mainly older women who are prepared to wear compres-sion stockings preventatively.

How do you argue in favor of this form of treatment? Dr. Reich-Schupke: Information is the key. Many people still think that varicose veins are a purely cosmetic problem. The fatal aspect of venous disorders is that , as with diabetes, patients only feel pain when the disease is already at an advanced stage. Therefore, in the first consultation, it must always be made very clear why the patient needs compression stockings. The results of the second Bonn vein study conducted by Prof. Eberhard Rabe show that there is a clear progression of these disorders over time. The participants of the first study in 2003 were re-examined about seven years later and the physicians noticed that the ve-nous disorders of patients who had not been treated with compression stockings had got worse. Results like these provide good argu-ments. With patients whose legs are at great

Compression stocking compliance

Despite the proven high degree of effectiveness of compression stockings in the treatment of phlebological and lymphological disorders, patients have to be motivated time and time again to wear them regularly. Bauerfeind life spoke to Priv.-Doz. Dr. med Stefanie Reich-Schupke, who has managed the outpatient clinic for veins and skin at the Artemed special-ist clinic in Bad Oeynhausen since April 2013.

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Life insurance for legs

PD Dr. Stefanie Reich-Schupke, Artemed specialist clinic, Bad Oeynhausen, Germany.


The VenoTrain micro balance combines the circulation-stimulating proper-ties of a compression stocking with the skin-smoothing properties of a skin care lotion. Thanks to the presence of skin care substances such as urea, precious oils and vitamin E, the moisture in the skin is main-tained and the roughness of the skin is reduced. The positive ef-fect on the skin was proven in a clinical study.

Integral skin careVenoTrain micro balance

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risk due to ulceration or recurring infec-tions (e.g. erysipelas), you sometimes have to be more forceful. Then I simply call the stockings “life insurance for legs.” I also use the fact that I wear stockings as prophylaxis myself to help convince patients.

How do the product features support compliance?Dr. Reich-Schupke: Thanks to modern mate-rials, the stockings have become softer, eas-ier to put on, and more comfortable to wear. Psychologically, the wide variety of stocking designs available plays an important role in acceptance: the less they are perceived as a medical aid, the better. Fashionable colors and a wide range of colors have a significant psychological impact. Patients appreciate the selection, even though most choose a traditional shade of black or beige.

What else encourages patients to persevere with treatment?Dr. Reich-Schupke: We always stress that the stockings themselves only rarely provoke allergies. In some circumstances, they can cause dry skin or redness, which can be pre-vented by using a strong lipid-replenishing skincare product containing urea or glyc-erine. It is also crucial that the stockings are fitted perfectly and that the material is suitable for the legs and skin. The Bauer-feind prescription poster is a handy guide for this, because although many practicing physicians are familiar with the compression classes, they often do not know that stock-ings from the same class can have complete-ly different characteristics due to differences in material and knit.

What makes a compression stocking good?Dr. Reich-Schupke: The ideal stocking has the right pressure, material , and stiffness

for the patient’s requirements. The patient should be able to put on the stocking easily and it should not slip or dig in. In addition, it should not irritate the skin very much, should be comfortable to wear, and should not make the patient sweat. Many modern microfiber fabrics provide this wearing com-fort and also have the advantage of looking almost exactly like normal opaque stockings.

What else would support better treatment?Dr. Reich-Schupke: The German Phlebology Society is trying to raise physicians’ aware-ness in this area through continuing educa-tion. It would be better if family physicians, gynecologists, and physiotherapists referred affected patients to specialists early. It is vital that treatment at a medical retailer is taken seriously, because studies show that the stockings supplied to one in three pa-tients do not meet their individual require-

ments. Their fit should be checked regularly at a medical retailer or by a physician.

You lecture at the Ruhr University Bochum. What advice do you pass on to your students for the future?Dr. Reich-Schupke: As a hybrid of dermato-logy and vascular surgery, phlebology has a very difficult status at many universities. This is not the case in Bochum, thanks to the vein center that actively treats patients and participates in research. At the vein center, we raise awareness of the wide range of compression treatments. It is important to me that my students know the differ-ence between a flat and a circular knit after seeing and touching them. As prospective physicians, they should know that a suitable compression stocking can be found for every patient , even those with advanced pain and deformed legs. †

“Fashionable colors and a wide range of colors have a significant psychological impact. Patients appreciate the selection, even though most choose a tradition-al shade of black or beige.”

