RICE stands for rest, ice, compression, and elevation.  It’s a tactic everyone should employ after an injury to relieve pain and prevent swelling and the earlier RICE treatment is started the better it works.  All 4 steps of RICE – Rest, Ice, Compression, Elevation – work in concert to help your body heal.  There are products out there, like the Aircast CryoCuff system, which incorporates both compression and cold therapy. Next time you suffer from an injury get started on the RICE treatment right away and see if it helps speed up your recovery.
 
R = Rest
Pain is our bodies’ way of telling us there is a problem and we need to stop. Resting is a crucial part in allowing your body to heal, as well as preventing further injury.  Resting means no bearing weight on the injury. Your doctor will be the best person to guide you on the specifics of what Rest means for you.

I = Ice
Icing the injured area helps prevent and/or reduce swelling.  Swelling contributes to the overall pain you are feeling and can make healing a slow process.  You can ice the injured area 4 to 8 times a day; remember to never leave the ice pack on the area for more than 15 – 20 minutes. 

C = Compression
Compression is another tactic for reducing swelling.  A pressure bandage or a compression brace will limit swelling. Your doctor can guide you to the ideal compression support for your injury, but a good rule of thumb to follow is if you feel throbbing after the compression loosen the brace.

E = Elevation
Elevation refers to raising the injured area above the level of the heart – another way to help reduce swelling.  While resting, make sure you’ve propped the injured area up.

Knee pain is something that plagued over 19 million Americans last year…and that’s only counting the people that went to the doctor. There are many factors that can contribute to your pain, but common knee injuries usually come from twisting the wrong way.  For those of us who have suffered from common knee pain, we recognize the fight to keep our knee healthy will be a battle we wage for years to come.

According to an article published by James N. Dillard, M.D., there is not one perfect remedy for common knee injuries.  “It takes proper rehab, regular self-care, weight loss, stretching and strengthening, some good medical care, and a dash of the complementary therapies to keep your bum knee serving your needs for as long as possible,” he states in the article.

Management of common knee pain can include a consistent regimen of physical therapy, consistent exercise, and acupuncture has been know to work for some.  Doctor Dillard notes some specifics to keep in mind if you suffer from common knee pain, as well as treatment options.  Click here to view his complete article on the treatment of common knee injuries.
 

Spring is here and with that comes the weather that just calls us to get outside and participate in our sport of choice.  Whether you’re a professional golfer or a weekend walker, this increase in activity can result in a variety of ankle injuries.  Instead of falling victim to your first (or fourth) ankle injury, the American College of Foot and Ankle Surgeons (ACFAS) recommends you follow these three steps:

1. Perform warm-up stretches and exercises before playing sports.
 
2. Wear the right shoes for the sport. For example, don't wear running shoes for sports that involve a lot of side-to-side movement, such as tennis and basketball.
 
3. Wear an ankle brace if you're recovering from an injury or have repeatedly sprained your ankle.  *Check out the DonJoy Velocity ankle brace – you can choose your level of support based on your activity level.

Opening day came and went and now baseball season is in full swing…pun intended.  With the start of the season comes a variety of injuries that plague baseball players of all ages.  From little league pitchers to major league outfielders, baseball sports injuries of the knee, ankle, or shoulder will affect every player at some point in time.  
 
Baseball injury prevention will be an important topic amongst coaches and players as we get into the season.  Measures can be taken to minimize sports injuries. Dr. Joseph Guettler, an orthopedic surgeon who specializes in sports medicine, wrote an article identifying the three major causes of injuries in baseball: throwing injuries, running and sliding injuries, and direct contact with a ball or bat.
 
Properly outfitting the baseball player in your family is an important aspect of baseball injury prevention.  There are specific knee braces for baseball, as well as ankle supports, shoulder stabilizers, and thumb guards.  Wearing sports braces as preventative measures increases your odds at preventing an injury (check out what it did for Georgia Tech football player Emmanuel Dieke). 

Photo courtesy of JamieL.WilliamsPhotography

Researches from the University of Arizona are studying how the structure of natural plants can promote healing and improve health.   According to David Gang, associate professor in the College of Agriculture and Life Sciences, physicians who have done studies on these plants have found that turmeric has potent anti-inflammatory properties.
 
Turmeric is a tropical plant, in the ginger family, which gives curry its yellow color. "Lots of older people swear by it," Gang said. "They used to have real big problems with arthritis and now they can go for their two mile walks again, they can garden again and their hands don't hurt, it's really amazing."
 
Although there is no definitive proof these spices can treat Osteoarthritis, turmeric is a wonderful spice to cook with so why not add it to your diet and see if you reap the benefits David Gang describes.   Click here to view the complete article about Gang’s research.

Suffering from osteoarthritis of the knee?  Check out these osteoarthritis knee braces from DonJoy.
Photo courtesy of wiccked.

Olympic champion Ted Ligety (Park City, UT), who suffered a knee injury Saturday in downhill training at the Nature Valley U.S. Alpine Championships in Alaska, will be in a brace for a few weeks but U.S. Ski Team officials are optimistic for his recovery. Ligety underwent an MRI scan Tuesday in Park City with the Team's Dr. Vern Cooley at the Rosenberg, Cooley, Metcalf Clinic to determine the extent of the injury. 

According to U.S. Ski Team Medical Director Richard Quincy, Ligety suffered damage to the medial collateral and posterior cruciate ligaments in his right knee, and some bone bruises. But there was no sign of damage to the more significant anterior cruciate ligament or to the menisci. At this time, no surgery is planned.

"We're optimistic for Ted so far," said Quincy. "He'll be in a DonJoy knee immobilizer for up to two weeks and we'll re-evaluate his injuries." There was no immediate determination on a date to return to on-snow training.

"I feel pretty fortunate that it's not as bad as it could be," said Ligety, who earned a bronze medal at the recent World Championships. "At this point, I'm just going to rest and recuperate in Park City. I'll have regular check-ups and will hopefully be able to get back into preparing for the Olympic season in the not too distant future."

Former USC quarterback, Mark Sanchez employs the Compex Sport Muscle Stimulator as part of his training regimen in preparation for the NFL.  “I’ve never felt better,” stated Sanchez in an interview with ESPN, which he attributes to the Active Recovery® Program provided by his Compex device.  “It flushes out the lactic acid,” Sanchez commented.  “It’s preventative medicine like icing your shoulder”. 
 
The Compex Sport Muscle Stimulator has been used by elite athletes for years.   In short, the Compex Sport enables atheletes to train more effectively and efficiently, resulting in a true competitive advantage.
 
Click here for specifics on how the Compex Sport Muscle Stimulator can benefit your training regimen.

This morning the Today Show provided a comprehensive overview of knee pain as part of a chronic aches and pain series.  Knee pain is is one of the most common sports injuries and according  to the Today Show is the single most common reason a person will see an orthopedic surgeon.  The video is about 5 minutes long and is a must-see for anyone who has suffered from knee pain at some point in time. 

Key takeaways from the video:

• Knee pain and injuries are more common in women.  Check out our previous post on this subject Are females more prone to ACL Injuries?
• Baby boomers are much more active than previous generations and the increased activity makes them more susceptible for knee pain and injuries.
• If you’re suffering from knee pain, get yourself into an injury prevention program. 
• Warning signs to look for to determine if you need to seek medical help for your knee pain

Foot orthoses provide knee pain relief in study

Prefabricated foot orthoses are superior to flat inserts in the short-term

When comparing Knee Brace manufacturers DonJoy stands out as the clear leader in innovation and design.  This video on DonJoy Knee Braces give you a clear idea why DonJoy is the leader in Knee Bracing Technology.

Results are better with brief immobilization than with bandage or boot, study finds

A new study to be published in the April 2008 edition of the Journal of Phytotherapy Research shows Pycnogenol, an antioxidant plant extract from the bark of the French maritime pine tree, reduced osteoarthritis symptoms by 56 percent.

In the randomized, double-blind, placebo-controlled study, held at Italy's Chieti-Pescara University, 156 patients with knee OA received 100 mg of Pycnogenol or placebo, daily for three months and were then evaluated using a number of tools. Patients were permitted to continue taking their choice of pain medication provided they recorded every tablet in a diary for later evaluation.

The pycnogenol group also:

 * Experienced a 55 percent improvement in joint pain

* Reduced pain medication use by 58 percent

* Had a 63 percent improvement in gastrointestinal complications

* Reduced stiffness by 53 percent

* Improved physical function scores by 57 percent

* Enhanced overall well-being by 64 percent

"The results of this study are significant as they clearly demonstrate the clinical action of Pycnogenol on OA and management of symptoms,” says Gianni Belcaro, MD, PhD, a lead researcher of the study. “The use of Pycnogenol many reduce costs and side effects of anti-inflammatory agents and offer a natural alternative solution to people suffering from OA." 4/23/08

COPPER MOUNTAIN, CO (Dec. 13) - Reigning overall champions Louie Vito (Sandy, UT) and Kelly Clark (West Dover, VT) boosted the best runs of the day to win their third Grand Prix halfpipe competitions in a row as the U.S. Snowboarding Grand Prix, presented by Sprint, opened for the season Saturday at Copper Mountain, CO.

"The last two years I haven't made finals at the first Grand Prix and that's kinda been a bummer. But, It's nice going into the rest of the season with the win and knowing that you have that accomplishment," Vito said. "Hopefully the rest of the season follows in the right direction like this."

Vito landed two identical runs of back-to-back 1080s, back-to-back 900s and a straight air, but it was his amplitude in the second run that got him the top men's spot.

"Louie stomped both of his runs and they were super clean," said U.S. Snowboarding Halfpipe Head Coach Mike Jankowski. "After his first run he said, 'coach, I want to get a better score.' So he didn't change anything, but he went bigger and better."

Vito was joined on the podium by fellow U.S. Snowboarding rider and X Games gold medalist Steve Fisher (Breckenridge, CO).

"Once you get that first taste of a win, it's hard to settle for anything less than that," Vito said. "With how many good riders there are in the first contest it's nice to start my season that way."

Clark Owns Both Runs
While Clark has said that this is a season for her to reflect on her riding as a whole, as opposed to being in it for the competition, she needed no extra help in winning the Grand Prix in Copper as she threw down the two highest scoring runs of the day.

"It's really encouraging. I didn't know how my approach was going to go today. My focus has really been on the fundamentals these last few months and I'm really excited to have done so well just focusing on the basics," Clark said. "I know once I get more into the technical aspects, it will be a really big strength to me."

As far as Jankowski is concerned, Clark's riding focuses will only make her a bigger force to be reckoned with.

"Kelly is riding at the top of her game right now, but at the same time she's also looking to improve and take her riding to the next level, so watch out for more great things to come from Kelly," Jankowski said.

Rocky Mountain News, December 14, 2008

Researchers are also trying to reconcile conflicting findings about gender as a risk factor for injury. Investigators from Oslo analyzed a single season of data for nine World Cup alpine ski teams and found a higher rate of injury for men than women (11 vs. 5.4 injuries per 1000 runs).5 However, all 14 of the ACL injuries reported occurred in female skiers, according to Tone Bere, a researcher in the Oslo Sports Trauma Research Center.

