Friday, October 24, 2014

Sports Medicine Q&A with Houston Methodist’s Dr. Scott Rand

houston methodist dr rand
Dr. Scott Rand
We thought it would be interesting to get a perspective on sports injuries from the other side of the table. We are excited to share with you a question and answer session we had with Scott Rand, M.D., a Houston-area sports medicine doctor within Houston Methodist hospital system’s Orthopedics & Sports Medicine clinic.

What led you to a career in sports medicine?
I played sports in high school, but was not really an athlete. During college and medical school, sports and exercise were just not part of what I did, but when I joined the Navy for my residency, I became attached to an active population of people. My residency was basically taking care of healthy people who hurt themselves, so the move to sports medicine was a natural fit. I enjoy taking care of people who take responsibility for their health and want to make themselves better.

What do you think is the biggest misconception about sports injuries?
Most of us think of sports injuries as the things that make the highlight reel for ESPN. Many more training days and competition days are missed because of overuse injuries and medical illnesses.

Injuries to the knee, especially the ligaments, seem to be incredibly prominent these days. Do you think this is the result of poor conditioning, tougher play, better medical care to diagnose a knee injury properly, or something else?
I don’t think knee injuries are that much more common now than they were 20 years ago. Since we have better technology and techniques for treating these injuries, they get more attention. Athletes are certainly bigger and stronger now, but I think the increased awareness comes from a larger number of athletes participating and a greater awareness because of the treatments we now have to treat these injuries, both surgically and non-surgically.

What is the most common sports-related injury you encounter in your work?
Right now, concussions are Number 1. We see athletes of all ages for all kinds of problems. During football and club soccer season, concussions are our leading injury. Injuries happen in collision sports. That is a given. Many positive things also come from participation, however, so I think that overall the benefits outweigh the risks.

What is the most common thing you see athletes do incorrectly when rehabbing from an injury?
Easy. Too much, too fast, too soon. We are always in search of the magic bullet or high tech procedure that will allow quicker return to play. Getting back on the field is the most important thing and anything that will speed that along is the right thing to do. That is a lie and is probably what is the most dangerous thing for athletes to look for.

When is surgery the wrong route to take for recovery from an injury?
When pain is the major factor. Orthopedic surgery can restore function pretty well, but when the driving issue is pain, surgery is often not the best solution. Pain may not go away, even if function improves.

Do you think physical therapy is being utilized by patients as much as it should?
Physical therapy has huge benefits for people, but unfortunately the outcome-based and evidence-based studies have not borne it out. Physical therapy fails when patients are not compliant with the exercise plan put forth by the physical therapist. PT that doesn’t make you sweat or cry wasn’t worth going to.

In your opinion, what is one of the biggest changes to sports medicine in the last few years?
The therapeutic modality that is getting the most attention right now is regenerative medicine. The promise of healing with your own tissue by simply injecting platelet-rich plasma or bone marrow or fat cell derived stem cells is very exciting. Right now the science is equivocal, but the potential for amazing things is there and will hopefully be made readily available.

What is the most rewarding aspect of working in sports medicine?
Taking care of people who have to be held back rather than pushed off the couch. Watching an athlete recover from a devastating acute or chronic injury and return to compete at a higher level than they ever could before.

If you could impart any words of wisdom on young coaches or athletes, what would they be?
Be alert and cognizant when something looks or feels wrong. Then stop. It sounds simple, but personal health is so often overlooked for the sake of the win. When it comes to your overall health, you’re in a marathon, not a sprint.

Dr. Rand is a graduate of the University of South Dakota School of Medicine, and is a board certified physician of family medicine with a certificate of added qualification in sports medicine (CAQSM). He is the director of the Primary Care Sports Medicine Fellowship program at Houston Methodist Willowbrook, one of only 111 accredited programs in the country. Additionally, he is the medical director of the Houston Methodist Human Performance Lab. His practice maintains a focus around overall medical care, concussion management, and non-operative orthopedic care of athletes and active people of all ages. Dr. Rand co-chairs an education testing subcommittee within the American Medical Society for Sports Medicine, guest speaks regularly, is a co-author and editor of the AMSSM’s Sports Medicine CAQ Study Guide, and is an assistant professor at Weill Cornell Medical College. Dr. Rand regularly serves as a consulting team physician for Houston-area high schools, club sports, running groups, and Rice University.