(PD Dr. Stefanie Reich-Schupke)

PD Dr. Stefanie Reich-Schupke, Artemed specialist clinic, Bad Oeynhausen, Germany.


please visit www.bauerfeind.com.


MEDICAL

Treatment of lymphedema

“The knowledge about lymphedema and its treatment is still very limited”, says Nele Devoogdt. The petite athletic woman has set out to change that. In 2006 she started her PhD-study on breast cancer related-lymphedema at the KU Leuven and University Hospitals Leuven. Since 2011 she is working in the hospital as a physiotherapist and has got the chance to establish a Lymphedema Center which is supported by the Leuven Cancer Institute. 40 percent of her work is dedicated to practical physiotherapy, 50 per-cent to clinical studies and in the remaining 10 percent she is educating students at the KU Leuven – University of Leuven.

Risk factor axillary surgery Currently, the majority of our patients (80 percent) are cancer patients with lymph-edema. Of them, the major part (70 percent) are women who developed secondary lymph-edema after breast cancer surgery”, she ex-plains. Though, the surgery for those patients has changed: “When I started my PhD at the hospital , out of ten women with primary and operable breast cancer, four to five patients received an axillary lymph node dissection and the other received the sentinel node procedure Today it’s only two out of ten.” Receiving an axillary lymph node dissection – in contrast to having a sentinel node biopsy – is still the main risk factor for developing secondary arm lymphedema. In her study in-cluding 160 breast cancer patients, incidence of arm lymphedema 24 months after axillary lymph node dissection was 30 percent, where-as prevalence was 18 percent. Other predictive factors for develop ment of breast cancer-related lymphedema are having postoperative swelling, high body mass index and receiving supraclavicular and axillary irradiation.

Decongestive lymphatic therapy In the Leuven Lymphoedema Center, patients with lymphedema are treated with deconges-tive lymphatic therapy. The intensive phase of therapy aims to minimize the lymph-edema volume in a short period of time. Nele

Devoogdt and her colleague Carol Swinnen use manual lymphatic drainage to stimulate lymphatic transport and to reduce fibrotic structures. After the lymphatic drainage they apply a multilayer compression bandage. The patients are asked to move the limb a lot while they wear the bandage.in order to im-prove lymphatic transport under the bandage. In addition, the patients receive information about skin care. “It’s essential for them to keep the skin well-hydrated and to avoid wounds”, stresses the lymphedema specialist. As soon as the edema is stable, the main-tenance phase is started. The multilayer bandage is replaced by a custom-made compression garment A compression spe-cialist comes to the center and takes the measurements for the compression garments. “For this job you really need a lot of experi-ence. The measurement has to be precise and you need a broad knowledge about different stockings”, emphasizes Nele Devoogdt , who is working very closely together with the specialist. “The advantage is that we know the patients’ individual needs by bandaging them. We know where they can have a lot of pressure and where not. This information is very useful for the compression specialist.” Other requirements for effective compres-sion garments are: the garment has to exert enough compression on the limb (for upper limb lymphoedema 20-40 mmHg and for lower limb lymphoedema 40-60 mmHg) and

the garment needs to have a large stiffness. Her patients use different brands of compres-sion garments, including VenoTrain curaflow products from Bauerfeind. “They find it very comfortable. Due to the high percentage of microfibre the material is very soft and this enhances compliance.”

Keep on movingOf course, also in the maintenance phase, the patients have to continue the skin care – and with exercising and moving a lot. “Currently, a lot of lymphedema patients think that they may not exert physical efforts with the af-fected limb. But regardless of whether upper or lower limbs are affected, muscle activity is needed to stimulate lymph transport.And patients with lymphedema have to wear their compression garments very consequent-ly! Until nowthere are still some therapists who find this is not necessary...” But this only encourages the dedicated woman to aug-ment and share knowledge about lymphedema and its treatment. And for that , she has a lot of ideas.“From January 2014 we organise information-al sessions for patients with lymphedema from inside and outside the hospital about the lymphatic system, the treatment of lymphede-ma and about different compressions devices and materials”, Nele Devoogdt says. Together with other ambitious persons she has devel-oped a special website for doctors, physical therapists and patients (see info box). “And in October 2014 we will start an inter-university course with the universities of Antwerp, Ghent and Leuven about the treatment of venous-, lip- and lymphedema”, she tells enthusiasti-cally. This one-year program for therapists is scientifically based and the lessons will be held by national and international experts. “And perhaps we will continue by establishing courses for medical doctors and for nurses as well”, she says. “There is still a lot of work to do, so let’s keep on moving!” †

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“There is still a lot of work to do”The University Hospital Leuven is one of the largest hospitals in Belgium. More than 8,800 employees work daily to provide a highly specialized patient care. One of them is Nele Devoogdt , PhD, physiotherapist and coordinator of the Lymphedema Center.