The Oslo results about ACL and gender are consistent with those of Vermont researchers, whose 1998 survey-based study of competitive alpine ski racers6 found that female skiers are 2.3 times more likely to experience a knee injury and 3.1 times more likely to experience an ACL disruption than their male counterparts. But a 1999 study⁷ from the Steadman Hawkins Sports Medicine Foundation in Vail, CO, found that the incidence of ACL injury among ski patrollers or instructors does not differ significantly between men and women (4.2 vs 4.4 injuries per 100,000 skier-days), suggesting that gender may be more significant as a risk factor for competitive skiers than for skiing pros.

Of course, the primary mechanism of ACL injuries in skiers is not in question. That would be the “phantom foot” scenario, in which a skier falls backwards in such a way that the load on the ACL causes the ligament to rupture (called phantom foot because the downhill ski produces a force as if an imaginary foot were pushing on its tail). The bindings that connect the boot to the ski are designed to release when excessive levels of force are experienced, but because the ski boot typically pivots around an axis near its heel, the bindings are better able to sense loads applied at the front of the ski than those applied at the back (as in a phantom foot fall).

“What the leg feels and what the binding feels are not the same thing,” said Carl F. Ettlinger, MME, an adjunct assistant professor in orthopedics and rehabilitation at UVM and a keynote speaker in Tromsö. “We don’t necessarily have an idealized binding, one that was designed for today’s skiers.”

That may be about to change. Former competitive skier Rick Howell has designed a knee-friendly binding that features a virtual second pivot point to better respond to torque generated during phantom foot falls, as well as force-filtering technology that differentiates skiing-related forces from potentially injurious forces to minimize inadvertent binding release.

A study⁸ that validates the new device, called KneeBinding, was presented in July 2007 at the International Society for Skiing Safety (ISSS) conference in Aviemore, Scotland. KneeBinding is expected to be available for the upcoming ski season.

In the meantime, Johnson, Ettlinger, and others are working to promote ACL awareness among skiers, including knee-friendly techniques for skiing, falling, and recovering from falls (see vermontskisafety.com).

They also recommend against the more-is-better approach to tightening bindings far beyond the typical range of release settings, also known as DIN settings (typical range, four to 12). Instead of preventing injury, release settings that are too high tend to result in bindings that fail to release when they should.

“Some competitors’ bindings go up into the 20s and 30s, and there isn’t any way out at that point,” said congress keynote speaker Jasper Shealy, PhD, professor emeritus of industrial and systems engineering at the Rochester Institute of Technology in New York. “It’s really gotten way out of order.”

from Biomechnics Magazine November/December 2008 by Jordana Bieze Foster

For 2006 Olympian Nate Holland, there is only one speed: faster than you. A snowboardcross specialist, Nate defines the sports chaotic style going all-out in every race. Also a big-time motocross racer, he thrives on speed and takes his fast paced adrenaline packed lifestyle from the mountain to the dirt.

It was great to see Nate Holland stop by to say hello at the DonJoy tent at Beaver Creek this past weekend.

On his way to do some training in Colorado Nate stopped by to check out the action at the Birds of Prey Downhill at Beaver Creek.

A big fan of DonJoy braces for both his snow and motocross riding it was good to catch up with Nate.  Good luck this season Nate!

TJ Lanning of the US Ski Team and DonJoy sponsored athlete and knee brace wearer finishes 26th in the Super G at Beaver Creek's Birds of Prey World Cup race this past weekend.

Completing a finish of six U.S. men in the top 30 was Marco Sullivan (Squaw Valley, CA) in 22nd, Scott Macartney (Crystal Mountain, WA) in 24th, Steven Nyman (Provo, UT) in 25th and TJ Lanning (Park City, UT) in 26th.

For Lanning, the best part of his race was finishing the day with World Cup points.

"I didn't have the greatest starting number today, but the course held up pretty well," Lanning said. "If you're in the points then you're in the points and that's where you always want to be."

There's a pop you can hear when your anterior cruciate ligament goes. Some people describe it as sickening, as though your knee is not quite attached and will no longer hold you up.

ACL injuries are common in various sports, especially snow sports.

Studies indicate that the number of skier-related ACL injuries tripled in the past 20 years. Time was that broken legs and heavy casts were the norm for skiers, but thanks to advances in boot design and quick release bindings, lower-leg fractures have all but disappeared. The changes, however, transferred stress to the knees. On the other hand, technology goes beyond that. Other advances—such as MRIs—have given doctors the ability to diagnose knee injuries more precisely, helping untold people to be able to walk and ski well into their later years.

Skiing is not the only sport that can induce ligament injuries. Soccer, basketball, football and tennis are all injury-prone sports because of pivoting, stop-start action. Even golf can be hazardous. Witness Tiger Wood's season-long absence from the sport he dominates, though word is that he injured his already fragile knee by running.

Athletes always want back on the playing field. How long they rehabilitate and how successful they are with it depends on the kind of injury and the athlete's level of conditioning.

Physical therapist Winston Purkiss at Sun Valley Sports Rehab said the resumption of activity is often "significantly shortened by the wish to return to the playing field. Rehabilitation for nine months to a year is what I recommend. With pros it's maybe six months."

A properly functioning knee, the largest joint in the body, is essential to movement and comfort. For every injury, a course of rest, ice, compression, and elevation (RICE) are imperative. Once the swelling is down, a fracture will demand partial or no weight bearing, while a ligament injury, which generally requires surgery, takes a different approach.

"The key is to get motion back first, then start on strength training," orthopedic surgeon Dr. Tony Buoncristiani said. "With the knee you can have a fracture, a patella break, a ligament or meniscus (cartilage) injury, and whether repair is performed or not will dictate the length of time. Bones take six to eight weeks to heal and an ACL can take from six to eight months. You may get strength back but what people forget is endurance."

"Often a non-pro will get in better shape from learning new exercises," physical therapist John Koth said. "But people will do their plyos (plyometric exercises) and still get to the bottom of Squirrel and their legs are burning. It's overall training."

And it just won't happen overnight since healing and rehab go in stages.

"Fifty percent of a (tendon) graft is incorporated in about six months into the bone tunnel," Buoncristiani said. "To ensure long-term survival, the graft must become revascularized. It continues to graft over the course of a year before it's 100 percent. Nerve fibers need to heal. The surrounding musculature needs to be strong. If not there is a chance of re-injury."

There are all sorts of exercises that a physical therapist should take one through, such as isometric and plyometric exercises like hops, jumps and bounding movements, and concentric movements like riding a bicycle.

"If you're weight bearing there is less of an atrophy effect," Buoncristiani said. In fact, crutches (of all kinds) can help with healing but hurt the mental side of recovery.

Plyometrics are the final phase. Building on the basics, specific sports programs are then added on.

OK, you're back in shape, so now what? Does a recovered knee injury require a brace? Buoncristiani thinks not.

"There are several published articles in sports medicine journals that show no decrease rate in ACL tears while wearing a custom brace," he said.

"It's shown braces don't do very much other than act as a reminder," said certified Feldenkrais physical therapist Mary Kay Foley at St. Luke's Elks Rehabilitation. "You have to make sure you are strong enough to adequately do the activity your doing. Neoprene sleeves keeps the tissues warm. But they don't prevent reinjury."

Koth agrees: "If you do all the rehab, the strength training, balance, sport-specific training and you have a functional ligament, then why do you need a brace?"

"A neoprene brace is anatomical mind-knee connection," Buoncristiani said.

"Right. Just don't do anything you're not good at," Koth said. "Otherwise you have repeat offenders."

Foley said functional testing will help determine one's readiness to hit the slopes. Tests include such movements as jumping, one-legged strength tests and one-legged squats.

"It's best to be led through those by a professional," she said. "Going back up depends on what type of injury you have. With bundled injuries and more involved surgeries, it's less likely you'd ski that year."

Despite the agreement on braces, there are several that people with injuries have used, including versions by Breg, Ossur, Bledsoe and DonJoy.

"They do have to be special ordered," Foley said. "It varies by the doctor."

Hailey Sport and Spine physical therapist Kim Mazik said some braces can help with "mild to moderate knee arthritic and dysfunctional proprioception, which is your body's awareness of itself in space."

"As for ligament injuries, you might need a custom-made brace to prevent rotation and or hyperextension," she said. "They give you more stability. Doctors have their own favorite brand. A knee is a hinge joint—it's not all that complicated. If you want a little extra support, a neoprene sleeve is fine. I love mine. I wear it for hiking."

Gloria Gunter of Physical Therapy Plus of Idaho, said that if a person has no ACL,. Even if he or she doesn't feel any instability, "a brace is an added protection along with your musculature, if you've had an injury and you're engaging in high-level sports."

"I err on the side of caution," she said.

 Written by Dana Dugan with the Idaho Mountain Express

Having recently twisted my ankle during an afternoon sprint to the train station, I was disheartened to learn that my recovery strategy, which is to do nothing, is the wrong approach.

The New York Times Health Guide offers an informative Q & A about ankle health with Dr. John G. Kennedy, assistant professor of orthopedic surgery at Weill Medical College of Cornell University and clinical director of the running clinic in the gait laboratory at the Hospital for Special Surgery in New York.

Here are a few highlights:

Q. Is it possible to ignore an ankle sprain and get on with your life?

A. The traditional treatment for the sprained ankle, our mothers used to tell us, was that if you didn’t break your ankle, then stop the whining, put some ice on it, and you will be fine. We are now learning that that may not have been the best strategy because it actually leads to more problems…. To ignore a sprain, you do so at your peril.

Q. What steps do you recommend for healing an ankle sprain?

A. Most ankle sprains result from forced and excessive inversion, an inward rolling of the ankles. These sprains frequently occur when stepping on another player’s foot or when a runner steps into a rut. The ligaments on the outside portion of the ankle, and the muscles on the lateral portion of the leg that are responsible for limiting ankle inversion, are typically injured. The high incidence of recurrent sprains that we see is primarily due to the failure to successfully complete an adequate three-phase treatment program.

Dr. Kennedy goes on to explain the three-step treatment plan. One of the more interesting tips includes toe exercises. When the foot is elevated, perform range-of-motion exercises by keeping your heel still and tracing the alphabet in capital letters with your big toe. To learn more about the three-phase treatment program and other ankle advice from Dr. Kennedy, click here.

Reprinted from  

Written by Tara Parker, June 20, 2008

There has been much debate about whether or not women are more prone to ACL injuries.  This is a great article written from the NCAA News Blog by Marta Lawrence that addresses this topic.  Click here to see the full article and great video.

ACL tears sideline female athletes

By Marta Lawrence
The NCAA News

Alexia Mickles lunged the wrong way, heard a loud crack and her softball season was over. Mickles, a soccer and softball student-athlete at Penfield High School near Rochester, New York, went to the ground holding her knee.

