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Air Born<br />
Stuntwoman’s Promising<br />
Career Saved by MalleoTrain S<br />
Innovative treatment of<br />
hip pain<br />
Hip orthosis SofTec Coxa as part of<br />
post-operative treatment plan Page 24<br />
“Appreciation for an underestimated<br />
specialist fi eld”<br />
Ratschow Memorial Medal for<br />
Prof. Waldemar L. Olszewski Page 31<br />
Issue <strong>2012</strong> | 2<br />
magazine<br />
<strong>international</strong><br />
Stabilization, movement<br />
and healing<br />
An interview about<br />
winter sport injuries Page 32
INSOLES<br />
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ONE<br />
FITS<br />
ALL.<br />
Foot orthoses with the X factor.<br />
Flexible synthetic foot orthoses with variable support.<br />
The �weightflex-X� in the core of the synthetic foot orthosis offers variable support according<br />
to individual foot conditions, therapeutic goals and body weight.<br />
Motion is Life: www.bauerfeind.com
Pictures: <strong>Bauerfeind</strong><br />
Dear readers,<br />
When it comes to sport , the summer of <strong>2012</strong><br />
had everything! First there was the European<br />
Football Championship, then the Olympic<br />
Games and fi nally the Paralympic Games.<br />
<strong>Bauerfeind</strong> was on hand at these two major<br />
events in London to provide support as an<br />
exclusive supplier of medical care, in the<br />
“Supports and orthoses” category, to all the<br />
athletes involved. Our products were used on<br />
more than 1,100 occasions at the Olympic and<br />
Paralympic Games – which I think is an impressive<br />
statistic! We<br />
take a brief look back<br />
at the involvement of<br />
our orthopedic service<br />
team at the Games on<br />
page 18f.<br />
Having the right<br />
medical aid is<br />
important for enabling<br />
athletes to keep up their sporting activities,<br />
as the young lady in our cover picture<br />
certainly discovered. From page 28 you can<br />
read about how stuntwoman Tally Rodin has a<br />
<strong>Bauerfeind</strong> support to thank for being able to<br />
continue her career.<br />
The medical focus of this <strong>Bauerfeind</strong> <strong>life</strong><br />
magazine is on the indication of osteoarthritis<br />
– a widespread condition, but one that is<br />
by no means associated only with old age.<br />
“With our supports, orthoses,<br />
medical compression stockings<br />
and orthopedic orthoses, we aim<br />
to boost patients’ well-being and<br />
enhance their quality of <strong>life</strong>!”<br />
Although the vast majority of osteoarthritis<br />
patients are elderly, it is also astonishing to<br />
fi nd just how many young people are affected<br />
by it. In our focus feature (from page 12), two<br />
physicians – one from Germany and one from<br />
Brazil – discuss various aspects of the broad<br />
topic of osteoarthritis.<br />
For this <strong>issue</strong> of <strong>Bauerfeind</strong> <strong>life</strong>, we have also<br />
once again talked to health professionals<br />
and therapists from all over the world about<br />
medical and thera-<br />
peutic problems and<br />
the use of <strong>Bauerfeind</strong><br />
products: from the<br />
use of the multifunctional<br />
orthosis SofTec<br />
Coxa for stabilizing<br />
hip joints in the USA<br />
right through to<br />
lymphedema treat-<br />
ment in Australia.<br />
Our products may be used in a wide variety<br />
of areas of application and in all sorts of<br />
places, but we always have one objective in<br />
mind: to maintain and restore health. With<br />
our supports, orthoses, medical compression<br />
stockings and orthopedic orthoses, we aim to<br />
boost patients’ well-being and enhance their<br />
quality of <strong>life</strong>!<br />
EDITORIAL<br />
Our “Made in Germany” products are highly<br />
rated all over the world, as demonstrated by<br />
the success of our 22 or more subsidiaries and<br />
numerous distributors across the globe. There<br />
is one subsidiary I would particularly like to<br />
mention to highlight the outstanding work of<br />
our <strong>international</strong> team: <strong>Bauerfeind</strong> Benelux,<br />
which celebrated its 25th anniversary this<br />
year (p. 21).<br />
With warm regards,<br />
Prof. Hans B. <strong>Bauerfeind</strong><br />
<strong>life</strong> magazine <strong>2012</strong>/2 3
CONTENTS<br />
Osteoarthritis: Deadly mictrotrauma – page 12<br />
IMPRINT:<br />
<strong>Bauerfeind</strong> <strong>life</strong> Magazine<br />
International Edition<br />
Printed on chlorine-free paper<br />
Editor:<br />
<strong>Bauerfeind</strong> AG<br />
Triebeser Strasse 16<br />
07937 Zeulenroda-Triebes, Germany<br />
Tel. +49(0)36628-66-1000<br />
info@bauerfeind.com<br />
www.bauerfeind.com<br />
Responsible:<br />
Simone Gebler, Christian Grimm<br />
Publisher and editorial offi ce:<br />
mk publishing GmbH<br />
Döllgaststrasse 7–9<br />
86199 Augsburg, Germany<br />
Tel. +49(0)821-34457-0<br />
info@mkpublishing.de<br />
www.mkpublishing.de<br />
4 <strong>life</strong> magazine <strong>2012</strong>/2<br />
Focus page 12<br />
Osteoarthritis: a widespread condition<br />
Biomechanical , biochemical and genetic<br />
factors all play a role in primary<br />
(age-related) osteoarthritis. Until now, less<br />
attention has been paid to microtraumas in<br />
the development of secondary osteoarthritis,<br />
especially in the knee and ankle.<br />
Title image<br />
Tally Rodin – model , acrobatic ic<br />
dancer, gymnast , stuntwoman. n.<br />
She had a micro tear in the<br />
tibialis posterior tendon of<br />
her right ankle. A <strong>Bauerfeind</strong> d<br />
brace helped to save her<br />
career.<br />
Pictures: Lee Cherry (Title), Werbefotografi e Weiss, Stefan Durstewitz, Nick Greenway, headshot-soho.co.uk, fotolia.com/Mary Durden
“We have a face” – page 26<br />
The foot as an interface – page 22 Diving: Another world– page 36<br />
3 Editorial<br />
4 Imprint<br />
8 News<br />
39 Service<br />
Moments page 6<br />
A successful “Tour of Europe”<br />
Focus page 12<br />
12 Osteoarthritis<br />
Deadly microtrauma<br />
16 Higienópolis Health Center, São Paulo<br />
Looking good on the beach –<br />
and staying healthier too<br />
Medical page 18<br />
18 London <strong>2012</strong><br />
Making a strong impression<br />
20 PD Dr. med. Bernd Wolfarth<br />
Health comes fi rst<br />
21 25 years of <strong>Bauerfeind</strong> Benelux<br />
On the way to gold<br />
22 Science and practice<br />
The foot as an interface<br />
CONTENTS<br />
Innovative treatment of hip pain – page 24<br />
24 SofTec Coxa<br />
Innovative treatment of hip pain<br />
26 AVE Orthopedische Klinieken, Huizen<br />
“We have a face”<br />
28 Stuntwoman Tally Rodin<br />
Air Born<br />
31 Recognition for Prof. Waldemar L.<br />
Olszewski<br />
“Appreciation for an underestimated<br />
specialist fi eld”<br />
32 Winter sport injuries<br />
Stabilization, movement and healing<br />
34 Lymphedema treatment in Australia<br />
“Treatment from an early stage is<br />
essential”<br />
In Motion page 36<br />
36 The outdoor <strong>life</strong> – diving<br />
Another world<br />
<strong>life</strong> magazine <strong>2012</strong>/2 5
MOMENTS<br />
Picture: Jens Blatter Spendentour<br />
6 <strong>life</strong> magazine <strong>2012</strong>/2<br />
A successful “Tour of Europe”<br />
Mission accomplished! On August 1, the participants of the <strong>2012</strong> Jens Blatter fundraising marathon<br />
reached their fi nal destination on the Allalinhorn mountain, 4,027 meters above sea level. The 60<br />
cyclists and their support teams had traveled almost 5,000 kilometers across the continent to get there,<br />
passing through Switzerland, Germany, the Netherlands, Belgium, France and Italy in just 17 days on<br />
their “Tour of Europe”. During the tour, the participants also stopped by the Bio-Seehotel Zeulenroda –<br />
a company in the <strong>Bauerfeind</strong> Group. Together with <strong>Bauerfeind</strong> AG, the hotel donated EUR 1,000 to the<br />
charity campaign. By the end of August , the total donations raised amounted to 150,000 Swiss francs.<br />
The money raised by the fundraising tour will go toward the Eduplex children’s aid project in Pretoria,<br />
which works to integrate children with hearing impairments into everyday school <strong>life</strong>.<br />
For further information please visit: www.jensblatter.ch.<br />
†
MOMENTS<br />
<strong>life</strong> magazine <strong>2012</strong>/2 7
NEWS<br />
“Motion Laboratory” in Moscow<br />
First <strong>Bauerfeind</strong> store opened in Russia<br />
“Dobry vecher” was the Russian greeting used by Thomas <strong>Bauerfeind</strong>,<br />
Member of the <strong>Bauerfeind</strong> Executive Board, as he welcomed the 40<br />
or more guests invited to the grand opening of the new <strong>Bauerfeind</strong><br />
store in Moscow. The company’s fi rst retail outlet in Russia was offi<br />
cially opened on April 12, <strong>2012</strong>, under the name “Motion Laboratory”,<br />
and with a distinctive store format that is regarded as an innovative<br />
feature in the Russian retail industry. With the opening of the<br />
Moscow store, <strong>Bauerfeind</strong> is extending its sales network in Eastern<br />
Europe. The “Motion Laboratory” is located right on the popular<br />
“Prospekt Mira” shopping street and offers customers in Russia’s<br />
capital city a new kind of retail concept. Athletes and patients can<br />
come to the store, which covers 120 square meters, to receive advice<br />
on how medical aids from <strong>Bauerfeind</strong> can be used in the prevention,<br />
London <strong>2012</strong><br />
A resounding <strong>international</strong> success<br />
London <strong>2012</strong> proved to be a successful premiere: for the fi rst time in history,<br />
the Olympic and Paralympic Games were planned and supervised by a single<br />
organizing committee. Both events met with a positive response all over the<br />
world. <strong>Bauerfeind</strong> AG from Zeulenroda, Germany, was in London for the Games<br />
as an exclusive supplier in the “Braces” category (supports and orthoses).<br />
Products provided by the Thuringian medical aid manufacturer were used on<br />
more than 700 occasions throughout the Olympics (see page 18). <strong>Bauerfeind</strong>’s<br />
supplier contract with the London <strong>2012</strong> organizing committee (LOCOG) also<br />
applied to the Paralympic Games, where <strong>Bauerfeind</strong> provided on-site medical<br />
support for the 4,400 or so Paralympic athletes from 164 countries taking<br />
part. From August 29 to September 9, a team of six <strong>Bauerfeind</strong> employees from<br />
the United Kingdom and Germany worked in shifts at the polyclinic in the<br />
main Olympic Village in Stratford. <strong>Bauerfeind</strong> supports for elbows and wrists,<br />
as well as supports for the back and knees, were in particularly high demand.<br />
The <strong>Bauerfeind</strong> team was called upon to provide aid almost 350 times during<br />
the Paralympics. For more information, see www.bauerfeind.com.<br />
†<br />
8 <strong>life</strong> magazine <strong>2012</strong>/2<br />
Ulf Harzmann, International<br />
Sales Manager <strong>Bauerfeind</strong> AG,<br />
together with Sergey Shaitov,<br />
CEO of Nikamed, and Member<br />
of the Executive Board Thomas<br />
<strong>Bauerfeind</strong> (left to right) cut<br />
the ribbon to mark the opening<br />
of the store.<br />
treatment and rehabilitation of injuries.There is huge demand in<br />
Russia for high-quality medical products, which is why <strong>Bauerfeind</strong>,<br />
as a leading manufacturer of medical aids, started working with<br />
Nikamed back in January 2011. Nikamed, which acts as an exclusive<br />
sales partner, is the leading company in the Russian orthopedics<br />
market and, just like <strong>Bauerfeind</strong>, it sets great store by the outstanding<br />
quality of the products it offers. Russian customers demand<br />
exceptional quality too – especially since, with no reimbursement<br />
system in Russia, they have to pay for the full costs of their medical<br />
aids themselves.<br />
<strong>Bauerfeind</strong> AG is already planning to set up more stores in Russia:<br />
additional outlets with exclusive sales partners are due to open in<br />
Moscow and St. Petersburg in 2013.<br />
†<br />
Fascinating the world: the London Olympic Summer Games <strong>2012</strong>.<br />
<strong>Bauerfeind</strong> provided supports at the Olympics and, for the fi rst<br />
time, at the Paralympic Games with its own team of orthotists.<br />
Pictures: <strong>Bauerfeind</strong>, Carlos Senkyr
VIII Meeting of the FVL<br />
Intensive scientifi c exchange<br />
From September 5 to 7, <strong>2012</strong>, more than 300 participants from<br />
Latin America, the USA and Europe gathered at the VIII Meeting<br />
of the Latin American Venous Forum (FVL) in Viña del Mar, Chile.<br />