Nele Devoogdt , PhD, coordinator of the Lymphede-ma Center (l.), and her colleague Carol Swinnen.

1 Removal of only the first lymph node, the sentinel node. Axillary lymph node dissection removes several lymph nodes.


MEDICAL

Nele Devoogdt uses manual lymphatic drain-age to stimulate the flow

of fluid and to reduce swelling and fibrotic

structures.


visit www.oedema.be (page in Dutch). Detailed information about the custom-made flat-knit VenoTrain curaflow compression gar-ments can be found at www.bauerfeind.com/venotraincuraflow-en.See page 39 for contact information for Bauerfeind Benelux.


MEDICAL

Physiotherapist Per Gade, CEO of “Arkadens Fysioterapi” and of FysioDanmark. Even ultrasonic devices are used.

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FysioDanmark

In Denmark, many physiotherapists are discovering a new strength: their ability to sell products! In addition to carrying out their usual work, they provide patients with information about medical aids such as supports and foot orthoses. This completes the treatment and improves the quality of their work.

A one-stop shop for quality

Confirmation of this comes at the end of the visit. On the way to Aalborg Airport , the taxi driver begins talking about his wife’s medi-cal care. The physician advised her to go to “Arkadens Fysioterapi” for treatment on her knee. It is not unusual for family physicians in Denmark to make recommendations, since they play a guiding role within the country’s healthcare system. However, recommending a physiotherapy clinic for treatment rather than follow-up treatment is by no means a regular occurrence. Although Danish phys-iotherapists enjoy an excellent reputation, advising a patient to consult them instead of a specialist colleague suggests that the physician holds “Arkadens Fysioterapi” in unusually high esteem. Three hours earlier, the taxi’s passenger had been able to see the physiotherapy clinic in Denmark’s fourth largest city for himself.

packaging takes up most of a whole side of the room: a wide variety of products in all sizes, from the SacroLoc to the LumboTrain and MalleoLoc, the entire GenuTrain range to the VenoTrain compression stockings and foot orthoses – everything is there. “We have you to thank for this,” says Per and turns to Agneta Cabréus, CEO of Bauer-feind Nordic and Frank Bærentsen, Sales Manager for Denmark. The storeroom is a well-chosen meeting place for the trio. In addition to its practical significance, it is definitely symbolic. It represents the collaboration between Bauerfeind Nordic and FysioDanmark, the country’s largest chain of physiotherapy clinics. “Arkadens Fysioterapi” is one of them. “Our collabora-tion began in 2011,” explains Agneta. “We wanted patients to benefit from the work of both of our companies here on site. The

In the long, wide corridor, there is an atmo-sphere of calm activity. The employees wear blue T-shirts with “Arkadens Fysioterapi” on the back. “A total of 27 physiotherapists work for us, including our colleagues in the smaller branches on the edge of Aalborg,” says Per Gade, CEO of “Arkadens Fysioterapi” and a physiotherapist himself. “Our teams are divided up. We have specialists for each part of the body,” explains the young CEO. After Per, a former professional footballer, has finished conducting his tour through the large treatment rooms and communal areas that are flooded with light , he stops in front of a small door. “Behind this door,” says Per, lowering his voice and opening the door, “something special is hidden.” The medium-sized, dark room is packed full of shelves. Physiotherapeutic and medical aids are piled up to the ceiling. Blue and white


MEDICAL

A storeroom with symbolic significance ...

new system just seemed natural to us – combining quality with quality.” Per, who is also CEO and a partner of FysioDanmark, stresses: “Advising patients on medical aids offering these products in our clinics was a completely new experience for us since, as physiotherapists, we are used to working solely with the patient.”

