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Issue 2017 | 1

Endowed professorship for Phlebology in BochumInterview with Dr. Stefanie Reich-Schupke Page 50

“Orthopedic shoe technology is both craftsmanship and science”100 years of orthopedic shoe technology in Germany Page 36

Brushing up on knowledge – made simpleCME courses on fields of expertise at Bauerfeind Page 44

When bones become a construction siteFocus on osteoporosisPage 16

internationalmagazine

Spinova® Osteo

BAUERFEIND.COM

THE NEW Spinova® Osteo – GREATER STABILITY, GREATER COMFORT, GREATER COMPLIANCE

• OPTIMAL STRAIGHTENING EFFECT thanks to long reclinator lever and adjustable tensile force

• PLEASANT TO WEAR thanks to free-moving abdomen and chest area

• SECURE POSITION EVEN WHEN MOVING thanks to elastic, close-fitting pelvic support

WEAR IT, DON'T BEAR IT!

A better quality of life in osteoporosis treatment

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life magazine 2017/1 3

EDITORIAL

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“In view of demographic develop-ments, we can expect osteopo-rosis to become much more of a problem in the future than it is today.”

Osteoporosis is one of the most significant health problems today, according to the World Health Organization (WHO). If this metabolic bone disorder is left untreated, patients will experience bone fractures, severe back pain and pain in extremi-ties, all of which leads to a significant deterioration of quality of life. In view of demographic developments, we can expect osteoporosis to become much more of a problem in the future than it is today. That’s why I’m all the more pleased to present to you in this issue a new orthosis for osteo-porosis treatment known as Spinova Osteo. Spinova Osteo provides both passive and active stabilization for the spine. It reduces pain and improves posture and gait and thus helps osteoporosis patients feel more secure and participate actively in life once again. You can read more about osteopo-rosis and our new orthosis in our focus feature starting on page 16 – from the perspective of a patient , an osteologist , and a spinal surgeon.

This issue of Bauerfeind life also addresses a very special anniversary that is taking place this year – 100 years of orthopedic shoe technology in Germany. Bauerfeind life is covering this milestone by discussing various aspects of orthopedic shoe techno-logy with a group of experts (see page 36), including the question of just how much technology the craft of making orthopedic shoes requires today.

Spring is coming, and that means many people will soon begin running again. We talked to the Medical Director of the Vienna City Marathon (VCM) about the types of injuries that often occur among runners

and the support the VCM medical team will be providing during the marathon in April. You can read about it on page 28.

On January 16, 2017, Dr. Stefanie Reich-Schupke assumed the professorship for Phlebology endowed by Bauerfeind AG at Ruhr University Bochum. You can find out what research topics she plans to ad-

dress on page 50. Along with our endowed professorship for Technical Orthopedics at Münster University of Applied Sciences, the science awards we’ve received over the years, and our CME continuing education courses (see page 44), the professorship in Bochum marks a further key component of our activities for promoting science and scientific research. I hope you enjoy reading this new issue of Bauerfeind life! Best regards,

Prof. Hans B. Bauerfeind

Spinova® Osteo

BAUERFEIND.COM

THE NEW Spinova® Osteo – GREATER STABILITY, GREATER COMFORT, GREATER COMPLIANCE

• OPTIMAL STRAIGHTENING EFFECT thanks to long reclinator lever and adjustable tensile force

• PLEASANT TO WEAR thanks to free-moving abdomen and chest area

• SECURE POSITION EVEN WHEN MOVING thanks to elastic, close-fitting pelvic support

WEAR IT, DON'T BEAR IT!

A better quality of life in osteoporosis treatment

spinova_osteo_INT_4c_210xXXX_170119.indd 3 19.01.2017 15:06:16

4 life magazine 2017/1

CONTENTS

IMPRINT:

Bauerfeind life magazineFrequency of publication: Three times per yearPrinted on chlorine-free paper

Editor:Bauerfeind AGTriebeser Straße 1607937 Zeulenroda-Triebes, GermanyTel.: +49(0)[email protected], www.bauerfeind-life.de

Authors and editorial board for this issue: Fridtjof Atterdal , Kristina Bardele, Astrid Basson, Dr. Uwe Berendt , Beatrice Bruecher, Bernd Festerling, Eckhard Freund, Simone Gebler, Markus Gerlich, Kirsten Göpel , Markus Gräßer, Falk Henning, Birgit Hollnagel , Peggy Kajrjakow, Michael Kießling, Solveig Klamt , Susanne Neubauer, Miriam Riedl , Dr. Rainer Scheuermann, Sandra Schirbel , Ulrike Schneider, Ashley Sutz

Publisher and editorial office:mk publishing GmbH Döllgaststraße 7–9, 86199 Augsburg, Germany Tel.: +49(0)821-34457-0 [email protected], www.mkpublishing.deArticles whose author is specified reflect the opinions of their author, not those of the publisher. Im

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About the cover image

Osteoporotic bone tissue can be recognized by disruptions to bone microarchitecture. The fine trabecular structure loses density and the empty spaces in between get larger. The bone statics then fall out of balance.

Focus Page 1616 Osteoporosis Bones need to move

20 Multimodal osteoporosis treatment “Osteoporosis is complex but manageable”

22 Spinova Osteo New orthosis for actively straightening

the spine

23 Clinical osteoporosis treatment The first vertebral fracture changes

everything

Focus on osteoporosis – Page 16


CONTENTS

3 Editorial

4 Imprint

6 World of Bauerfeind

12 News

52 Contact

54 People

Medical Page 2424 Modified SecuTec Genu knee orthosis “Secure fit , great design”26 Strain-related conditions suffered by

competitive athletes Unequal leg length triggers a chain reaction28 Runner injuries “Problems with knees should

be checked”30 U.S. track and field physician team “Supports are a great help”31 LumboTrain studies: Effective in two ways High level of muscle activity, less pain32 LumboTrain in Luxembourg Pleasant companion 33 LumboTrain in physiotherapy “Our patients don’t want any chemicals”

Retail Page 3434 VenoTrain micro and VenoTrain soft Stylish and effective 36 Expert discussion “Orthopedic shoe technology is both

craftsmanship and science”

42 Orthopedic shoe technology in Italy and Spain

Better image thanks to digital measurement technology

Background Page 4444 Continuing medical education (CME) Brushing up on knowledge – made simple

Place to be Page 4646 Traveling in northern Portugal Enchanting Porto

Stimulus Page 5050 Endowed professorship for Phlebology Point of contact for domestic and

international research projects

Expert discussion – Page 36 Place to be: Enchanting Porto – Page 46

LumboTrain in physiotherapy – Page 33 Stylish and effective – Page 34


WORLD OF BAUERFEIND

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Andreas Toba fights his way backThe artistic gymnast is currently working hard on his return to athletic competition. Despite suffering a torn cruciate ligament during the qualification for the team finals at the Summer Olympics in 2016, he still climbed on the horse and his performance ensured that his team made the finals. Toba was done for the games, however. Bauerfeind is supplying medical aids to help the 26-year-old multisport champion with his recovery. The approach utilized here is aligned with the recovery process. For example, shortly after he suffered the injury, Toba was given the immobilizing GenuLoc orthosis, followed by the restrictive SecuTec Genu hard-frame orthosis (see photo). “I would never have been able to start training again without it ,” Toba explains. “The orthosis gives me a feeling of security, and during the current regeneration phase it’s especially important to have optimal support so that you can concentrate on the exercises rather than the knee.” Toba is now training with the muscle-activating SofTec Genu orthosis. His goal is participate in the World Championships in Montreal this fall. †

WORLD OF BAUERFEIND


WORLD OF BAUERFEIND

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WORLD OF BAUERFEIND

Scoring like the prosDribble, fake, pass – 15 graduates of the “Technical Sport Orthopedics” continuing education course hit the court in the Bundesleistungszentrum Kienbaum athletic facility near Berlin at the beginning of December 2016. They were there for the four-day Bauerfeind Basketball Camp that featured professional training provided by the Alba Berlin basketball team as well as medical , therapeutic, and orthopedic content. For example, Christian Teusch, Senior Physician at the Merzig Clinic, was on hand to talk about ankle injuries in basketball and offered an inside look at the work team physicians do with athletes during tournaments. †

Well taken care of by BauerfeindBauerfeind Austria and the Austrian Skiing Association (ÖSV) have a partnership dating back to 2010. Ski cross world champion Andrea Limbacher is now benefiting from this partnership for a second time. Bauerfeind provided assistance to Limbacher after she suffered her first knee injury in March 2016, when she fell badly while skiing and ended up tearing several ligaments in her right knee. Shortly after she recovered and resumed training, the 27-year-old fell badly again in January 2017, this time suffering a torn cruciate ligament in her left knee. Never-theless, Limbacher is determined to take part in the 2018 Winter Olympics, and Bauerfeind will accompany her to Pyeongchang, South Korea. In the meantime, the company is supplying the Austrian skier with supports and orthoses to help her recover from her current injury. †