She had torn her anterior cruciate ligament, or ACL.

Although the research varies, female athletes are two and a half to four times more likely to tear their ACLs than men, depending on the sport. Understanding the reasons behind these disproportionate numbers is “the million dollar question,” says Dr. Michael Maloney, director of the sports medicine division at the University of Rochester Medical Center.

Through a local grant, Maloney is leading an effort to train area female high school athletes, including Mickles, about how to protect their knees from injury.

Athletes who enter the program are provided with a screening to determine how they jump, land, run, cut and pivot. Once the athlete’s at-risk positions have been identified, she is given a series of exercises and conditioning drills designed to retrain her muscles’ response to those activities.

In its first year, the injury prevention program reached almost 1,300 soccer, basketball and volleyball student-athletes in 26 high schools in the Rochester area. During that time, Maloney says there were five non-contact ACL tears, which he says was “a pretty low number.” Maloney typically would expect to see one and a half to two ACL tears per 100 female athletes participating in those sports.

The program wasn’t implemented in time to prevent Mickles’ original injury, but she says she’s happy she has the opportunity to participate now. “I really think it would help if every team were able to do it because I think there would be even less injuries,” she says.

Neuromuscular factors

While training programs like the Rochester program have succeeded, they struggle against biological and sometimes social factors – battles that, according to some, boys don’t ever wage.

Unlike male athletes, for example, female athletes tend to land in a knock-kneed position. Most researchers point to this subtle difference as one of the main reasons women are more likely to tear their ACLs than men.

Nerve-firing patterns between the thigh muscle and the hamstrings – called the neuromuscular response – are different in women than in men, says Thomas Trojian, director of the injury prevention and sports outreach programs at the New England Musculoskeletal Institute and team physician at Connecticut. “As women and males reach puberty, they tend to land differently,” he says.

“Boys are running around and athletic and are being trained from a neuromuscular perspective early on and women are later to get into that, and they never develop the same neuromuscular training as boys do even if they’re incredible athletes,” says Dr. Craig Levitz, chairman of the Department of Orthopedics, Orthopedic Surgery and director of sports medicine at South Nassau Communities Hospital in Oceanside, New York.

While Levitz says neuromuscular training programs that teach the muscles how to protect the knee are critical for girls, they don’t seem to be necessary for boys. “For some reason, that’s something that seems ingrained in the male genetics and has to be learned in the female genetics,” he says.

Implementing programs that target young female athletes is key, Trojian says, because, “muscle-firing patters have been set and it’s harder to break as people get older. You’ve been successful – very successful – by doing what you do and now someone is asking you to change what you do, and that’s not that easy.”

Training programs, like those in Rochester, are designed to overcome natural tendencies, which can be difficult. “No one teaches you how to run,” Levitz says. “No one teaches your muscles how to contract when you land or jump. That’s something that just happens– your body just figures it out.”

Without practice and repetition, an individual’s body will do what comes naturally and those natural tendencies can be risky for women. For that reason, participants in the Rochester program are encouraged to incorporate the stretching, strengthening and plyometrics exercises in daily warm-ups and practices. The intent is to make these exercises part of the athlete’s routine, training her body to respond differently.“

Muscle memory is sometimes hard to reverse,” says Maloney, “but certainly it can be done.”

Body Chemistry

Some researchers also cite hormones in explaining a female’s vulnerability to ACL tears. As women mature, their bodies produce chemicals such as estrogen, which make their joints more flexible and therefore more prone to tears. As men mature, their bodies produce more muscle, which can protect the knee.

“Estrogen affects the collagen production and there appear to be times in the menstrual cycle when people tend to be able to identify greater ACL tears,” says Trojian. He cautions, however, that the findings vary and without hormonal studies across a large female athlete population, a link between hormones and ACL tears cannot be definitively proven. If hormones do play a role, Trojian thinks the impact is likely small.

Anatomical differences

Women and men also have important difference in the anatomy of their knees. For example, female ACLs are smaller than male ACLs.

The notch housing the ACL is also typically smaller in women than in men. “Most people have noticed that women that tear their ACL have a much tighter notch,” says Levitz. The smaller notch leaves less room for movement when a person hyperextends.

Most experts agree, even with programs like those in Rochester, women will continue to be at a greater risk for ACL tears than men. “I don’t know if it’s a researchable answer,” says Levitz, “It’s not like cancer. In my opinion there’s not a cure. It’s just one of the occupational hazards of female athletes.”

Nobody may be able to explain why women are more prone to ACL injuries than men, but for athletes like Mickles, training muscles to respond differently may be the best chance at preventing future injuries.

Basketball Ankle Injury Prevention Info

• Warm up and stretch prior to playing or practicing.
• Wear proper footwear. Shoes that don’t fit or are substandard can increase risk of ankle injury.
• Train for ankle flexibility, strength, and balance. By incorporating Achilles tendon stretching and mobility exercises into a workout routine, the ankle keeps a high range of motion. A limited range of motion can increase the chance of an ankle injury.
• Balance is also important, and should be considered in all running and jumping. When an individual lands on one foot, off balance, the likelihood for an ankle sprain is increased.
• Consider wearing an basketball ankle brace when training and playing basketball. A good ankle brace can help keep the ankle from turning, particularly when landing jumps. A few great ankle braces for basketball are the Aircast Ankle Brace – Aircast AirSport Ankle Brace, Aircast Ankle Brace - Aircast A60 and DonJoy Stabilizing Ankle Brace

Elite athletes and sport enthusiasts throughout Europe use Compex Sport to enhance their training and improve their athletic performance. The first sports muscle stimulator cleared by the FDA for sale in the USA. Compex Sport is proven in European clinical tests to build muscle size and strength, as well as improve endurance and aid in faster muscle recovery on a post event basis. Compex Sport includes four training programs and two special programs.

How Does it Work?

Who Should Use It?

It is very common to see many of the NCAA football players wearing DonJoy ACL knee braces, however, this weekend it was very clear that many more players are protecting their other body joints with DonJoy braces as well.   Take for instance, Nick Oppenneer (left), junior cornerback for Colorado State University.  He's seen here preventing injury to his elbow by wearing the DonJoy Elbow Guard.  In addition to Nick, we noticed Air Force freshmen quarterback, Tim Jefferson, sporting the DonJoy Stabilizing Ankle Braces to provide protection to his ankles enabling him to make some fancy moves that helped his team secure a victory over his opponent, UNLV.

Just more examples how DonJoy continues to be the "brace of choice" for top athletes around the country.

Playing team sports, jogging, or doing other high impact activities that repeatedly pound, twist, and turn the knees can stress aging joints. Highly active, middle-aged patients may develop painful knees as a result of osteoarthritis (OA). This painful condition happens when the cartilage lining on the ends of bones gradually wears away.

It can affect one or both knees.

• Symptoms: You may experience pain when standing or going up and down stairs. The knee may buckle and give way, lock in place, or become stiff and swollen.
• Patients: Most people with osteoarthritis of the knee are over age 55 and/or obese and/or have a family history of osteoarthritis. Younger, highly active people may also develop osteoarthritis if their knee suffered a significant injury.
• Diagnosis: See your doctor for diagnosis and treatment. The doctor will consider your comprehensive medical history, perform a physical examination and possibly order tests and/or imaging studies before recommending a course of treatment.

Extending the Life of the Middle-Aged Knee

Increasingly, baby boomers with osteoarthritis of the knee are asking for total knee replacement surgery. But first they should try making changes to their lifestyles. Mayo Clinic orthopaedic surgeon Arlen D. Hanssen, MD presented a briefing on "Our Aging Population" at the 2002 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). He said many highly active patients in their 40s and 50s feel inspired by advertising and news reports about the success of knee replacement surgeries. But often they refuse to change their lifestyles to extend the life of their natural knees.

"They come in and say, 'Fix me','" Dr. Hanssen explained, and they hope for a complete end to their symptoms without making any changes in their activities. In reality, doctors use a complex medical process to determine whether total knee replacement is appropriate for a patient. They consider age, activity demands, and other factors. Long-term results of joint replacement are less certain in younger patients.

For middle-aged people, the earlier a doctor diagnoses osteoarthritis of the knee, the more likely conservative treatment may help. If osteoarthritis of the knee is in its early stages, your doctor may recommend low impact activities and other non-operative treatments that can delay or eliminate the need for surgery. In some cases, activity modification may be the only treatment a middle-aged patient needs. "In other cases when surgery is eventually needed, the patient still has to modify activities first to preserve the replacement joint," Hanssen advises.

Substitute Smooth, Low-Impact Activities

Moderate physical activity lessens joint pain and improves flexibility and function. Baby boomer patients with osteoarthritis of the knee should continue exercising, but change the forms of their activities:

• Stop doing high-impact activities that twist and turn the joints. This includes running, tennis, racquetball, basketball, baseball, etc.
• Start doing smooth, low-impact activities that are easier on the joints. Recommended activities include stretching, swimming, water aerobics, cycling, walking on a treadmill or outside, playing golf, etc.

Other Conservative Options

Other options that may extend the life of your natural knee include medications, steroid injections, physical therapy, and mechanical aids.

• Medications: The doctor may prescribe nonsteroidal anti-inflammatory medications to help reduce inflammation. Certain dietary supplements such as Glucosamine and Chondroitin may also be helpful. (Note: The U.S. Food and Drug Administration does not test dietary supplements. These compounds may cause negative interactions with other medications or excessive bleeding during surgery. Always consult your doctor before taking dietary supplements.)
• Injections: The doctor may inject the knee joint with strong anti-inflammatory medications, called corticosteroids. This can relieve pain and swelling for awhile. Viscosupplementation or injection of hyaluronic acid preparations may also help relieve the symptoms of an arthritic knee.
• Physical therapy: The doctor may give you a balanced fitness program including physical/occupational therapy to improve joint flexibility, increase range of motion, strengthen muscle, bone and cartilage tissues and reduce pain. It may also help to ice the affected joint for short periods, several times a day.
• Mechanical aids: You may need supportive or assistive devices such as an elastic bandage, splint, brace, cane, crutches, or walker.

American Academy of Orthopedic Surgeons: July 2007

If you have ever sprained your ankle, then you are at increased risk for injury again in the future.  Although almost everyone has twisted their ankle from time to time, a sprain is indicated by severe swelling.  A second or third degree sprain can take weeks, or even months, to heal completely, and even after healing, you have to take precautions not to injure your ankle again.

If you are athletically minded, then you really need to pay attention and protect your ankle from future injury.  If not, you could seriously damage your ankle, foot, or leg!

One of the easiest ways to protect your vulnerable ankle, even during high-impact sports, is with a good quality protective ankle brace.  One such brace is the DonJoy Velocity Ankle Brace.  This brace prevents any unnatural inversion, eversion, or rotation, but allows completely unrestricted movement otherwise. 

Many times, athletes and other folks don’t wear the protective gear they should because it is cumbersome or uncomfortable.  However, with the DonJoy Velocity Ankle Brace, you get a full-quality brace that comes in a variety of styles. For added comfort, the brace also has a heat moldable foot plate.

