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.