WORLD OF BAUERFEIND

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WORLD OF BAUERFEIND

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Extensive discussions on HHVG draft legislation

The right partner in Russia

➊ Nearly 400 medical supply retailers and orthotists met on November 3 and 4, 2016 for the 11th Bauerfeind Sector Forum in Munich. A major topic at the event was the new draft legislation on improving the provision of therapeutic and medical aids (German acronym: HHVG). A discussion on the topic was conducted with Dr. Roy Kühne (center), member of the Health Committee of the German Parliament (Bundes-tag); Gisela Bödeker (2nd from right) from Bödeker Orthopädie-Technik GmbH, Albin Mayer (2nd from left) from Orthopädie-Technik Mayer & Behnsen GmbH, and Dr. Dirk Usadel (left), an attorney from Munich. The discussion was moderated by Henning Quanz (right). A large number of people in the audience agreed with Dr. Kühne about the need to fundamentally restructure the Medical Aids Register. There was also extensive agreement regarding the need to eliminate the HHVG clause requiring additional payments to health insurance companies to be reported. †

➋ Several milestones were celebrated in Moscow in early December 2016. First of all , Bauerfeind AG and Nikamed, its Russian distribution partner, celebrated the fifth anniversary of their partnership. In addition, Nikamed celebrated its 20th anniversary in 2016 and opened the 100th Ortheka store stocking Bauerfeind products. Professor Hans B. Bauerfeind praised the successful partnership in his speech at the reception in Moscow. “Nikamed is the perfect partner to distribute our products in Russia,” said the Chairman of Bauerfeind AG. “We share the same understanding of excellent quality in terms of products, services, and sales.” Pictured, from left: Anton Shaitov, Nikamed project manager; Sergey Shaitov, Nikamed Managing Director; Prof. Hans B. Bauerfeind and his wife, Marion Bauerfeind; and Ulf Harzmann, General Manager International Sales at Bauerfeind AG. †


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Supports and orthoses are part of the rehabilitation program for use with smartphones and tablet PCs.

Combined overstocking and liner.

Bauerfeind online shop

Measuring and ordering Bauerfeind products is now easier than ever before. The Bauerfeind online shop has a new design and offers even more product information and technical features – but the biggest change involves the fact that the Bauerfeind measurement systems are now fully integrated into the website. This means that customers with measurement systems only need to enter the new access data in the Bauerfeind measurement technology software system, after which their existing measurement and supply data are automatically loaded. Customer Service provides information on this and other features tel.: +49 36628-66 33 66. †

Measurement systems now fully integrated

The Bauerfeind online shop: Faster and easier – with new features as well.

VenoTrain ulcertec compression stocking system

The VenoTrain ulcertec compression stocking system – with its unique compression profile – assists the healing process of venous ulcers on the leg after the decongestion phase. The system’s overstocking and liner combine to create and permanently maintain the therapeutically specified contact pressure in the ankle area. To be worn day and night , the liner holds the wound dressing in place. It provides continuous, low-level compression during periods of rest , thus assisting the wound healing process by applying basic compression, even at night. The overstocking is worn over the liner during the day and ensures the required high level of working pressure during movement. The two-component system not only comes in five sizes (each in two circumference sizes and lengths); it is also now available as a custom-made solution. †

Now available as a custom-made solution

Bauerfeind USA has partnered with the medical software company Trainer Rx (www.trainer-rx.com) to launch a comprehensive, prescription-based rehab program taking patients from injury through recovery. The platform features surgical and conservative “pathways” with audio, video and written instructions on rehab exercises and home self-care. In an exclusive deal , Bauerfeind’s products are prominently displayed in over 100 individual exercise videos showing how the braces and supports can help in a rehab program.Trainer Rx is meant to supplement , not replace, in-clinic physical therapy. As insurance companies continue to reduce authorized PT visits and patient co-pays/deductibles remain high, healthcare providers and patients struggle to find cost effective recovery solutions. Trainer Rx provides a longitudinal recovery program allowing doctors, patients, and physical therapists to track progress while providing evidence-based medicine. By improving patient compliance and satisfaction as well as measuring patient reported outcomes, Trainer Rx benefits patients and healthcare providers alike. †

Recovery made simpleBauerfeind and Trainer Rx


NEWS

GloboTec Comfort style heel foot orthosis

Stabbing pain in the heel can make walking extremely painful. The “GloboTec Comfort , style heel” orthopedic orthosis counteracts the causes and helps prevent the problem from becoming chronic. Its slim core construction adapts to fit the foot shape, relieving the tendon and the rest of the plantar fascia. This provides effective relief to the painful , inflamed area. A heel cushion that is customized for this central section of the foot cushions the hindfoot when walking. Comfortably soft movement with reduced pain is further guaranteed by a three-millimeter long-sole cushioning. As an everyday product , the new foot orthosis bridges the gap between emergency treatment with heel cushions and the premium care provided by the ErgoPad redux heel orthosis. The GloboTec Comfort style heel is available in sizes 35-48 and can even be worn in very snug-fitting shoes. †

Targeting chronic heel and ankle pain early

The highly endowed award is presented every two years.

The straps and adjustable joint splints guide the knee securely during movement.

The special foot orthosis structure ensures targeted pressure relief.

GenuTrain S Pro knee support

GenuTrain S Pro provides support for the knee joint in the case of minor to moderate instability, arthrosis of the knee, arthritis, and meniscus injuries, and it also protects the knee by restricting bending and stretching movements. As of April , the support will also be available as a custom-made solution. Here, circumferences are measured at the middle of the knee and five other parts of the leg, after which the associated distances are defined in order to ensure the anatomically shaped knitted fabric fits perfectly. The side joint splints, which are also anatomically shaped, can be individually adjusted by an orthotist. †

Now part of the range as a custom-made solution

9. Bauerfeind Phlebology Award

Phlebologists, angiologists, and dermatologists – pay attention! Since 2001, Bauerfeind AG has been conferring the Bauerfeind Phlebology Award, which is endowed with EUR 20,000, in association with the Interna-tional Union of Phlebology (IUP). Those who have an idea for an excellent phlebological study design in the field of compression treatment can enter their concept for consideration in the 9th BPA competition up until Octo-ber 30, 2017. The assessment and selection of the submitted proposals is performed by an international jury made up of high-ranking partici-pants and chaired by Dr. Nick Morrison, President of the IUP. The awards ceremony will take place during the IUP World Congress from February 3-8, 2018 in Melbourne, Australia. If you have any questions about the Bauerfeind Phlebology Award and how to apply, please contact: Dr. Hans-Jürgen Thomä, e-mail: [email protected]. †

Submit your entry now!


15 kilograms, which means it’s ideal for mobile applications,” he says. “For example, it’s perfect for use in special company campaigns and at trade fairs and other events.”

Remote management and maintenanceThe Rothballer 360 also offers another key benefit , as the initial commissioning of the calibration-free system only requires the installation of a software program that comes with the product on a CD. Installation support and instructions

Rothballer 360 measurement system

and training for users can all be managed remotely. Medical retailers that opt for the Rothballer 360 not only benefit from an image boost and fast measuring procedures (“an upper leg measurement takes less than 30 seconds,” says Rothballer); they also obtain precise and reproducible data from the system. “The system doesn’t replace specialists; it supports them,” Rothballer explains. “The specialist always conducts a plausibility check of the measurement results and uses the mouse to set the measuring points at the knee, or at the crotch and waist in the case of pantyhose. The highly precise digital measurement of the legs ensures a perfect fit later on, as well as a high degree of wearing comfort , all of which adds up to better treatment results.” †

“Space often plays a major role for orthopedic technology specialists and medical supply retailers who are looking for a measurement system for fitting compression stockings,” says Jörg Rothballer, founder of Rothballer electronic systems. “Such companies are also interested in reliable deliveries and easy commissioning of the devices – regardless of where they need to be used.”

The Rothballer 360 is a new compact 3D scanning system for the lower extremities that meets all of these requirements. The measurement system consists of a small rotating platform with a scanner that can be folded out when it’s needed and which then circles around the patient. “All you need for this is 1.6 meters by 1.6 meters of space,” Rothballer explains. “After the measurements have been taken, the arm with the scanner is simply folded back in and the entire system can be set off to the side or turned upright.“ It was very important to Rothballer, who is himself a master orthotist , that the 3D measurement system be portable. “It weighs only around

Set it down, open it up, and start measuringThe Rothballer 360 is now available. The 3D measurement system for providing compression stockings is particularly compact and easy to operate.

Jörg Rothballer, founder of Roth-baller electronic systems.