Q. I’m a hardcore swimmer, and I’ve noticed some pain in my upper shoulder recently. Is this some kind of serious injury, and if so, how can I treat it?

Record numbers of middle-aged and elderly individuals are now experiencing the same sports-related injuries that used to only be reserved for young athletes. Members of the baby boomer generation, or those born between 1946 and 1960, are more much active than the previous generation, and are also more likely to continue exercising into old age. This is leading to a marked increase in the level of injury among the elderly population, and concern among doctors that these injuries may be difficult to treat.

Sports-related injuries are so common among the elderly that they have now become the second most common reason for scheduling a doctor’s visit, surpassed only by the common cold. Emergency room visits have also gone up 33% among baby boomers within the past seven years, due to the increase in athletic injuries.

"It was very uncommon to see so many people become avid runners into their 60's and 70's a generation ago," says Dr. Asif Ilyas, orthopedic surgeon at Temple University. "But it's very common now to have middle-aged people take up such a high-endurance sport and run at a much later age."

Doctors are seeing baby boomers for a variety of conditions, including everything from tennis elbow to knee pain to muscle tears. However, the good news is that this generation is more likely than youngsters to take their health more seriously and get injuries checked out promptly. The best way for baby boomers to reduce their risk of injury during sports is to warm up thoroughly before any physical activity begins, and also utilize sports braces and supports if needed.

Q. I’m a 35-year-old calf roper who has recently been experiencing some pain in my lower back. I’ve noticed that the pain seems to be gradually getting worse, and I also feel a sense of stiffness after I finish roping. Any suggestions to help deal with these issues?

A. First of all, rodeo is obviously known for being one of the toughest sports out there, because of the havoc it can wreak on your joints and muscles (not to mention the high risk of injury). So it’s not surprising that you’re starting to experience some aches and stiffness in your lumbosacral region.

I recommend that you consult a physician, physical therapist, or sports medicine specialist regarding simple exercises you can do to minimize pain and tension in your back. Often, these can encourage circulation to the area to help promote healing.

Another thing that can help is to start wearing a Donjoy Lumbosacral Support Brace. This can provide compression to the area in order to aid in the recovery process. Your best bet is to find a brace that allows you both comfort and breathability, while also applying firm pressure to the area being healed.

In addition to these methods, you may want to consider treating the area with some type of healing gel to relax your back muscles and reduce the chance of experiencing painful spasms. Applying a gel will also increase circulation to the area, as well as deliver painkilling medicines to your muscles to minimize inflammation and swelling.

The 2008 Olympics have officially begun, which means that many will finally get their questions answered regarding the effects of polluted air on Olympic athletic performance. Mark Hertsgaard’s classic 1999 novel Earth Odyssey first opened Westerners’ eyes to China’s dire environmental issues. Now that the decision has been made to host the 2008 Olympics in Beijing, it remains to be seen how Olympic athletes will be affected.

Earth Odyssey detailed the serious implications of China’s pollution problem, which occurs as a result of the country’s huge amount of coal consumption. Hertsgaard reported that the air in urban China is literally cloudy and black, and has caused many citizens to developed lung and asthma problems as a result of the poor air quality.

Medical News Today recently released a report on the affects of air pollution on Olympic athletes, which says that exercising in such an environment may cause the athletes to develop acute cases of asthma. "With exposure to an environment that has poor quality, air pollutants may trigger symptoms of asthma in a dose-dependent manner," say Donald McKenzie and Louis-Philippe Boulet. Beijing has made efforts to reduce pollution after Beijing was announced as the 2008 location, but “a significant percentage of the pollution (about 35%) at the Olympic Stadium can be attributed to sources outside Beijing. Controlling only local sources of pollution may not be sufficient to achieve the air quality goal set for the Beijing games.”

It has become common knowledge in recent years that exercise during pregnancy is safe, and even beneficial for a mother and her baby, and also that maternity back braces are a great way to deal with back problems during this time. However, many women still refrain from rigorous activity while pregnant for fear of hurting their baby, and the truth is that women are indeed more vulnerable to injury during this time. This is why it is a good idea to take extra precaution to prevent injury while pregnant.

First of all, only continue to exercise if your doctor has specifically given you the okay to do so. Women who suffer from hypertension, an incompetent cervix, poor fetal growth, premature labor, and other serious health conditions should refrain from physical activity while pregnant.

Second, be sure to take plenty of time to warm up and cool down before and after your workout. These transitioning techniques will help your body to adjust to exercise better, thus making it less susceptible to injury.

Third, if you do become injured while exercising, visit your doctor immediately to determine if you have harmed your baby in any way. Even small injuries can create problems if left untreated throughout the course of your pregnancy. If you find that your back feels sore or weak while exercising, consider wearing a DonJoy Maternity Belt, which is designed to relieve discomfort for the lower abdomen and back during all stages of pregnancy. This will support the weight of your stomach and put less stress on your torso, allowing you to move and exercise more freely.

Basketball knee injuries are becoming more and more common. Torn ACLs, LCL instabilities, and general wear and tear on the knees have sidelined some of the best NBA players within the past year, including LeBron James and David Beckham. This leaves amateur players wondering what they can do treat their own injuries quickly and effectively, especially because knee problems are often very serious, and can end up being career-ending.

Donjoy knee braces are currently being used by many amateur and professional basketball players to recover from all types of knee injuries. The Donjoy Armor Protective Knee Brace can help treat basketball injuries by stabilizing the knee and protecting the shins and knees from further blows or stress. It will also help prevent the knee cap from popping out of place during a bad fall.

Things to look for when buying a quality knee brace are good fit, comfort, and durability. Your brace should stay in place and never pinch or scrape your skin. It should also be fitted with a medial swooping frame to allow you adequate range of motion, while still giving you the protection and stability that you need.

Knee problems can also arise from simple overuse of the legs and feet, so players should take breaks often during play to allow the area to rest and recover. Donjoy knee braces have been proven to be an effective way to prevent injury, so wearing them for protection is recommended if the knee starts to feel swollen or sore.

Motocross racers always fear the idea of suffering a career-ending knee injury or a devastating blow to the shin or thigh. Top motocross athlete Grant Langston has recently come out to endorse the DonJoy Impact Guard Knee And Shin Protector, which is designed to protect the knee and shin area from the trauma of blunt blows in the case of an accident. Langston has his own line of motocross parts and apparel, and has been racing since the age of 9.

In 2007, Langston was declared the 1st U.S. Open Champion and 1st American National 450cc Champion. He is also known as the youngest rider ever to win a National 80cc Championship. Langston himself became injured during a collision in May 2008, and suffered a concussion and broken collar bone as a result of the incident. Langston recommends the Donjoy Impact Guard Knee and Shin Protector to racers because it features a hinged cover to prevent ripping of clothes and uniforms, and also comes in five different sizes to fit riders of every type. Grant Langston has tested the guard and loves it.                            

The most common injuries in motocross racing are ACL tears, rotator cuff tears, and wrist fractures, which can take a great deal of time and rehabilitative effort to heal completely. Other gear that is recommended for motocross racers to prevent and treat injuries includes DonJoy ankle braces, wrist braces, and elbow braces. Helmets are currently mandatory apparel in the sport, due to the high risks involved in motocross racing.

Research magazine Science Daily released a recent report stating that “Tommy John” elbow reconstruction surgery has been successful for 83% of baseball players undergoing the procedure. The 2008 American Orthopaedic Society for Sports Medicine Annual Meeting at JW Marriott Orlando Grande Lakes reported that these athletes were able to return to the same or better level of play following the surgery.

“Tommy John” surgery is a procedure that replaces the Ulnar Collateral Ligament in the elbow with a tendon from another place on the body. It is named after Hall of Fame pitcher Tommy John, who was the first player to have the surgery in 1974. Until Tommy John’s surgery, UCL injuries were considered to be career-ending.

Of the 743 Tommy John surgery patients that were polled, 94.5% were baseball players, and the remaining 5.5% were players of some other sport. A shocking 50% of the surgeries performed were on high school athletes, raising concern regarding the health and care of younger players. Full recovery time following the surgery amounts to almost one year. Minnesota Twins Pitcher Francisco Liriano is reportedly on the verge of being called up to the Majors after missing more than a season and a half due to the surgery.

E. Lyle Cain, MD, fellowship director for the American Sports Medicine Institute, Andrews Sports Medicine and Orthopaedic Center in Birmingham, Alabama, comments that “The reality is that this surgery is successful and that's good. But a disturbing trend of younger kids needing the surgery is troubling. This should be a wake-up call to parents and coaches that specialization in baseball where kids don't get adequate time off is very dangerous."

Chondromalacia of the patella, commonly known as Runner’s Knee, can definitely be a major pain - quite literally. It usually occurs as runners reach the 40 miles per week mark, and persists even after taking short breaks from running, which is why it tends to annoy the most dedicated of runners. Because running often works to develop the hamstring muscles faster than the quads, the power imbalance within the thigh can be enough to slide your kneecap out of its normal groove. Ouch. Runner’s knee can also occur as a result of overpronation or supination, which means turning your feet in or out too much while running.

Luckily, there are a few surefire ways to get your knees functioning better throughout your runs. Be sure to ice your knees immediately after running, for at least 15 minutes. Treat the pain with anti-inflammatory meds like ibuprofen or aspirin that will also help to relieve the swelling, and consult your doctor about possibly purchasing orthotics for your running shoes to balance out any foot problems.

Another way to treat Runner’s Knee is to use a knee support brace while running, such as the DonJoy Cross Strap pictured above. These braces apply comfortable but effective pressure on the patellar tendon to help alleviate pain around the kneecap. Be sure to measure your knee before ordering to ensure that you receive a well-fitting brace that will work best for you. Using these simple methods, you can say goodbye Runner’s Knee, and get back to focusing on the marathon at hand.

I've decided to start a series of posts on Rehabilitation. Much of what we do in sports medicine involves rehabilitation and trying to get people back on their feet or their previous level of activity. Injury can significantly debilitate a personal physically and psychologically and thus rehabilitation is the key to getting back into action.

Too many people think that after an injury the best solution is complete rest. While initial rest and activity modification is essential to break the cycle of injury and to allow the body to heal and recuperate, complete rest is not good. We are human beings that must be active. If we do not use our physical or mental gifts, we undoubtedly will lose them. This concept is essential to musculoskeletal care. For those of us that are young, a long period of inactivity will not slow us down that much. However, the older you are, the more likely that inactivity can send you down that downward spiral of decompensation.

For rehabilitation of the shoulder, it is essential to avoid the activity that exacerbated the shoulder in the first place. Most of the time, it is the rotator cuff tendon that is strained. Overhead activity such as tennis, throwing, or swimming will increase inflammation. Thus these activities should be minimized. In order to strengthen the rotator cuff muscle, the most commonly recommended set of exercises involves using theraband resisitance excercises.