Physiotherapists you can trustIn Denmark, the state covers about 80 percent of all expenditure on healthcare, financed by taxes. However, patients usually pay for services such as medications, dental care, and physiotherapy (60 percent) out of their own pocket. This means that the value of treatment has to be right to avoid fluctua-tion. “Quality in the provision of our services is the be-all and end-all ,” says Per. “It is the only way we can retain patients. Now we can improve our quality even more.” Frank Bærentsen plays a significant role in this. The sales manager, a physiotherapist himself, visits each individual FysioDanmark clinic. There he explains to his colleagues how they can convince their patients to also purchase a foot orthosis after their foot treatment , for example. “The aim is to top off the thera-pist’s work. Their work is of a high medical

standard, just like our products.” Per also stresses another aspect: “We don’t want to send patients into the city, to any sports store. No, the advice must be provided right here, in a location they can trust with spe-cialist expertise.” Per has tasked an external consultant with supporting Frank’s activities. While Frank

concentrates on the products, the consul-tant teaches the ABCs of selling to custom-ers. “This is where we physiotherapists have shortcomings,” says Per, referring to their “blind spot.” “We want to heal. Until now, supplementary products were on the fringe of our work.” However, the key is that “one works better with the other,” says Per. “The combination of the two really clicked. Now we’re convinced by the “one stop shop” concept.” The patients are responding very

positively to FysioDanmark’s extended range. “The complaints rate is almost zero,” says Per, which is clear evidence that a high-quality range is in great demand among patients. Supportive products for running are the most popular, although patients of all ages are represented. Is it coincidence or necessity that the CEO of FysioDanmark is

also expanding his chain of clinics in view of its pleasing development? In the next few years, he is aiming to increase the number of clinics from the current total of 49 to 80. At the end of the conversation, the mention of Bauerfeind’s Bodytronic 600 digital measure-ment system made him prick up his ears. The system enables a precise leg measure-ment to be taken for care using compression stockings and knee and ankle supports. This would be a perfect fit for the clinics. †


please visit www.fysiodanmark.dk.See page 39 for contact information for Bauerfeind Nordic.

Patients in the well-equipped gym of “Arkadens Fysioterapi”.


TRADE & TECHNICS

These days, no specialist orthopedic supplier can get by without reliable measurement and production technology. “To further improve our ability to give advice and to stand out from the competition, we decided to install Bauerfeind’s Bodytronic 600 measurement system,” explains Marc Moser, a member of ORTHO-TEAM’s management. “The modern measurement technology fits into our concept perfectly. We want to use it to sharpen our profile further still and in-crease customers’ faith in their treatment.” Circumference, length, and volume measure-ments for the appropriate tailor-made care using supports and compression stockings are therefore now taken digitally at the Bern, Solothurn, Basel , Lucerne, Zurich, and St. Gallen sites.

Innovative projection of beams of lightBodytronic 600 can measure the legs up to the hips. This makes it possible to select perfectly fitting compression stockings from the entire VenoTrain range or Train sup-ports to treat the knee and ankle. To take measurements, the system projects beams of light , a process that has been used in the automotive industry for many years. This process cannot be disrupted by external factors and is completely safe for humans because it uses normal , visible light.

Precise 3D image To generate the 3D model , the measure-ment system projects beams of light onto the body part to be measured and captures them digitally. The system quickly gene-rates a perfect 3D model with the length and circumference measurements of the body part to be treated – without touching the patient at all and without any need for mea-surement clothing. During the measurement process, the patient stands on a measure-ment platform that revolves automatically.

In Switzerland, the ORTHO-TEAM Group is a market leader in the supply of orthopedic and phlebological aids. It is no surprise that the company is also setting new standards with modern measurement technology. Since last year, Bauerfeind’s Bodytronic 600 has been in use at six sites in all the major cities of German-speaking Switzerland.

“ The system helps us stand out on the market”

Bodytronic 600 measurement system


TRADE & TECHNICS

The steady rotation excludes the potential for error, thereby avoiding time-consuming repetitions of the process. The circumference and length measurements taken from the 3D image can then serve as the basis for selecting a product from the Bauerfeind online shop. In the shop, the product configuration tool suggests the

perfect size. The medical retailer can decide between a custom-made solution or a stan-dard product depending on the proportions of the patient’s body. This removes the need for time-consuming searches in catalogs or size tables. After all other required product features, such as the compression class, color, or pattern, have been selected by

the specialist , the product can be ordered directly from the Bauerfeind online shop.

Providing evidence to health insurance funds“At the moment , we mainly use the system for providing care using medical compression stockings, and sometimes for supports – if they are custom-made,” says Marc Moser. “The non-contact measurement process is very comfortable for customers and the modern technology has already given rise to a great deal of amazement and admiration.”However, making a good impression is, of course, not the only thing that is impor-tant to him and his team. “For us, the most significant features are the precise,

Nadaraja Maden, Head of Ortec, Bern site.