Friday, October 3, 2014

ACL Injuries in the NFL

ACL injuries seem to be so prevalent in professional sports these days. How prevalent are they? Take a look at this infographic we put together on ACL injuries in the NFL, and remember to take care of your body when you're playing sports!

acl injuries in the nfl

Saturday, September 27, 2014

DonJoy Defiance vs. Reaction

After a knee injury, it can be difficult to know which type of brace is best for your recovery. One built for ligaments won’t function the same as one built to prevent dislocations, for example. Today we’d like to compare and contrast two of DonJoy’s more popular models: the Defiance and Reaction knee braces.

The Defiance is unofficially known as the flagship brace of DonJoy. Its patented leverage system and lightweight, high-tech design make it the go-to brace for any sort of ligament instabilities. ACL, PCL, MCL, LCL. You name a ligament, the Defiance will handle it. While the Defiance may be lightweight, it is no slouch when it comes to durability and stability. Its carbon-composite build makes it perfect for high-impact sports like rugby, snow sports or football when protection is an absolute must. It’s also available with the LoPro FourcePoint Hinge, the only hinge clinically-proven to protect the ACL. It does all this with a low-profile design to keep it out of your way and under clothing or uniforms.

The Reaction, on the other hand, was designed for kneecap stability and anterior knee pain reduction. The brace’s elastomeric web design helps absorb pressure that would normally be felt on the patella and disperse it throughout the rest of your knee. It’s a fantastic brace if you have arthritis or tendonitis problems that could use the helping hand. The brace’s open web design and mesh backing lets your knee breathe comfortably unlike traditional elastic designs.

The chart below summarizes the main differences between the Reaction and the Defiance.

Reaction Defiance
Built For Tendonitis, Arthritis, Knee Cap Dislocation and Stability Ligament protection (ACL, MCL, PCL, LCL)
Durability Velcro can be known to wear out due to continued use Perfect for high-impact sports
Design Elastomeric webbing to disperse pain Lightweight carbon-composite frame
Misc 6-month warranty Custom built, lifetime warranty on hinges and frames

We pride ourselves on carrying the best and most varied selection of knee braces for pre- and post-op conditions, but your condition might not fit one of these two braces. Always be sure to consult a medical professional to find out what sort of support your knee needs to help you stay healthy and active!

Friday, September 26, 2014

Five Durable Players to Pick up in Your NFL Fantasy League

The NFL season is in full swing and with it the ever-competitive and intriguing fantasy football season. Whether playing for bragging rights with your friends or with a pool of anonymous players for a cash prize, it’s the ultimate chance to test your knowledge of statistics and roll the dice. We’re just a few short weeks into the season and we’ve already seen players go down with season-ending or season-shortening injuries. Here are a few players we’d recommend you pick up on the waiver wire or trade for if your roster has already been decimated by injuries.
  1. Philip Rivers – The San Diego QB has been consistent throughout his entire career, averaging around 30 touchdown passes, 4,200+ passing yards, and a yearly QB rating hovering around 100. The rest of the Chargers’ 2014 season will be highlighted by tough road games, but Rivers’ poise against Seattle’s menacing secondary has to be encouraging for any fantasy league player.

  2. Kirk Cousins – OK, OK, he came into the game for Robert Griffin III against a lowly Jacksonville Jaguars team and torched them (as expected) but he’s now going to be THE guy moving forward for Washington the rest of the year. Washington’s schedule won’t be easy this year, but with games against questionable NFC West, NFC South and AFC South opponents, they could eek their way into the wild card conversation. Cousins has looked good in spot starts, has a high football IQ, and when given time to throw, completes close to 70% of his passes. He also fits well into Jay Gruden’s offensive scheme. You just might want to sit him against Seattle :)

  3. Darren Sproles – You probably drafted his Philadelphia counterpart, LeSean McCoy. You had plenty of reason to do so! With Sproles’ undeniable speed and ability to accelerate in open space, he’s a threat in both the passing and running game. He’s missed only a handful of games over his career and rushes for an average of 5.1 yards per carry. His catches average 9.1 yards, and if history tells us anything, then he’ll average around 65-70 catches this year coming out of the Eagles backfield. Oh, he’s also only fumbled the ball THREE TIMES in his entire career. He’ll carve up defenses like St. Louis, New York, Tennessee, Washington, and Dallas, making you look like a genius for picking him up. 

