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

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

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

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

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.

Thursday, July 24, 2014

Diabetics: Eat This Not That

There's no question that diabetes is on the rise in America, but since most of the risk factors are diet related, it's often preventable by simply making prudent diet and lifestyle choices. Even if you've already been diagnosed with diabetes, it's possible, in some cases, to reverse the disease or, at the very least, control it through diet. And, by the way, this doesn't mean depriving yourself totally of foods you love or resigning yourself to a lifetime of nothing but bland and boring "health foods."

A healthy diet designed to prevent or control diabetes is really no different than any other healthy diet. The most significant risk factor for contracting diabetes is being overweight, especially if the weight is being carried around the abdomen as a "spare tire." Several studies have suggested that waist size is a better indicator of potential risk for diabetes than the body mass index.

Eating right is the #1 defense against diabetes. While exercise is important, diet is the most important factor regarding weight loss. It's untrue that you have to cut out every bit of sugar and it's also a myth that a high-protein diet is best since too much protein, especially animal protein, has been shown to promote insulin resistance. You also don't have to cut out all carbohydrates. A healthy diet is a balanced diet consisting of fats, carbs and protein. The secret is to eat the correct types of these foods. Carbohydrates, for instance, should consist of whole grains because they contain essential fiber that slows the digestion of, and therefore the release of carbs (sugars) into the bloodstream, helping to regulate blood sugar levels.

Carbohydrates have the biggest impact on diabetes risk - much more so than proteins or fats. You should limit consumption of refined carbs such as white rice and bread, pasta, snack foods, sodas and candy. Slow-release, high-fiber, complex carbohydrates are digested more slowly and help blood sugar levels stay more even and allow the body to produce less insulin. They also make you feel fuller for longer and provide more long-lasting energy.

Here are some suggestions you may want to incorporate into your diet:

  • Instead of white bread, try whole-grain bread such as a whole-wheat
  • Replace white rice with brown or wild rice
  • Eat high-fiber breakfast cereal such as Raisin Bran instead of the high-sugar alternatives
  • Replace instant oatmeal with rolled or steel-cut oats
  • Use whole-wheat pasta instead of regular pasta
  • Replace cornflakes with bran flakes
  • Opt for green leafy vegetables instead of peas and corn
  • Replace your white potatoes, French fries and mashed spuds with yams (or sweet potatoes), squash or a mash made from cauliflower

Wednesday, July 23, 2014

What to Expect After Herniated Disc Surgery

herniated disc surgery
Not much can be more debilitating and painful than a back injury, and you never quite realize just how many muscles from your back are involved in simple movements. When it comes to a herniated disc in your spine, most of the time your best option will be surgery. So you go under the knife and the surgery is a success. Problem solved, right? In many ways, yes, but your body now needs to adjust to having less of that disc between your vertebrae. Let’s talk about what you can expect post-herniated disc surgery and how to best take care of your back in the long run.

Things to Do After Herniated Disc Surgery

Your body won’t magically get back to 100% after surgery. It’ll take time and hard work to guide it along the way and prevent future injuries from occuring. You’ll eventually want to start taking physical therapy to aid in the recovery of your back. This is important for two reasons:
  1. You need to  build strength in all of the muscles that support the spine. These muscles need to be even stronger than they were to shoulder the load of having less cartilage in your back.
  2. Your body needs to repair weak or deadened nerves in that area of your spine. A slipped disc pushes all sorts of delicate nerves out of place, and your body will need time to restore them to their former glory.
So what muscles are important to strengthen? Your physical therapist will know this, but for your own reference, the perispinals, abdominals, obliques, psoas, glutes, and piriformis all play a part in back strength. You’re looking to strengthen your whole core, basically. So how do you achieve strength without stressing your back? Consider the following exercises:
Planks – propping yourself off the ground and bracing yourself on your toes and forearms while keeping your back straight
Bridges – laying on your back with your knees bent at a 45 degree angle and gently lifting your torso off the ground and slowly lowering it back down
Supermans – laying face down on the floor and lifting your arms and legs off the ground, keeping them from touching the floor


Things to Avoid After Herniated Disc Surgery

It’s incredibly easy to damage your body shortly after surgery. The muscles, skin, cartilage and nerves are all in a very delicate state, so it’s good to practice some everyday routines to let your body heal itself.
  • It’s incredibly important to immobilize that part of your back after surgery. You can achieve this through the use of a back brace. These braces aren’t so much used for support as they are to remind you not to move that particular section of your back.
  • Don’t exercise! It may be tempting to whip yourself back into shape, but exercise will put strain on the surgical spot and your back as a whole. 
  • Don't sit in one place for too long. Standing is great for keeping your spine straight. Take walks, work at a standing desk, do whatever is necessary to prevent your spine from compressing.
The road to recovery won’t be the same for every patient. Age and overall athleticism can play a part in your recovery. That being said, it’s not unreasonable to assume that if you’re an older patient with a less active lifestyle, your recovery period will be slower than that of a younger person. Overall, the approach is the same; build your core strength, repair your weakened nerves, immobilize the surgical area, and give it time!