“Our aim for this congress is to provide a training opportunity for<br />
specialists and to encourage the exchange of knowledge regarding<br />
the treatment of venous and lymphatic diseases. This will provide<br />
specialists with effective ‘working tools’ that they can use for the<br />
benefi t of their patients,” explained vascular surgeon Dr. Alvaro<br />
Orrego, President of the VIII FVL Meeting. <strong>Bauerfeind</strong>, one of the<br />
three diamond sponsors of the event , had its own exhibition stand,<br />
where it not only presented its range of compression stockings, but<br />
also carried out live measurements using Bodytronic 300 (Image<br />
3D) with the help of its local partner Artevascular. For further<br />
information please visit www.fvl.cl.<br />
†<br />
GenuTrain P3 with individually adjustable corrective strap<br />
GenuTrain P3<br />
25th Austrian Women’s Run<br />
A win for the <strong>Bauerfeind</strong> team<br />
A new record was set in Vienna<br />
on June 3, <strong>2012</strong>: exactly 30,052<br />
participants from 66 countries<br />
lined up at the start of the 25th<br />
Austrian Women’s Run, preparing<br />
to run laps around the Prater<br />
park in Vienna. The Women’s Run<br />
therefore continues to attract more<br />
participants than any other race<br />
of its kind in Europe. <strong>Bauerfeind</strong><br />
Austria was represented by various<br />
teams at the event , with physicians,<br />
physiotherapists and employees of<br />
Members of the <strong>Bauerfeind</strong> team.<br />
<strong>Bauerfeind</strong> was present at the VIII FVL Meeting with its<br />
own exhibition stand.<br />
The GenuTrain P3 knee support has been<br />
revised and is now available with an<br />
individually adjustable corrective strap.<br />
Together with the two integral pads, the<br />
corrective strap holds the kneecap in a<br />
central position and protects it against<br />
lateral drifting to the outside. The new<br />
strap enables you to better adjust the<br />
support to your kneecap’s individual<br />
size. Its corrective tensile force can thus<br />
be matched to the indication in question<br />
and the loading situation. This provides<br />
optimal relief for the kneecap and<br />
guides it securely during movement. †<br />
NEWS<br />
our various sales partners among<br />
those involved. A total of 35 runners<br />
and walkers entered the race – all<br />
equipped with VenoTrain sports<br />
compression stockings. And the<br />
<strong>Bauerfeind</strong> sportswomen proved<br />
pretty fast , fi nishing fi rst in the<br />
5 km run and third over the 10 km<br />
distance, ensuring that two of the<br />
company’s teams claimed a place on<br />
the podium. For more information<br />
on the <strong>international</strong> race, visit www.<br />
oesterreichischer-frauenlauf.at. †<br />
<strong>life</strong> magazine <strong>2012</strong>/2 9
NEWS<br />
VenoTrain micro<br />
New standard color “honey”<br />
The standard color range for the VenoTrain<br />
micro is being brightened up in response to<br />
customer demand. The gray-brown “walnut”<br />
is being replaced by the golden “honey”<br />
tone, which falls between the two beige<br />
shades “cream” and “caramel” in the color<br />
spectrum. The popular compression stocking<br />
range therefore offers an equal selection<br />
of light and dark shades. All versions of<br />
the VenoTrain micro have been available in<br />
“honey” since July.<br />
†<br />
Medica <strong>2012</strong><br />
10 <strong>life</strong> magazine <strong>2012</strong>/2<br />
<strong>Bauerfeind</strong>’s most popular<br />
compression stocking is the<br />
VenoTrain micro.<br />
cream<br />
honey<br />
caramel<br />
<strong>Bauerfeind</strong> at the world’s largest medical trade fair<br />
MEDICA will once again be welcoming visitors to Düsseldorf from November<br />
14 to 17, <strong>2012</strong>. The event is expected to attract some 4,500 exhibitors from<br />
at least 60 countries. <strong>Bauerfeind</strong> will naturally be among those making an<br />
appearance at the world’s largest and leading medical trade fair, once again<br />
with its own exhibition stand. At Stand 4K50 in Hall 4, the company will<br />
focus on presenting its latest new developments and advancements, such as<br />
the high-grade ErgoPad weightfl ex synthetic orthosis, the new generation of<br />
the GenuTrain P3, an active knee support for improving patellar tracking, the<br />
CaligaLoc ankle support , or the design edition of the VenoTrain micro. Further<br />
information about the trade fair is available at www.medica.de.<br />
†<br />
Now available as an individual stocking<br />
VenoTrain soft<br />
If a medical prescription allows for one compression stocking only, for<br />
example in the case of thrombosis prophylaxis following surgery on one<br />
leg, medical retailers can now offer patients individual VenoTrain soft<br />
compression stockings. The VenoTrain soft individual stocking is available<br />
in the color “natural” and in compression classes 1 and 2, and it can<br />
be supplied in all standard sizes as a knee- or thigh-high stocking with<br />
closed or open toes. This comfortable compression stocking impresses<br />
with its reliable medical effectiveness and the benefi cial micromassage<br />
effect it produces while it is worn. With its “natural”-colored, dye-free<br />
fi nish, it is also ideal for patients with sensitive skin types and is particularly<br />
recommended for post-operative use.<br />
†<br />
The VenoTrain soft individual stocking is available in Ccl 1 and 2.<br />
The MEDICA: a magnet for visitors.<br />
Pictures: <strong>Bauerfeind</strong>, Messe Düsseldorf/Constanze Tillmann
Triathlon de Paris<br />
Expo-Village near the Eiffel Tower<br />
The <strong>Bauerfeind</strong> exhibition stand was near the Eiffel Tower. The stand team advised participants and visitors with great dedication.<br />
The “Garmin Triathlon de Paris” took place in the French capital on<br />
July 7 and 8, <strong>2012</strong>. Over 4,500 athletes competed against one another<br />
in the swimming, cycling and running disciplines. First of all , the<br />
triathletes took part in a qualifying competition for the French “D1”<br />
club championships on July 7. As the “Garmin Triathlon de Paris” is<br />
designed as a public event rather than as a contest exclusively for<br />
elite athletes, even amateur triathletes had the chance to join in the<br />
1,500-meter swim, 40-kilometer cycle ride and 10-kilometer run on<br />
July 8. <strong>Bauerfeind</strong> was also present at this great event , setting up<br />
its own exhibition stand by the Eiffel Tower. The <strong>Bauerfeind</strong> team<br />
was supported by its partner “A.C.O.M.M santé”, which supplies<br />
<strong>Bauerfeind</strong> products in the Paris region. Many interested competitors<br />
and spectators took advantage of the opportunity to seek<br />
advice from the team at the stand about products such as the<br />
GenuTrain knee support , the LordoLoc stabilizing orthosis for the<br />
lumbar spine or the VenoTrain sport compression stockings.<br />
†<br />
ErgoPad weightfl ex<br />
The X factor<br />
<strong>Bauerfeind</strong> has developed a new injection molding system<br />
for manufacturing synthetic foot orthoses by combining two<br />
types of plastic in a single orthotic core. With three different<br />
degrees of fi rmness, the asymmetric “weightfl ex-X” in the core<br />
supports the wearer with a variable supporting force depending<br />
on the individual condition of the foot , therapeutic goals<br />
and body weight. Thanks to their fl exibility in the forefoot<br />
and heel areas, the foot orthoses can easily be worn in shoes<br />
with higher heels.<br />
ErgoPad weightfl ex, the new orthopedic foot orthosis from<br />
<strong>Bauerfeind</strong>, is based on the spiral-dynamic principle of<br />
natural movement. The “weightfl ex-X” integrated into the<br />
orthotic core directs forces from the outside inward via two<br />
pivot points, thus supporting the torsional ability of the feet<br />
and optimizing the wearer’s gait pattern. Side pieces facing<br />
each other act as countersupports. Moderate longitudinal<br />
and transversal arch supports raise and stabilize the feet and<br />
reduce non-physiological loads.<br />
†<br />
The foot orthosis can easily be adapted to fi t any heel gradient.<br />
NEWS<br />
<strong>life</strong> magazine <strong>2012</strong>/2 11
FOCUS<br />
12 <strong>life</strong> magazine <strong>2012</strong>/2<br />
Osteoarthritis<br />
Deadly microtrauma<br />
The role played in the development of<br />
secondary osteoarthritis by very small<br />
trauma-related defects of the articular<br />
cartilage is often underestimated. This is<br />
the view of Professor Dieter Kohn, Director<br />
of the orthopedic clinic and polyclinic<br />
at the Saarland University Hospital.<br />
Basically, a constant series of microinjuries<br />
can develop into full-blown osteoarthritis.<br />
Fast action is required with<br />
regard to treatment. >>>
FOCUS<br />
Picture: Werbefotografi e Weiss<br />
<strong>life</strong> magazine <strong>2012</strong>/2 13
FOCUS<br />
Prof. Dieter Kohn, Director of the orthopedic clinic and polyclinic at the Saarland University Hospital , Germany, talking to <strong>life</strong> magazine.<br />
>>> Out of 1,000 patients undergoing a knee<br />
arthroscopy, some 600 were found to have hyaline<br />
cartilage damage. Almost half of these<br />
defects were caused by osteoarthritis (Hjelle,<br />
K. et al.; see references). Joints bearing the<br />
weight of the body are at particular risk. This<br />
is especially true of the knee. Between six<br />
and eight million people in Germany have<br />
osteoarthritis of the knee. Almost half of<br />
those aged over 45 and almost all of those<br />
aged over 75 have knee symptoms associated<br />
with osteoarthritis. A typical example of a<br />
common condition. The pressing question<br />
still remains unanswered, however. Why is<br />
osteoarthritis such a huge problem? Why do<br />
14 <strong>life</strong> magazine <strong>2012</strong>/2<br />
cartilage defects (in adults) not just regenerate?<br />
Could it have something to do with the<br />
fact that cartilage has no blood supply? Does<br />
the synovial fl uid, the liquid in the joints,<br />
prevent regeneration? Does another, completely<br />
unrelated factor play a decisive role? Despite<br />
a plethora of studies, including attempts<br />
to multiply cartilage cells under laboratory<br />
conditions, there is no currently no prospect<br />
of a cause-based therapy to combat loss of<br />
joint cartilage.<br />
Five million steps leave their mark<br />
As if all this were not enough. “Why do we<br />
keep seeing osteoarthritis of the collarbone<br />
and sternum,” wonders Professor Kohn, an<br />
orthopedic specialist , “even though there<br />
aren’t any weight-bearing joints in these<br />
areas at all?” The physician, whose list of<br />
publications on osteoarthritis runs to several<br />
pages, is reluctant to waste his breath<br />
on this: “We simply don’t know.” But do our<br />
genes have anything to do with it? There<br />
are some families where even elderly members<br />
develop no signs of osteoarthritis. With<br />
other families, by contrast , many members<br />
fi nd themselves affected by joint disease.<br />
Even the diagnostics in this area are beset<br />
with uncertainty. “Osteoarthritis can be<br />
identifi ed objectively on the basis of X-ray<br />
Pictures: Werbefotografi e Weiss, <strong>Bauerfeind</strong>
or MRI fi ndings,” explains the physician,<br />
“but the fi ndings are not always associated<br />
with symptoms. And vice versa!”<br />
Although the extremely varied clinical<br />
picture associated with osteoarthritis raises<br />
many questions, there are a few hard facts<br />
as well: we each walk around fi ve million<br />
steps every year, reckons the orthopedic<br />
specialist. There can be no doubt that this<br />
involves some wear and tear. The picture<br />
is far less obvious for another causative<br />
factor, although Professor Kohn believes its<br />
effects can be serious: “We tend to underestimate<br />
the many small instances of trauma.<br />
Think about footballers, not the top players,<br />
but those who play and train for fi ve hours<br />
a week and always tend to pick up knocks.”<br />
The typical scenarios involve strains and<br />
sprains. “It’s frightening how many cases I<br />
see of men between 40 and 55 with severe<br />
osteoarthritis of the knee, despite being in<br />
good physical condition through sports-related<br />
training. They all tend to have played<br />
a lot of sport during that physically active<br />
period between the ages of 15 and 30.”<br />
Prevention – the earlier the better<br />
“If only I’d known...” is the reaction of many<br />
an (amateur) athlete when diagnosed with<br />
osteoarthritis. “I would advise any young<br />
athlete with what they believe to be a sprain,<br />