For theraband exercises you need to get a send of resistance bands such as the DonJoy bands. You tie one end to a door handle or a post and then proceed to do exercises such as internal and external rotation of your arm with your elbows at your side. It is essential to consult a physician or a physical therapist for adequate instruction on the exercises. However, once you establish a routine of exercises, you build up your strength by increasing to the thicker and more resistant bands.

The theory behind band exercises is to strengthen the thin rotator cuff muscles. Overhead activity will still irritate the tendons, however, if the tendons are strong and thick from your exercises, they won't tear.

As usual, it is recommended that you properly warm up prior to exercises and that you apply ice therapy afterwards.

Repetitive overhead throwing can place signficant stress on the shoulder and elbow joint. Over time this stress can lead to changes in anatomy for the young throwing athlete. The little league pitcher is particularly susceptible to injury as these children often play in multiple leagues, are involved in other youth sports, and often have coaching staff that focus on performance rather than injury prevention.

The key to protecting your child's pitching arm is understanding the mechanics and the tremendous force placed on the shoulder and elbow joint. The throwing motion is actually a kinetic chain of events that channels force from the legs and trunk. The weakest link in this kinetic chain is the growth plate of the shoulder and elbow bones. In boys aged 8 to 15 years, studies have shown over half of these athletes with repetitive overhead throwing show changes in the growth plates of the shoulder. Thus, it is essential to prevent these changes and monitor for injury.

The most essential aspect of preventing shoulder injuries is to limit the number of pitches thrown. Most sports medicine physicians recommend using the USA Baseball Medical and Safety Advisory Committee guidelines for pitch counts. These guidelines have a complicated formula to determine how many pitches your child can throw based on the number of days of complete rest.

The general rule of thumb is this - after one day of rest your child can pitch double the number of pitches equal to his age. For each additional day of rest he can pitch an additional number equal to his age. For example, if your boy is 10 years old and has rested one day, he can pitch 20 pitches. If he has two days of rest he can pitch 30 pitches. Three days of rest 40 pitches. Four days of rest he can pitch 50 pitches. The maximum number of pitches is equal to four days of rest. So in order to protect a 10 year old's arm from injury he should never throw more than 50 pitches.

An additional rule of thumb is that no youth pitcher should pitch more than 2 games per week.

For the avid ground athlete who often gets a swollen knee, there are relatively few treatments that will help. The first thing that should be done is your typical R-I-C-E regimen. Rest, Ice, Compression, Elevation. These are hard and fast rules for the knee that swells up from overactivity. When your knee swells up, doctors call this an "effusion". Basically your knee is getting angry inside and cannot handle the stress of your activity. In an effort to produce more lubrication into the joint, the knee elutes fluid into the joint. It's also a clear signal that you need to take a load off.

For the expert patient with chronic knee effusions, it can be a real hassle to pack ice in a bag and wrap it around your knee. It melts, it gets messy, and if you don't have an ice machine, it is a pain. Alternatively you can use a freeze gel pad. Some people don't like the gel because it doesn't stay cold long enough. If you really want to take good care of your knee, you should consider getting a Cryo Cuff. The Cryo Cuff is really the best thing since sliced bread came out. It's a cuff that you put around your knee and attach to a small tubing that is connected to an ice cooler. It keeps your knee cold for a long time.

The actual way the cooling system works is that there is a motor in the cooler that circulates fluid into the tubing and through the cuff. By circulating the water in the cooling system the water stays cold for longer and you don't need to get up every 20 or 30 minutes to get a new bag of ice. Many years ago the Cryo Cuff was prohibitively expensive for any regular person to buy. You typically only got to use on in the hospital or at a physical therapists office. Nowadays, prices are very reasonable. The Cryo Cuff is routinely used for people after total knee replacement surgery or ACL reconstruction. For the athletic patient who wants to get rid of knee swelling fast, the Cryo Cuff will do the trick.

If you love your knee, go out and get an Aircast Cyro Cuff.

If you saw Dwayne Wade dislocate his shoulder earlier this basketball season you probably heard that collective "Ouch!" from everyone who saw the replay. So what happens if you dislocate your shoulder playing basketball or from some other sport?

The first thing you should do is seek medical attention. If there is an Orthopaedist on site, perhaps he may try and "reduce" or put back in place your shoulder. However, it is best to go to the local emergency department for pain medications and local anesthesia during the reduction. Most typically, "conscious sedation" is given. This is a combination of strong intravenous pain killers with a sedative that basically puts you to sleep very briefly. If a muscle relaxant is also given, it will make the reduction maneuver easier.

If you do dislocate your shoulder, it is important to get it put back in place as soon as possible. Within 6 to 8 hours is ideal because after that period the swelling becomes cumbersome and makes the reduction difficult. If your shoulder is not reducible in the emergency department it will need to be reduced under general anesthesia in the operating room. There are risks associated with general anasthesia so this is not the ideal way to get your shoulder reduced.

Once your shoulder is put back in place, you should keep it in an arm immobilizer or a "sling and swathe". Immobilizing the shoulder for a short duration of time is essential until you can be examined by a physician once the swelling has gone down.

There is some debate about whether a first-time dislocation should be treated conservatively or should be stabilized via shoulder surgery. Recent studies following patients over a 25-year period after their dislocation show that non-operative treatment of a shoulder dislocation in people under 40 years of age provides good long term results. If you are a high-performance athlete or older than 40, perhaps surgery will give you a better return to high function. Either way, it is important for you to seek immediate medical attention, wear an immobilizer after the dislocation, and have proper follow up after initial treatment.

Much of the audience of this blog are individuals who are looking for ways to improve their health via bracing. Some people are visiting because they are trying to prevent an injury. Others are reading because they were injuried and are trying to recover or they had a surgical repair and they are in rehabilitation. One large segment of the population are those who are aging and needing total joint replacements. It is this segment of readers who should listen up to this post.

Total hip replacement is a procedure that is done more than 200,000 times per year with numbers increasing each year. One complication of a total hip replacement is dislocation. This typically occurs about 1 percent of the time and is highly dependent on two factors. First is the quality of the replacement. Second is the obedience of the patient in avoiding movements that put the hip at risk for dislocation. The quality of a total hip replacement is dependent upon the positioning of components and repair of the soft tissues around the hip joint. Malpositioning of the hardware and failure to repair the soft tissues put the patient at risk for dislocation.

The other main reason for hip dislocation is failure to adhere to hip precautions. Hip precautions are precautions that doctors give to their total hip replacement patients to prevent dislocation. The main precautions are to not bend the hip more than 80 degrees (such as sitting on a low chair or low toilet seat), to not slouch or cross your legs, and to minimize external rotation of the leg with a bent knee. Some patients adhere to these precautions for several months after their surgery. Then they become comfortable with their total joint and they start to become more active and put themselves at risk for dislocation. If this is not the scenario, then perhaps the patient tripped and fell and dislocated.

When a person dislocates, he or she needs to go to the local Emergency Department of a hospital. There they will put the hip back in place. They will also give the patient a knee immobilizer. Putting your knee in an immobilizer prevents bending of the knee which also makes it difficult to bend the hip, which significantly reduces the chance of dislocating. Thus, if you have a knee immobilizer already you can bring it with you to the hospital. If you dislocate at home and spontaneously pop back in, then you should put on your knee immobilizer until you see your doctor. Either way, you don't want to see how much your hospital charges you for a knee immobilizer. So if you have a total hip replacement in, it is a good idea to go out and get a basic knee immobilizer.

Osteoarthritis is the natural wear and tear of the articular cartilage of joints. When we are born we have smooth gliding articulating cartilage at the knee joints. Over time, the surface wears down and the cartilage degenerates. Thus the main causes of osteoarthritis are genetic predisposition to arthritis, obesity, high-impact activity, and trauma. Genetics are an uncontrollable factor in our lives. Some people are more at risk for early arthritis than others no matter what they do. Being obese definitely places undue stresses on a joint. Studies have shown that every 1 pound of weight loss reduce the amount of forces transmitted through the knee joint by 4 times! Thus even a limited weight loss program could reduce that force to make a person asymptomatic.

High impact activities such as running on hard pavement increase the amount of wear on joints. Activity modification to lower impact sports such as bicycling or swimming or even reducing the number of miles jogged per week can improve symptoms. Trauma is another uncontrollable factor for osteoarthritis. If you have a trauma such as a car accident or a fall that affects the joints, the chances of post-traumatic arthritis down the road are increased. Cartilage is relatively avascular and after injury it repairs very poorly. Even a crack in the cartilage will heal with fibrous tissue called fibrocartilage that has no where near the smoothness and gliding capabilities as native articular cartilage.

When the cartilage degenerates significantly, the joint becomes incongruent. What this means is that one side of the knee joint does not exactly match the other side. The joint actually "subluxates" during movement which causes friction in the joint and slight dislocation of the joint. This subluxation exacerbates the inflammation in the knee. Thus bracing helps to stabilize the joint in proper alignment to prevent subluxation. If arthritis affects one side of the knee more than other, special braces can also help unload the affected side to relieve pressure on the knee.

Although most athletes at all levels of competition suffer injuries, the highest level athletes suffer injuries despite their elite level of training and performance. Two key muscles that are susceptible to injury are the hamstrings and the calf muscles including the Achilles tendon. These muscles are more susceptible to injury because they are paired with other groups of muscles on the other side of the leg, also known as antagonists.

In general, muscles shorten when they contract. This is called a concentric contraction. The best example is that of the biceps. When you lift a dumbell (or beer for that matter), your biceps contracts and shortens and bulges when it does this. However, there are some muscles in the body that can lengthen when they contract. The hamstrings and calf muscles are examples of this.

When an athlete lifts his leg up such as when he is doing hurdles or sprinting, each time he elevates the leg forward the hamstring is lengthening and it is also contracting. This is called an "eccentric" contraction. In the calf muscle, when you dorsiflex your foot (lift the toes toward your head) and you push off such as in running or going up stairs, the calf muscle is contracting and also lengthening at the same time. Thus eccentric contractions such as those put the muscle at risk for injury.

The key to injury prevention is eccentric strengthening. It is not enough to exercise and practice, it is essential to do strength training where muscles are susceptible to injury.

Some great exercises to strengthen the calf eccentrically is to do toe raising on a step. If this is too easy, add weight to your upper body. An alternative is to use a leg press machine with your heel off of the press platform with your toes on the platform in dorsiflexion.

Some great exercises to strengthen the hamstring eccentrically are to use a flat leg curl hamstring machine and to use a "drop and catch" exercise where you curl the hamstring and flex the knee, then as you start to lower the leg, let the weight fall and "catch" it near the bottom of the motion arc. This simulates an eccentric contaction. An alternative exercise is to do straight legged deadlifts lifting the barbell from the floor to a standing position. Using a similar "drop and catch" method you can catch the weight at the end arc of motion where the hamstrings are tight.

Some of the best athletes in the world do not know about eccentric strengthening. Learning how to strengthen muscles in this fashion will help prevent that season ending hamstring or calf injury.