“In the orthopedic technology division, we regularly use scanning, such as for the 3D modeling of torso orthoses or seats. I therefore found it very easy to use the Bodytronic technology. I think the main advantages of the system are the precise, error-free measurement process and the reproducibility of the measurement data. As the measurements are always taken in the same way, it is more accurate than taking them manually. The direct con-nection to the ordering system makes it much easier to obtain custom-made solu-tions. Bodytronic 600 is also a valuable marketing tool for us. As a market-leading company, we ultimately always have to be up-to-date with the latest developments in the industry. I would be delighted if we could also use the system for other areas of care in future.”

“A valuable marketing tool”

>>>

Bodytronic 600 can measure the legs up to the hips. This makes it possible

to select perfectly fitting compression stockings from the entire

VenoTrain range or Train supports to treat the knee and ankle.

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Patrik Baumann, Ortec hospital service and customer service at the Bern site.

“The system is almost self-explanatory, and we also received good training from the Bauerfeind employees. I use the Bodytronic 600 to measure for compres-sion stockings and the GenuTrain knee support. I find it particularly useful for the stockings. The measurements are precise and you have them in the system straight away. You don’t have to take measurements again for simple follow-up care. I personally also like the fact that a precise stocking recommendation is provided at the end. That way, you don’t have to find out the sizes yourself after measurement. This saves me a great deal of time! Most of our customers are pleasantly surprised by the modern technology. It helps us stand out from the competition even more. Bodytronic really enhances ORTHO-TEAM’s image.”

“Saves a great deal of time”

reproducible measurement process, the simplified order process, particularly for custom-made solutions, and the documented measurement results,” says the manager. These results not only make internal quality management easier, but also serve as a tool for networking with physicians and thera-pists. “They are, of course, also interested in the measurement results to monitor the progress of treatment.”Marc Moser also lists another advantage that is very important to him: Bodytronic 600 simplifies communication with health insurance funds. “Particularly with com-pression stockings, it is very useful to be able to use the leg volume measurements to demonstrate the requirement for a custom-

Anne Jeangros, Head of Sanitec/Compression Stockings, Bern site.

“Thanks to the Bodytronic 600, when we are supplying compression stockings, we can quickly tell whether the customer’s body measurements have changed. This is particularly useful for customers with edemas. For example, we have edema patients who came to us before surgery. It is then particularly impressive for them to see how much the volume of their legs has reduced after surgery. This is also in-teresting to communicate to physicians. In general , one of the main advantages is, of course, that the system provides repro-ducible data. There are always minute dif-ferences between manual measurements. One employee pulls slightly tighter than the other, but the device always measures in the same way.”

“ Volume changes are visible immediately”

TRADE & TECHNICS

made solution to health insurance funds,” he emphasizes. Even if a new product is required due to physical changes, the avail-able measurements can be used as a refer-ence when trying to convince the funding organization.40 percent of the compression stockings supplied by ORTHO-TEAM are custom-made solutions. “This is because a large number of compression stockings are also supplied at pharmacies or drug stores in Switzerland. Sometimes patients are not even measured manually, but are just sold the product straight away, over the counter,” says the manager. However, compression stockings ultimately cannot be compared with a drug that is the same for all patients. “In the end, the aid must fit the body perfectly to be able to fulfill its therapeutic purpose and be comfortable to wear. Therefore, many patients come to us because they know that expertise and technology are available here.”

The interest is thereFour to twenty employees work with the measurement system depending on the site. “No one was really scared to touch it. The system is so easy to use – almost like an iPhone,” says Marc Moser with a smile. The company has advertised the new techno-logy in its own magazine for physicians and therapists, on its own website, and with an article in the magazine of a hospital net-work. “After that , we already had compres-sion stocking wearers coming in who were

specifically interested in being measured with the Bodytronic 600. As I said, the sys-tem is a good opportunity for us to distin-guish ourselves on the market and enhance our image further still.” †

Marc Moser, a member of ORTHO-TEAM’s management.

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please visit www.ortho-team.ch.For more information on Bodytronic please visit: www.bauerfeind.com/en/products/measurement-technology.html

>>>

MEDICAL

life magazin 2014/1 35

International scientists honoredCommitment to research and development has always been very important at Bauerfeind AG. Two awards in the field of phlebology funded by Bauerfeind went to France and England in 2013.