  4. Jordy Nelson – We’re not sure why anyone would pass on Green Bay’s new “it” guy, but in case you did, here’s a reminder that you made a mistake. After spending the first six seasons of his career in the shadow of household Packer names like Donald Driver, Greg Jennings, and James Jones, Nelson has emerged to become the favorite target for QB Aaron Rodgers. Having only missed a small handful of games over his career, Nelson has become an architect of the sideline catch, creating height and separation from his defenders where other receivers might not be able to find it. He averages over 15 yards per catch and has only fumbled once in his career. The Packers may be trying to diversify their offense with Eddie Lacy and James Starks running the ball, but you don’t leash an arm like Rodgers’ when you have it. Nelson will carve up the secondaries of Minnesota, Miami, Atlanta, and Tampa Bay just to name a few.

  5. Steve Smith – The veteran, long-time-Panther-now-Raven looked like a man possessed this past week against Pittsburgh. He’s missed just a few games over the course of his career and averages over 14.5 yards per catch. With Jacoby Jones as Joe Flacco’s primary target and Baltimore’s tendency to rely on the short passing game, expect Steve Smith to be the receiver left overlooked by the defense. Baltimore’s journey this year won’t be an easy one in the always-tough AFC North, but games against the NFC and AFC South with less-than-stellar secondaries will give him a chance to shine.

Wednesday, September 24, 2014

Product Spotlight: Donjoy Velocity Ankle Brace

DonJoy's Velocity Ankle Brace, available in three different support levels, is the most useful brace for men and women at risk for injury-prone ankles. These braces are also ideal for those who have already experienced an ankle injury and are on the mend, and especially for those involved in athletics or high-impact activities who want to be proactive in preventing potential injuries.

These Velocity Ankle Braces are so popular because they're not only functional but also very comfortable to wear. They feature a plastic shell that's both lightweight and heat moldable, giving each user a semi-customizable fit. The semi-rigid plastic that makes up the foot plate and lateral uprights provides protection against impact, such as being kicked during sports like soccer, football or rugby.

DonJoy offers three styles of the Velocity Ankle Brace:

Light Support (LS) is the standard configuration capable of providing the foundation required for prevention of ankle injury and treatment for those recovering from previous injuries. This is a bilaterally hinged brace with correct anatomical design that allows for unrestricted foot movement while guarding against unnatural ankle rotation that's the cause of most ankle sprains. Compression of the ankle to prevent swelling is provided by special R3 (Rapid, Rigid, Ratcheting) Technology™ incorporated into the calf cuff. Lightweight and low profile, this brace is designed to comfortably fit into the user's shoe. It can also be trimmed to accommodate the use of orthotics, if necessary.

The Medium Support (MS) Velocity Ankle Brace starts with the basic LS Brace and adds a soft, speed wrap that creates additional compression to the medial and lateral malleolus bones, which are the bony protrusions coming out of the sides of each ankle. This helps control inflammation and provides more support for those needing it, especially those recovering from past ankle injury.

The Extra Support (ES) Velocity Ankle Brace takes the MS model and adds one additional speed wrap with laces for compression around the foot. The ES is the most popular choice of Velocity braces and is ideal for those suffering from chronic ankle problems, those rehabilitating from a past injury, and for athletes engaging in any type of sports activity where cutting or pivoting maneuvers are common.

