November 03, 2016

most ankle sprains occur as inversion injuries

Several weeks ago, I discovered a reasonably new company resides in New York which was developed by Dr. Barry Katz, a former basketball player and lover from the sport who transpires with also be a memory foam radiologist. His company, Ektio, markets a basketball shoe that doesn't come with an NBA stars face onto it or a flashy advertising campaign, but rather states include revolutionary design technology that is specifically aimed at reducing ankle sprains with a mechanism that will specifically limit excessive inversion of the foot, the ankle movement that's responsible for 95% of basketball ankle sprains. It appeared like an intriguing concept to me and that i quickly began researching the minds behind the shoe's technology, the substance and data behind the claims that were being marketed, and the overall ingenuity within the product design.
With the procedure for researching and learning about the shoe's concept, design, and reliability, I had been because of the opportunity to speak with/interview both Dr. Barry Katz in addition to former NBA star and hall of famer, Rick Barry, who's an advocate and spokesman for the company. Though empirical data always means a bit more in my experience than testimonials and spoken claims, it had been great to get a opportunity to ask more questions and truly gain understanding of the goals of the company and also the driving forces behind the design.
So before we dive into examining the shoe and the claims regarding ankle sprains that are explained Ektio, why don't we review ankle sprains having a specific look at ankle sprains in basketball.
When one hears the phrase ankle sprain, most athletes/exercise enthusiasts can envision a person 'rolling' his or her ankle and then enduring that terrible sharp pain that might seem to nag forever when trying to plant, pivot, run, etc. Much like most topics in sports medicine, anatomy is important in breaking down and understanding ankle sprains.
The 4 main movements that the rearfoot is responsible for are:
1. Dorsiflexion (Pointing your foot upwards towards the shin)
2. Plantarflexion (pointing the food downwards like pushing on a gas pedal)
3. Inversion (Turning the ankle inwards so the side of your foot is facing the ground)
4. Eversion (The alternative of inversion in which the ankle turns the foot outwards)
The rearfoot, which is also sometimes known as the talocrucal joint, is really a hinge joint that's found at the distal end of shin bones (the tibia and fibula) and the upper part of one of the foot bones known as the talus. The ends from the shin bones form a deep socket known as the maleolar mortise. This deep pocket serves to both stabilize the joint and behave as an anatomic pulley to help make the characteristic motion from the ankle.
In addition to the bony stabilization of the ankle joint we have a lot of ligamentous structures that actually work to help contain the bones together in a stable pattern and endure the many stressors we placed on our bodies.
As previously mentioned, most ankle sprains occur as inversion injuries because of the way we tend to twist/roll-over on our weight-bearing leg when we have shoes on. The twisting motion at the joint puts lots of stress on areas of the lateral ligaments (outside) called the anterior talofibular (most often injured) and also the calcaneofibular (second most commonly injured). These injuries most commonly increase the risk for pain and swelling on the outside of the ankle that people experience with sprains.
The less common ankle sprains involve eversion injuries, which occur whenever we roll out ankles outwards and overstretch a ligament known as the deltoid ligament. This can commonly cause pain, swelling, and may cause instability inside portion of the ankle.
For additional info on the classification of ankle sprains and common treatments, you can check out a previous article I wrote a few years ago in reaction to our beloved, Rob Gronkowski's 'high' ankle sprain right before the playoffs.
With a much better understanding of the anatomy, we are able to discuss ankle sprains in basketball and the thought/theory behind Dr. Katz's technology. A 2010 study published in JBJS concerning the epidemiology of ankle sprains indicated that incidence of ankle sprains in america 2.15/1000 people per year. They also stated that overall, there isn't any improvement in incidence between men and women, but that whenever one examines the population between 15-24, males have a higher incidence (7.2/1000 people) when compared with females.