Since 1969, the Ratschow Memorial Medal has been awarded annually by the Curato-rium Angiologiae Internationalis to particu-larly deserving scientists from the field of vascular medicine and related disciplines. Bauerfeind has been a patron of the founda-tion awarding this medal for a number of years.

Lifetime achievement awardIn 2013, the prestigious lifetime achieve-ment award went to vascular surgeon Dr. Michel R. Perrin. The 81-year-old French physician with an extensive list of publi-cations to his name has held prominent positions including President of the French Society of Phlebology and Vice President of the International Union of Phlebology (IUP). He worked as a vascular surgeon in Lyon, both in hospitals and practices, and taught as a Professor at Grenoble University Hospital. “A lot has happened in the field of vascular surgery over the past few decades,” says the Ratschow Medal winner. “For example, when I was still a young surgeon, deep venous

surgery was taboo.” He sees determining the effectiveness of the various treatment meth-ods and preventing chronic venous insuf-ficiency using conservative or interventional treatment as some of the most urgent tasks for the discipline of phlebology.

Seventh Bauerfeind Phlebology AwardSince 2001, Bauerfeind AG has been confer-ring the Bauerfeind Phlebology Award, which comes with prize money of EUR 20,000, in as-sociation with the IUP. The aim of the prize is to honor an exceptionally interesting and creative study design in the field of phlebol-ogy that has a connection to compression treatment. British physician Dr. Christopher

R. Lattimer, currently working at Ealing Hospital in Wallington, received the award during the IUP World Congress in fall 2013 in Boston. He impressed the international judg-ing panel of seven members with his study design on the effectiveness of different com-pression stockings in patients with chronic venous insufficiency, post-thrombotic syndrome, and lymphedema, and in healthy test subjects. In his current research project , Dr. Lattimer is primarily interested in finding out which of the four patient groups receives the most benefit from class 1 and 2 compres-sion stockings in terms of venous drainage performance. †

Bauerfeind’s support for research


on the Bauerfeind awards for scientific achievement , visit www.bauerfeind.com/special-prizes.The closing date for applications for the 8th Bauerfeind Phlebol-ogy Award is May 31, 2015. The award will be conferred at the chapter meeting of the IUP in August 2015 in Seoul , South Korea.

Conferment of the 2013 Max Ratschow Memorial Medal: Winner Dr. Michel R. Perrin (middle), Prof. Eberhard Rabe (left), President of the Curatorium Angiologiae Internationalis and Dr. Hans-Jürgen Thomä, Bauerfeind.

Award ceremony during the IUP World Congress in Boston: Dr. Christopher Lattimer (right), winner of the 2013 Bauerfeind Phlebology Award, and Dr. Hans-Jürgen Thomä, Bauerfeind.


IN MOTION

2014 Winter Olympics

Orthoses, supports, orthopedic foot orthoses and medical compression stockings – Bauerfeind AG shipped more than 5,000 items to Sochi for the Winter Olympic Games. As part of the service, Bauerfeind teams were on site at the three Olympic polyclinics from January 30 to February 26, supplying athletes with medical products from Thuringia to treat or prevent injuries. Here is a review of Bauerfeind’s Olympic activities.

Bauerfeind’s service in high demand

The newest Olympic disciplines proved par-ticularly likely to cause injuries: more than 80 supports and orthoses were given out to freestylers, skicrossers and snowboarders, mostly for knee and back problems. Most of the athletes were able to continue taking part in their competitions once they had been provided with Bauerfeind products. As well as acute injuries, old wounds that flared up again under excessive strain had to be treated. Aside from knee and back

provided with perfectly fitting foot orthoses for their training and competition shoes. Medical compression stockings are becom-ing increasingly popular with winter sports athletes. They wear them during training and competitive events, to help the recovery process and, of course, on long flights. The athletes therefore often came back to the polyclinic just before they left Sochi to have their legs measured for suitable compression stockings. †

problems, the athletes also complained of joint instability, damaged shoulders or injured elbows. The patients included athletes from the new disciplines, as well as, for example, ice hockey players, alpine or cross-country skiers, curling players and bobsledders.Almost 400 athletes made use of Bauer-feind’s service overall. They came from 54 different countries, including Russia, Swit-zerland, Canada and China. Athletes from the smaller teams received treatment too, such as alpine skiers from Ireland, Liech-tenstein and the Virgin Islands or cross-country skiers from Israel and Iran. Thanks to two AFT grinding machines on site, Bauerfeind had the best facilities available to adapt orthopedic foot orthoses at the polyclinics. Ice hockey players, speed skaters and cross-country skiers, who are particularly prone to foot problems, were


IN MOTION

Pictures: Bauerfeind

First International Sports Medicine Conference

The first International Sports Medicine Congress hosted by Bauerfeind AG between February 7 and 11 lived up to its name: more than 160 delegates from ten nations came together in Istanbul and made the most of their proximity to Sochi by paying a visit to the Winter Olympic Games.