Sizing Specifications

DonJoy Velocity Braces are appropriate for use by either men or women and come in black or white. They're available in three sizes (S-M-L), in two calf sizes (standard and wide), and can be ordered for either the left or right foot.
  • Small – men's shoe size 8 & under, women's 9-1/2 and under
  • Medium – men's 8-12, women's 9.5-13.5
  • Large – men's 12 & up, women's 13.5 & up

Friday, September 12, 2014

Get Back Pain Relief with the Aspen Horizon 631 LSO

aspen horizon 631 hso back brace
A popular choice from Aspen Horizon, the 631 LSO back brace can provide relief to those who suffer from acute or chronic low back pain. It’s low-profile and ergonomic design allows you to comfortably wear the brace under your clothing. 

Its adjustable sizing fits a variety of people, from those with a 24 inch waist all the way up to a 54 inch waist. With the addition of extension panels, the sizing accommodates even larger waists- up to 70 inches. Simply tighten or loosen until the brace comfortably fits your body. Its construction prevents the back panel from bunching up, allowing for a snug but flexible fit.

With tri-band technology, this brace provides stability while allowing for effective compression and flexibility of the body. As with all other Horizon braces, the Horizon 631 LSO can be reconfigured to act as a Horizon PRO brace, allowing for continual treatment of recurring back discomfort. Lateral panels are included in this full back support brace to provide support on the sides of the spine if needed.

Wearing this brace is easy and can be put on relatively quickly. Wrap it around your abdomen, overlapping the right side of the brace over the left in the front. Pull on the dual lacers to adjust compression levels as needed- the left for lower compression and the right for upper compression. Once the optimal levels of compression have been reached, secure the tabs to the front of the brace.

Constructed of breathable mesh fabric, this back brace is easy to clean, and it should be cleaned regularly. Simply hand wash in cold water with a mild soap, rinse, and allow it to air dry before it is worn again.

The 631 LSO back brace is a great option for post-op patients, as it’s able to provide several configurations to assist with the recovery process. If you or any of your patients are looking for a spine brace to assist with rapid recovery, this is it. MMAR Medical carries a variety of spinal back braces to assist with your back pain relief regimen. 

Monday, August 25, 2014

How to Properly Fit Youth Football Shoulder Pads

How to Fit Youth Football Pads


With the end of August comes the beginning of fall and a new season of sports, one of the most popular being football. Whether you’re a parent getting your child equipped for their first time on the gridiron or a coach strapping the pads on your varsity squad, making sure your athlete's pads fit properly makes for not only a comfortable game but a safe one as well. Improperly fitted equipment can lead to injuries, so consider the following steps on how to properly fit those youth football shoulder pads before the games begin. To make the measurements easy, grab a tailor’s tape measure.
  1. Measure your player’s chest at its broadest. Across the pectoral muscles where a shirt would fit tightest will give you the most accurate measurement. 
  2. Measure shoulder width. This is done by measuring across the back from tip to tip. Begin and stop your measurement where the AC joints begin. That’s where the shoulder pads need to naturally drape to protect joints.
  3. Weigh the player. Several shoulder pads are built to accommodate different sizes of players, so an accurate weight measurement is important. 
Now that you have some physical measurements, it’s time to try on the pads that match those measurements.
  1. Once everything is strapped in place, the pads should fit comfortably tight against the chest and back with minimal extra padding coming off the shoulders. The player shouldn’t feel buried within the pads.
  2. Make sure the upper chest and the top of the back are completely covered at all times by moving around in the pads. Raise the player's arms up. Shift around. Have them do all the normal movements he or she would do in a football game.
  3. Comfortable? Everything in place? Time to order those pads. If not, repeat necessary steps to find pads that fit the player properly. 
There you have it! Well-fitting pads will keep your youth football stars comfortable and safe from injury. We recommend pads and accessories from Douglas for durability and fit. Do you have any tips that work for you when fitting shoulder pads? Sound off in the comments below and let us know about them!

Best Ankle Braces for Basketball Players

Among foot and knee injuries, ankle damage is also an extremely common occurrence for basketball players. Their constant movement of running, sudden stopping, and cutting and jumping puts a high volume of stress on the ankles. Picture this:  a player goes in and jumps for a rebound and he lands in the crowd of players anticipating him at the bottom. The problem awaiting is that it’s so easy for him to heavily land on someone else’s shoe, which can cause his ankle to twist or roll too far inward or outward.