After University of Pennsylvania volleyball players were mandated to wear a ankle brace, just one ankle injury occurred in the course of seven seasons.

"From our data, it appears that the use of such a brace is an effective way to decrease the incidence of ankle injuries in this active but vulnerable group of athletes," conclude Dr. Brian J. Sennett of the University of Pennsylvania School of Medicine in Philadelphia and colleagues.

Ankle injuries are common among female volleyball players, accounting for up to 36% of all injuries in these athletes, Sennett and his team note in their report in the American Journal of Sports Medicine.

Penn players have been wearing Ankle Braces since 1998. To evaluate whether the braces had actually been effective, the researchers compared rates of ankle injuries at their university to data from the National Collegiate Athletic Association (NCAA) for female volleyball players.

There were 797 ankle injuries during 811,710 NCAA practices or games from 1988 to 2005, translating to an injury rate of 0.98 for every 1,000 exposures. For the Penn players, there was just a single ankle injury during 13,500 games or practices during those seven seasons, for an injury rate of 0.07 per 1,000 exposures.

Nearly half of the 132 Penn players in the study had suffered ankle injuries before starting to play college volleyball, Sennett and his team note.

"Although our data are statistically significant and may change current thinking about orthosis use in these elite athletes, further investigation is warranted," they write. This research could include comparison of the effectiveness of various types of ankle braces, the researchers add, as well as how they affect performance.

SOURCE: American Journal of Sports Medicine, February 2008.

Thought we'd seen everything until now.  A knee brace that generates enough electricity to power 10 cellphones has recently been developed  by scientists recently. The brace collects the energy of a person's knee braking after taking a step, similar to the way a hybrid car brakes collect energy to charge their batteries. The device only weighs 3.5 pounds, and does not need the intense effort that other human-powered energy generators such as hand cranks require. And while the cellphone measurement given by the creators is pretty useless, they do have several practical applications in mind.

Scientists suggest that the brace could be used by campers and soldiers to power GPS locators and satellite phones in areas with limited access to electricity. It could also charge prosthetic knees, eliminating the need for periodic surgery to replace the batteries in the joint.

The current version of the knee brace is just a proof-of-concept; the team plans to make the device less bulky while still retaining its energy harvesting capabilities. We think this is a great idea with lots of potential (even if it was created in part by a University of Michigan professor). Hopefully we can get a working model before CES next year so we'll never need to worry about our laptop running out of juice.

Aside from pain relief and protection from injury knee braces provide this is another way those who wear knee braces can have a leg up on their non-brace counterparts.

Nonsurgical treatment options depend on whether your problem is an ankle sprain or ankle instability.

Ankle Sprain
The best results after an ankle sprain come when treatment is started right away. Treatments are used to stop the swelling, ease pain, and protect how much weight is placed on the injured ankle. A simple way to remember these treatments is by the letters in the word RICE. These stand for rest, ice, compression, and elevation.

• Rest: The injured tissues in the ankle need time to heal. Crutches will prevent too much weight from being placed on the ankle.
• Ice: Applying ice or cold packs can help ease pain and may reduce swelling.
• Compression: Gentle compression pushes extra swelling away from the ankle. This is usually accomplished by using an elastic wrap or ankle support.
• Elevation: Supporting your ankle above the level of your heart helps control swelling.

Mild pain relievers help with the discomfort. Anti-inflammatory medications can help ease pain and swelling and get people back to activity sooner after an ankle sprain. These medications include common over-the-counter drugs such as ibuprofen.

As treatment progresses, it is helpful to gradually begin putting weight through the joint. Casts have fallen out of favor because soft tissues weaken when they are kept immobile. But ankle braces that can be worn to support the ankle, but still allow weight bearing, are the most popular treatment for helping reduce strain on the healing tissues.

Healing of the ligaments usually takes about six weeks, but swelling may be present for several months. Your doctor may suggest that you work with a physical therapist to help you regain full range of ankle motion, improve balance, and maximize strength.

Brady appeared to be limping Sunday as he left his news conference following the Patriots' 21-12 victory over the San Diego Chargers in the AFC Championship game.

Yesterday, Brady did not directly answer a question about being hurt during his regular appearance on WEEI's "Dennis and Callahan" show. When he was asked about having his leg looked at on the sideline early in the fourth quarter, he replied:

"There are always kind of bumps and bruises. I'll be ready for the Super Bowl. I'm not missing this one. I'd have to be on a stretcher to miss this one. There will just be some treatment this week and, like I said, games like this you get a little nicked up, but it's nothing serious."

Brady was sacked twice Sunday and appeared to be slightly hobbled after Igor Olshansky and Stephen Cooper tackled him for an 8-yard loss on the final drive of the game.

An injury might explain Brady's subpar - by his MVP standards - performance against the Chargers. He was 22 of 32 for 209 yards and two touchdowns, but was intercepted three times, including once in the end zone by Antonio Cromartie late in the third quarter, Brady's first red zone pick in two seasons.

 

Tom Brady's right foot was under wraps yesterday in an Aircast Walking Boot  in New York, but he promises he'll be in full uniform for the Super Bowl.

 

One of our favorite informative websites is www.kneeguru.co.uk. Knee Guru has compiled quite a nice database of information pertaining to a variety of knee pain and injury issues.

Some of topics covered by this site include:

General Knee Info

Knee Anatomy

Understanding Knee Arthritis

Dictionary of Knee Issues

Clinical Casebook

In-depth Insights

We highly recommend this site and thank the Knee Guru for compling all this helpful and informative information.

It’s easy to find the cause of heel pain. In many cases, our behavior makes it easy to diagnose, whether it stems from the exercise routines we do, or perhaps the repetitive lifting we do on the job. Regardless of what type of activity leads to heel pain, when it comes down to it, the cause is overuse.

With most occurrences of heel pain, symptoms can be helped by an array of treatments, ranging from simple exercises to surgical procedures. The variety gives heel pain sufferers some choices in how they would like to approach treatment, but some treatments certainly would be better than others depending on the severity of symptoms.

At Home Treatments

For mild pain that comes from the initial onset of a case of plantar fasciitis, treatment can begin at home. Keeping the plantar fascia ligament stretched is important to counteract any strain on the tissue. If the plantar fascia stays stretched and “warmed up,” the less risk there is for tearing the fibrous tissue.

One of the easiest ways to keep the fascia stretched is to take a wide belt and place its center under the ball of the foot.  Keeping your knees straight, pull the belt upwards until the tissue along the bottom of the foot feels taut, and hold the this position for about ten seconds, then relax the foot and repeat. In addition, you might also want to take a tennis ball and roll it up and down the length of the foot. Rolling a tennis ball can be done at home, or even at the office, helping to keep and fascia stretched and loose throughout the day. It is especially important to do these exercises in the morning, as the fascia is particularly tight when we first get out of bed in the morning, and it also happens to be the time of day when pain can be at its worst.

The value of these simple, easy home treatments is that heel pain sufferers can help curb heel pain before it gets worse, and it helps minimize the risk of needing more severe or cumbersome forms of treatment.

Conservative Treatments That Keep You Moving

How do you know if your knee brace fits correctly?

This is not a difficult answer.  Off the shelf or ready-made knee braces are made for a general population no matter what body part is injured.  Braces can help treat many different problems or help support a healthy body part to prevent injury.  However the brace cannot do its job unless it fits correctly, meaning it doesn’t fall off or move around.

Here are a few tips to make sure you have your brace on correctly.

 1)    The knee brace should fit comfortable, but snug.  You should be able to move in the allowable range of motion – meaning most knee braces allow some motion but restrict other motion.  The motion restricted is usually to support the injured body part (tendon, ligament, muscle, bone etc.)

2)    Be sure to follow the directions on how to strap on the straps. (Betterbraces.com offers online directions on each product.) There is usually a fairly logical sequence to follow.  The straps should not cut off circulation or be too loose that they don’t stay in place.

3)    Have an expert check the knee brace if your still not sure.  This is the best way to insure the knee brace is working properly.  The last thing you want is to wear a knee brace that isn’t working right and you end up hurting yourself.

Now that the New Year is upon us we all make New Year’s resolutions, and the number one resolution on everyone’s list is to “get in shape”. Hear are a few tips to help you stay injury free while you try to get in shape this year.

1)    Start slow.  Don’t over do it in your first couple of workouts.  You didn’t get out of shape in one day, and your body is not going to get back into shape in one day either.  Your body needs time adjust to your new work out regimen.  Also you don’t want to mentally burn out.

2)    Know your going to be sore.  Your body will be going though some changes during your process of changing your fitness level.  This is natural and don’t get discouraged and think it is always going to be like this after each work out.  Be expecting the soreness for about the first month of your new program.

3)    Make obtainable goals.  Remember your body needs time to make adjustments.   So first start with a 2 mile run at a comfortable pace, instead of saying I want to run a marathon under 4 hours in one month.

4)    Be sure to warm up before your activities.   A brisk walk or some simple calisthenics will do this for you.  You should warm up for about 5 minutes before heading into your workout or activity.

5)    Be sure to stretch.  Keeping your muscles limber will help reduce your chances of injury.  When you stretch make sure you are stretching your muscles that you plan on using during your activity.

6)    If you do start to feel some muscle or tendon aches. Here are a few simple remedies.

a.     Use cold therapy after exercise to reduce pain and swelling

Knee braces are another way to provide stability, support, and pain relief for patients with knee osteoarthritis. It has been estimated that about 10 million Americans have been diagnosed with knee osteoarthritis. Other common treatment options include:

• Medications (such as nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids)
• Lifestyle modifications (including weight loss and strengthening exercises)
• Joint protection techniques
• Assistive devices
• Joint surgery is considered a last resort treatment option

Patients should consider trying a knee brace to see if there is noticeable benefit.The knee brace would be a complementary treatment, to go along with any other treatments being used.

The Appropriate Knee Brace for You

There are different kinds of knee braces and it's important for your doctor or a health professional to help decide which knee brace might be appropriate for you. Three knee components to consider are:

• medial (on the inside of the knee joint)
• lateral (on the outside of the knee joint)
• patellofemoral (behind the kneecap)

Usually knee braces are recommended for patients who have cartilage loss in one component of the knee, also known as unicompartmental knee damage. Osteoarthritis most commonly develops in the medial component.

Types of Knee Braces

Single-piece sleeves made of neoprene, an elastic-rubbery material, are the most simple knee braces. The knee brace is pulled on over the foot of the affected leg and is placed over the knee where it provides compression, warmth, and support. This type of knee brace is for mild to moderate osteoarthritis and it is available over the counter in most drug stores. The fit should be snug.

An unloader brace is a semi-rigid knee brace made from molded plastic and foam. Steel struts inserted on the sides limit lateral knee movement and add stability. This brace is custom-fit to each individual patient for whom it is prescribed (usually patients with medial component osteoarthritis). Essentially, it relieves pain by transferring pressure from the inside to the outside part of the knee.