The research also demonstrated that 49.3% of ankle sprains were associated with sports as well as those ankle sport-related ankle sprains, an overwhelming 41.1% of these were basketball related. To further illustrate sport-specific data regarding ankle sprains, a study in the British Journal of Sports Medicine that examined sport-related ankle sprain epidemiology reported that 70% of basketball players described a history of ankle sprain which 80% of them reported multiple sprains. Using the rapidly growing popularity and marketing of basketball over the past many years, the dpi is probably a bit higher and also the number of chronic ankle injuries might be under-represented.
Chronic ankle problems typically lead to increased residual symptoms such as pain, muscular weakness, instability (ease of giving way), swelling, stiffness, and crepitus (cracking). Furthermore, numerous studies show that recurrence seems to be fairly high, giving way to an athlete who appears to perpetually be sidelined with ankle troubles.
Although this is definitely not surprising to anyone who has ever played basketball, it will be implies that from a sports medicine standpoint that concentrate on ankle injury prevention in basketball is critical to keeping player in the game and healthy. Sure, we can treat ankle sprains rest, ice, elevation, compression, anti-inflammatories, braces, or even surgery, but the the easy way help a sports athlete is to prevent them generally.
This is when Dr. Katz thought he could make a move to assist. Together with his experience playing basketball and his knowledge of orthopedic anatomy, he remarked that the best way to approach ankle sprains is as simple as redesigning probably the most critical piece of equipment that the basketball player uses, the shoe.
In each and every sport, footwear is important to performance. We have sport-specific footwear for from wrestling to ballet, yet with ankle sprains being so common in basketball, the fundamental design of the shoes haven't really changed too much over the past decade.
Since the advent of 'Chuck Taylors,' basketball shoes have always been high-topped shoes with about adding extra ankle stability. As the higher support helps in reducing the allowing this to continue motion from the ankle, it does not help much an excessive amount of with preventing inversion, which as we've discussed earlier is the culprit to 95% of basketball sprains.
Dr. Katz describes the importance of shoes in ankle sprains, by indicating that the reason one commonly sprains an ankle is that the feet are another object from the shoes. Once the shoe becomes inverted, the ankle slides within the shoe, inducing the lateral side from the foot being almost parallel towards the floor. His solution to this problem was to add several strategically placed straps inside the shoe that aim to secure the wearers foot to the shoe.
Specifically, the very first strap wraps round the walls of the shoe to support the lateral components of the ankle, whereas the 2nd strap lays directly within the ankle mortise to prevent the wearer's foot motionless within the shoe, thus attempting to get rid of the aforementioned phenomenon of the foot sliding within the shoe.
In addition to the two straps, the sole from the shoe has a lateral piece of rubber put on the exterior of the shoe that serves as bumper, to assist prevent roll-over injuries.
So does the shoe work? Well, in the limit data that's available, it appears that the shoe does a pretty decent job at preventing inversion from the ankle. After being sent the draft of the unpublished study performed at Drexel University, we've got the technology applied to the shoe certainly looks promising. The study was limited, only using five subjects and examining the right ankle. Subjects were tested in both their standard basketball shoe along with the Ektio shoe and an Ankle Flexibility Tester (device that enables cyclic load-unloading torque to become applied) was put on test inversion, eversion, and internal/external rotation.
Their results established that the shoe limited inversion from the ankle to under 30 degrees, which is significant for the reason that most ankle sprains occur at angles of inversion more than 30 degrees. Furthermore, it appears that the increased stability with the Ektio shoe in terms of limiting inversion was between 14-20% as compared to the standard shoe. While there was a statistically significant increase in stability limiting ankle inversion, this research didn't appear to significantly limit any of the other 5 motions within the ankle, that are crucial in performing the necessary movements for success in basketball such as pivoting, shifting jumping and running.
Though the study is unquestionably interesting and promising with this new technology, it's significantly weakened by the small sample size and could certainly display an increased power if more subjects were added to the research design in the future. Furthermore, it was not indicated if the standard basketball shoe was exactly the same make/brand on each one of the players. In a study examining shoes, it is really an important variable to address.