Practical even in small rooms: The Rothballer 360 can be folded up and stored in a space-saving manner after use.

“The system doesn’t replace specialists; it supports them.”

(Jörg Rothballer)

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Further information

For additional information about the Rothballer 360 3D measurement system, call the service hotline: +49 (0)961-518 71 94.

NEWS

IMPORTANT DATES


Bodytronic 600 measurement system

Up until recently, the Bodytronic 600 digital measurement system could only be used to measure legs up to the hip. Now Bauerfeind developers have gone a step further by enabling exact 3D models of the upper body to be created with Bodytronic 600. To this end, the scanner is now height adjustable. The measurement procedure itself remains unchanged: The patient stands on a mea-surement platform that rotates at a constant speed while beams of light are projected as a pattern onto the upper body. This pattern is then captured digitally, thereby enabling the calculation of an exact 3D cloud diagram

New: 3D model of the upper body

March 2017

March 16–18, 2017Therapie Leipzig trade fair, Leipzig, Germany, www.therapie-leipzig.de

March 21–24, 2017 134th Conference of the German Surgical Society, Munich, Germany, www.chirurgie2017.de

April 2017

April 26–29, 2017 49th Conference of the German Dermatological Society, Berlin, Germany, www.derma.de/de/fuer-aerzte/49-ddg-tagung/

April 27–29, 201765th Annual Conference of the Association of Southern German Orthopedics and Trauma Surgeons (VSOU), Baden-Baden, Germany, http://jahrestagung2017.vsou.de

April 27–29, 2017 EXPOLIFE, Kassel , Germany, www.expolife.de

May 2017

May 3–5, 201727th Conference of the European Wound Management Association, Amsterdam, Netherlands, www.ewma.org/ewma-conference/2017/

May 10–12, 2017DEWU Deutscher Wundkongress der ICW e.V. (German Wound Conference), Bremen, Germany, www.deutscher-wundkongress.de

May 13–15, 2017XXVI International Conference on Sports Re-habilitation, Traumatology, Barcelona, Spain, www.footballmedicinestrategies.com/en/

May 26–27, 201743rd European Congress of Lymphology, Stuttgart , Germany, www.eurolymphology.org

May 31 – June 2, 201718TH EFORT Annual Congress, Vienna, Austria, www.efort2017.org

June 2017

June 23–24, 2017 32nd Annual Conference of the German Society for Orthopedic Traumatologic Sports Medicine (GOTS), Berlin, Germany, www.gots-kongress.org

June 23–25, 2017 8th Wachau Venous Symposium, Melk, Austria, www.venensymposium.org

June 29 – July 1, 2017 8th European Venous Forum, Annual Meeting, Porto, Portugal , www.europeanvenousforum.org

To generate the 3D model , the system projects beams of light onto the relevant body part and records them digitally.

Now possible: Digital models of the upper body.

of the body segment. Bodytronic 600 uses the data thus obtained to create an exact three-dimensional image of the body area measured. Such 3D models of the upper body make it easier for technicians to produce and make adjustments to back orthotic aids. The 3D data can be exported in standard formats, which means it can be further processed in the user’s own CAD/CAM software system (digital plaster cast room).

Free software updateThe expanded system function is implement-ed via a free software update. Bodytronic 600 users interested in conducting upper body measurements should contact the measurement technology hotline: +49 (0)36628-66-29 00.Looking ahead, further refinements will make it possible to derive the sizes for medical aids from the dimensions of the upper body model and then order the appropriate product directly from the Bauerfeind online shop. †


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Bones need to moveOsteoporosis

Every vertebral body is like a solid house in which the horizontal and vertical trabeculae from the frame and massive roof plates are mounted on the walls. When bone metabolism starts to change at the age of 30, bone statics can slowly become unbalanced and a powerful deterioration process can set in that blocks bone regeneration. That’s how things work naturally – but osteoporosis accelerates these processes. >>>


Her pain got worse, however, and she went to the doctor. When the x-rays came back, she was shocked to find out that she had suffered two vertebral fractures. The “good news” was that the fractures were stable and that surgery would initially not be required. Nevertheless, the day before Christmas two years ago is a day Ursula Hartwich will never forget.

Despite frequent indications, only few people get checked for osteoporosisThe dangerous thing about osteoporosis is that there are very few initial external

The trabeculae deteriorate more rapidly, bones become less firm and more brittle and eventually break – first one and then many. People with osteoporosis are afraid that they will no longer be able to lead the same type life that they have in the past. However, a new back orthosis can help people who suf-fer from osteoporosis regain their confidence and lead active lives: Spinova Osteo reduces pain, straightens the spine, and improves the patient’s gait. In this manner, the orthosis help bones once again do what they need to most , which is move.

One of many: Ursula Hartwich You can hardly see any signs left by the woman walking through the autumn leaves, which rustle only just a little when Ursula Hartwich walks on by. Hartwich, 73, moves pretty fast. The young person accompanying her has to make an effort to keep pace. “I love nothing better than to be outside in na-ture,” says Hartwich as she looks up into the trees in the Stadtpark in Leipzig. She keeps moving quickly and has no need to slow down – which is actually amazing because Ursula Hartwich has osteoporosis.

Half of all women over 70 suffer from osteoporosisSome six million people have osteoporosis in Germany, and around 80 percent of them are women. The exact numbers are difficult to determine because the condition often goes undetected for a long period of time. According to the World Health Organization (WHO), osteoporosis is one of the most com-mon diseases worldwide. It is most frequent-ly caused by insufficient levels of estrogen. When hormone concentrations decline in women during menopause, bone deteriorates faster than it regenerates. One out of three

women begin suffering from osteoporosis directly after menopause, while half of all women over 70 have osteoporosis.

“I thought it was a bruise”Just two years ago a walk in the park would have been unthinkable for Ursula Hartwich. It was in that year that she fell while getting out of a tram on the day before Christmas. “At first I only felt slight pain in my back,” Hartwich, who is a petite women, recalls. “I thought I had a bruise, and you tend to grow accustomed to pain to a certain extent when you get old.”

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Ursula Hartwich now walks with confidence: Spinova Osteo is underneath her jacket to support her.

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>>>

Risk factors for osteoporosis

• Lack of movement

• Low-calcium diet

• Vitamin D deficiency

• Nicotine, alcohol

• Low weight (BMI < 20)

• Estrogen deficiency

• Metabolic disorders

• Medications – e.g. cortisone


symptoms. In the early stages of the disease, patients often complain of a feeling of weak-ness in the back. Pain is often dismissed as being “age-related,” meaning the disease is frequently detected too late. The Dach-verband Osteologie (Umbrella Association for Osteology) estimates that only half the people who suffer multiple osteoporotic frac-tures are actually treated for osteoporosis.

“I had bad reactions to bone-strengthening medication”A bone density test using the DXA method revealed a value for Hartwich of less than minus 2.5, which is the threshold value for osteoporosis. She was very much aware of her risk of suffering another osteoporotic frac-ture, but she had only limited possibilities to do something about it: “I had bad reactions to the bone-strengthening medication (bisphosphonates),” Hartwich explains. “I was very careful at home and I drank milk – I didn’t things would get that bad that fast.”

Prevention: A healthy diet and exercise Milk products are the primary source of cal-cium, which is the main component of bone. Many Germans don’t take in enough calcium, and they also don’t exercise enough – and both of these aspects increase the likelihood of suffering from osteoporosis. Lack of move-ment leads to a deterioration of bone mass. Regular exercise helps bones absorb calcium, and when the sun shines, vitamin D forms, which transports calcium from the intestines to bone tissue. Elderly people should also avoid being underweight (BMI < 20). Exces-sively low weight leads to a lack of muscle mass and because muscles and bones are closely related to one another, lower muscle mass also means less bone material. More specifically, the density of a bone increases in line with the degree of muscle force ex-erted upon it , and the sensitivity threshold must be repeatedly reset here.