bruising, or strain injury to see a specialist.<br />
And I would advise my colleagues to take<br />
these seriously.” Professor Kohn has been<br />
“in the knee business”, as he calls it , since<br />
1982. He knows what he is talking about: “If<br />
patients are experiencing chronic symptoms<br />
and an MRI following a ‘nothing injury’<br />
shows visible signs of damage, there will<br />
defi nitely be consequences. But the consequences,<br />
which may not necessarily involve<br />
surgery, cannot be left to chance. They must<br />
allow the injury to heal and adjust their<br />
activity levels accordingly. There’s no point<br />
getting people fi t again, by only dealing with<br />
the warning pain while ignoring the lesion<br />
and the stress involved. This would inevitably<br />
mean progression from the preliminary<br />
stages, through a period of wear, to eventual<br />
osteoarthritis.”<br />
With the knee, matters are complicated by<br />
the high risk of injury to ligaments. “You<br />
often hear the term ‘isolated rupture of the<br />
anterior cruciate ligament’ in this context ,<br />
but this is misleading,” explains the expert<br />
with some frustration. “The forces which<br />
cause a ligament to tear are invariably suffi<br />
cient to cause bony avulsions or cartilage<br />
damage as well , no matter how small they<br />
are. It’s nonsense to talk about an ‘isolated’<br />
rupture,” he affi rms. By implication, talk of<br />
“isolated” treatment seems out of place too,<br />
since the predominant type of dysfunction<br />
is now instability. The orthopedic specialist<br />
uses biomechanics to highlight the hidden<br />
risk of osteoarthritis associated with<br />
instability: “If the knee loses a key ligament ,<br />
the kinematics are completely out of kilter.<br />
The stress on the cartilage increases with<br />
every movement. Shearing forces cause tiny<br />
new traumas to the cartilage with every step<br />
that is taken. We need to eliminate these by<br />
restoring stability. The quicker the better.”<br />
Orthoses can do a lot of good in such cases.<br />
Professor Kohn cites the SofTec Genu knee<br />
FOCUS<br />
orthosis as a case in point. He particularly<br />
tends to use this for medial ligament tears.<br />
“My experiences of this have only been<br />
positive,” he points out. “As movement is<br />
guided by the orthosis splints at the side, it<br />
becomes possible to stabilize the joint.”<br />
The problem: osteoarthritis reveals<br />
few early symptoms<br />
It is absolutely critical to take early measures<br />
to counter osteoarthritis of the knee. Professor<br />
Kohn is quite clear about this, from both<br />
the physician’s and the patient’s perspective.<br />
Instability or excessive strain, lack of<br />
exercise or poor diet – all these factors need<br />
to be remedied. The trouble is that osteoarthritis<br />
does not tend to hurt during the early<br />
stages. This makes education all the more<br />
important. Osteoarthritis is synonymous with<br />
extensive, poorly defi ned cartilage defects.<br />
Once the articular cartilage has been completely<br />
lost , the only remaining treatment<br />
option in many cases is resurfacing with<br />
an endoprosthesis. “We need to remember,<br />
however, that we still have a range of options<br />
before we get to this stage,” emphasizes<br />
Professor Kohn. For example, reconstructive<br />
surgical procedures like repositioning operations<br />
can improve joint function and thereby<br />
delay the need to implant an endoprosthesis<br />
for resurfacing purposes. “Foot orthoses<br />
also provide an effective means of relieving<br />
the stress on parts of joints,” says Professor<br />
Kohn. “Before I decide that a joint prosthesis<br />
is called for, I always check whether all options<br />
for keeping the natural joint have been<br />
exhausted.”<br />
†<br />
SofTec Genu: Multifunctional orthosis for<br />
stabilization of the knee.<br />
References:<br />
Hjelle, K., Solheim, E., Strand, T., Muri, R., Brittberg,<br />
M.: Articular cartilage defects in 1,000 knee arthroscopies.<br />
Arthroscopy 2002; 18: 730-734.<br />
<strong>life</strong> magazine <strong>2012</strong>/2 15
FOCUS<br />
Higienópolis Health Center, São Paulo<br />
Looking good on the beach –<br />
and staying healthier too<br />
Giant rainforests, heavenly coasts – Brazil is nature’s paradise, and it is increasingly<br />
becoming a haven for sports enthusiasts too. The country is currently experiencing a real<br />
fi tness boom, and health centers, which offer orthopedic care as well as medical aids, fi t<br />
well into this exercise scheme. The treatments provided by Prof. Wagner Castropil also<br />
follow an integrative concept.<br />
More and more Brazilians want to take up<br />
sports. With some of the world’s greatest<br />
sporting events, such as the 2014 Football<br />
World Cup and the 2016 Olympic Games, due<br />
to be held on home soil , Brazil’s distinctive<br />
enthusiasm for sport may give rise to more<br />
work for people in medical professions, such<br />
as the São Paulo-based orthopedic specialist<br />
Prof. Wagner Castropil , for example. The<br />
specialist in sports medicine and his twenty<br />
colleagues at the VITA clinic, the largest private<br />
orthopedic clinic in the city, treat around<br />
5,000 patients per month. Prof. Castropil himself<br />
performs around 150 shoulder operations<br />
and 200 knee operations each year, albeit in<br />
cooperating hospitals rather than at the VITA<br />
clinic. “People often just used to run once<br />
around the block, but now they want to run<br />
a marathon,” he says, describing the problem<br />
of overambition, which can lead to injuries.<br />
“Or they want to look good running along the<br />
beach.” The physician believes that it is not<br />
16 <strong>life</strong> magazine <strong>2012</strong>/2<br />
just the latest fi tness boom that is responsible<br />
for the steep increase in patient numbers,<br />
but also the clinic’s favorable location in<br />
terms of transport links – a decisive factor<br />
in a city known for its constant traffi c jams.<br />
In the land of the Sugarloaf mountain and<br />
the Copacabana, the sea has a great deal of<br />
attractive appeal. The same is true of health<br />
centers in favorable locations. São Paulo is<br />
notorious for its constant traffi c jams. “It is<br />
important for our patients to be able to get<br />
to us quickly and easily,” says the physician.<br />
The Higienópolis Health Center, which houses<br />
the VITA clinic, is on the outskirts of the huge<br />
metropolis of São Paulo, the third largest city<br />
in the world.<br />
Pain – the great inhibitor<br />
Prof. Castropil treats patients of all ages,<br />
including many people suffering from osteoarthritis<br />
and even former Olympic judokas.<br />
He describes how 50- to 55-year-old patients<br />
Prof. Wagner Castropil checks whether the GenuTrain P3 fi ts correctly on his patient.<br />
with varying degrees of osteoarthritis often<br />
come to him. One thing is of absolute<br />
importance to the physician when dealing<br />
with his knee patients: breaking through the<br />
pain barrier or, as he calls it , the “continuous<br />
inhibition refl ex”! “It is important to<br />
understand,” he explains, “that pain hinders<br />
everything. Happiness, motivation, quality of<br />
<strong>life</strong>. And, above all else, movement. The body<br />
cries out with every step: Stop, it hurts!” To<br />
silence the great inhibitor, Prof. Castropil<br />
prescribes many of his osteoarthritic patients<br />
the GenuTrain A3 knee support. The<br />
3 As in the name stand for “Anti”, “Arthros”<br />
and “Algos” (“against joint pain”). As a rule,<br />
the physician prescribes the active support<br />
to patients in the early to advanced stages<br />
of osteoarthritis. “We encourage them to<br />
put the support on immediately after they<br />
get up, and to wear it for two to four weeks,”<br />
he recommends. He sees pain reduction and<br />
strengthening of the muscles – particularly<br />
the quadriceps – as the decisive factors.<br />
This, he believes, prevents the “specter of<br />
atrophy” from arising. “The result is that<br />
patients often do not want to take off the<br />
support at all any more after four weeks.”<br />
This is understandable, if you consider that<br />
the corresponding knee scores (IKDC) have<br />
signifi cantly improved, as demonstrated by<br />
Prof. Castropil’s tests.<br />
“Envelope of functions”<br />
For minor osteoarthritis at stage 1, as well as<br />
for knee complaints resulting from overstraining<br />
or instability, Prof. Castropil prefers<br />
to recommend the GenuTrain P3 (“Permanent Paulo Sao<br />
Patella Protection”) active support to his<br />
patients – to improve the guidance of the Store<br />
patella. He stresses that it fi ts excellently<br />
into the “envelope of functions” concept. <strong>Bauerfeind</strong><br />
This approach to treatment originally comes<br />
from the USA. The “envelope of functions” Pictures:
Prof. Wagner Castropil , specialist in sports medicine, performs around 150 shoulder and 200 knee operations each year.<br />
is based on taking a holistic view of the<br />
joints, which form seamlessly functioning<br />
units in their “protective envelopes”. Under<br />
physiological stress, the accompanying ligaments,<br />
tendons, muscles, cartilage and bones<br />
perform their tasks without any problems.<br />
External disruptions can, to a certain extent ,<br />
be self-regulated within the “envelope”.<br />
However, serious injuries, such as a torn<br />
cruciate ligament , stop the “envelope of<br />
functions” working properly. In the healing<br />
phase, all efforts must be made to restore<br />
this functionality to its former state.<br />
Two fl oors down: <strong>Bauerfeind</strong><br />
“There are several options available to me for<br />
trying to restore the status quo,” says Prof.<br />
Castropil. “Depending on the specifi c case,<br />
I can treat the cartilage with glucosamine,<br />
inject hyaluronic acid into the joint , and I<br />
can also prescribe the GenuTrain P3 to help<br />
re-establish the ‘envelope of functions’.” He<br />
prescribes the GenuTrain P3 for use during<br />
physical activities only. Luckily for Prof.<br />
Castropil’s patients in traffi c-riddled São<br />
Paulo, to get their GenuTrain A3 or GenuTrain<br />
P3, they simply have to take the escalator<br />
two fl oors down. This is because the only<br />
<strong>Bauerfeind</strong> store currently set up in the<br />
whole of South America is located directly<br />
For further information please visit:<br />
www.vita-org.br<br />
FOCUS<br />
beneath the VITA clinic. The store was<br />
opened at the end of March <strong>2012</strong>. Housed<br />
in a shopping arcade, the store covers over<br />
50 square meters and sells supports and<br />
orthoses, medical compression stockings and<br />
orthopedic insoles. The Higienópolis Health<br />
Center also houses other medical facilities,<br />
such as a cardiology outpatient clinic, a<br />
nutritional advice center, and dentistry and<br />
physiotherapy practices. However, patients<br />
still have some way to go to reach a certain<br />
famous beach from here.<br />
†<br />
<strong>life</strong> magazine <strong>2012</strong>/2 17
MEDICAL<br />
Colombian triple jumper Caterine<br />
Ibarguen attracted some curious<br />
glances as she jumped her way<br />
to a silver medal wearing a MyoTrain<br />
thigh support.<br />
18 <strong>life</strong> magazine <strong>2012</strong>/2<br />
Pictures: picture alliance/Kerim Okten, <strong>Bauerfeind</strong>
Summer Olympic Games London <strong>2012</strong><br />
Making a strong impression<br />
It was the event of the summer: the Olympic Games in London. With its very own team of<br />
orthotists, <strong>Bauerfeind</strong> AG was on hand to provide medical care for all 10,500 athletes from<br />
204 nations competing at the Games. Its supports, orthoses, medical compression stockings<br />
and orthopedic orthoses came to the aid of athletes on more than 700 occasions.<br />
These are moments we will never forget: the<br />
stunning success of Usain Bolt , the jubilation<br />
in the Olympic stadium as heptathlete Jessica<br />
Linda Stahl ,<br />
javelin thrower,<br />
bronze medal at<br />
London <strong>2012</strong>.<br />
“To be able to win a medal<br />
at the Olympic Games,<br />
everything has to be just<br />
right – including the<br />
medical care. <strong>Bauerfeind</strong><br />
provided me with very<br />
reliable support.”<br />
Ennis completed her lap of honor, or the<br />
thrilling fi nal of the men’s beach volleyball<br />
competition. The athletes in London were<br />
provided with the best conditions to deliver<br />
top sporting performance – including a sophisticated<br />
medical care system. <strong>Bauerfeind</strong><br />
was involved in the Games once again in <strong>2012</strong><br />