Professional diversity

The main focus of the scientific program was on the back and knee. A lively debate ensued on a number of topics, including the issue of indications for the surgical treat-ment of degenerative spine conditions – with regard to both the timing, and the nature and extent of the surgery. Some consensus could be formed on the issue of timing at least. Nevertheless, the “right” time to operate is dependent on many factors (includ-ing the duration of the symptoms, accompanying diseases, the scope and success of the conservative treatment) and can often not be determined with absolute certainty. While some physicians were visiting a hospital in Istanbul , the majority of the Congress delegates travelled to Sochi. They soaked up some of the Olympic atmosphere at an ice hockey match and luge race. †

The congress in Istanbul offered the opportunity for some lively debate.


IN MOTION

Adresses:

Bauerfeind Austria

Theory and practice in the Arlberg region

In early February, participants in the Winter Sports Forum held by Bauerfeind Austria had the chance to catch a glimpse behind the scenes of elite Olympic sport.While the Olympic Games got underway in Sochi, the guests at the Winter Sports Forum at the Ski Austria Academy in St. Christoph am Arlberg explored the topic of load con-trol. They saw how precise and finely tuned training schedules have to be to ensure that athletes can perform at their peak in competition.

preparations for the Olympics from a coach’s perspective. This not only involved training, but also logistical matters, safety, medical care and preparations immediately before the competition.Meanwhile, Wolfgang Pachatz talked about preparing for his trip to Sochi. An employee of Bauerfeind Austria, he was involved in the Paralympic Games in March as a sports physiotherapist. †

In the case of the Austrian biathletes, for example, it was clear that their extensive training regime leaves them with very little free time. The theoretical part of the event was followed by a practical element , as all of the participants had a go at the biathlon themselves. On the second day, Herbert Mandel , head coach of the Austrian women’s skiing team from 2002 to 2013, gave an account of

Herbert Mandel , head coach of the Austrian women’s skiing team from 2002 to 2013.

Picturesque scenery: St. Christoph am Arlberg.

Orthopedic technology in Sochi

There were three Olympic Villages at the 2014 Winter Olympics: one on the coast and two in the mountains. Each Village had its own polyclinic, where Bauerfeind ran a “bracing clinic”.

Consolidated expertise

Providing an on-site service in three Olympic Villages at once proved challenging in terms of both logistics and personnel. On the one hand, a sufficient supply of products had to be guaranteed in all locations at all times. On the other hand, more orthotists were required than ever. From January 30 to February 26, a total of 13 orthotists were working on site for Bauerfeind, four of whom had already been involved in the Games in Vancouver and Lon-don. Bauerfeind had strengthened its team since 2010 and 2012, adding seven experi-enced orthotists and orthopedic technology specialists from medical supply retailers that stock Bauerfeind products. This meant that it

could offer a consolidated pool of expertise in Sochi. After all , every member of the team was a specialist in providing treatment for athletes and had also undergone advanced training in sports orthopedics. “We have seen how important our on-site involvement in the polyclinics is,” explains Lars Birnbaum, Head of Sport Marketing at Bauerfeind. “Trust in our orthotists plays a major role in this,” he stresses. “If it wasn’t for their professional approach and, in par-ticular, their expertise, our Olympic activities would not have been so successful. Athletes and support staff are impressed by the qual-ity of our products and are keen to try out new things, even during the Olympics.” †

Measuring feet for the individual fitting of foot orthoses.