Spinova Osteo at her sideThe pain continued after Ursula Hartwich’s fall , but pain medication wasn’t an option after her bad reaction to the pills. So, what was she to do? “I was completely rattled,” Hartwich says in a soft voice as as she sits down straight on the sofa in her small apart-ment after returning from her walk in the park. “Then my doctor prescribed this here for me.” Hartwich now turns her upper body, reaches for an object lying next to her and places it on a table. It’s an orthosis – “my constant companion,” she says. “Well , nearly constant ,” she adds with a smile. Hartwich

Further informationAdditional information on these conditions and their symptoms can be found at the Dachverband Osteologie (Umbrella Association for Osteology) website: www.dv-osteologie.org.

mainly wears the new Spinova Osteo when she goes on walks with her beloved hiking

club, which she’s been a member of for over 20 years. “For one long year I couldn’t go on any hikes – that was the worst thing for me,”

Osteoporosis and osteoarthritis: New CME course

Bauerfeind is now offering a certified CME course on degenerative diseases. The first course module addresses the pathogenesis and diagnosis of osteo-porosis, as well as treatment options. It was created by Dr. Peter Schorr from the Vitarium Health Center in Dillingen/Saar. Module 2, which examines the clinical symptoms and treatment of osteoarthritis, was created by Dr. Stefan Sell , Chief Physician at Gelenkzentrum (joint center) Schwarzwald, Neuen-bürg Hospital. The German course can be found on the portal at www.cme-medipoint.de and is also available from Customer Service as a printed bro-chure. An English-language PDF can be ordered via e-mail ([email protected]). You can read more about Bauerfeind CME courses on page 44.

she recalls. The stabilizing and straightening orthosis now allows Hartwich to once again go hiking and take walks in the park. The pain she suffered is nearly gone. “I feel secure in my body again,” she says as the visit comes to an end – and orthosis or no orthosis, she insists on accompanying us to the elevator. Her Spinova Osteo hangs on a coat rack, almost like a reminder of what good posture is supposed to look like. †

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Spinova Osteo corrects posture and encourages patients to stand up straight.

“I feel secure in my body again.”

(Ursula Hartwich)


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high their risk is, while others already display symptoms. Many are completely surprised when they find out that their diffuse symp-toms are being caused by osteoporosis.

Are more and more people learning about the disorder?Dr. Schorr: Things have gotten better. There are a lot of informative reports in the media.

Bauerfeind life: You work in a facility that focuses on osteoporosis. How does that benefit patients?Dr. Schorr: All physicians in our orthopedic group practice have been certified by the Dachverband Osteologie (Umbrella Association for Osteology – DVO) since 2004. This certifica-tion in bone metabolism disorders has to be renewed every five years, which means that

patients are always treated by physicians who possess the latest knowledge in the field.

What type of patients seek you out?Dr. Schorr: Most of our patients are women who come to us after menopause. However, we also have male patients. The knowledge all of these patients possess is varied. Some are well informed and just want to find out how

Multimodal osteoporosis treatment

“ Osteoporosis is complex but manageable”As an osteologist and pain therapist , Dr. Peter Schorr from the Vitarium Health Center in Dillingen/Saar knows a great deal about how the disease emerges and progresses. Schorr believes that a flexible straightening orthosis offers a very good option for treating stable vertebral fractures.

Dr. Peter Schorr recommends multimodal osteoporosis treatment for pain therapy applications. Orthoses are part of this approach as well.


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However, even we doctors didn’t really be-come aware of osteoporosis until the 1980s. The disorder is tricky. For example, a patient can sit down abruptly and suffer a fracture of the vertebral body without having previously experienced a level of trauma one would con-sider necessary for this. It’s hard to predict something like that. Osteoporosis creeps up on people. The fractures in the initial stages are often compression fractures with diverse symptoms ranging from absolutely no discom-fort to severe pain.

How do you treat osteoporosis at your center?Dr. Schorr: First we need to determine if we’re dealing with primary hormone-related osteo-porosis or secondary osteoporosis that results from risk factors. It’s therefore very important to draw up a detailed medical history in each case. We also measure bone density in the spinal and hip areas using the DXA method. Diagnoses and treatment decisions are car-ried out on the basis of the DVO guidelines: Depending on the results of the examination of the patient , we select the right medication to prevent further bone atrophy and prescribe

vitamin D and/or calcium supplements. We of-ten need to relieve pain as well , and as a pain therapist I can initiate a multimodal treat-ment. However, it takes more than painkillers and physiotherapy to alleviate pain. I also need to relieve pressure on skeletal sections of the spine subject to inappropriate mechani-cal stress – and I do this with orthoses.

How do orthoses support your multimodal treatment concept? Dr. Schorr: Orthoses are designed to straight-en the upper body and relieve pressure on sec-tions of the ventral vertebral body. They can reduce the pain caused by static inappropriate mechanical stress and help prevent further fractures. It’s important to be able to adapt orthoses to individual body shapes. The idea is to achieve as much support as necessary with the least possible restriction, as patients will only wear an orthosis that they feel comfort-able in. This is actually where the problem lies,

as some orthoses work well when patients are standing but cause pressure or slide upwards toward the head when they sit down.

What’s your opinion of the new Spinova Osteo?Dr. Schorr: There aren’t all that many orthoses that meet the requirements I’ve mentioned. The Spinova Osteo is a straightening orthosis that also works well when patients are seated. Its central axis ends in a form-fitting manner at the upper spine; it doesn’t slide up. It’s un-obtrusive under clothing, provides for a secure enclosure of the pelvic area, and displays good stability in the back region. It straightens up the thoracic spine, but its structural design prevents hyperlordosis. The orthosis provides support toward the back and also allows for movement , which is extremely important.

Movement rather than stabilization?Dr. Schorr: Both! Naturally, external stabiliza-tion is important in the case of fresh stable vertebral fractures, as such stabilization relieves pressure on the affected areas of the vertebral body and also alleviates pain. In this sense, stabilization makes it possible to reduce the use of painkillers, which is an important aspect with regard to older patients who may already be taking multiple medications or have problems with side effects and interactions. This in turn improves quality of life and makes things safer for patients – in the sense of pre-venting falls as well. At the same time, use of the right orthosis increases mobility, which is something we also want to see after a vertebral

fracture because it’s important that patients begin to trust their bodies again and start moving. Orthoses with activating functions for back extensor muscles and trunk muscles can promote such trust and movement.

Is it just the muscles that benefit from the movement , or do the bones benefit as well?Dr. Schorr: Movement and pressure and the associated muscle pull a have a positive ef-fect on bone metabolism. The tension of the muscles exerts mechanical pressure on the bones. The piezoelectric properties of bones convert this mechanical force into electrical potential that impacts bone cell metabolism. This metabolism is out of balance in osteo-porosis patients. Here, osteoclasts, which are cells that break down bone, are present in greater numbers than the osteoblasts that build up bone. However, when pressure is exerted on bones, the tables are turned: Growth of osteoblasts is stimulated and bone material becomes more solid again. In other words, the type of movement that the right orthosis enables can, in combination with other treatment steps, improve bone density in osteoporosis patients. This means that it’s important to choose an orthosis that’s conducive to the multimodal treatment.

Is osteoporosis curable?Dr. Schorr: Let me put it this way: Osteo-porosis is a complex condition that must be treated – but it can also be managed if you start treating it early and properly. †

“Movement and pressure and the associated muscle pull have a positive effect on bone metabolism.”

(Dr. Peter Schorr)

Dr. Schorr likes the new Spinova Osteo because it straightens up the thoracic spine while also preventing hyperlordosis and allowing for movement.


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Spinova Osteo

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Spinova Osteo relieves pressure on the spine, especially in patients with osteoporosis, by straightening the upper body, stabilizing the sagittal plane, and providing support in a way that reminds patients to correct their posture. This reduces pain, prevents postural misalignments, and improves the patient’s gait.

New orthosis for actively straightening the spine

The Spinova Osteo straightens the spine both passively and actively. Its low pelvic support firmly encloses the pelvic girdle and thus stabilizes the area between the spine and the lower extremities. The stabilization of the tho-racic spine and the correction of the kyphosis is achieved with an aluminum reclinator with a particularly long lever. This reclinator is held in place by a special tensioning strap system that presses it against the entire spine in a form-fitting manner. The tensioning straps are adjusted to achieve the desired straightening pressure. In the case of postural misalign-ments, the orthosis exerts gentle pressure against the patient’s back to encourage him or her to stand up straight. This active posture correction feature strengthens the upper back muscles. As a result , Spinova Osteo helps re-establish good sagittal balance by ensuring a stable pelvis, an upright posture, and strong back muscles. This in turn helps prevent falls and also supports osteoporosis patients undergoing kinesitherapy treatments.

Can be adapted to individual patients Spinova Osteo stands out through its very lightweight and flat design. It’s unobtrusive under clothing and has a discreet appearance. The orthosis leaves the chest and stomach area free; Velcro fastenings with hand and finger loops make it easy to take on and off. The orthosis is part of the innovative Spinova product family that

allows functions to be adjusted to individual patients. For example, the tensile force of the straps, and thus the posture correction, can be set individually by the patient when he or she puts on the orthosis. As a straightening

Patients can use the finger loops to adjust the straightening tensile force as required.

orthosis, Spinova Osteo also complies with the recommendations in the osteoporosis guidelines issued by the Dachverband Osteologie (Umbrella Association for Osteology – DVO). †

Comfortable design: The orthosis leaves the ab-dominal and chest area free.

Spinova Osteo straightens the spine, keeps the pelvis stable, and improves sagittal balance.