as a partner of the Olympic organizing committee:<br />
the company supplied products to the<br />
three polyclinics in Stratford (main Olympic<br />
Village), Eton Dorney (Olympic Village for the<br />
rowing and canoeing events) and Weymouth<br />
Portland (Olympic Village for the sailing competitions),<br />
as well as to all 35 event venues.<br />
From July 16 to August 12, a total of eight<br />
<strong>Bauerfeind</strong> employees from the UK, Germany<br />
and the Netherlands worked in shifts at the<br />
polyclinic in the main Olympic Village in<br />
Stratford. With two orthotists on duty per day,<br />
the <strong>Bauerfeind</strong> team was on hand from 7.00<br />
am to 11.00 pm. The polyclinic was open to<br />
all 16,000 or so people staying in the Olympic<br />
Village in Stratford, with athletes from all over<br />
the world coming along every day in search<br />
of medical advice. Some of them also needed<br />
<strong>Bauerfeind</strong> products, either because they<br />
had injured themselves, an old problem had<br />
fl ared up again or they were showing various<br />
signs of overstraining. A variety of supports<br />
and orthoses from the <strong>Bauerfeind</strong> product<br />
range for the feet , knees, hips, spinal column,<br />
shoulders, hands, and elbows were supplied<br />
for this purpose, as well as medical compression<br />
stockings and orthopedic orthoses.<br />
Hemke van<br />
der Zwaag,<br />
orthotist (CPO),<br />
<strong>Bauerfeind</strong> Benelux.<br />
“I was impressed by the<br />
team spirit and the<br />
positive atmosphere<br />
in the polyclinic. The<br />
athletes and staff at<br />
the polyclinic were very<br />
enthusiastic about<br />
our services and our<br />
fantastic products. It<br />
was an honor to be part<br />
of it all!”<br />
“There were so many<br />
incredibly gratifying<br />
moments. When athletes<br />
came back, for example,<br />
to tell us that a product<br />
had worked and helped<br />
them to get back up<br />
and running. It’s a<br />
great feeling to get<br />
such positive feedback<br />
from the athletes. We<br />
didn’t have a single<br />
complaint!”<br />
MEDICAL<br />
<strong>Bauerfeind</strong>: an “exclusive supplier”<br />
For this year’s summer games, the London<br />
Organising Committee of the Olympic<br />
Games and Paralympic Games (LOCOG)<br />
invited tenders in a number of different<br />
Dirk Schwager,<br />
orthotist (CPO),<br />
<strong>Bauerfeind</strong> Germany.<br />
categories. <strong>Bauerfeind</strong> participated in the<br />
tendering process for the “braces” category,<br />
along with 15 other companies from<br />
around the world. “We were delighted to be<br />
awarded the contract ,” said Chief Executive<br />
Offi cer Prof. Hans B. <strong>Bauerfeind</strong>, “The<br />
decisive factor that set <strong>Bauerfeind</strong>’s >>><br />
<strong>life</strong> magazine <strong>2012</strong>/2 19
MEDICAL<br />
>>> bid apart from the rest was the<br />
outstanding quality of our supports and<br />
orthoses. This is further proof that our<br />
“Made in Germany” products are highly<br />
rated at an <strong>international</strong> level.”<br />
Working hand in hand<br />
In order to provide athletes with the help<br />
they needed, the <strong>Bauerfeind</strong> team worked<br />
hand in hand with colleagues from other<br />
departments, such as orthopedists. Once a<br />
diagnosis had been made, the <strong>Bauerfeind</strong> orthotists<br />
used this as a basis for selecting the<br />
right product , assessed what size of product<br />
was required, and explained to the athletes<br />
how the product works and how they should<br />
put it on. The products, such as orthoses, were<br />
also individually adjusted to fi t if required.<br />
Supports, orthoses, medical compression<br />
stockings and orthopedic orthoses were supplied<br />
to athletes on more than 700 occasions<br />
in total.<br />
Interview<br />
Health is the top priority<br />
Interview with Dr. Bernd Wolfarth, Chief Physician for the German Olympic team.<br />
You have already been involved in fi ve Olympic<br />
Games. What was it like for you in London?<br />
PD Dr. Wolfarth: There is always something<br />
particularly special about the Olympic<br />
Games. It was certainly rather easier for us<br />
to work in London than in Beijing, purely<br />
because there was no language barrier. In<br />
Beijing, we Europeans also had to cope with<br />
the time difference, a different food culture<br />
20 <strong>life</strong> magazine <strong>2012</strong>/2<br />
Priv.-Doz. Dr. med.<br />
Bernd Wolfarth.<br />
Elizabeth Crane,<br />
Managing Director<br />
<strong>Bauerfeind</strong> UK.<br />
“Customers in the UK now<br />
know that <strong>Bauerfeind</strong> is not<br />
a small family company but<br />
an <strong>international</strong> brand with<br />
a vast amount of experience<br />
and expertise in medical<br />
products.”<br />
and a different climate. The equipment at the<br />
polyclinic in the Olympic Village once again<br />
left virtually nothing to be desired, and our<br />
cooperation with the <strong>Bauerfeind</strong> team on<br />
orthopedic care was excellent. <strong>Bauerfeind</strong><br />
has also been involved in the polyclinics<br />
since the Winter Olympics in Vancouver –<br />
which is an ideal situation for us. Whenever<br />
we needed anything, we could get hold of<br />
just the right product via the short offi cial<br />
channels.<br />
What were the most common medical<br />
problems?<br />
PD Dr. Wolfarth: Infections, as expected.<br />
It is important to differentiate between<br />
injuries, because there are a lot of simple<br />
problems that can be treated directly by<br />
physiotherapists and be brought under<br />
<strong>Bauerfeind</strong> products in the spotlight<br />
While the orthopedic support provided to athletes<br />
was generally not visible to spectators,<br />
the Colombian triple jumper Caterine Ibarguen<br />
attracted some curious glances as she jumped<br />
her way to a silver medal wearing a MyoTrain<br />
thigh support. The LumboTrain sported by<br />
javelin thrower Linda Stahl , another medalist ,<br />
could also be seen by observant spectators as<br />
it showed through her top. “Supports for the<br />
ankle, knee and back were in particularly high<br />
demand,” said Lars Birnbaum, Head of Sport<br />
Marketing at <strong>Bauerfeind</strong>. To make sure there<br />
would be enough to go round, some 200 extra<br />
products in various sizes were shipped in from<br />
the company’s headquarters in Zeulenroda.<br />
“We had more than 10,000 products here in<br />
total , but in the last few days we naturally did<br />
not want to have to turn any injured athletes<br />
away because the size they needed was not in<br />
stock. We managed to handle this perfectly,”<br />
Lars Birnbaum added.<br />
†<br />
control. Minor muscular injuries are the<br />
most common. Fortunately, we rarely see any<br />
serious injuries.<br />
What goes through your mind when you have<br />
to decide, from a medical perspective, how fi t<br />
an athlete is to compete?<br />
PD Dr. Wolfarth: That is always a diffi cult<br />
decision, especially in the case of athletes<br />
involved in sports that only receive any<br />
public attention perhaps once every four<br />
years, at the Olympics. If an athlete is<br />
working toward that one particular moment ,<br />
and then an infection or a muscular injury<br />
puts him out of action, it’s a personal tragedy<br />
that affects you, too – there’s no question<br />
about it. However, when it comes to making<br />
decisions about an athlete’s fi tness for sport<br />
or competition, the athlete’s health is always<br />
our top priority!<br />
†<br />
Pictures: headshot-soho.co.uk, <strong>Bauerfeind</strong>, <strong>Bauerfeind</strong> Benelux/Ridderhof
25 years of <strong>Bauerfeind</strong> Benelux<br />
On the way to gold<br />
On September 7, <strong>2012</strong>, <strong>Bauerfeind</strong> Benelux welcomed guests to a symposium and<br />
gala evening to celebrate a very special occasion: the company’s 25th – or “silver” –<br />
anniversary. Guests came from all over the world to attend the event in Haarlem.<br />
Prof. Hans B. <strong>Bauerfeind</strong> (left) came to celebrate the 25th anniversary with Bram Dieleman. Welcoming the guests of the jubilee.<br />
After the Austrian, US, Swiss and French<br />
companies, Benelux was the fi fth subsidiary<br />
established abroad by <strong>Bauerfeind</strong> AG in the<br />
1980s. When Bram Dieleman took over the<br />
management of the company on August<br />
1, 1987, there were just fi ve <strong>Bauerfeind</strong><br />
orthopedic products and one variety of compression<br />
stockings available in the Benelux<br />
region. Now the entire product range is on<br />
offer and the company is leading the orthopedics<br />
and phlebology market in Benelux.<br />
Manager, motivator and initiator<br />
Bram Dieleman leads the 35-strong team<br />
of employees at <strong>Bauerfeind</strong> Benelux with<br />
plenty of dedication and commitment.<br />
“He is a manager, motivator and initiator<br />
all rolled into one,” said Prof. Hans B.<br />
<strong>Bauerfeind</strong>, full of praise in his speech at<br />
the event. He also refl ected on the rapid<br />
growth enjoyed by <strong>Bauerfeind</strong> Benelux,<br />
which has led to a few relocations over the<br />
past 25 years! The subsidiary was initially<br />
based in Tegelen, near Venlo, before setting<br />
up offi ce in Haarlem. By 1993, these<br />
premises once again proved too cramped, so<br />
<strong>Bauerfeind</strong> constructed its very own, larger<br />
building in Holland for the fi rst time. “It<br />
was very daunting, as in 1994 – soon after<br />
we moved in – the reimbursement for the<br />
GenuTrain knee support was abolished,”<br />
recalls Prof. <strong>Bauerfeind</strong>, “Yet in spite of the<br />
diffi cult market conditions, the company<br />
was still able to pay the mortgage and<br />
<strong>Bauerfeind</strong> Benelux continued to grow.”<br />
The company had grown out of its premises<br />
again by 2003, so it moved into its current<br />
offi ces located just 400 meters away.<br />
The <strong>Bauerfeind</strong> offi ce in Haarlem.<br />
A chance to mingle after the symposium.<br />
Sparkling atmosphere at the gala evening.<br />
MEDICAL<br />
Reliable partner<br />
An enthusiastic skater, cyclist , skier and<br />
golfer, Bram Dieleman likes to draw comparisons<br />
between the company and elite<br />
athletes: they are always trying to raise the<br />
bar a little higher. But they can’t do this<br />
alone. Success always depends on having<br />
support , a good team and reliable partners.<br />
To thank its partners, in particular, for their<br />
good cooperation, <strong>Bauerfeind</strong> Benelux invited<br />
them to a symposium entitled “On the<br />
way to gold” on September 7. The theme of<br />
the event was the future of healthcare and<br />
medical supply. The guest speakers included<br />
Prof. C. Niek van Dijk (AMC Amsterdam),<br />
Prof. H. A. Martino Neumann (Erasmus<br />
Medical Center, Rotterdam), Johan de Wit<br />
(CVZ), Prof. Dr. Jan Willem Velthuijsen<br />
(PriceWaterhouseCoopers), Jan Schutrups<br />
(Schutrups, Exloo) and Prof. Hans B.<br />
<strong>Bauerfeind</strong>. The audience came from all<br />
over the world to gather in Haarlem, where<br />
they enjoyed the sincere Dutch hospitality<br />
and the glamorous atmosphere of the<br />
event , which was held in a large marquee.<br />
The anniversary celebrations fi nished on<br />
a successful note, with music, acrobatic<br />
performances and plenty of interesting<br />
conversation.<br />
†<br />
<strong>life</strong> magazine <strong>2012</strong>/2 21
MEDICAL<br />
Science and practice<br />
The foot as an interface<br />
‘I would like the term shin splints to be banned – there should be a law against it!’<br />
Daily Mail , 1.6.<strong>2012</strong>. Marathon man, Dr. Nat Padhiar has a dislike of the term shin<br />
splints and passion for exercise induced leg pain (EILP) in sport.<br />
He is extremely proud, though not of himself<br />
even though he has very good reason to be:<br />
Consultant Podiatric Surgeon at the Royal<br />
Hospital London, Fellow of the Faculty of<br />
Podiatric Surgery at the College of Podiatrists,<br />
Honorary Reader in the Centre<br />
for Sports and Exercise Medicine (CSEM),<br />
William Harvey Research Institute, Queen<br />
Mary, University of London and Clinical Lead<br />
for Podiatry at The London <strong>2012</strong> Olympic &<br />
Paralympic Games, the list is endless. But it<br />
is his children, rather than himself, who is<br />
the source of his pride – his son Ciaran aged<br />
15 years recently won his school’s annual<br />
Golf tournament. His proud father smiles<br />
and says, “Sport is very important in our<br />
family, it is important not only for health<br />
and fi tness, but also for things like team<br />