If this has ever happened to you, what you are experiencing are your ankle’s ligaments being stretched and torn – otherwise known as a sprain. Depending on the magnitude of your injury, these ligaments may partly or completely tear. Treating a sprain includes a short duration of complete immobilization and oftentimes using a supporting device, like an ankle brace, in order for the ligaments to heal correctly. Ankle braces reduce the amount of stress placed on your ankle and allows you to get back in the game much quicker. Without proper recovery, these injuries are easily prone to re-injury.

Read below to see our favorite ankle braces for basketball players:

To Recover From a Sprained Ankle
http://www.mmarmedical.com/M_Brace_Mercurio_Ankle_Lock_15_p/15.htm


For basketball players who are suffering from a general ankle sprain and slowly transitioning back into physical activity, the M-Brace Mercurio Ankle Lock #15 is the ideal ankle brace. With its figure eight, cross strap, the brace provides mild to light, medial and lateral compression and support for moderate injuries. Its breathable, 100% cotton velour construction thoroughly ventilates the ankle and foot. And more like a wrap than a brace, it fits and feels similar to a sock, which makes it incredibly comfortable to wear on a daily basis for someone who is in the process of rehabilitating.

To Support Acute/Severe Ankle Injuries
http://www.mmarmedical.com/DonJoy_RocketSoc_Ankle_Support_Brace_p/11-033x-x-06000.htm

When it comes to treating and preventing acute ankle injuries, the DonJoy RocketSoc Ankle Support Brace is a sure bet. Since it’s important to keep your ligaments still/stabilized and in place after acute sprains, the RocketSoc’s lace-up and strap secure your ankle in a sturdy, yet natural, position. Don’t be fooled by its modest design! As light as it is, you’ll be surprised to see that it provides the maximum amount of support you may need. The straps tightly fasten around your ankle while still allowing you complete range of motion.

To Support Chronic Ankle Injuries
http://www.mmarmedical.com/McDavid_Ankle_Brace_w_straps_p/195.htm

The McDavid Ankle Brace w/ Straps provides maximum support for people who suffer from chronic ankle sprains or instability. Research has shown that the McDavid ankle brace reduces the chance of injury by 3x. Its figure-6 strap design, single-layer nylon construction, adjustable laces, ventilated tongue and paddled lining are just a few of the ways this brace protects your ankle from medial or lateral vulnerability. Don’t let chronic injuries stop you from living a full and active life. This McDavid ankle brace is just one of the few ankle braces for sprained ankles that can support you and keep you moving at the same time throughout your life and athletic career.

To Prevent Further Injury
http://www.mmarmedical.com/Active_Innovation_T2_Ankle_Stirrup_p/trt220-trt240.htm

Lastly, and perhaps most importantly, an ankle brace should prevent you from further injuries. The Active Innovation T2 Ankle Stirrup is a hinged, U-shaped ankle brace that subdues heavy pressure on your ankle joint and protects your ankle from the harmful inversion and eversion movement (rolling inward and outward) often seen in basketball. The bilateral hinge stabilizes the ankle while still allowing freedom of movement. And the best part about this ankle brace is its ability to mold to the shape and contour of the user’s ankle, promoting comfortable and seamless movement on and off the court.

If these braces aren’t quite your cup of tea, visit our Ankle Braces for Basketball page. At MMARMedical, we take care of the hard part for you by researching and selecting the best ankle braces for your specific situation. Browse and find what you’re looking for today.

Tuesday, August 12, 2014

How I can accommodate a contracture of the fifth digit only?

Continuing our work with Restorative Medical, Inc., below we share a question from an Orthotic Fitter to Karen Bonn of Restorative Medical, Inc. and the best response:

Question: Do you have a recommendation as to how I can accommodate a contracture of basically the fifth digit only? Therapist also wants to treat ulnar drift and "max pain" in bilateral hands.  The picture is below.




Response: I would suggest a prefabricated Prosperity Hand™ (if you cannot do Custom Hand Splints), and mold the 3rd/4th finger plate down with a heat gun to apply only mild, comfortable stretch.  As the finger’s range improves, that plate can be gradually remolded to continue the PROCESS toward full extension.