More than one way to fight osteoporosis

Bauerfeind also offers two other osteo-porosis treatment orthoses besides Spinova Osteo: DorsoTrain and SofTec Dorso. DorsoTrain, which is shaped like a bodysuit and has lateral body straps and a plastic reclinator integrated into the back section, aligns the spine and gives it mod-erate support. It can be taken on and off easily with a zipper, is made of a breath-able, skin-friendly material , and offers relatively extensive freedom of movement. The SofTec Dorso spinal orthosis is used

in cases involving multiple osteoporotic fractures. It can also be employed to treat spondylolisthesis or used after opera-tions on tumors. It relieves pressure on the spine and has a stabilizing effect up to TH8 with its firm knitted fabric and a reclinator made of carbon fiber-reinforced plastic. Like Spinova Osteo, SofTec Dorso is also worn like a jacket and fixed with ten-sioning straps. Also like Spinova Osteo, it leaves the chest area free and guides the straightening forces over the shoulders.


Clinical osteoporosis treatment

Once a vertebral fracture occurs, the risk of other fractures occurring increases substantially. Neurosurgeon Dr Torsten Roediger would like to address this problem at an early stage – and orthoses are a component of his approach here.

The first vertebral fracture changes everything

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Dr. Roediger recently had to once again explain to a patient that surgery made no sense in her particular case. The patient in question had already suffered numerous compression fractures. “That was really a big blow for her,” says Roediger. Nevertheless, surgery is not always the best option for helping patients with osteoporosis – in terms of a risk-benefit calculation as well. For example, the very poor bone quality of patients in advanced stages of osteoporosis can lead to subsequent breaks or material weaknesses after surgery, and these might make it necessary for the attendant physician to perform additional and even more extensive operations. For this reason, a great deal of thought must go into the treatment approach for each patient , particularly with regard to whether surgery should also be considered as an option. Roediger, who works at the Clinic for Orthopedics and Trauma Surgery at St. Joseph’s Hospital in the Tempelhof district of Berlin, occasionally has to deal with an orthopedic surgeon’s worst nightmare: “Bones as soft as butter – I can sometimes penetrate a highly osteoporotic bone without much effort using a normal surgical penetration needle. I would need a hammer to do that with a healthy bone.”

Surgery and multimodal treatmentOne thing is needed more than anything else if vertebral fractures are to be properly treated and permanently healed: a solid bone foundation. Surgical procedures such as filling vertebral fractures with cement (vertebroplasty/kyphoplasty), or stabilizing affected areas with a screw-rod system, have to be based on specific concepts that will be effective over the long term as well. “When you look at post-surgical x-rays, you often see a good result ,” says Roediger. “The question is: How long will it last?” One thing is therefore clear for Roediger: “Multimodal

Neurosurgeon Dr. Torsten Roediger believes multimodal osteoporosis treatments should be used at the earliest possible stage.

osteoporosis treatment should be started as soon as possible.” Medication for strength-ening bones and thus preventing further fractures is the key here. Indeed, as Roediger points out: “By the time patients come to us, it’s often too late.”

Flexible orthosis for a complex system in motion Once a vertebral fracture occurs, the risk of other fractures occurring becomes extremely high. Orthoses can play a major protective role in such situations, according to Roedi-ger. “External stabilization is a very reliable system,” he explains, adding that straight-ening and flexible orthoses can be easily integrated into patients’ everyday lives and have also proved their worth in post-surgical settings. “I can effectively use orthoses that allow movement at an early stage after surgery,” Roediger explains. “The spine is a complex moveable organ that can be sup-

ported very well with a flexible orthosis in a manner that builds up muscles while at the same time ensuring additional stabilization.

Regaining one’s previous quality of lifeOrthoses are used quite often in clinical settings to treat osteoporosis patients who have suffered vertebral fractures. “However, studies on the therapeutic effects of orthoses have also increased their acceptance among physicians in private practice even further,” Roediger points out. Good communication between physicians in private practice and their colleagues in hospitals, as well as continual examinations of bone density in short intervals, are absolutely essential for creating a solid foundation for the prevention of osteoporosis and thus fractures as well. “We are an ageing society,” Roediger explains, “but that doesn’t mean that we have to accept age-related diseases.” †


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Modified SecuTec Genu knee orthosis

Two experts, one orthosis: Dr. Hendrik Baum, Deputy Senior Physician at the Clinic for Orthopedics and Trauma Surgery at Altenburger Land Hospital , and Stephan Pohle, expert orthotist at Sanitätshaus Altenburg GmbH, talk about the new SecuTec Genu, which they both helped further develop.

“Secure fit , great design”

Bauerfeind life: Who do you supply the new SecuTec Genu to?Dr. Baum: Athletes and non-athletes, young patients and old patients. The orthosis, which has been developed further, can be used in a broad and varied way to treat most knee injuries. For example, it can be employed for the conservative treatment of collateral ligament injuries as well as after a meniscus refixation or a complex surgical re-construction of the knee joint. In the case of athletes especially, orthoses need to display

a high level of stability and functionality. A good example here involves skiers who have suffered injuries such as collateral ligament or cruciate ligament tears. However, SecuTec Genu can also be used proactively to prevent relapses or counteract existing instabilities. Does this also apply to hobby skiers?Dr. Baum: The orthosis can be used to treat everyone from competitive athletes to “nor-mal” patients. If a patient asks me about their ability to resume athletic activity after

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Two experts, three points of view: Dr. Hendrik Baum meets up with orthotist Stephan Pohle in the clinic operated by Sanitätshaus Altenburg GmbH. Pohle is currently using the new SecuTec Genu to help with his recovery from a knee injury.

a recently treated knee injury, especially one associated with skiing, I will recommend that they participate in sports only under certain circumstances – and then with a fit-ted orthosis. SecuTec Genu has in fact dem-onstrated its ability to withstand stress and protect sensitive areas in the case of strain brought about by athletic activity especially. Both “normal” patients and athletes benefit here if one uses this parameter as a standard for product development and then defines a stabilization target.


Mr. Pohle, you yourself have experience us-ing the knee orthosis as a patient following an accident. What do you as a technician have to say about the new properties of the orthosis? Stephan Pohle: From a technical point of view, I very much like the hinge adjustment feature, which is now simple and practical

and includes an easily readable scale. I can do the adjustments without having to use a tool or exert myself too much, which makes it a lot easier to put the orthosis on the patient. That makes for smoother patient consultations and therefore allows me to spend more time explaining details. I also think the new height-adjustable calf strap is very good. It shows patients that although the product is pre-fabricated, I can nevertheless individually adjust it to their anatomy. This type of fast and easy adjustment is incredibly valuable to patients who are still very much occupied by their knee injury. In addition, calf circumference can change quickly throughout the course of rehabilitation, which means slips have to be avoided at all costs.

Other alterations are also made to ensure secure positioning of the orthosis… Stephan Pohle: … of course – a proper fit is extremely important. The orthosis should never be allowed to exert pressure in the wrong place. The additional thigh strap plays a key role here, as it allows for an extra fastening. The orthosis fits tightly on the knee and doesn’t slide back. This makes for a very convincing feeling of security and stability – and patients notice this as soon as they put on the orthosis.

Stephan Pohle, expert orthotist at Sanitätshaus Altenburg GmbH.

SecuTec Genu – stabilizing knee orthosis

This further development of SecuTec Genu features new functional solutions that improve both conser-vative and pre and post-surgical treatment of knee injuries.The frontal application of the orthosis and the more simplified locking of its straps make it easy for patients to put on, espe-cially when their freedom of movement is limited due to a recent operation or the injury itself. The hard-frame ortho-sis can be adjusted without tools, which makes it easier to adapt the light and flat aid to

Dr. Baum: The additional thigh strap expands the contact surface to the thigh even further and thus makes the orthosis even more stable. The fit is also tighter. This keeps the orthosis from sliding, which would make it less effective.

How have patients responded to the flatter and more modern design? Dr. Baum: It’s truly a great development! We in the medical field are always looking to make things like implants and medical aids smaller, lighter, and more inconspicuousness, but also more effective at the same time. A particularly flat orthosis is therefore a logical step here. Such a design increases the level of wearing comfort and patients also feel less restricted. In addition, this design results in less contact with or injuries to the opposite side in the case of cyclists

and hockey players, or patients with large thigh circumferences. The initial experience that’s been gained with athletes who underwent cruciate ligament surgery and then wore SecuTec Genu has confirmed that the patients are especially pleased by the lightness and flat design of the new orthosis.Stephan Pohle: The distinctive color of the orthosis also stands out , of course. It clearly sets the new orthosis apart from a traditional medical aid. I’m sure that more than a few young patients opt for this orthosis because of its vibrant color.