spirit , leadership and discipline” and Dr. Nat<br />
Padhiar should know. He has completed 34<br />
marathons and over 150 half marathons with<br />
two of the marathons on Mount Everest –<br />
from Gorak Shep (5164m) which is very near<br />
to Base Camp (5364m) to Namche Bazaar<br />
(3750m). “I have been running my whole<br />
<strong>life</strong>.” Tennis and cricket are among his other<br />
passions. And as a member of a medical<br />
team, he has also provided support at the<br />
World Student Games, Commonwealth Games,<br />
Island Games (Guernsey), Everest Marathon,<br />
Mongolia Sunrise to Sunset Marathon, London<br />
Marathon and London Triathlon.<br />
Shin splints – a dinosaur term<br />
Where do you start? “With the leg, of course!”<br />
Dr. Nat Padhiar has devoted the last 20 years<br />
of his career to researching different causes<br />
of EILP in sport and has completed a PhD<br />
investigating various aspects of Chronic<br />
Exertional Compartment Syndrome (CECS).<br />
Dr. Padhiar clarifi es in his interview with<br />
<strong>Bauerfeind</strong> <strong>life</strong> that shin splints is an umbrella<br />
term describing a number of conditions<br />
that cause EILP that can be associated with<br />
more than 35 different conditions. Each of<br />
these conditions requires a detailed history<br />
www.headshot-soho.co.uk<br />
and objective investigations to make a specifi<br />
c diagnosis in order to provide appropriate Dr. Nat Padhiar, Consultant Podiatric Surgeon at the Royal Hospital London.<br />
Pictures:<br />
22 <strong>life</strong> magazine <strong>2012</strong>/2
and effective treatment. As an expert in the<br />
fi eld based at his private clinic which he has<br />
named after his mentor and friend, The John<br />
King Centre for Leg Pain at BMI London Independent<br />
Hospital , he estimates that the use<br />
of the term shin splints is resulting in half of<br />
EILP cases being misdiagnosed.<br />
Science and practice<br />
Evidence-based practice: audit and research<br />
are an important and integral part of his<br />
practice. As a Reader in CSEM, Dr. Padhiar<br />
has supervised well over 200 research<br />
projects, published numerous papers, coauthored<br />
a chapter in a book and has a foot<br />
condition named after him, Crisp-Padhiar<br />
Syndrome. One of his current research<br />
projects is a prospective study looking at<br />
the effectiveness of Prolotherapy in Medial<br />
Tibial Stress Syndrome in combination with<br />
<strong>Bauerfeind</strong> VenoTrain compression stockings,<br />
where he explains ‘Prof Hargen’s study has<br />
shown that compression improves microcirculation<br />
and thus aids healing’.<br />
Breaking the vicious cycle<br />
Changing the subject to foot and ankle<br />
injuries in sport and the sort of conditions<br />
he is likely to encounter at the forthcoming<br />
London <strong>2012</strong> Olympic & Paralympic Games,<br />
he explains fi rstly the biomechanics of<br />
the foot and how it affects the lower limb<br />
kinetic chain. “The foot is the interface<br />
between the ground and the body. ‘Normal’<br />
relationships between body segments are<br />
a pre-requisite for ‘normal’ function. Any<br />
signifi cant deviation in position, structure<br />
or function may lead to abnormal compensation.<br />
This is change in position, structure of<br />
a part as a consequence of abnormality. This<br />
usually leads to mistiming of joint motion<br />
in the gait cycle, misalignment of joint , altered<br />
angle of muscle function and reduced<br />
capacity to withstand forces acting on that<br />
part. He gives an example, “An overpronated<br />
foot , for example, could be one of the causes<br />
of patella-femoral knee pain.”<br />
His approach to management appears to<br />
be quite simple, “Make a diagnosis (good<br />
history), defi ne the severity of the problem<br />
(imaging and investigations), reduce the<br />
pathology and pain (oral medication, injections<br />
& surgery), strengthen and stabilize<br />
(foot orthoses, braces & physiotherapy),<br />
reduce the pre-disposing factors for long<br />
term benefi t & prevention (core stability<br />
etc.) and rehabilitation back to sport”.<br />
Dynamic, just like <strong>life</strong> itself<br />
The fact that , for Dr. Padhiar, the foot or the<br />
lower extremity also forms the interface be-<br />
tween science and practice is demonstrated<br />
by him as he examines Kerrie-Ann Craddock,<br />
the rugby player from London Saracens RFC<br />
who suffers from chronic exertional compartment<br />
syndrome of the lower leg. Using a<br />
16g cannula, Dr. Padhiar inserts a Rorabeck<br />
catheter linked to a pressure transducer<br />
into the affected compartments to measure<br />
For further information<br />
MEDICAL<br />
the intra-compartment pressure both at<br />
rest and during exercise. He stresses the<br />
importance of collecting dynamic data with<br />
pressure tracing which allows for objective<br />
and meaningful evaluation of the results. He<br />
is very critical of the static systems widely<br />
Kerrie-Ann Craddock (right) suffers from chronic compartment syndrome in her lower leg.<br />
Using a cannula, Dr. Padhiar inserts a sensor into the t<strong>issue</strong> to measure the local pressure.<br />
used in Sports Medicine. Dr. Padhiar is again<br />
very proud of his Dynamic Intra-compartment<br />
Pressure testing system in The John<br />
King Centre which he partly developed himself<br />
with the help of a bright physicist , Tahir<br />
Mahmood. “It works just like <strong>life</strong> itself – and<br />
like <strong>Bauerfeind</strong> with its active orthoses,” he<br />
says with a smile: “dynamically.”<br />
†<br />
about Dr. Nat Padhiar and the BMI London Independent Hospital:<br />
www.londonsportscare.co.uk<br />
www.bmihealthcare.co.uk/lih<br />
<strong>life</strong> magazine <strong>2012</strong>/2 23
MEDICAL<br />
SofTec Coxa<br />
Innovative treatment of hip pain<br />
With the number of hip arthroscopies projected to double by 2013*, it is important that<br />
orthopedic surgeons employ post-operative treatment plans that increase patient compliance.<br />
Orthopedic surgeon Dr. Allston Stubbs evaluates approximately 1,500 patients per<br />
year and performs arthroscopic hip surgery on an average of 24 patients per month. Using<br />
<strong>Bauerfeind</strong>’s active hip orthosis SofTec Coxa as part of his post-operative treatment plan,<br />
he fi nds higher patient compliance and satisfaction.<br />
How common is sports-related hip pain?<br />
Dr. Stubbs: Sports-related hip pain is a<br />
common problem affecting a variety of ages<br />
and ability levels. The true prevalence is<br />
not known, but in my clinic our average age<br />
is about 30 years old, with women being<br />
slightly more affected than men.<br />
How has the treatment of hip pain changed in<br />
the last 15 years?<br />
Dr. Stubbs: Over the last 15 years, the<br />
treatment of hip pain has changed relative<br />
to a better understanding of the causes of<br />
hip pain and diagnostic tools. Also, a better<br />
awareness by medical providers and athletic<br />
trainers improved diagnostic capabilities.<br />
Highly-informed patients, utilizing tools now<br />
commonly found on the internet , are better<br />
able to direct their health care professionals<br />
to proper hip pain diagnosis and treatment.<br />
What common indications related to hip pain<br />
do you see on a regular basis at your clinic?<br />
Dr. Stubbs: My clinic primarily evaluates and<br />
treats patients with sports medicine-related<br />
hip conditions. It may be as self-limiting as<br />
a muscle strain or more involved, such as a<br />
cartilage tear. We do see hip arthritis as well ,<br />
but along a spectrum of the earliest stages<br />
to more progressed arthritis. Athletes with<br />
common cases of cartilage tears, such as<br />
femoroacetabular impingement , are evaluated<br />
and counseled on treatment options and<br />
their return to sport.<br />
Who is your typical patient?<br />
Dr. Stubbs: Our typical patient is active<br />
and passionate about <strong>life</strong>. Most patients are<br />
athletic in some capacity for fi tness, as the<br />
weekend warrior, and collegiate and professional<br />
athletes. Men and women are both<br />
affected. Our age range is typically 12 to 70<br />
years of age.<br />
24 <strong>life</strong> magazine <strong>2012</strong>/2<br />
Dr. Stubbs – Clinical study<br />
Dr. Allston Stubbs is Medical Director of<br />
Hip Arthroscopy for Wake Forest Baptist<br />
Health and Wake Forest University School<br />
of Medicine, and assistant professor in the<br />
Sports Medicine Program of the Department<br />
of Orthopaedic Surgery at Wake<br />
Forest University in Winston-Salem, North<br />
Carolina. An expert in hip arthroscopy,<br />
he has published orthopedic research,<br />
created instructional videos and lectured<br />
at conferences within the United States<br />
and abroad. As an active researcher,<br />
Dr. Stubbs is currently working with<br />
<strong>Bauerfeind</strong> on a clinical study involving<br />
the biomechanics of hip bracing. Results<br />
of the two-year-study are expected the<br />
summer of 2013. Understanding the<br />
biomechanical function of sports hip<br />
orthoses and its implicit effect on therapeutic<br />
post-operative recovery can help<br />
in improving the overall outcomes following<br />
hip arthroscopy procedures.<br />
How do you utilize <strong>Bauerfeind</strong> active orthoses<br />
as part of your protocols?<br />
Dr. Stubbs: We use the SofTec Coxa hip brace<br />
as a primarily post-operative orthosis. This<br />
<strong>Bauerfeind</strong> brace assists our patients by providing<br />
controlled range of motion, lumbopelvic<br />
support and lateral impact protection in<br />
the event of a collision or fall.<br />
You have tried other products. What makes the<br />
<strong>Bauerfeind</strong> product different , and why did you<br />
select its use over the others?<br />
Dr. Stubbs: We were having problems with<br />
patient compliance with the other hip supports<br />
we were using. We found that patient<br />
satisfaction and compliance was higher using<br />
the SofTec Coxa. Its ease of use, appropriate<br />
fi tting, comfort , and being a four-season<br />
brace gave the patient confi dence.<br />
What features and benefi ts are most important<br />
in use of the SofTec Coxa?<br />
Dr. Stubbs: We value patient satisfaction the<br />
most in our use of the SofTec Coxa hip brace.<br />
We feel the basis of high patient satisfaction<br />
relies on a brace that is well made of high<br />
quality materials, provides a “customized”<br />
feel and effectively transitions the patient<br />
“The design of the SofTec Coxa<br />
allows each patient to feel as<br />
if they have a personalized orthosis.”<br />
(Dr. Allston Stubbs)<br />
from the immediate post-operative period to<br />
the return to full activity.<br />
How does the design of the SofTec Coxa allow<br />
you to enhance patient treatment?<br />
Dr. Stubbs: The design of the SofTec Coxa<br />
allows each patient to feel as if they have a<br />
personalized orthosis. Most importantly, the<br />
fi t of the brace can be adjusted throughout<br />
Pictures: Nick Greenway
Orthopedic surgeon Dr. Allston Stubbs explains to his patient how to use the SofTec Coxa.<br />
the post-operative period. Further, the range<br />
of motion of the brace can be adapted to<br />
the patient’s needs and requirements. These<br />
qualities ensure a high patient compliance<br />
rate over the course of treatment.<br />
Most hip braces on the market are used for an<br />
average of 10 days. How long do your patients<br />
wear the SofTec Coxa for?<br />
Dr. Stubbs: The majority of our patients use<br />
the brace for six weeks. We encourage patients<br />
to use it whenever they fi nd it appropriate as<br />
they return to their favorite activities.<br />
Where do you see the future of arthroscopic<br />
hip treatment , and where do you see the role<br />
of active orthoses such as the SofTec Coxa in<br />
the future?<br />
Dr. Stubbs: Arthroscopic hip treatment<br />
continues to evolve as one treatment option<br />
for patients with hip pain. Orthoses such<br />
as the SofTec Coxa will continue to evolve<br />
with the advent of new techniques and<br />
For further information please contact:<br />
<strong>Bauerfeind</strong> USA (address, page 39)<br />
MEDICAL<br />
procedures. The SofTec Coxa is a valuable<br />
addition to our patient treatment program,<br />
and we’re excited to use it. Our patients are<br />
very pleased as well.<br />
†<br />
* The Journal of the American Academy of Orthopaedic<br />
Surgeons, June <strong>2012</strong>, Volume 6, Number 6.<br />
<strong>life</strong> magazine <strong>2012</strong>/2 25
MEDICAL<br />
AVE Orthopedische Klinieken, Huizen, the Netherlands<br />
“We have a face”<br />
Independent treatment centers are a specialty of the Netherlands. Their focus is on providing<br />