Saturday, July 19, 2014

Inspiring Jackie Robinson Quotes

Jackie Robinson broke the color barrier in modern baseball, paving the way for a more ethnically diverse and representative group of players in Major League Baseball. In the face of insurmountable odds and discrimination, Robinson was poised to represent himself in a respectable manner with a winning, competitive spirit. Here at MMAR, we wanted to review some of his famous quotes and imagine how they might’ve inspired athletes who came after him. Enjoy.

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I’m not concerned with your liking or disliking me. All I ask is that you respect me as a human being.
Starting this article with Tiger Woods might be divisive, and plenty of people have their opinions about the man off the golf course. One thing you can’t deny is Woods’ competitive spirit. After an arthroscopic knee procedure didn’t do the trick two months before the 2008 U.S. Open, Woods fought through intense knee pain to win the tournament in a playoff round against Rocco Mediate that has been heralded as one of the best 1x1 competitions many have seen in recent golf memory. It was Woods’ 14th Major golf championship.

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Above anything else, I hate to lose.
Back in the fall of 2004, the Boston Red Sox were trying to do the impossible: beat the New York Yankees in four straight games after falling behind in the best-of-seven American League Championship Series 0-3. They turned to a determined yet hobbled Curt Schilling to take the mound in Game 6 with a torn tendon sheath in his right ankle. Schilling hated to lose and didn’t want to be the one to end the Red Sox season. The result? Seven innings of pitching brilliance while fighting through pain and soaking his sock in blood. The Red Sox went on to win the ALCS and the World Series.

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There’s not an American in this country free until every one of us is free.
Okay, okay, we’re stretching a bit with this one back before Robinson became a famous athlete, but Olympian Jesse Owens’ performance in the 1936 Berlin Olympics speaks to racial acceptance and freedom across the board. Despite the obviously tense situation in Germany with Adolf Hitler and the Nazis in power, Owens became a household name by winning four gold medals. It may have been several years later before the Nazi regime’s control ended, but a simple showing of sport and athletics by Owens spoke volumes for how the rest of the world felt about the unrest going on in Europe.

A life is not important except in the impact it has on other lives.
One of the most underrated baseball players in terms of skill and his impact on the world was Roberto Clemente. Widely considered to be the Latin American player that opened the door to Major League Baseball for future Hispanic generations, Clemente saw the importance of using his fame and fortune for good. He regularly involved himself in charity work throughout his native Puerto Rico and other Latin American countries, providing children with baseball equipment to encourage the spread and popularity of the game as well as delivering food to needy families. Clemente truly understood the importance of impacting others with his life. MLB recognized it, too, making him the first Latin American inducted into their Hall of Fame and creating an award in his honor given to players that put charity first.

Baseball is like a poker game. Nobody wants to quit when he’s losing and nobody wants you to quit when you’re ahead.
Boston Celtics point guard Rajon Rondo certainly didn’t want to quit against the Miami Heat in Game 3 of the 2011 NBA Eastern Conference Semifinals when his team was losing. After dislocating his elbow in the middle of the game, Rondo got his elbow set, treated as much as it could in the training room, and then  came back out to finish the game playing one-handed. Nobody wants to quit when he or she is losing. Boston would win the game but unfortunately lose the series.

Adversity and challenges in sports are part of what make them more than just games. They become tools for learning, improving, inspiring, and growing as a person. Visit MMAR Medical to see more ways you can improve and grow as an athlete, and sound off in the comments section below to tell us about times you overcame adversity or injury in sports to be a stronger, better person.

Wednesday, July 2, 2014

How to Prevent Common Summer Injuries

At MMAR Medical, our goal is helping you stay healthy and happy.   Keep in mind some of the most common summer injuries (below in the infographic) and learn ways to prevent or minimize your risk.  

Have you or your family had an injury this summer? What happened, and what advice do you have to others?