This leads one to ask another question, when the shoes are limiting inversion, perform the wearers feel that the shoe is different compared to standard shoes they are utilised to? I had been given the chance to consult with former NBA player, hall of famer, and spokesperson for Ektio, Rick Barry, who indicated that he didn't feel any improvement in wearing the shoe. He stated that when he was contacted about the shoe concept, he was intrigued and wanted to give it a try. When he realized how the shoe felt and the fact that it seemed like it might create a real difference in terms of preventing ankle injuries, he desired to jump in to advertise it. Mr. Barry also joked with me, proclaiming that he is able to with certainty state that the shoe doesn't feel much different than other basketball shoes because his youngest son, who's quite picky, wears them with no complaints.
Though anecdotal evidence is great to hear, it's always better to see empiric data. This really is were a study in the Hospital for Special Surgery comes in. They examined the Ektio shoe versus bare feet, standard basketball shoe, and a standard shoe with an ankle brace, while participants were involved in normal basketball activities such as running, jumping, and pivoting and recorded muscle firing patterns within the gastrocnemius/soleus complex, the tibialis anterior, and the peroneus longus muscles. Out of this data, they figured there have been no significant differences between the Ektio shoe and the standard shoe or barefoot, which indicates there seems to be no compensatory force on the other facets of the ankle or leg because of the limitation of inversion to less than 25-30 degrees. It also might point to that the athlete is not performing any differently on the court while wearing this shoe.
Regardless of the small size and also the rawness from the data presented in these preliminary studies, the idea of the shoe and the construct from the technology is promising to hopefully help in reducing ankle sprains inside a sport by which ankle sprains affect more than half from the participants.
Through my conversation with Dr. Katz and Rick Barry, it seemed these individuals truly want to produce a shoe and promote a product that not only performs well in the game, but additionally keeps the athlete safe. Rick Barry said, 'Any current player would be stupid to not want to get their hands on these.' He indicated frustration with the fact that it is not easy to obtain a shoe to be worn in the NBA due to the multi-million dollar contracts that larger companies can offer teams and players to wear their product.
So what's next with this product and also the future of Dr. Katz's technology? Gurus Dr. Katz if he considered expanding his design construct to other sports and possibly conducting a larger study. He explained that he certainly want to expand and modify his construct to use to other sports where ankle injuries are prevalent for example football. Furthermore, he stated that he also has a desire for including his construct in military combat boots to assist prevent ankle sprains within our soldiers who currently experience difficult terrain and incredible force on the ankle and legs.
Overall, the Ektio shoe appears to be an encouraging product with a well considered design and construct. It's refreshing to determine footwear being marketed with a small company having a specific goal of helping keep your athlete safer as opposed to the more common, overly expensive shoes with flashy colors and an athlete's name branded throughout them. Though I cannot say set up data in the preliminary studies will continue to carry true inside a more comprehensive study with more participants and tighter controlled variables, the preliminary data is really interesting and something to keep track of as Dr. Katz is constantly on the try to gain ground in the tough world of marketing a sporting equipment.
Transpire on paper this piece was not to advertise a specific product, or suggest that every athlete needs a particular shoe. This is certainly not true. Every player is slightly different in terms of their ankle construct and biomechanics, and really should select equipment that most closely fits his or her needs. It is, however, my opinion that being best informed concerning the options that are available, particularly the ones that do not get billboard or magazine advertising, is important in selecting the best products for your physical and structural needs. Reducing ankle sprains in sports (especially basketball) has been an important topic in sports medicine for quite some time. Just like any sports injury, there are no products that can completely prevent something from occurring and that we should be aware injuries as they occur and treat them within the easiest ways possible. Adequate training both on and off the playing field or court, as well as appropriate rest and recovery are critical in almost any sport. Adjunctive products may offer benefits in prevention and management of injuries, but always remember to find adequate assessment associated with a injury with a qualified doctor.

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