immediate and effi cient care for patients. With orthopedic problems in particular, the centers<br />
are able to make use of the advantages they have over public hospitals and private clinics.<br />
If you are visiting Arno van Lieshout at his<br />
place of work, you will be met with a surprising<br />
sight: no automatic doors, no long corridors,<br />
no stethoscope in his jacket pocket.<br />
The physician greets visitors in the very<br />
place where he welcomes his patients: at a<br />
large wooden desk in a well-lit offi ce. An examination<br />
couch, medical posters and a knee<br />
prosthesis are the only things that remind<br />
visitors they are in a hospital. This is deliberate.<br />
“We don’t have a hospital atmosphere,”<br />
says the orthopedic surgeon. “The patients<br />
like it that way. And so do we.”<br />
Arno van Lieshout works together with three<br />
other orthopedic specialists at the AVE<br />
Orthopedische Klinieken (AVE Orthopedic<br />
Clinics) – a so-called ‘ZBC’. The acronym<br />
stands for ‘Zelfstandig Behandel Centrum’ –<br />
an independent treatment center, which are<br />
common in the Netherlands. These centers<br />
started to appear in the 1980s. Alongside<br />
the public hospitals and private clinics,<br />
they form an important pillar of the Dutch<br />
healthcare system. There are now around 200<br />
of these small , independent clinics spread<br />
all over the country. Thanks to their fl exible<br />
structures, in most cases the ZBCs are able<br />
to treat patients more quickly and more effectively<br />
than larger hospitals. Even just the<br />
partnership of two specialists can constitute<br />
The knee orthosis SecuTec Genu.<br />
26 <strong>life</strong> magazine <strong>2012</strong>/2<br />
a ZBC. They are not private clinics, however.<br />
Just like other medical service providers,<br />
they are recognized by hospitals. Typically<br />
for an independent treatment center, facilities<br />
such as operating theaters are rented, or<br />
x-ray examinations are bought in and used<br />
for providing their own services.<br />
cated hip operations in ASA III patients are<br />
well taken care of by the hospitals, but we<br />
can complete a knee arthroscopy in healthy<br />
patients within fi fteen minutes. That saves<br />
both time and money.”<br />
But money is not everything, and the physician<br />
knows that too. “We are approachable,<br />
people can come to us,” he says. “They can<br />
call us, send us an e-mail or come in and see<br />
us. We have a face!”<br />
Anonymity in hospitals, the resulting unpopularity,<br />
immense cost increases – all of these<br />
factors were reasons for founding the ZBCs.<br />
Effi ciency, high quality and fl exibility is the<br />
motto here. Direct partnerships and costsaving<br />
collaborations are designed to help<br />
both the system and the patients equally. For<br />
example, AVE Orthopedische Klinieken work<br />
closely with regional hospitals and also with<br />
local medical supply retailers and physiotherapists.<br />
Patients don’t want to feel ill<br />
The AVE Orthopedische Klinieken, with their<br />
headquarters in Huizen, have several sites<br />
in the Netherlands. The one in Almere is<br />
an important branch. Situated around 20<br />
kilometers east of the gates of Amsterdam is<br />
a city with symbolic signifi cance: Almere is<br />
the fastest-growing city in the Netherlands.<br />
“Where you are now sitting was under water<br />
30 years ago,” Arno van Lieshout explains. In<br />
a huge land reclamation project , the ground<br />
on which Almere stands today was reclaimed<br />
from the Zuiderzeethe neighboring Lake<br />
Ijseel. According to the physician, the city’s<br />
200,000, predominantly young inhabitants Coherence of resources<br />
appreciate new structures – even in the Working collaboratively, it is important to<br />
healthcare system. “We often see young Arno van Lieshout and his colleages that<br />
sportsmen and women who have injured support is provided in the places where it<br />
themselves,” he says, describing his main cli- is needed most. That may be on site at a<br />
entele. “They don’t feel ill and don’t want to rented hospital bed or on AVE premises.<br />
be treated as people who are ill. They come The same applies where medical products<br />
to us because it is our job to solve problems are concerned: “With active supports and<br />
– and to solve them as quickly as possible.” knee orthoses, I can rely on the team at<br />
People often come to AVE for a second <strong>Bauerfeind</strong>,” says the physician. Admittedly<br />
opinion. And in many cases, the patient he needs the medical aid itself – such as the<br />
then stays with the AVE. “Just this morning SecuTec Genu knee orthosis, used to provide<br />
a patient came to me after a tibia correc- security following the fi tting of artifi cial<br />
tion to ask when would be the best time to cruciate ligaments – more than its bearer.<br />
remove the plate,” says Arno van Lieshout , But there is personal contact involved, for<br />
describing a particular case. “He had lost example with Edwin Mosterd, Sales Manager<br />
confi dence in the other physicians after they of <strong>Bauerfeind</strong> Netherlands, who symbolizes<br />
had damaged a nerve during the operation. all AVE activities: immediate, quick, and<br />
Now we will continue his treatment.” effective. And there is another medical aid in<br />
the <strong>Bauerfeind</strong> range that is ideal here. The<br />
An “approachable” physician<br />
GenuTrain, for example, the active support<br />
Continuing treatment that others are unwill- for the knee, fulfi lls the requirements that<br />
ing or unable to carry out is one thing, but the orthopedic clinic demands of itself:<br />
working with colleagues from the hospitals is “The support provides security in cases of<br />
another – and it is much more common. “It knee instability,” says Arno van Lieshout.<br />
is never the case that we can do everything “Security – that is exactly what we aim to<br />
better,” the physician concedes. “Compli- provide at AVE.”<br />
†<br />
Pictures: Stefan Durstewitz, <strong>Bauerfeind</strong>
Orthopedic specialist Arno<br />
van Lieshout works at the<br />
AVE Orthopedische Klinieken,<br />
Huizen.<br />
For further information please visit:<br />
MEDICAL<br />
www.ave-orthopedischeklinieken.nl<br />
See page 39 for contact information for <strong>Bauerfeind</strong> Benelux.<br />
<strong>life</strong> magazine <strong>2012</strong>/2 27
MEDICAL<br />
Picture: private<br />
28 <strong>life</strong> magazine <strong>2012</strong>/2<br />
Stuntwoman’s Promising Career Saved by MalleoTrain S<br />
Air Born<br />
Tally Rodin – model , acrobatic dancer, gymnast , stuntwoman<br />
– is not your typical teen. At 18 she has already planned<br />
her professional career, one that includes moving from<br />
Stouffville, Ontario, to Hollywood, California, to become a top<br />
notch stuntwoman. It is an unusual profession to be sure,<br />
but one that seems to suit the ambitious and multi-talented<br />
athlete. “Doing stunts is exhilarating,” said Tally. “It all feels<br />
very natural to me.” A <strong>Bauerfeind</strong> brace helped to save her<br />
career. >>>
MEDICAL<br />
Tally Rodin doing a handstand during a contemporary solo.<br />
<strong>life</strong> magazine <strong>2012</strong>/2 29
MEDICAL<br />
MalleoTrain S: Active support for greater ankle stability and security during physical activity.<br />
>>> Already an accomplished professional<br />
with gigs in her portfolio like dancing,<br />
modeling and performing as a stuntwoman<br />
in a Sunny D TV and internet commercial ,<br />
Tally’s love of the art of movement began<br />
at a very early age. “I didn’t want to be<br />
left behind when my seven-year-old sister<br />
Samantha took dance lessons, so when I was<br />
two, I asked my parents to sign me up. But<br />
it wasn’t until I turned two and a half that<br />
I was fi nally old enough to begin lessons,”<br />
said Tally. She was unstoppable from that<br />
moment on.<br />
Dance and gymnastics soon became a<br />
routine part of her after-school day, and as<br />
a teen, she spent from 3 to 10 pm every day<br />
in the gym and studio. Her accomplishments<br />
out of the studio, including amateur and professional<br />
dance, acting, martial arts, stunts<br />
and modeling for fi lm, television and stage<br />
productions, led to her becoming something<br />
of a celebrity in her community.<br />
Ankle injury<br />
But Tally’s hard work all came crashing down<br />
two years ago. “I was practicing around<br />
my home on the grass when I landed a full<br />
back layout with 360 spin. I landed too<br />
far forward and felt and heard a snap or<br />
For further information please visit:<br />
www.tallyrodin.com<br />
30 <strong>life</strong> magazine <strong>2012</strong>/2<br />
pop. I collapsed to the ground. Right away<br />
I couldn’t walk. I thought , ‘Oh, my God,<br />
my foot’s broken.’ I was only 16 and had<br />
already started my career by teaching dance,<br />
gymnastics, and being a stunt person. I was<br />
devastated,” she recalled.<br />
Tally had a micro tear in the tibialis posterior<br />
Tally Rodin, dancer and stunt woman from<br />
Canada.<br />
tendon of her right ankle. It was her fi rst<br />
injury. As fate would have it , just a week<br />
later she had a trip booked to Los Angeles to<br />
participate in an intensive dance workshop.<br />
Once she could walk, though still in pain, she<br />
went straight to the studio and took out al-<br />
“It fi ts perfectly and worked<br />
unlike any other product I<br />
previously tried.”<br />
(Tally Rodin)<br />
most everything that involved her right foot.<br />
At the competition, she froze her ankle with<br />
a gel and competed on it. She admitted it<br />
was the worst decision she ever made.<br />
“I then bought the cheap braces you get at<br />
a pharmacy, wore those in LA and just sat<br />
out when my ankle was in too much pain<br />
to handle. Other than that , I was using the<br />
R.I.C.E. technique (Rest , Ice, Compression,<br />
Elevation) as much as possible,” she said.<br />
“The MalleoTrain S was my <strong>life</strong> saver”<br />
But her ankle wasn’t healing. Tally’s father,<br />
Harley, went online to fi nd a brace that could<br />
support his daughter’s ankle and help it<br />
heal. He discovered the <strong>Bauerfeind</strong> website<br />
and the MalleoTrain S compression brace. A<br />
local podiatrist confi rmed that the support it<br />
provided was just what Tally needed.<br />
“After using the product , I was very happy. It<br />
gave me a lot of relief, and every time it was<br />
on I stopped worrying about re-injuring my<br />
ankle,” said Tally.<br />
It has been two long years since her injury,<br />
but Tally is recovering. Along with wearing<br />
the MalleoTrain S, undergoing physiotherapy<br />
and one PRP injection (Platelet Rich<br />
Plasma), her professional days are looking<br />
brighter. She was back into her full training<br />
schedule at the end of July.<br />
“I thought my acrobatic dancing and professional<br />
stunt work career was over,” said Tally.<br />
“The MalleoTrain S* was my <strong>life</strong> saver because<br />
it provided the ankle support I needed<br />
to continue my extensive training program,<br />
and it allowed my ankle to heal. It fi ts perfectly<br />
and worked unlike any other product<br />
I previously tried. I’m looking forward to<br />
returning to my peak performance level , and<br />
I have incredible respect for the MalleoTrain<br />
S for saving my career.”<br />
†<br />
* <strong>Bauerfeind</strong> worked with Tally Rodin to produce a neutralcolored<br />
MalleoTrain S especially for her that she could wear<br />
in competition. The company is now further developing this<br />
version for use by athletes who participate in martial arts,<br />
dance and gymnastics.<br />
Picture: Lee Cherry, <strong>Bauerfeind</strong>, Wolfgang Maxwitat
Recognition for Prof. Waldemar L. Olszewski<br />
“Appreciation for an underestimated<br />
specialist fi eld”<br />
Prof. Waldemar L. Olszewski is to be awarded the Ratschow Memorial Medal for his <strong>life</strong>’s work,<br />
at the annual conference of the Deutsche Gesellschaft für Phlebologie (German Society of<br />
Phlebology) on September 21, <strong>2012</strong>. With his work over the decades, Prof. Olszewski has made<br />
a a signifi cant contribution to the fi eld of lymphology.<br />
The particular interest Prof. Waldemar L. Olszewski<br />
has shown in the human lymph system<br />
and everything connected with it dates back<br />
to the start of his medical studies. “The textbooks<br />
contained plenty of information about<br />
the circulation of the blood, but nothing<br />
about what goes on in the interstitial space,”<br />
recalls Prof. Olszewski, who is currently a<br />
professor at the Medical Research Center of<br />
the Polish Academy of Sciences in Warsaw.<br />