A vibrant color as a compliance factor?Stephan Pohle: Why not? I think it gets young people to identify more with the product; they can tell people: ”Hey, check out this cool thing I’ve got.” The orthosis therefore becomes something one would rather show off than hide – some patients might even decide to wear shorts with it. In this sense, it becomes something of a lifestyle product for people with injuries, although those who use it also trust it completely to do what it’s supposed to. Ultimately, all of these aspects make treatments more effective. †

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individual patient anatomies. A sixth strap on the thigh and a height adjustable calf strap ensure a secure fit. The frames for the thigh and calf come in different sizes and can be combined as needed, which means the orthosis can be made to fit each patient per-

fectly. As a result , a greater number of patients with knee

injuries can now be treated more precisely in line with their

injury patterns and their specific physical constitution. The new

SecuTec Genu is available in classic navy blue and sporty green.

Dr. Hendrik Baum, Deputy Senior Physician at Altenburger Land Hospital.


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Strain-Related Conditions in Competitive Athletes

Unequal leg length triggers a chain reactionDr. Raùl Carrillo from Mexico has been part of the medical delegation for the Ukrainian national team at no less than nine Olympic Games (Summer and Winter Olympics) and provided medical assistance during multiple world championships in different disciplines. The chiropractor is known for his expertise in injuries affecting the neuromusculoskeletal system.

Bauerfeind life: Which parts of athlete’s body are the most at risk?Dr. Carrillo: According to statistics from the International Olympic Committee (IOC), the most common symptoms can be found in the back. Powerful biomechanical forces primarily affect the lumbar spine – then comes the cervical spine, then the upper back, followed by the knees, ankles and shoulders. What kind of injuries and biomechanical alterations can be observed? Dr. Carrillo: It’s well known that excessive strain can trigger a cascade effect. For example, an athlete with legs of different lengths must realize that the function of all joints belonging to the movement axis will be impaired: ankles, knees, hips and spinal joints. The bordering osteocartilaginous structures are also affected, and obviously the associated muscles and tendons.

What can be the consequences of such a cascade effect?Dr. Carrillo: I remember an extreme case of a competitive Taekwondo world champion, whose right leg was one centimeter shorter than the other. With this athlete, one could speak of a chain reaction. She had compensatory scoliosis due to the short limb. This sideways curve of the spine, in turn, caused severe, persistent pain in her middle and lower back. In addition, she suffered two meniscal tears in her right knee that were surgically treated due to the overloading and altered gait. And this painful situation was completed by a hip injury with recurrent bursitis and chronic muscle problems in the TFL and ischiotibial muscles. We identified all of these symptoms retrospectively, after we examined the athlete thoroughly.

The first domino to fall was the difference in leg length. Thus we had to start from point one in order to try to achieve a more stable, functioning structure.

How important are orthopedic aids such as supports and orthoses in your work?Dr. Carrillo: Orthopedic aids play a decisive role especially in combination with physical therapy or chiropractic care. For me, they are of great value in helping to reduce mechanical overload placed on highly stressed joints, ligaments, tendons and muscles. They help injured athletes return to their sport faster.

Dr. Raùl Carrillo took care of Ukrainian athletes at the 2016 Olympics in Rio de Janeiro, where he also made use of the technical orthopedic services provided by Bauerfeind.

The Director and founder of Rebioger/In-tegra Clinics is also a member of the med-ical staff at the Swiss Hospital and the Angeles Hospital in Monterrey, Mexico. He is a Northwestern College of Chiropractic graduate with postgraduate studies at the Centro Internacional de Restauración Neurológica (CIREN), in Havana, Cuba. The specialist has been holding presenta-tions worldwide on sports-related injuries of the neuromusculoskeletal system.

Dr. Raùl Carrillo


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They also contribute to the prevention of further damage. And they can also help protect and stabilize places in the body which are especially vulnerable, such as the knee after cruciate ligament repair, during all postoperative stages.

Can you name some concrete examples?Dr. Carrillo: After collateral ligament or meniscus injuries, I like to use the GenuTrain S. The GenuTrain P3 works wonderfully with patients who suffer from a patellar disfunction such as “mistracking”, where it can stop or prevent cartilage injuries. In order to protect the hand from excess strain after carpal tunnel surgery while allowing it to move freely during everyday activities, I use the ManuTrain active support or the ManuLoc Rhizo if there is any involvement of the 1st metacarpal like with De Quervain’s syndrome. When it comes to the ankle, the AchilloTrain helps me during postoperative or non-surgical care for ruptured Achilles’ tendons or with tendinosis.

What experiences have you and your patients had with these products?Dr. Carrillo: Basically, I must say that Bauerfeind products provide excellent stability due to their neuromuscular effect. When I use supports for knees, elbows and ankles, my patients tell me that they are much more comfortable – and most importantly, involve no friction – when compared to the neoprene supports they had been using. And medical products made of neoprene can sometimes even cause abrasions. One of Bauerfeind’s achievements is their outstanding materials and the anatomic design of their products, as well as their long durability. Are there sports disciplines which can especially benefit from a certain support?Dr. Carrillo: Archers and fencers can really benefit from the OmoTrain shoulder support. These athletes must often train for

hours with their arms fully extended. The strain on the rotator cuffs is enormous, and muscle tears are not uncommon. In addition, there are bursitis and severe tendinosis. Here, the active support can make training a lot easier by reducing the stress on the tendons and muscles in the shoulder area at the rotator cuff. How often are supports and orthoses prescribed in Mexico?Dr. Carrillo: No more and no less than in other countries where the population has become aware of the advantages of a healthy lifestyle, meaning that the general population are becoming more active in recreational sports or just getting involved in a self-regulated fitness program.In Mexico, required medical aids are usually provided by the public healthcare system. Meanwhile many private patients obtain these products themselves, or they are provided by their insurance. Can stress symptoms in sports be prevented?Dr. Carrillo: As a member of the Ukrainian Olympic Team for the last nine Games, Summer and Winter Olympics, as well as the Mexican Taekwondo Team since 2006, I’ve gained considerable experience with these issues relating to the neuromusculoskeletal system. My answer is: It makes sense to perform preventive structural and bio-mechanical evaluations at an early stage, especially with kids starting with serious long hour training programs for different sports or physical activities like ballet , dancing, etc.This includes for example ergonomic adjust-ments made to training and competitive equipment or techniques.It is very important to promote the interaction between patients, coaches, physical therapists, orthopedic specialists, radiologists and chiropractors – in the athletes’ best interest regarding health and performance. The most important thing in my experience is developing a great sense of TEAMWORK. †

Team players in the treatment plan designed by Dr. Carrillo: OmoTrain,

ManuTrain, GenuTrain S, and AchilloTrain.


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Runner injuries

“Many runners are so excited and enthusi-astic about taking part in the marathon or relay events that all thoughts about their health go out of the window,” says Prof. Dr. Christian Gäbler, Head of the Center for Sport and Joint Surgery at Josefstadt Private Hos-pital and Medical Director of the VCM. “We believe it is our responsibility to encourage the participants to pay more attention to their fitness and physical condition. We do this using tools such as email campaigns and the VCM website.” For example, entrants new to running are advised to fill in the PAR-Q questionnaire*, which aims to help them de-termine whether they should consult a phy-sician before taking up exercise. Moreover, for the last four years, every participant who registers for the VCM has also been asked to provide information about their health, such as details about any pre-existing conditions, medication they are currently taking or allergies. “We once, for instance, attended a runner who had collapsed on the course, but after entering his start number into our

On April 22 and 23, 2017, thousands of runners will once again lace up their trainers to take part in races during the weekend of the Vienna City Marathon (VCM). In the run-up to the event , the medical team is pulling out all the stops to minimize the health risks to participants and to ensure that they can be on hand to provide the best possible assistance in the event of any competitors suffering falls.

“ Knee problems should be checked out”

system we discovered, at the click of a but-ton, that he had blood sugar problems. This enabled us to get to the root of his condition extremely quickly and respond appropri-ately,” says the VCM Medical Director. “The response rate is pleasingly high, with more than 50 percent of participants providing us with medical information before the event ,” says the specialist in trauma surgery and sports traumatology with some enthusiasm.

Runners forced to pull out in extreme casesThe VCM Medical Center at the Vienna Sports World Marathon Expo serves as a last-minute port of call for runners experiencing worrying health problems. The on-site team comprises experts in sports traumatology, sports physi-cians, sports scientists, orthopedists, inter-nists, specialists in physical therapy and phys-iotherapists, all of whom have a keen interest in running. “Anyone who isn’t sure whether it is safe for them to run – due to a cold or mus-cular pain, for example – should drop in,” says Prof. Dr. Gäbler. “While we come across quite

a few runners with cramp, for instance, every year we also see people suffering from cardiac arrhythmia, for whom the race could cause a serious medical emergency.” Each year, an average of 400 people attend the Medical Center with health problems before the start of the marathon. “Of these, we force around five percent to pull out. Without a doubt , this is one of the reasons why we haven’t experi-enced any serious medical emergencies at the Vienna City Marathon in recent years.”