The unloader knee brace can also be designed for patients with cartilage damage in the lateral component of the knee, as well as patients with severe osteoarthritis of the knee who are looking for temporary pain relief while they wait to have knee replacement surgery. .

We suggest that patients allow a week to one month to adjust to how the unloader brace feels. Right from the start, don't expect comfort. It takes a little time. Take it off from time to time so you can exercise and strengthen muscles. It's also important to remember that a knee brace is just one part of a patient's treatment regimen. Don't disregard other aspects of your treatment regimen without first talking to your

How much knee brace do you need?  This video shows an example of someone who probably should have been wearing a more rigid knee brace, but thankfully she was at least wearing a semi-rigid brace  that probably saved her.

At first it looks like the knee brace totally failed, but at the end she is seen walking off without much pain so it must have helped.

Knee Braces, Knee Braces, Knee Braces.  Lot's of choices.  Which one is right for your knee injury?

There are many choices when in comes to knee braces.  Your decision should be based on what type of injury you've had or your are trying to prevent.  You also may need to factor in your activity.  A brace for walking around the block can be a lot different than what Peyton Manning (he wears the DonJoy Defiance ) needs for his knee during the Super Bowl. 

Here is a look at the different choices based on the levels of knee sprains.  We'll address some other factors in the coming days and weeks.

First Degree Sprains can usually be self addressed by using cold therapy/ice packs, bracing and light exercises to improve the strength of the hamstring and quadriceps muscles. Braces for a First Degree Sprain will provide only mild support and are not usually sufficient to provide protection to joints where ligament injury has occurred or is a risk. These are usually used for mild support, warmth and compression.

 Click here for Products to Treat First Degree Knee Sprains

Second Degree Sprains can heal on their own with self care. Although some ligament instability may still exist , it is important to provide the right treatment. To reduce symptoms, use ice, exercise and a compressive knee brace for 2-3 weeks.

 Click here for Products to Treat Second Degree Knee Sprains

Third Degree Sprains usually require surgery when a rupture is diagnosed. Post-surgical care involves efforts to restore natural movement of the knee. Physical therapy to rehabilitate the knee generally follows surgery. Ice packs are applied to reduce swelling and pain and knee braces are worn to help support the knee, provide compression to reduce swelling and hinged braces are necessary to provide more stabilization.

 Click here for Products to Treat Third Degree Knee Sprains

Another example of a top NFL player bouncing back from injury so quickly is Adrian Peterson who tore a ligament several weeks ago.  Since that time he apparently been working on an underwater treadmill and then protecting his ligament tear with a DonJoy Knee Brace.

Here are a couple good videos on the therapy and Adrian's thoughts on his Knee Brace.  Note this was before he ran for 78 yards and two touchdowns on 20 carries and caught one pass for 17 yards as the Vikings downed the Bears 20-13 on Monday Night Football in Week 15.

Click on this link to watch Adrian Peterson discuss getting used to his DonJoy Knee Brace

Below is video showing the water treadmill therapy Adrian Peterson has used to bounce back from his ACL Injury.

A week after spraining his left knee Chargers Quarterback Philip Rivers was able to start against the Detroit Lions wearing a knee brace.  It's amazing how quickly these NFL players are able to rebound from knee strains.  It's hard to say how much his DonJoy knee brace helped him during the game, but at least he was in there and well protected from further injury. 

The image above shows him passing to NFL MVP Ladanian Tomlinson with the DonJoy Knee Brace on.

Image is credited to: http://www.chargers.com/fan_zone/photo-gallery/slideshow_20071216.htm

Now that the snow is starting to drop across the country many skiers and snowboarders are starting to hit the mountains.  Since it’s the start of the season, many are hitting the slopes ill-prepared.  They’re realizing the physical workouts they’ve been doing the past few months, if at all, did not prepare them for the rigorous demands of their favorite snow sport.  These are the times when there is a rise in ski related injuries.  Everything from a broken wrist, sprained elbow, separated shoulder to torn knee ligaments.  The tearing of the anterior cruciate ligament (ACL) in the knee is one of the most common skiing injuries and most painful. 

One study looking at female skiers found that their anterior cruciate ligament (ACL) injury rate was six times that of their male counterparts. Physical conditioning may have a significant impact on injury rates — that is, the better shape a skier is in, the less frequent the injuries.

When injuries most likely occur:

• First day of skiing
• Early morning when skier or boarder is not warmed up
• Late in the day when rider becomes fatigued
• At the end of a ski trip
• Adverse snow conditions

Before heading out on your next ski or boarding trip, it might be wise to look into ways of preventing injuries such as a conditioning program to strengthen your muscles, cardiovascular workouts to increase your stamina and wear support braces to help minimize the chance of strains and torn knee ligaments.  DonJoy ACL Knee Brace is highly recommended for skiing to help reduce the risk of injury and the Aircast A2 Wrist Brace

DonJoy Knee Braces were part of an epic ride last week.  Garrett McNamara one of surfing's top big wave riders caught an amazing ride while wearing custom knee braces made by DonJoy.

Last week a swell hit the west coast that brought some of the biggest waves we have ever had.  This picture was taken at Mavericks, which is located in Northern California in Half Moon Bay.  The water is somewhere around 49 degrees and patrolled by very large water creatures called Great White Sharks. 

If you can zoom in on the picture you will notice Garrett is wearing his Defiance III Knee Braces on both knees.  This wave is well over 50 feet and puts him in contention for the biggest wave surfed this year.  Wow!

The new DonJoy Tru-Pull Lite was recently introduced by DonJoy the worlds largest maker of knee braces.  It is perfect for those with mild patella subluxation and patella arthritis and general patellofemoral problems.  Those individuals will benefit from this rather slight knee brace.  It is a great device to "pull' the patella into proper alignment.  It is only 8 1/2 inches tall and features a single pre-bent hinge design.

There is also a patented tacky yet soft buttress pad that gently sticks to the skin to provide a constant corrective pulling force on the patella during activity.

The pull straps are made from Breath-O-Prene material and they apply pressure on the buttress during flexion and extention.  It is lightweight and and the material wicks moisture, is breathable, hypoallergenic and antimicrobial.  The flexible hinges provide moderal mediolateral support.  It is availble in left or right and XS through XXXL.

If you are looking for a relief of patella tracking disorders in a small package with the latest innovative materials and construction be sure to check out the DonJoy Tru-Pull Lite.

Tennis Elbow Pain

Tennis Elbow also known as Lateral epicondylitis, is not limited to tennis players. The backhand swing in tennis can strain the muscles and tendons of the elbow in a way that leads to tennis elbow. But many other types of repetitive activities can also lead to tennis elbow: painting with a brush or roller, running a chain saw, and using many types of hand tools. Any activities that repeatedly stress the same forearm muscles can cause symptoms of tennis elbow.

Why did I develop tennis elbow?

Overuse of the muscles and tendons of the forearm and elbow are the most common reason people develop tennis elbow. Repeating some types of activities over and over again can put too much strain on the elbow tendons. These activities are not necessarily high-level sports competition. Hammering nails, picking up heavy buckets, or pruning shrubs can all cause the pain of tennis elbow.

What does tennis elbow feel like?

The main symptom of tennis elbow is tenderness and pain that starts at the lateral epicondyle of the elbow. The pain may spread down the forearm. It may go as far as the back of the middle and ring fingers. The forearm muscles may also feel tight and sore.

The pain usually gets worse when you bend your wrist backward, turn your palm upward, or hold something with a stiff wrist or straightened elbow. Grasping items also makes the pain worse. Just reaching into the refrigerator to get a carton of milk can cause pain. Sometimes the elbow feels stiff and won't straighten out completely.

What can I do to make my pain go away?

The key to nonsurgical treatment is to keep the collagen from breaking down further. The goal is to help the tendon heal.

A Tennis Elbow Brace that that provides compression and absorbs the shock will often help the conditions subside or and ease a lot of the pain during activity.

Using a Cold Therapy Wrap to reduce the inflammation is also an effective way to treat tennis elbow.

If the problem is caused by acute inflammation, anti-inflammatory medications such as ibuprofen may give you some relief. If inflammation doesn't go away, your doctor may inject the elbow with cortisone. Cortisone is a powerful anti-inflammatory medication. Its benefits are temporary, but they can last for a period of weeks to several months.

Your doctor may suggest using ultrasound to guide a needle into the sore area. The ultrasound gives a clear picture of areas in the tendon that contain scar tissue. Poking holes in the tendon breaks up scar tissue and gets the tendon to bleed. Bleeding in the tendon helps stimulate the healing response.

Shock wave therapy is a newer form of nonsurgical treatment. It uses a machine to generate shock wave pulses to the sore area. Patients generally receive the treatment once each wee

In soccer we all know we can you can't use your hands, but you obviously you can use your feet and other parts or your body including your head. 

If done properly it can be one of the prettiest plays to watch and most effective ways to score.

Aside from shin guards soccer players haven't worn much protection, but now more and more pro players and younger soccer players are wearing the DonJoy Hatrick Soccer Head Guard.  If you ever taken one to the noggin or a concussion you might want to take a look at this padded comfortable head gear for soccer players.  It's looks pretty much like a  head band and works to dampen the shock from head to ball contact and head to head contact or...

even head to foot contact...see video below...

Ouch!  He looks a bit dazed and confused.  Soccer players obviously are very vulnerable to head injuries.

This seems funny, but concussions from soccer are a serious issue amongst players of all levels.

We are often asked about the importance of wearing an ankle brace or ankle support for tennis or other court sports.  There are usually two groups of people:

1. Those that have never sprained their ankle

2. Those that have sprained their ankle in the past

For those of you in the group that have never sprained your ankle the only reason you'd consider wearing an ankle brace is for prevention.  So is worth strapping on an ankle brace just as a precautionary measure?  To you I say yes.  It only takes one ankle sprain to make you more suceptable to ankle sprains in the future.  In other words, the more you sprain your ankle the more you will sprain your ankle. 

Need further proof?  Watch this video of pro player Tatiana Golovin who is playing Maria Sharapova.  Be warned this is a graphic depiction of a professional athlete spraining their ankle.

Now that you've seen the video of an ankle sprain you should be convinced you might want to get a pair of ankle braces. Note we recommend wearing braces on both ankles even if you only have issues in one of them.  You want to be balanced and protect your good ankle as well.

So which ankle brace is best for tennis?

All around ankle stability:

The U.S. Ski Team and U.S. Snowboard Team has selected DonJoy as their official medical supplier and exclusive knee brace provider.  According to the American Orthopedic Society for Sports Medicine, skiers are prone to knee, thumb, hand, and head injuries and snowboarders have a higher potential for foot, ankle, and upper extremity injuries.

HOW DO SKIERS GET HURT?