“What happens there? How does the intercellular<br />
fl uid from t<strong>issue</strong> fi nd its way back into<br />
the circulatory system, and what are the forces<br />
driving this fl uid? These questions bothered<br />
me. Not to mention the unresolved questions<br />
about the chemistry of lymph. This is how I<br />
later became concerned with disorders of the<br />
lymphatic system, particularly lymphedemas.”<br />
Basic research<br />
Over the following decades, the physiology<br />
and surgery of the lymphatic system<br />
became one of Prof. Olszewski’s main areas<br />
of scientifi c and clinical interest. Numerous<br />
groundbreaking discoveries in lymphology<br />
can be traced back to him. For example, he<br />
made the discovery that the human lymph<br />
system is subject to spontaneous, rhythmic<br />
contractions. Prof. Olszewski also developed<br />
the procedure for lymphovenous anastomosis<br />
and conducted research into the chemistry<br />
of human lymph, as well as into the hydraulic<br />
contractility of subcutaneous t<strong>issue</strong>.<br />
Even the policy of administering low-dose<br />
penicillin over long periods, now practiced<br />
with great success in a number of Asian<br />
countries, to help prevent chronic derma-<br />
The Ratschow<br />
Memorial Medal<br />
MEDICAL<br />
The Curatorium Internationalis<br />
Angiologiae has<br />
awarded the Ratschow<br />
Commemorative Medal<br />
every year since 1969. The<br />
medal recognizes particularly<br />
deserving scientists<br />
from the fi eld of vascular<br />
medicine and associated<br />
disciplines for their <strong>life</strong>’s<br />
work. For many years<br />
<strong>Bauerfeind</strong> AG has been a<br />
patron of the foundation<br />
awarding the medal.<br />
Dr. Hans-Jürgen Thomä,<br />
<strong>Bauerfeind</strong>, Prof. Dr. Dr. h.c.<br />
Kurt-Udo Tiedjen, award<br />
winner Prof. Dr. Waldemar<br />
L. Olszewski and Prof. Dr.<br />
Eberhard Rabe (f. l. t. r.).<br />
titis and lymphangitis was inspired by him<br />
and his work on the bacteriology of human<br />
lymph.<br />
“Lymphological research is actually more of<br />
a hobby of mine, albeit one I am really enthusiastic<br />
about ,” explains Prof. Olszewski,<br />
in spite of these various successes. “Vascular<br />
surgery is my bread and butter.”<br />
And on this point he voices his fundamental<br />
criticism: “The world of academic science<br />
has totally underestimated the fi eld of<br />
lymphology. This is gradually starting to<br />
change. As such, I feel that being recognized<br />
with the Ratschow Medal is not just<br />
a great personal honor, but also shows<br />
signifi cant appreciation of a specialist fi eld<br />
that has often failed to get the recognition<br />
it deserves.”<br />
†<br />
<strong>life</strong> magazine <strong>2012</strong>/2 31
MEDICAL<br />
Winter sport injuries<br />
Stabilization, movement and healing<br />
Fast , faster, fastest. In skiing, continuously enhanced materials, well-prepared slopes<br />
and artifi cial snow all help fulfi ll this need for speed. These factors may not bring injury<br />
statistics down to zero, but medical treatment options have also been developed further.<br />
<strong>Bauerfeind</strong> <strong>life</strong> discussed this topic with Dr. Gerhard Oberthaler, a trauma surgeon and<br />
team physician for the Austrian Ski Association.<br />
You provide support for the players in the Red<br />
Bull Salzburg ice hockey team, along with<br />
Ludwig Paischer, a successful <strong>international</strong><br />
judoka, and the athletes of the Austrian Ski<br />
Association. What are the particular challenges<br />
facing a team physician when it comes<br />
to winter sports?<br />
Dr. Gerhard Oberthaler.<br />
Dr. Gerhard Oberthaler: Naturally, I have<br />
to be able to ski safely myself, so I can get<br />
medical supplies to injured skiers on diffi cult<br />
and icy slopes quickly and safely.<br />
Are there fundamental differences between<br />
the injuries suffered by novice skiers and<br />
professionals?<br />
Dr. Gerhard Oberthaler: You might assume<br />
that professional athletes ski faster and are<br />
more willing to take risks, meaning that they<br />
are more likely to suffer more serious injuries<br />
than amateur skiers. However, amateurs<br />
often misjudge their own abilities, which can<br />
result in accidents both on- and off-piste.<br />
Better slope preparation and the use of<br />
artifi cial snow also encourage faster skiing,<br />
32 <strong>life</strong> magazine <strong>2012</strong>/2<br />
thus increasing the chance of accidents at<br />
higher speeds.<br />
So what are the most common winter sport<br />
injuries?<br />
Dr. Gerhard Oberthaler: Trivial injuries<br />
like sprains, bruises, torn muscle fi bers or<br />
sprains are the most notable ones. Naturally,<br />
we also see serious injuries to joints and<br />
ligaments or even broken bones. The higher<br />
the speed at which the accident or collision<br />
takes place, the more likely it is that serious<br />
injuries will occur, such as fractures in the<br />
thighs, spine and hips.<br />
Are there different types of injuries in Alpine<br />
skiing and snowboarding?<br />
Dr. Gerhard Oberthaler: Yes, completely different.<br />
Alpine skiers are more likely to injure<br />
their knees or shins, while snowboarders’<br />
vulnerable points are their wrists and arms.<br />
This also explains why, in terms of statistics,<br />
knee injuries are the most common injuries<br />
in winter sports, but injuries to hands and<br />
arms combined occur almost as frequently.<br />
Is it possible to identify a trend in this regard<br />
over the years?<br />
Dr. Gerhard Oberthaler: With the changes<br />
to equipment and technical possibilities,<br />
there has also been a shift in terms of injuries.<br />
Take ski boots, for example: previously,<br />
the leverage forces acting on the edge of the<br />
ski boots often led to fractures in the tibia,<br />
particularly what are known as boot-top<br />
fractures. Over the years, ski boots have been<br />
cut higher and higher to transfer the force<br />
more effectively to the ski. This has shifted<br />
injuries upward, from the lower leg toward<br />
the knee. Too much pressure on the skier<br />
during skiing can therefore cause tears in<br />
the cruciate ligaments, even without a fall.<br />
Has your work as a trauma surgeon also<br />
changed?<br />
Dr. Gerhard Oberthaler: Medicine has naturally<br />
developed enormously over the past<br />
20 years. We now have more refi ned surgical<br />
technology and better, that is to say more<br />
conservative, medical aids and therapies<br />
at our disposal. Today, many operations are<br />
performed as non-invasively as possible by
means of keyhole surgery. In terms of the<br />
knee, for example, arthroscopic surgery can<br />
be performed on a meniscus or cruciate<br />
ligament injury. Previously, far more injuries<br />
were treated using plaster casts, a method<br />
which brought with it a number of disadvantages.<br />
With the use of metal implants, i.e.<br />
screws, plates, etc., we can achieve faster<br />
rehabilitation.<br />
What does this mean in concrete terms?<br />
Dr. Gerhard Oberthaler: Let’s take the<br />
“classic” hand injury, skier’s thumb, as an example.<br />
This is a tear in the fi rst metacarpophalangeal<br />
joint , and surgery is unavoidable<br />
in this case. Previously, the patient would<br />
have been given a plaster cast , which would<br />
have been very restrictive in terms of daily<br />
<strong>life</strong>. It would be fi ve weeks at the earliest<br />
before rehabilitation could begin, after the<br />
plaster cast was removed. Today, by contrast ,<br />
patients’ symptoms can be completely eradicated<br />
after just fi ve weeks. This is partly due<br />
to the use of stabilizing orthoses.<br />
Could you explain how they are used in more<br />
detail?<br />
Dr. Gerhard Oberthaler: Metal or bioresorbable<br />
implants now ensure that joints<br />
are stabilized directly after an operation,<br />
MEDICAL<br />
with orthoses providing additional support.<br />
Although using a thumb orthosis such<br />
as RhizoLoc reduces mobility in the fi rst<br />
metacarpophalangeal joint , it speeds up the<br />
healing process. The reason for this is that<br />
the movement of the joint can be controlled,<br />
which has a positive effect on the metabolism,<br />
improving the blood supply to the joint<br />
so that it can regain its functionality more<br />
easily. Orthoses are also extremely useful<br />
for treating strains and supporting muscles.<br />
Patients enjoy a better quality of everyday<br />
<strong>life</strong> right from the start as, in contrast to<br />
a plaster cast , orthoses can be temporarily<br />
removed for washing.<br />
†<br />
Snowboarders’ vulnerable points<br />
are their wrists and arms.<br />
Pictures: private, f1online/Imagebroker RM<br />
<strong>life</strong> magazine <strong>2012</strong>/2 33
MEDICAL<br />
Lymphedema treatment in Australia<br />
“ Treatment from an early stage<br />
is essential”<br />
The ALA (Australasian Lymphology Association) is the peak professional body promoting best<br />
practice in the management , research and education of lymphoedema and works towards<br />
increasing public awareness of the condition throughout Australia and New Zealand.<br />
Penelope Sanderson, Manager of the Mercy Health Lymphoedema Clinic in Melbourne, Victoria, with one of her young patients.<br />
“Australia is a very large country geographically,<br />
with only 22 million people, and the<br />
healthcare system is governed individually<br />
by each of the seven states and territories.<br />
There are differences for people accessing<br />
lymphedema treatment and fi nancial support<br />
in each state,” explains Penelope Sanderson,<br />
who has served as President of the association<br />
over the past two years.<br />
The ALA was established in 2000, after a<br />
<strong>Bauerfeind</strong><br />
ALA is working toward a number of initia-<br />
thorough preparation phase, to ensure that tives designed to boost training, manage-<br />
Pictures:<br />
34 <strong>life</strong> magazine <strong>2012</strong>/2<br />
lymphology gains the important status it deserves<br />
and the recognition it requires across<br />
Australia. <strong>Bauerfeind</strong> supports the work of<br />
the ALA as a Corporate Member..<br />
Extensive campaigning<br />
As the leading association of all professionals<br />
involved in the fi eld of lymphology<br />
throughout Australia and New Zealand, the<br />
ment and research in this area. Two years<br />
ago, for example, the ALA introduced the<br />
National Lymphoedema Practitioners Register<br />
(NLPR), a publicly accessible website<br />
register of lymphedema practitioners who<br />
have been accredited in accordance with<br />
the requirements of the ALA. “This is an<br />
important step toward building a network<br />
of therapists,” Penelope Sanderson is keen<br />
to stress, “which enables both patients and<br />
healthcare professionals to get in touch with
the experts who are qualifi ed to deal with<br />
their requirements.” The ALA also has a key<br />
role to play in raising public awareness of<br />
the crucial importance of diagnosing and<br />
treating lymphedema at an early stage. “This<br />
was part of our highly successful inaugural<br />
Lymphoedema Awareness Campaign in <strong>2012</strong>,<br />
which received extensive coverage in the<br />
media – both on television and in the local<br />
and national press – as well as on our own<br />
Facebook page,” says Penelope Sanderson.<br />
“The essential points were to provide the<br />
public with information about the fi rst<br />
warning signs of lymphedema and about how<br />
important it is to start treatment early, to<br />
prevent the condition from progressing.”<br />
Lymphatic compression<br />
treatment in Australia<br />
<strong>Bauerfeind</strong> has been established in the<br />
Australian market for almost fi ve years<br />
and in this time has worked closely<br />
with the LCGP. The VenoTrain curafl ow<br />
product range has been widely used and<br />
been approved to provide patients with<br />
high-quality custom-made lymphatic<br />
treatment. The strong, fi nely meshed knit<br />
of these garments combines excellent<br />
elasticity with optimally controlled surface<br />
pressure. Thanks to its high microfi<br />
ber content , latex-free materials and<br />
special comfort zones, VenoTrain curafl ow<br />
sets new standards in patient-friendly<br />
lymphatic therapy.<br />
Financial support program<br />
For those affected by lymphedema, however,<br />
early treatment by lymphedema practitioners<br />
is only the fi rst step. In the next stage, as<br />
part of their therapy, they may also need to to fulfi ll certain criteria. They must be shown<br />
wear compression products that they can rely to exert controlled pressure in accordance<br />