If the Ulnar Drift is at the wrist, order the Ulnar Drift Strapping or at the very least the Velcro® on wrist pad. Correcting these deformities will help relieve the discomfort.



If it is from the MCPs and effects the fingers only, we would normally recommend the Ulnar Drift Finger Separators, and add the Ulnar Drift Strapping if needed. 



Since the Prosperity Hand™ is recommended for this patient, it might create a challenge to use finger separators since the base under the fingers is split between the 3rd and 4th digits. We can make a Velcro®-on pad the correct size to fit on the lateral side of the little finger to help correct the Ulnar Drift.  The finger strap that separates the 3rd finger from the 4th should adequately correct any Ulnar Drift in the 1st and 2nd fingers. Ulnar Drift tends to be a very painful condition so – as any lost range of motion condition – we want to provide a gradual comfortable stretch.

Please let this patient’s clinicians know it takes 6 weeks of prolonged low load passive stretch to realign the proteins (Actin and Myosin in the Sarcomere "units") in the muscle to PREPARE the muscle to be relengthened (not restretched).  It is so common for people to look at all patients as if they were orthopedic patients and perform aggressive stretching for a length of time, and then assume that is all that can be done when they do not achieve good results.  Instead, if they adjust the correct technology of splint to only put comfortable, flexible low load passive stretch on the joint(s), then keep them on caseload just until the therapist is comfortable with the wearing schedule, the splint is adjusted to comfortable meet their range at that time with a gentle stretch, and has established a Plan of Care. At that time, discharge them back to nursing for daily donning and doffing, but put on their therapy calendar to look at them again in 6-8 weeks to possibly pick them back up on therapy case load to readjust the splint farther toward normal alignment.  At that time, the patient’s tissue should be ready to begin the relengthening process.  If this is continued every few months throughout the year, at the end of 12 months the therapy staff will be amazed at the progress, and they have used the patient’s therapy cap wisely.  

Carrying out this process to correct lost range of motion “contractures” can, according to the joints/body parts affected, prevent Hospitalizations and ReHospitalizations, wounds, pain, feeding tubes, specialized beds and wheel chairs, dementia symptoms, falls... and even the need for institutionalization for 24 hour nursing care.  Correcting these deformities also helps to protect caregivers’ backs from injury during turning, repositioning and lifting patients, which saves medical facilities vast amounts of money on Worker’s Compensation injuries (and protects family members’ backs at home).  Win/win!

Therefore, the key is to differentiate patients between Orthopedic and Restorative (Neuro) and treat them accordingly.  Neuro patients who have lost range of motion – whether from tone, shortened tissue or a combination of both – require Flex Technology Splints™ to allow the body to go through its process to reach a relaxation through the Central Nervous System by gentle, flexible tugs on the tissue. 

Orthopedic patients require rigid splints after surgery or injury to hold a body part or joint in a specific plane to facilitate healing and function. Totally different types of patients that require totally different treatment measures and totally different splints.

A general understanding of the Central Nervous System and also the anatomy and physiology in the extremities is vital to providing appropriate treatment for these patients with conditions like: Cerebral Palsy; Traumatic Brain Injury, Acquired Brain Injury, Strokes and other brain conditions; Multiple Sclerosis; Parkinson’s; Spinal Cord Injury; Dementia and End Stage Alzheimer’s disease.  When patients suffer an injury or disease process of the Central Nervous System it is common for that person to begin to have inappropriate muscle contractions to a certain area of the body, in the entire body, or in the body below the level of a spinal cord injury, according to the area of injury and the extent of the injury.  These muscle contractions that are not relaxed because the controlling apparatus is not getting the message from higher neural centers to tell the muscle to relax is referred to as “tone.”

Unaddressed or inappropriately addressed tone leads to shortened tissue and any amount of tone or shortened tissue that prevents full range of motion is a “contracture” and a contracture is a deformity.  We talk about three types of Restorative, or Neuro contractures: Tone, shortened tissue, and a combination of both. 