Excessive strain a frequent problem According to Prof. Dr. Gäbler, problems caused by excessive strain are the most fre-quent medical issues experienced by runners during training. “The Achilles tendon is the worst affected, followed by the knee and the foot – which is commonly afflicted by a heel spur or other similar problems,” explains the specialist in sports injuries. “More often than not these conditions are caused by unsuit-able footwear,” says Prof. Dr. Gäbler. “Time and time again, I’m astounded by how much energy people put into this hobby without taking the time to undergo a running style and treadmill analysis and seek expert advice to help find the right footwear.” He claims that fatigue fractures are quite a frequently occurring problem, especially in spring. “Vitamin D deficiency is endemic in

Prof. Dr. Christian Gäbler, Head of the Center for Sport and Joint Surgery at Josefstadt Private Hospital , is the Medical Direc-tor of the VCM.

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Central Europe. Runners who increase the length of their training sessions very quickly and extensively are at a particularly high risk of suffering rapid stress reactions in their bones that subsequently develop into fa-tigue fractures. These are especially common in the knee, tarsal region and shin.”

Beware of meniscal damageProf. Dr. Gäbler claims that the majority of athletes unfortunately don’t consult their physician until a problem has already arisen. “At the Sportordination clinic in Vienna, I see around 4,000 athletes from a wide range of disciplines every year, and the majority of them suffer from knee or strain-related prob-lems. Runners in particular have a tendency to trivialize knee complaints,” he continues, add-ing that this is especially problematic when meniscal damage is at the root of their knee pain. “The meniscus is a natural shock ab-sorber. Over time, anyone who runs with a torn meniscus damages their knee as well. I often find that my patients already have significant cartilage damage.” Prof. Dr. Gäbler therefore makes an urgent appeal to all runners to always have knee problems checked out. He has successfully treated many patients with orthopedic aids. “I especially like to use the GenuTrain P3 in runners with maltracking of the knee. I’ve experienced a lot of positive results with this, as it often eases or even stops the athletes’ symptoms very quickly. Above all , the specialist in trauma surgery and sports traumatology believes it is very important that “the use of orthopedic aids is always accompanied with targeted physiotherapy.” And what does Prof. Dr. Gäbler make of the rising popularity of compression stockings, which are also an increasingly frequent sight at the Vienna City Marathon? “I’m very pleased by this development! They are especially beneficial for long-distance runners during both training and races. I notice that runners who wear compression clothing recover a lot better than those who don’t.” As a marathon and half-marathon runner himself, he also has experience of this first hand: “I’ve felt the beneficial effects of these products on recovery in my own body, which is why I always wear compression stockings whenever I run more than 10 kilometers.” †

* The PAR-Q (Physical Activity Readiness Questionnaire) helps individuals determine whether they are ready to begin an exercise routine and was developed by the Canadian Society for Exercise Physiology.

Further information

on the 34th Vienna City Marathon is available at www.vienna-marathon.com.

After starting between the skyscrapers of the UNO City (United Nations Office complex), the

VCM takes runners over the 864-meter bridge crossing the River Danube.


torn muscles and tendons, and broken bones,” continues Dr. Mason.

Proprioceptive effect of supportsWithin the broad range of therapeutic measures that Dr. Mason uses to treat acute and chronic problems, he places a high value on orthopedic supports and orthoses. “I really like using supports – they’re a great help. From Bauerfeind, I most frequently use the MalleoTrain and AchilloTrain for ankle and Achilles tendon complaints, and the GenuTrain knee support ,” reports the native Jamaican. “We want to actively stabilize the athletes with these supports, and to use compression to improve proprioception, which can be impaired by an injury.” Abbey D’Agostino also benefitted from the lateral joint splints of the GenuTrain Pro S. Depending on how the adjustment of the hinges are set , these splints can be used to restrict flexion and extension angle of the leg and correct incorrect movements. †

From the Medical Staff of US Track and Field

From towering achievements to disappointment and injuries – as physician to the US Track and Field Team, R. Amadeus Mason, MD, has already experienced the many highs and lows of his protégés. His goal is to provide the best possible medical support , and this includes using orthopedic supports and orthoses.

“Supports are a great help”

It was one of the most moving scenes at the 2016 Summer Olympics in Rio de Janeiro: During the 5,000 m qualifying heat , US Track and Field athlete Abbey D’Agostino accidentally collided with Nikki Hamblin of New Zealand, who had fallen. Instead of worrying about herself, Abbey D’Agostino helped her competitor to get up, but shortly thereafter sank to the ground in pain. This time, Nikki Hamblin stood by her. The American finished the race far behind the others, but had suffered tears to her anterior cruciate ligament and meniscus. Her team physician, Dr. R. Amadeus Mason, then fitted her with a GenuTrain S Pro from Bauerfeind. “The support is light , easy to put on, and offered the athlete outstanding stabilization,” said the Assistant Professor for Orthopedics at Emory University in Atlanta, Georgia.Dr. R. Amadeus Mason is active in international competition as Chief Medical Officer for the US Track and Field Team. When he travels with the national

team, he usually has access to the athletes’ medical history. Not so at local events, such as national championships. “But this is not a problem, for the type of injuries that occur during competitions are normally easily treatable without needing a complete medical history,” says the sports physician. The most common injuries during training and preparation for competitions are injuries to the ligaments and tendons caused by excess strain. “In competitions themselves, we continually encounter acute traumas,

Dr. R. Amadeus Mason, MD, As-sistant Professor for Orthopedics at Emory University in Atlanta, Georgia.

Two days later, Abbey appeared on the Today Show on Copacabana beach wearing a GenuTrain S Pro.

Rio de Janeiro, August 16, 2016: Nikki Hamblin (left) and Abbey D‘Agostino after colliding during the 5,000 m qualifying heat.

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LumboTrain studies: effectiveness demonstrated twice

An initial study already found evidence that wearing the LumboTrain increases muscle activity. Now, during a second study, pathophysiologist PD Dr. med. Christoph Anders from Jena University Hospital has been able to confirm this and observed a reduction in pain among patients with acute non-specific back pain.

High level of muscle activity, less pain

Around 30 to 40 percent of the population suffer from acute “non-specific” back pain. This term is widely used because there is rarely an obvious cause for this type of pain. “Tense muscles or fasciae are the chief possible culprits of this non-specific, acute, largely lumbar back pain,” says PD Dr. Anders from the Clinic for Trauma, Hand and Reconstructive Surgery at Jena University Hospital. “But overstretched ligaments and shortened tendons shouldn’t be ruled out.” Since the symptoms have no clear causes, a multidisciplinary approach is the best course of treatment. Lumbar supports play an important role in this.

Second pain reduction studyAn initial LumboTrain study on healthy patients countered the criticism that wearing lumbar supports weakens the trunk muscles by finding that this orthosis actually increases both the activity and coordination of certain muscle groups.1A second study examined the effect of lumbar supports on the trunk muscles when walking and under static loading in patients with non-specific, acute lumbar back pain.2

Control group felt more pain than support groupDuring the study, the perception of pain was investigated using the visual analog scale (VAS) at different points in time and

under the effects of static and dynamic loading. Two results stood out in particular. Firstly, in comparison with the control group (patients not wearing a support), the deviation in the amount of pain perceived by the support group (patients wearing a support) on the various assessment dates was lower. Secondly, after walking on the

treadmill , the control group felt more pain than the support group. Lead investigator PD Dr. Anders sums this up as follows: “Besides providing passive stabilization, the support has a stimulating effect on the back muscles. This combination of effects promotes and thereby shortens the natural healing process.” †

Conclusion:

LumboTrain has been proven to relieve pain and activate muscles. The effect is immediate and continues while the patient wears the support. No evidence of muscle atrophy has been found.

1 See Bauerfeind life 2/2014; Anders, C. et al.: Prospective study of the trunk musculature under the influence of compressive lumbar supports. 2 Anders, C. et al.: Prospective study of the trunk musculature under the influence of compressive lumbar supports in patients with acute lumbar back pain.

PD Dr. med. Christoph Anders, Jena University Hospital.

Without support With support

Perception of pain assessed by the visual analog scale (VAS)

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Start of assessment After walking on treadmill

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Demonstrably less pain: The negative figures indicate that pain decreased over the period of the investigation. The scores from the following periods were compared: U1 = maximum of two days following diagnosis, U2 = one week after U1, U3 = three weeks after U1.

Using electromyography to measure muscle activity.