Tuesday, June 24, 2014

5 Safe & Fun Family-Friendly Sports

If your family never gets enough time outside, use the summer season to change things up! Running out of fun family activity ideas? Have no fear - we’ve got you covered. Here at MMAR Medical, we know that with hectic schedules, getting enough time outside can be difficult. Here is a list of 5 outdoor family activities that are fun for everyone:

Capture the Flag

Divide the family into two teams and give each team a flag – it can be anything of your choosing (even a piece of fabric). Split up your yard into two equal boxes: one box for one team and another box for the other team. Place a flag at the back line of each box and line up the players of each team on their respective flag line. Once the game starts, the players sprint to the other side and try to gather the other team’s flag to take back to their flag line. If any player is tagged in opposing territory, he’s out and must stand behind the other team’s flag line. If he brings the flag back to his home flag line, he is safe and scores a point. The team that scores 3 points first wins.

Flag Football

Flag football has been a P.E. class favorite for a long time. Why not bring it to your backyard? The rules are similar to regular football except each player has 2 foot long flags suspended from a removable belt or tucked into their shorts. The tugging off of a flag resembles the typical football tackle. So, if a player were to have his flag taken, the player is therefore “tackled.” If you want a safer way to play football, flag football is the best alternative. Invite the whole neighborhood over and get playing!

Get out your bikes and explore your neighborhood the old fashioned way. If you live in a suburban neighborhood, bike around with your kids and see all the things that you might have missed while driving. If you’re neighborhood isn’t the safest place for kids to bike, check out local nature trails or biking trails. Not only will this be a great bonding experience for your family, it will also help your kids get some necessary outside time. Tell your kids to bring a friend for added incentive to get outside!


If you have a basketball hoop or a neighborhood basketball court, why not take the kids over to play a good-old fashioned game of H.O.R.S.E? Decide on the order of the players: who goes first, who goes second, etc. The first player attempts a shot at the hoop from any position and any style. If the first player makes the shot, the player that follows the first player then has to mimic exactly how the first player made the shot. If the second player is not able to make the shot the same way the first player did, they get the letter “H”. If player 2 makes the shot, the third player has to attempt to make the same shot the first player made. If player 3 fails to make the shot, they get the letter “H”. Whoever makes it to HORSE first, loses the game.


Geocaching uses GPS units to find hidden treasure in your neighborhoods, common parks, or nature trails. There’s also an app for your phone! If your kids love to treasure hunt, then they will love geocaching. Dress your kids for the outdoors and bring along water, snacks, a pen and a few assorted trinkets (think playing cards, figurines, etc). Input the basic coordinates of the cache and try to find it with your kids! Once you find the cache, there should be a few small items around it. If you decide to take something from the cache (for memories!), then you must replace the item with one of your little trinkets. There might also be a logbook at the cache site. If so, use your handy pen to sign the guest log! The geocaching website also lists family-friendly and kid-friendly caches.

Use the summer months to get your kids active! This list is only a small selection of fun
family outdoor activities! For information on sports and injuries, check out MMAR Medical.

Thursday, June 12, 2014

DonJoy Playmaker Knee Brace vs. DonJoy Playmaker II Knee Brace

Have you always been a sports enthusiast? Being an athlete can take a toll on your body and it takes a lot of effort and care to stay fit and be in shape. Once in a while, even the fittest athlete is hit by some sort of injury.

If you are a runner or skier, or play sports such as basketball, tennis, squash, soccer, or golf, you are very likely prone to ligament tears and instabilities. Fortunately, with advances in technology, ligament troubles are not a problem.

The DonJoy Playmaker Knee Brace and the DonJoy Playmaker II Knee Brace are two braces that will allow you to keep playing the sports you love without worrying as much about future injuries. Both of these products are similar yet different. Let us take a look at both the products to help you make an informed decision as to which product would suit your purpose better.

Differences between the DonJoy Playmaker & DonJoy Playmaker II

The DonJoy Playmaker Knee Brace is a flexible brace that provides support and is made for mild to moderate knee ligament troubles. The Playmaker is a soft-hinged brace but it differs from other braces because it has an exclusive and patented arrangement of straps. These straps have been proven to reinforce and increase stability in the knee ligaments.

The Playmaker comes in two different materials. One of them is neoprene which is used mainly for surfer’s wetsuits. The other material is called Drytex and is lightweight and more breathable than neoprene. Drytex helps during warm weather due to better airflow. The Playmaker can also be worn in water and you can use a cover over the brace to prevent the water current from loosening the straps. In addition, the Playmaker can be worn in either leg which gives you the option of buying just one.

Also, you can choose from a sleeve or wraparound Playmaker. With the sleeve, you will have to slide it onto your foot, while the wraparound with its Velcro straps can be opened and placed on the knee directly. Finally the Playmaker Brace comes in seven different sizes to suit your needs.