Many variables affect injury rates in skiers, most commonly ability, age, gender, physical conditioning and snow conditions. Beginners have three times the injury rate of experts, but their injuries are less severe. Experts have less frequent but more severe injuries (head injuries, fractures and high grade ligament sprains). This is probably due to their higher speed on the ski slope. Intermediate skiers fall somewhere in-between. Another key factor is age. The highest injury rate is among 11 to 13 year olds. Their ability is intermediate, but their judgment is not as good as adults. Injures in teenagers (13 to 20 year olds) are slightly less frequent, but more severe. Many have the skill levels of adults with immature judgment. Finally, children younger than 12 years old have twice the injury rate of adults, but fewer than that of adolescents. Females have twice the injury rate of males, which is thought to stem from conditioning. One study looking at female ski racers found that their anterior cruciate ligament (ACL) injury rate was six times that of their male counterparts. Physical conditioning may have a significant impact on injury rates — that is, the better shape a skier is in, the less frequent the injuries. Most studies focus on destination ski resorts, where most skiers are vacationers. Injuries are most likely to occur on: • the first day of ski week; • in the early morning when the skier is not warmed up; • in the late morning and late in the day when fatigue sets in; and • at the end of the week when the cumulative effects of the vacation make the skier tired. Snow conditions affect injury patterns, as well. Hard pack snow generally yields high-speed and impact injuries. Powder and heavy snow is associated with more torsional or twisting injuries. Quick changes in snow conditions, such as hitting the line between groomed and ungroomed snow, may cause a fall that leads to an injury.

SNOWBOARDING INJURY TRENDS

Snowboarding has a slightly higher potential for upper extremity injuries, but it may be safer on the knees. There is an increased rate of foot and ankle injuries associated with snowboarding. The lead foot has twice the number of injuries than the back foot. One study showed that the hybrid or “mid-stiff-ness” boots were the safest style of boots. There may be more high-energy injuries such as femur fractures, high-speed injuries and injuries caused by getting “big air".

GENERAL INJURY PREVENTION

• Prepare for the season and get in shape.

• Get your equipment checked at a certified shop.

• Self-release your bindings each day you ski.

It's great to see Donovan McNabb of the Philadelphia Eagles and Joseph Addai of the Indianpolis Colts wearing DonJoy braces.

Here's McNabb wearing the DonJoy Defiance Knee Brace to protect his ACL Knee Injury .

Here's Joseph Addai of the NFL Super Bowl Champion Indianpolis Colts wearing the DonJoy Velocity Ankle Brace.  If you ever watched him run and cut from side to side you know puts a lot of strain on his ankles and the Velocity Ankle Brace is the sturdiest Ankle Brace DonJoy has in it's arsenal.

Since 1978, the Aircast Air-Stirrup Ankle Brace has been the "standard of care" for the treatment ankle injuries and has been cited in over 100 medical journals for its superior performance in helping to heal ankle injuries.

Did you know Aircast devices have been used by almost one out of every five families?

What make make Aircast Ankle Braces unique is that they feature two air cells on each side of the ankle that produce graduated compression during movement. The compression promotes efficient edema reduction as with aircast aircell milk out the edema to speed healing and reduce inflammation.

Aircast pioneered the functional management of ankle sprains by developing the Air-Stirrup® Ankle Brace— now the standard of treatment for ankle sprains.

Ankle sprains happen often in sports, especially to runners and athletes in jumping sports. To treat an ankle sprain, RICE--or rest, ice, compression, and elevation--is just what the doctor ordered. But can anything else be done to get you back on your feet more quickly?

When you sprain your ankle, you lose the ability to fully bend your foot and ankle upward. When this movement, technically known as dorsiflexion, is painful, standing and walking on the injured ankle can hurt. Physical therapists try to improve ankle dorsiflexion using a technique called joint mobilization. With the patient lying down, the physical therapist supports the ankle at about a 90-degree angle with one hand and assists movement of the ankle joint with the other.

In this study, the authors wanted to know whether this technique, in which the therapist adds hands on mobilization, helped patients more than RICE alone.  Though patients got better no matter what their treatment, they got better faster when they had joint mobilization in addition to RICE. Patients who had joint mobilization needed fewer treatment sessions. They showed pain-free ankle movement sooner, and they were able to walk more quickly than those who only had RICE.

Fortunately, the body has some natural healing mechanisms. Either on its own or with help, a sprained ankle will heal eventually. Still, this study suggests that a little "laying on of hands" can go a long way toward getting you back on the track or field.

References:
Toni Green, GradDipPhty, GradDipManipTher, MAppSc, et al. A Randomized Controlled Trial of a Passive Accessory Joint Mobilization on Acute Ankle Inversion Sprains. In Physical Therapy. April 2001. Vol. 81. No. 4. Pp. 984-994

Knee Brace Undersleeves are something to consider when wearing a rigid or hinged knee brace.  Many of the knee braces made today fit extremely well and tend not to migrate during activity as they may have done years ago. 

With that said, anytime you wear a brace all day or during a your favorite sport it might be good idea to wear an undersleeve to protect your skin.  And with winter on the way knee brace undersleeve are an effective way to keep the knee warm and with the compression they provide they can help ease a bit of the pain and help your knee feel more secure.

DonJoy makes undersleeves out of two different materials:

Neoprene - which is thicker to provide a bit more padding, better compression and support, but tends to get more warm so you'll sweat more with it on especially during sports like basketball, football and soccer.  The small perforations do help a bit to keep you cool.  If you knee like compression around your entire knee and like the warmth this one is a good choice for your knee.

Supplex/Lycra  - really effective to at creating a layer of soft material between you and your knee brace.  These undersleeves are breathable and will wick moisture away from your leg.  Does a great job of preventing chaffing and keeping a bit of compression around the entire leg. If you have sensitive skin and you want to stay cool this is the one for you.

Since both these styles tend to get a sweaty it's a good idea to pick up a few so you can rotate them in the wash if you are using them more than a few times a week.

Soccer players who wear protective headgear suffer nearly half as many concussions as those who play without helmets, according to a new study conducted by researchers at Canada's McGill University.

Researchers followed 250 adolescent (ages 12 to 17) soccer players during the 2006 season. They found that 53 percent of those who did not wear protective headgear suffered concussions compared to 27 percent of those who wore safety gear.

The study, published in the July 2007 issue of the British Journal of Sports Medicine, also found that:

• Nearly half of the players (47.8%) experienced symptoms of a concussion during the 2006 season.
• Approximately 4 out of 5 athletes did not realize that they had suffered a concussion
• Multiple concussions were less frequent among the injured athletes (50.0%) who wore protective headgear than those who did not (69.3%).
• Nearly one-quarter (23.9%) of players suffering concussions experienced symptoms for at least one day or longer.
• Female soccer players were at increased risk of suffering concussions.
• Female soccer players not wearing protective headgear were also at increased risk of suffering other kinds of head injuries, such as abrasions, lacerations or contusions on areas of the head that otherwise would have been covered by the headgear.

Should Soccer Players Wear Headgear?

The McGill study is the first "to say that soft protective headgear for soccer signifi

Ankle Sprain and Instability

An ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. Ligaments are bands of tissue—like rubber bands—that connect one bone to another and bind the joints together. In the ankle joint, ligaments provide stability by limiting side-to-side movement. Some ankle sprains are much worse than others. The severity of an ankle sprain depends on whether the ligament is stretched, partially torn, or completely torn, as well as on the number of ligaments involved. Ankle sprains are not the same as strains, which affect muscles rather than ligaments.  Find Solutions for Ankle Sprains or Learn More About Ankle Sprains

Achilles Tendonitis

The Achilles tendon is fibrous tissue that connects the heel to the calf muscle. Leg muscles are the most powerful muscle group in the body and the Achilles tendon is the thickest and strongest tendon in the body. Contracting the calf muscles pulls the Achilles tendon, which pushes the foot downward. This contraction enables: standing on the toes, walking, running, and jumping. Overuse, misalignment, improper footwear, medication side effects, and/or accidents can all result in Achilles tendonitis. Multiple causes often contribute to the same Achilles tendon injury.  Find Solutions for Achilles Tendonitis or Learn More

Ankle Osteoarthritis

Osteoarthritis is a condition characterized by the breakdown and eventual loss of cartilage in one or more joints. Cartilage—the connective tissue found at the end of the bones in the joints—protects and cushions the bones during movement. When cartilage deteriorates or is lost, symptoms develop that can restrict one’s ability to easily perform daily activities. Osteoarthritis appears at various joints throughout the body, including the hands, feet, spine, hips, and knees. In the foot, the disease most frequently occurs in the big toe, although it is also often found in the midfoot and ankle.  Find Solutions for Ankle Osteoarthritis or Last Blog Entry: No Entries To Display. Click here to post your comments.

Osteoarthritis (OA) of the knee is one of the five leading causes of disability among elderly men and women. The risk for disability from osteoarthritis of the knee is as great as that from cardiovascular disease.

Several factors may increase the risk of developing osteoarthritis of the knee.

Over 10 million Americans have been diagnosed with osteoarthritis of the knee.  Since a few popular pain relief drugs have been taken off the market, many arthritis sufferers are turning to other treatment options such as knee braces to combat their chronic pain.

We read an article published by the Cleveland Clinic’s Arthritis Advisor that was just released and pulled seven reasons why millions are looking to knee braces for pain relief:

1.       Bracing options can be simple, such as knee sleeves made of neoprene that decrease pain for people with mild arthritis.

2.       More advanced knee braces relieve pain by transferring pressure from one part of the knee to the other.

3.       Knee braces increase mobility and reduce pain from cartilage destruction allowing the patient to walk more rapidly and for greater distances.

4.       Technology has allowed companies to create easy to use, breathable braces that have a sleek profile.

5.       Most braces don’t require a prescription.

6.<

You don't have to look far to find DonJoy products in action in the Fall. Each Saturday and Sunday during NCAA and NFL football games, you'll notice DonJoy's products in action supporting and protecting the knees and ankles of some of the game's most famous athletes. In training rooms, physical therapy clinics and in the offices of top orthopedic surgeons around the world, you're sure to find the DonJoy name.

We all know that world famous Soccer Player David Beckham has garnered a lot of attention with his arrival into the US.  His sports injuries woes have slowed down his presence on the field.

Here he is sporting the DonJoy Deluxe Hinged Knee Sleeve a few days after he sprained his medial collateral ligament  a knee injury that will keep out of the LA Galaxy's Soccer line up for at least six weeks. 

In addition the Knee Brace he's also wearing the DonJoy Stabilizing Ankle Brace.  Great choice especially since as of Summer 2007 DonJoy upgraded this brace to eliminate the stitching inside so there is no more chaffing and also improved the figure 8 strapping system to provide even more support.  We should note that this ankle brace is often compared to the ASO Ankle Brace which is a great brace, but with the recent improvements made by DonJoy we give the nod to the DonJoy Stabilizing Ankle Brace for fit, comfort, stability and price.

As the leading provider of sports medicine products on the internet BetterBraces.com is proud to officially launch our "Better Sports Medicine for Better Health" Blog. 

We are exicted to have a forum in which we can review products, provide helpful athletic training tips, injury rehabilitation information, videos and much much more.

Be sure to tag this blog as a place to find out anything and everthing related to sports medicine.