LumboTrain in Luxembourg

Up close and personal – like Bauerfeind’s LumboTrain, Dr. Victor Moser, an orthopedist from Esch-sur-Alzette in Luxembourg, likes to work very closely with his patients. Since 2003, he has prescribed the back support more than 4,000 times for both medical reasons and to assist people in their daily lives.

Pleasant companion

Dr. Moser describes himself as “a man who doesn’t mind getting his hands dirty” by performing reinforcements and other recon-structive surgery on the spine. Or at least he never used to. Now his days as a trainee surgeon are over, Dr. Moser adopts a largely

conservative treatment approach in his orthopedic practice. The orthopedist only treats around ten percent of his patients in the large hospital with which he is affiliat-ed. “Physicians are too quick to operate on the back,” says Dr. Moser with some convic-tion, adding that it is essential to consider how patients will fare after surgery.

Intervertebral discs trouble bankers and drivers alike According to Dr. Moser, patients often don’t feel any better after surgery. The opposite can be said, however, for treatment with the LumboTrain back support. “It is of huge benefit to patients.”

The Luxembourg-based physician uses the active support to treat virtually all forms of instability in the lumbar spine region. “It shapes itself to the spine without causing any stiffening and it eases the pain.”

Dr. Moser’s patients include both profession-al drivers and bankers. These occupational groups frequently have intervertebral disc problems in common. “They both suffer as a result of sitting for too long,” says the ortho-pedist from experience. “LumboTrain helps them to cope with their everyday lives.”

“It’s there when you need it”Back patients often require long-term treatment , which is why, according to Dr. Moser, they require something to support them in their daily lives, whether they are at work, in the kitchen, in the garden or ironing. “LumboTrain is a pleasant com-panion. It’s there when you need it. And it’s barely noticeable under your clothes.” The high number of LumboTrain supports Dr. Moser has prescribed to date is down to the fact that he treats a wide range of

patients of all ages. “As a former physician for the Luxembourgish girls’ gymnast team, I also treat a lot of young girls in this field,” comments Dr. Moser. “Many 14 and 15 year olds already have pronounced intervertebral disc disorders. And LumboTrain helps them

as well.” Dr. Moser used to sell the support directly himself. These days, however, he writes a prescription for the product and the patients pick it up from their local medical supply retailer. They pay for it initially but generally receive a full reimbursement from the state health insurance fund (Caisse de maladie). †

“LumboTrain is of huge benefit to patients.”

(Dr. Victor Moser)

The LumboTrain active support and its model designed especially for women, LumboTrain Lady, fit comfortably yet firmly around the center of the body. The abdominal compression above leads to a slight straightening of the lumbar spine, relieving strain on the lower back. This pain-relieving effect is boosted by the viscoelastic back pad, which has 26 nubs that provide a targeted massage during movement. This relieves tension and simultaneously activates the stabilizing trunk muscles. Over time, this strengthens the muscles and improves the wearer’s posture, helping to prevent back pain from developing.

Strengthens the backLumboTrain lumbar support

LumboTrain eases pain and helps to relieve tension.

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(Dr. Victor Moser)

Dr. Victor Moser, orthopedist in Esch-sur-Alzette, Luxembourg.


LumboTrain in physiotherapy

When Andreas Stommel first opened his outpatient rehabilitation center in the German city of Bonn he employed six people. Today, however, this figure has grown to sixty. The number of back patients has risen too – as have their expectations. “But that’s a good thing!” says the physiotherapist.

“Our patients don’t want any chemicals”

Bauerfeind life: “The back” is the topic on everyone’s lips. Some patients even know how they want to be treated. Does that annoy you?Andreas Stommel: No, not at all. I’m always happy to meet patients who have an idea about what’s caused their condition. After all , what could be better than encountering patients who know that they sit down too much and aren’t active enough? Many people who come and see me have already been prescribed a LumboTrain from their family physician or orthopedist. And that’s great because they already have a passive support on which we can build.

And turn into an active support?Andreas Stommel: Exactly. As physiothera-pists, we follow the approach of combining active and passive methods into a tandem solution. With LumboTrain, we can implement this method very well in practice. Of course, we

have patients who are happy to perform exer-cises for us while wearing their active support. But , it goes without saying, that we also treat patients who are less inclined to exercise. They lie down on the couch expecting to receive a massage. But their attitude changes when we explain to them that muscles are the motor of movement. These consultations take time but we see them as part and parcel of what we do.

How does LumboTrain help you with this?Andreas Stommel: Patients immediately notice an increase in their stability. And that motivates them. What’s more, LumboTrain doesn’t restrict them. It’s suitable for every-one, from bankers to hairdressers. And it can be used in any situation.

Do your patients have any general reservations about wearing a support?

Andreas Stommel: I’ve never met anyone with a bad word to say about LumboTrain. With its delicate, close-fitting structure, it is completely invisible under your clothes. And it works! Our patients don’t want any chemicals. Or side effects. I have the impression that people are becoming more and more sensitive in this regard, which means they are grateful whenever anyone shows them an alternative to painkillers. Low back pain, lumbago, muscular insufficiency of the spine and intervertebral disk prolapse or protrusion may affect each patient differently. This is why we need to perform detailed examinations in order to identify treatments tailored to their needs. This involves looking at the bigger picture and not just at their X-ray results. At the end of the day, we treat people and not X-ray images. †

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Andreas Stommel’s patients notice an increase in stability when wearing a LumboTrain.


tension, tendency to edema) or with superficial vein thrombosis. It can also be worn after venous surgery. The fine knit is specially designed to gently massage and revitalize the skin, while stimulating circulation. Its timelessly classic opaque design makes it highly versatile. A further benefit is that VenoTrain soft is fantastic at concealing small flaws on the legs. The stocking is available in compression classes 1 and 2 in many different styles. †

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VenoTrain micro and VenoTrain soft

VenoTrain micro and VenoTrain soft are now each available in two attractive fashion colors. With these two compression stockings, Bauerfeind provides reliable therapeutic aids for mild to moderate vein problems.

Stylish and effective

The annual release of VenoTrain micro in fashion colors that change every year has long proved immensely popular among medical supply retailers. This is because it is often much easier to convince customers to comply with compression therapy once they realize that compression stockings don’t necessarily resemble medical products, but can actually look extremely fashionable. As confirmed by numerous medical retailers, trendy colors help with this.

Two lots of two fashion colorsInstead of making VenoTrain micro available in four different fashion colors that vary each year, in February 2017 Bauerfeind switched to releasing two fashion colors for VenoTrain micro and two for VenoTrain soft. This year, Bauerfeind’s most popular compression stocking, VenoTrain micro, is available in the trendy shades of Salmon and Vanilla in addition to its nine standard colors. The fashion color editions of the micro stockings are, of course, also available in the Tango double-stripe pattern, the Jive striped cable-knit design or with a navy blue or black batik effect. Besides its five existing standard colors, in 2017 VenoTrain soft is available in the current fashion colors of Bordeaux and Anthracite.

VenoTrain micro – the versatile, feel-good stockingBoth of Bauerfeind’s classic stockings are suitable for standard phlebological cases in which patients require mild to moderate compression. The extra-smooth VenoTrain micro has a microfiber content of over 50 percent , making it particularly soft and gentle on the skin. The high-quality material content regulates heat for improved wearing comfort by transporting moisture away, allowing air to circulate to the skin and preventing any unpleasant build-up of heat. VenoTrain

micro compression stockings look good and feel great. The fashionable stocking sits perfectly on the leg without creasing. The comfort sole has specific pressure relief zones along the heel and the ball of the foot. Elastic expansion zones in the middle of the sole ensure more stability in this area. The pantyhose in particular helps create an attractive and shapely silhouette.

VenoTrain micro is designed for wearers with firmer connective tissue. The stocking’s smooth, highly elastic knitted fabric stimulates circulation and relieves stress on the veins in cases of mild vein problems, including spider veins and varicose veins, in compression classes 1 and 2. VenoTrain micro is ideally suited for business and travel , as well as for preventive care and during pregnancy.

VenoTrain soft – the gentle stocking with a massage effectVenoTrain soft also has a proven medical effect and is a versatile and reliable unisex compression stocking. Thanks to its long-lasting knit fabric, this robust stocking can withstand plenty of wear, yet is comfortably soft and gentle on the skin. It is particularly suitable for people with softer connective tissue and lends soothing support. VenoTrain soft provides everyday comfort for wearers with weak veins with or without clinical symptoms (e.g. heaviness,

“Even though physicians specify certain parameters in their prescriptions, medical supply retailers have a large part to play in choosing the right stocking for patients. I always look at the customer’s legs before recommending a suitable stocking. VenoTrain micro is suitable for patients with mild vein weakness and firm tissue, for example. Meanwhile, customers with softer tissue and legs that swell over the course of the day require a stocking with a firmer knitted fabric such

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