on. Due to the nature of their design, these with the RAL quality assurance standards, for<br />
compression products only have a limited example. Their quality also has to be verifi ed<br />
serviceable <strong>life</strong>, which means that they must in accordance with the Oeko-Tex Standard<br />
be replaced every six months on average. 100 or an equivalent standard. Lymphedema<br />
Penelope Sanderson, who is Manager of the patients who reside permanently in the state<br />
Mercy Health Lymphoedema Clinic in Mel- of Victoria and receive a pension or only a<br />
bourne, Victoria, heads up a multidisciplinary low income are eligible for fi nancial support<br />
team specializing in treating lymphedema from the program. Depending on a number of<br />
patients. “Here at the Mercy Health Lymph- factors, the LCGP covers part of the costs of<br />
oedema Clinic, we often found that , while the compression products.<br />
patients were certainly willing to undergo<br />
treatment , they could not afford the costs of Children as lymphatic patients<br />
compression products on a long-term basis,” In her work, Penelope Sanderson focuses<br />
says Penelope. “ Together with our patients particular attention on lymphological<br />
and the Lymphoedema Association of Victo- treatment for children. “In recent years,<br />
ria (consumer group) we lobbied the govern- more and more children and young people<br />
ment to set up a fund to fi nance the costs have come to us with lymphatic problems.<br />
of compression products for lymphedema In numerical terms, they still don’t make up<br />
treatment. We had to apply a bit of pressure a large proportion of our patients, but these<br />
before the government eventually decided,<br />
after the completion of a pilot scheme, to<br />
provide long-term fi nancing for such a fund.<br />
The result is the Lymphoedema Compression<br />
Garment Program (LCGP) set up to address<br />
the <strong>issue</strong>s for patients on low incomes to<br />
receive fi nancial assistance for compression<br />
stockings.”<br />
It is important that the funding is used to<br />
promote effective and targeted therapy.<br />
Products endorsed by the LCGP therefore have<br />
VenoTrain curafl ow<br />
For further information please visit:<br />
www.lymphology.asn.au (ALA website)<br />
www.nlpr.asn.au (NLPR website)<br />
MAS Medical , the exclusive <strong>Bauerfeind</strong> distributor:<br />
www.bauerfeind.com.au<br />
MEDICAL<br />
young people have to undergo treatment for<br />
the rest of their lives,” she says, outlining<br />
the situation. “That’s why it is important<br />
for treatment to begin at an early stage,<br />
and for the children and their families to<br />
be provided with training and support in<br />
“ It is important that the funding<br />
is used to promote effective and<br />
targeted therapy.” (Penelope Sanderson)<br />
handling compression products. Those<br />
affected are often completely overwhelmed<br />
at fi rst when they fi nd out that this is a<br />
chronic condition. Here at the clinic, we<br />
provide psychological support , as well as<br />
advising families on how to deal with a<br />
healthcare system that is sometimes far<br />
from straightforward.”<br />
†<br />
<strong>life</strong> magazine <strong>2012</strong>/2 35
IN MOTION<br />
Picture: Corbis/Darryl Leniuk<br />
36 <strong>life</strong> magazine <strong>2012</strong>/2<br />
Pictures: <strong>Bauerfeind</strong>
The outdoor <strong>life</strong> – diving<br />
Another world<br />
It is like anything else: you need to look under the<br />
surface to see how things really are. This is particularly<br />
true of diving. Anyone penetrating the surface of the<br />
sea fi nds they are diving into another world.<br />
The ritual is always the same: the fi nal check, turning on the oxygen valve,<br />
donning the diving goggles, putting the mouthpiece in place. The leap<br />
from the boat into the sea is liking traveling through time to enter a whole<br />
new world, a world which cannot even be described properly when standing<br />
on the boat. The world beneath the sea is a self-enclosed habitat. We, the<br />
divers, are merely guests in this world full of color, fi sh, and <strong>life</strong>. >>><br />
IN MOTION<br />
<strong>life</strong> magazine <strong>2012</strong>/2 37
IN MOTION<br />
Are the oxygen reserves and pressure readings in the green? The diver uses special hand signals to give the OK.<br />
>>> The seas around the Earth offer countless<br />
sites for diving, and every diver can fi nd<br />
something to enjoy under the water. Some<br />
like the brightly colored coral and its bizarre<br />
shapes or the comical clownfi sh in the poisonous<br />
anemones. Others like the different<br />
kinds of sharks, the mantas, and barracudas.<br />
There are also those who like the hollows,<br />
grottos, and underwater labyrinths, while<br />
others get their kicks by exploring old shipwrecks.<br />
Wreck diving is one of the greatest<br />
fascinations for sports divers. It gives divers<br />
the chance to really indulge their appetite<br />
for adventure and discovery. It is impossible<br />
to describe the feeling of diving down to a<br />
wreck, when that initial hazy image becomes<br />
ever more detailed and clearer the closer you<br />
approach.<br />
Wrecks at sea always have their own special<br />
story to tell: the story of their <strong>life</strong>, their<br />
destruction, and their watery burial. Rather<br />
more controversial , although genuinely<br />
thrilling, is cage diving with white sharks,<br />
which mainly takes place off South Africa<br />
and South Australia. These gigantic sharks<br />
with their cold eyes and huge teeth send a<br />
shiver down the spine, even in the warmest<br />
of water. The more varied a diver’s ambitions<br />
For further information:<br />
Various diving associations offer open-water diving courses. Most<br />
diving sport associations have the relevant authorization. The openwater<br />
diving training and certifi cation provided by PADI (Professional<br />
Association of Diving Instructors, www.padi.com) is recognized by<br />
scuba drivers around the world. PADI is also the world’s biggest member<br />
organization for sports diving. Professional PADI members make up the<br />
majority of sports divers around the world and <strong>issue</strong> more than 900,000<br />
certifi cates every year.<br />
38 <strong>life</strong> magazine <strong>2012</strong>/2<br />
are, the more varied their list of favorite<br />
diving spots will be.<br />
Selected diving hot spots<br />
A very interesting diving area, which is also<br />
close to Europe, is the Red Sea. Egypt is an<br />
ideal base from which to access the many<br />
reefs and wrecks, as well as being an affordable<br />
holiday destination with a very good<br />
tourism infrastructure in the holiday regions.<br />
There is a resort to suit practically all pockets<br />
and more diving bases than you could wish<br />
for.<br />
Even little Bonaire has almost 100 diving<br />
sites, many of which can be accessed from<br />
land. Bonaire is something of a dream island<br />
for diving fanatics. Located in the southern<br />
part of the Caribbean just 80 kilometers north<br />
of Venezuela, the island forms part of the<br />
Dutch Caribbean (formerly the Dutch Antilles),<br />
along with Aruba and Curaçao. Seen from<br />
above, Bonaire looks like a giant boomerang<br />
drifting on the sea. During September and<br />
October, the “coral spawning” is the kind of<br />
event to attract divers who like the sport for<br />
its contact with the living, natural world.<br />
Set in the Indian Ocean to the south west of<br />
India, the Maldives offer some tremendous<br />
sites of natural beauty with their living reefs.<br />
The annual average temperature for the<br />
Maldives is around 28 degrees. The temperature<br />
never drops below 25 degrees and water<br />
temperatures remain constant at 28 degrees.<br />
In other words, a little piece of paradise.<br />
Far more lively than the Maldives is the<br />
Divers’ paradise: the Maldives.<br />
world’s largest and best-known diving hot<br />
spot , the Great Barrier Reef off the east coast<br />
of Australia, which at over 2,000 kilometers<br />
long offers countless areas for diving. More<br />
than two million diving and snorkeling fans<br />
slide into the clear water of the Great Barrier<br />
Reef every year to enjoy the colorful coral and<br />
the limitless variety of fi sh.<br />
Getting started is easy<br />
Those new to diving are best advised to<br />
complete their diving training at a local diving<br />
school. Anyone wishing to start a diving<br />
course during a foreign holiday, however,<br />
would do well if possible to try and fi nd a diving<br />
course which teaches the basics in their<br />
own language, since some knowledge of the<br />
theory could literally save their lives. Providing<br />
you stick to the rules you have learned,<br />
diving should be more fascinating than<br />
dangerous. Arrogance and overconfi dence are<br />
what make it dangerous.<br />
†<br />
Pictures: Fotolia/JonMilnes/traveller
Adresses:<br />
<strong>Bauerfeind</strong> worldwide<br />
<strong>Bauerfeind</strong> AG<br />
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Phone +49 (0) 36628-66-10 00<br />
Fax +49 (0) 36628-66-19 99<br />
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Fax +43 (0) 800 44 30 131<br />
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Netherlands<br />
Phone +31 (0) 23 531 94 27<br />
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France<br />
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Phone +33 (0) 1 48 63 28 96<br />
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Italy<br />
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Filiale Italiana<br />
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Phone +39 039 6 08 12 52<br />
Fax +39 039 6 08 26 68<br />
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Nordic<br />
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Phone +389 (0) 2 3179 002<br />
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Serbia<br />
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Phone +381 (0) 11 26 65 999<br />
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Blk 41 Cambridge Road<br />
#01-21 Singapore 210041<br />
Phone +65 6396 3497<br />
Fax +65 6295 5062<br />
E-mail info@bauerfeind.com.sg<br />
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Phone +386(0) 1 4272 941<br />
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E-mail info@bauerfeind.si<br />
Spain<br />
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Phone +34 96 385 66 33<br />
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E-mail info@bauerfeind.es<br />
Switzerland<br />
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Phone +41 (0) 56 485 82 42<br />
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E-mail info@bauerfeind.ch<br />
United Arab Emirates<br />
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Phone +971 4 4335 685<br />
Fax +971 4 4370 344<br />
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<strong>Bauerfeind</strong> UK<br />
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Phone +44 (0) 121 446 53 53<br />
Fax +44 (0) 121 446 54 54<br />
E-mail info@bauerfeind.co.uk<br />
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Suite 700<br />
Marietta, GA 30066<br />
Phone 1 800 423 34 05<br />
Phone (770) 429 83 30<br />
Fax (770) 429 84 77<br />
E-mail info@bauerfeindusa.com<br />
SERVICE<br />
<strong>life</strong> magazine <strong>2012</strong>/2 39
MEDICAL COMPRESSION STOCKINGS<br />
Motion is Life: www.bauerfeind.com<br />
� —— Vena poplitea<br />
� —— Vena saphena magna<br />
� —— Vena tibialis anterior<br />
� —— Vena tibialis posterior<br />
Vena femoralis —— Ve Vena na ffem<br />
emor oral alis is �<br />
Vena saphena magna —— �<br />
medical compression stockings:<br />
systematic indication-based treatment.<br />
soft | soft S<br />
For mild to moderate erate<br />
vein problems<br />
Robust, long-stretch ch<br />
stockings with a gentle entle<br />
massage effect during ing<br />
movement – special al soft S<br />
version for people who spe spend end<br />
a lot of time sitting g down<br />
impuls + i<br />
Short-stretch Sh stockings kings<br />
that th generate a constant onstant<br />
deep de action even during<br />
slight sli muscle movements ements<br />
– microfibers make e these<br />
stockings sto soft and breathable breathaable<br />
Vena poplitea —— �<br />
Vena tibialis posterior —— �<br />
Vena saphena parva —— �<br />
Vena saphena magna —— �<br />
ulcertec<br />
For F advanced vein ein For F active venous us<br />
problems pr<br />
ulcers u<br />
A practical combination nation of o of f<br />
outer o stocking and d liner,<br />
with w a unique pressure ssure<br />
profile p that accelerates erates the thhe<br />
healing h process while hile ensuring enssuring<br />
exceptional e patient nt comfort comfoort