On the other hand, the DonJoy Playmaker II Knee Brace is very similar to the Playmaker Knee Brace. It is meant to help with ligament tears and instabilities. Also, the Playmaker II also comes in seven different sizes to choose from. It also comes in two different materials, Neoprene and Spacer. The Playmaker II has been further enhanced with Hi10, which is a high tenacity nylon/spandex fabric. This offers supreme comfort and fit making it very comfortable to pursue any kind of sport. The spacer fabric further adds to the comfort by providing a cool environment.

Finally, the Playmaker II continues to use the same design as the Playmaker Knee Brace with molded strap tabs which assist with effortless adjustment of the knee brace.

So what are you waiting for? Pick your knee brace today and enjoy the freedom of playing your loved sport.

MMAR Medical carries a huge selection of sports braces that will help you get back on your feet after an injury. Visit our store for our entire selection of therapy products.

Thursday, May 22, 2014

ACL Injury Trivia: Famous ACL Injuries in Sports

An ACL (Anterior Cruciate Ligament) injury can often spell the end of a career for some athletes. Hearing the famous "pop" of the ACL normally means the end of the season and the beginning of a long journey to recovery. However, an end of the season certainly doesn't mean the end of a career for these nine athletes. Here at MMAR Medical, we put together a quick trivia quiz of famous ACL injuries in sports. We brought together soccer knee injuries, football players with ACL injuries and basketball players who were also affected by tearing their ACL in our trivia.

See if you can guess these famous athletes' ACL injuries before you check the answers under the pictures.


1. Which Minnesota Vikings player broke the all-time record for rushing yards in a season in the NFL a year after he tore his ACL?

2. How many yards did Kansas City Chiefs running back Jamaal Charles rush in the 2012 NFL season – just a year after he tore his ACL?

3. Which Patriots player, in the same year he tore his ACL, finished the 2010 season with 86 receptions for 848 yards and seven touchdowns in his total 15 games played?


1. How many months did it take Kendrick Perkins to return to basketball after rehabbing his ACL tear?

2. Which Indiana Pacers player played all 82 games the year after he tore his ACL?

3. Baron Davis was the number ____ pick in the 1999 NBA draft after he tore his ACL in that same year.


1. After he was out for 12 months due to a torn ACL, which soccer player holds several records for Juventus, including the club’s top scorer and the club's most appearances?

2. In 2000, this soccer player missed the last two months of the season but still came out with plenty of awards, including top assist maker in the League, FWA footballer of the year and Arsenal's player of the season.

3. The following season after Michael Owen tore his ACL in the 2006 World Cup, he broke Gary Lineker's record for most ________________________ for England.



1. Adrian Peterson

2. 1,509 yards

3. Wes Welker


1. 6 months

2. Al Harrington

3. Third pick


1. Alessandro Del Piero

2. Most Goals in Competitive Internationals

3. Third pick

ACL injuries are painful and disruptive, but they don’t always have to mean ending your career. Use these nine athletes as inspiration for your recovery period and you’ll be back on the field or the court in no time. For more information on ACL injuries and more visit our website MMAR Medical.

Tuesday, May 6, 2014

Product Spotlight: Freedom Spinal LSO Back Brace

When you suffer from back pain, finding effective treatment is more than a relief—it can completely change your lifestyle. The Freedom Spinal Lumbar Sacral Orthotic (LSO) is named for the freedom that comes with back pain relief, and it is also one of the few LSOs that truly allows for an active lifestyle while wearing the device.

The Freedom Spinal LSO is designed to treat back pain related to spondylosis, chronic lumbar instability, post-operative rehabilitation, degenerative disc disease, chronic back pain, spinal stenosis, herniated lumbar discs, and more through relieving the load on your lumbar discs.

How does the Freedom LSO work?

The Freedom LSO relieves the load your body puts on your lumbar discs by lifting and compressing your anterior weight. The LSO features two straps that are tightened to improve posture and decrease pressure on your lumbar discs, relieving pain.

Three removable panels on the Freedom LSO offer varying levels of support. As you move through treatment, these panels can be removed so that you can gradually improve your lumbar strength according to your treatment regimen.

The low-profile design of the device gives you a wide range of motion so that you can continue your active lifestyle. In fact, it's recommended that you use the Freedom LSO only when you're engaging in activities that can aggravate your lumbar discs, or when you are experience pain symptoms. This allows your lumbar discs to strengthen and heal without pain when you are both active and resting.

If you have an active lifestyle and have recently discovered that your back pain is related to lumbar issues, the Freedom LSO back brace is one of the most effective braces of its kind. Talk to your doctor or order today from

MMAR Medical is a retailer of a wide range of medical devices for patients and doctors including back braces, heating pads, lumbar traction devices, and other therapy products.