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SERVICE

Adresses:

Bauerfeind worldwideBauerfeind AGTriebeser Straße 1607937 Zeulenroda-TriebesGermanyPhone +49 (0) 36628-66-10 00Fax +49 (0) 36628-66-19 99E-mail [email protected]

AustriaBauerfeind Ges.m.b.H.Hainburger Straße 33A-1030 ViennaPhone +43 (0) 800 44 30 130Fax +43 (0) 800 44 30 131E-mail [email protected]

BeneluxBauerfeind Benelux B.V.Waarderveldweg 1NL-2031 BK Haarlem

NetherlandsPhone +31 (0) 23 531 94 27Fax +31 (0) 23 532 19 70E-mail [email protected]

BelgiumPhone +32 (0) 2 527 40 60Fax +32 (0) 2 502 94 10E-mail [email protected]

Bosnia and HerzegovinaBauerfeind d.o.o.Midžić Mahala 133BA-77000 BihaćPhone +387 (0) 37 313 198Fax +387 (0) 37 319 074E-mail [email protected]

Bauerfeind d.o.o. Ul. Nikole Pašića 34 BA-78000 Banja LukaPhone +387 (0) 51 327 720Fax +387 (0) 51 327 721 E-mail [email protected] Bauerfeind – Mostar d.o.o.Kralja Tvrtka 24 BA-88000 MostarPhone +387 (0) 36 334 277Fax +387 (0) 36 334 276

CroatiaBauerfeind d.o.o.Goleška 20HR-10020 ZagrebPhone +385 (0) 1 65 42 855Fax +385 (0) 1 65 42 860E-mail [email protected]

FranceBauerfeind France S.A.R.L.B.P. 50258F-95957 Roissy CDG Cedex Phone +33 (0) 1 48 63 28 96Fax +33 (0) 1 48 63 29 63E-mail [email protected]

ItalyBauerfeind GmbH & Co.Filiale ItalianaVia Po 9I-20871 Vimercate (MB)Phone +39 039 6 08 12 52Fax +39 039 6 08 26 68E-mail [email protected]

NordicBauerfeind Nordic ABRoslagsgatan 24SE-113 55 StockholmPhone +46 (0) 774-100 020Fax +46 (0) 774-100 021E-mail [email protected]

PolandBauerfeind Polska Sp. z o.o.Sky Office Center, Ul. Rzymowskiego 3PL - 02-697 WarszawaPhone +48 727 677 675Phone +48 608 722 543Phone +49 (0) 36628 66 1667E-mail [email protected]

Republic of MacedoniaBauerfeind Dooel Skopje50 Divizija 24 aMK-1000 SkopjePhone +389 (0) 2 3179 002Fax +389 (0) 2 3179 004E-mail [email protected]

SerbiaBauerfeind d.o.o.Miloja Djaka 6 CS-11000 BeogradPhone +381 (0) 11 26 65 999Fax +381 (0) 11 26 69 745E-mail [email protected]

SingaporeBauerfeind Singapore Pte Ltd.Blk 41 Cambridge Road#01-21 Singapore 210041Phone +65 6396 3497Fax +65 6295 5062E-mail [email protected]

SloveniaBauerfeind d.o.o. Dolenjska cesta 242b SI–1000 Ljubljana Phone +386(0) 1 4272 941Fax +386(0) 1 4272 951E-mail [email protected]

SpainBauerfeind Ibérica, S.A.Historiador Diago 13E-46007 ValenciaPhone +34 96 385 66 33Fax +34 96 385 66 99E-mail [email protected]

SwitzerlandBauerfeind AGVorderi Böde 5CH-5452 OberrohrdorfPhone +41 (0) 56 485 82 42Fax +41 (0) 56 485 82 59E-mail [email protected]

United Arab EmiratesBauerfeind Middle East FZ-LLCDubai Healthcare CityP.O. Box 505116, UAE-DubaiPhone +971 4 4335 685Fax +971 4 4370 344E-mail [email protected]

United KingdomBauerfeind UKPhyllis House229 Bristol RoadGB-Birmingham B5 7UBPhone +44 (0) 121 446 53 53Fax +44 (0) 121 446 54 54E-mail [email protected]

USABauerfeind USA, Inc.3005 Chastain Meadows ParkwaySuite 700Marietta, GA 30066Phone 1 800 423 34 05Phone (770) 429 83 30Fax (770) 429 84 77E-mail [email protected]

F O O T O R T H O S E S

Motion is Life: www.bauerfeind.com

A perfect grip for stopping and turning

ErgoPad® ball & racket – protects the feet from overloading while playing ball or net sports.

These sports foot orthoses with a flexible weightflex core give the feet a perfect grip. The raised heel cup stabilizes the hindfoot and ankle, while proprioceptive spots stimulate and strengthen the foot muscles. weightflex®

technology

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