Contracture deformities are an injury, and many times a preventable deformity.  Many patients with brain or spinal cord injuries develop tone the 3rd day after injury when they are still in the ICU.  If we fit them with a Flex Technology Splint™ and use nonaggressive stretching techniques then and continually relax the inappropriate muscle contractions (tone), we may see these patients go through the hospital stay with no deformity – through the rehab stay with no deformity – and perhaps walk home instead of leaving in a wheelchair and at times even to a long term care facility.   At the very least they will have less far deformity.

Rigid, orthopedic splints were never designed for neuro patients.  They were available and at some point it was realized that neuro patients needed splints, so the available ones were used on them.  If we watch the effects on patients using rigid splints versus when a Flex Technology Splint™ is used, the difference is remarkable.  Rigid splints and aggressive stretching tends to initiate tone in neuro patients, where the Flex splints will typically relax tone in about 15 minutes as they provide a gentle, flexible tug on the Golgi Tendon Apparatus. 

A highly respected Kentucky Physical Medicine and Rehab Physician, Kenneth Mook wrote:  “I have found that a static, rigid splint is not effective in controlling spasticity because it provides a persistence of a spastic event by not allowing the muscle to shorten. A splint that has static properties with some dynamic “give” during a spastic event allows the muscle to shorten, thereby the spastic event regresses, and yet the splint maintains the proper positioning of the joint.   

Most RMI products can be found online at our Neuroflex Store. 

Tuesday, August 5, 2014

How to Trouble Shoot Contractured Hands

Trouble shooting for challenging contractured hands

We're pleased to feature this post, written with help from Restorative Medical, Inc, a long established partner of MMAR Medical.

For Radial Drift you have two options:   
1. You can order the hand splint appropriate for the patient and add UD Wrist Pads (the ladies that make them call them "pillows") which you will attach to the wrist straps on the lateral - little finger side with the black surface next to the patients skin.  It simply Velcro’s around the strap at the place that does the most good.  I put them where they come just above the plastic of the splint and they provide the "push" required to realign the Radial Drift condition.  $3 to add the "pillow"

2.  The other option is to order the hand splint appropriate for the patient and add Radial Drift Strapping.  This provides you with the "pillow" but also means you will receive your desired splint with the straps sewn on going in different directions to realign the wrist and hand. Basically, if a body part is going the wrong way, put a strap over it to tug it in the opposite direction.  Multiple straps that do the zigzag type of realignment are very effective.  $5 to make the splint with Radial Drift Strapping
 

In contrast, for Ulnar Drift you have two options. 
1. You can order the hand splint appropriate for the patient and add UD Wrist Pads (the ladies that make them call them "pillows") which you will attach to the wrist straps on the medial - thumb side with the black surface next to the patients skin.  It simply Velcro’s around the strap at the place that does the most good.  I put them where they come just above the plastic of the splint and they provide the "push" required to realign the UD condition.  $3 to add the "pillow"

2.  The other option is to order the hand splint appropriate for the patient and add UD Strapping.  This provides you with the "pillow" but also means you will receive your desired splint with the straps sewn on going in different directions to realign the wrist and hand.  If a body part is going the wrong way, put a strap over it to tug it in the opposite direction.  Multiple straps that do the zigzag type of realignment are very effective.  $5 to make the splint with UD Strapping

In addition - for many hands, there is a need for UD Finger Separators.  These will realign whatever is going on with the fingers - whether overlapping, Ulnar Drift like with Rheumatoid Arthritis, or extensor tone/hyper extension.  Remove the blue 3 bump finger separators and replace them with these black longer silky straps that have Velcro tabs at the end of each to separate and realign each finger.  They are long enough to comfortably, gradually bring fingers toward and to normal alignment. Velcro them to either side of the hand splint to tug fingers in the desired direction. 

For Hyperextension of fingers, the Dorsal Interphalangeal Flexion Assistance strap (2" wide strap that has elastic properties, that goes over the fingers and Velcro’s under each side of the hand splint. This can go over the blue strap of the hand splint, or can go directly over the fingers --- MAKE SURE there is no pressure or abrasion if you put it directly over the fingers. 


Please see this RMI/MMAR video for options that can be used with our prefabricated hand splints that provide even more ways to custom fit for individual patient’s needs.