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If you’re experiencing pain and stiffness along your Achilles area then chances are you may have Achilles Tendonitis. Achilles tendonitis is the inflammation of the Achilles tendon above the heel and can be caused by an increase in high impact activities such as running or jumping.

The Achilles tendon joins the calf muscle (Gastrocnemius) to the heel bone (Calcaneus) which is the largest and strongest tendon in the body; however, due to poor blood supply to the tendon, damage takes longer to heal than other soft tissue injuries.

Symptoms & Causes

Achilles tendonitis can present as pain anywhere along the tendon, localised warmth, mild swelling or pink/redness. Pain is intensified when you push up on your toes and lift your heel off the ground. This is due to the tendon contracting and being put under load. Achilles tendonitis is often worsened by:

• An increase in usual running distance
• Running uphill frequently which creates a repeated stretch on the Achilles tendon as the ankle is positioned in dorsi flexion (position where the toes point up towards the body)
• Pronation and over pronation. This is when the foot rolls inwards and the arch of the foot collapses, this position increases the strain on the Achilles and can cause injury
• Wearing high heels

Achilles tendonitis is a common overuse injury in athletes. The Achilles tendon can be put under stress from overuse of the calves in physical activities such as running and cycling. It is seen in runners who are doing excessive sprinting and speed work but not stretching enough when their calves are tight. Further to this, cyclists whom have their seat position too low are putting their Achilles tendon under stretch due to the foot and ankle being in a dorsiflexed position on the pedals.

Each time the Achilles tendonitis heals, it repairs with a small amount of scar tissue or adhesions. Adhesions will build up over multiple injuries to the Achilles tendon, making the tendon less flexible. Therefore, you should rest and treat the tendonitis as soon as possible. Here are some ways to prevent and treat Achilles tendonitis.

Treatment & Prevention

Stretching

It is important to always stretch the calves, hamstrings and Achilles to maintain strong and flexible leg muscles. One way to stretch the Achilles tendon is to stand with the knees very slightly bent, lean the body forward to reach for the floor. Take deep breaths in and as you exhale allow your body weight to move your torso closer to your knees and your hands will reach further towards your feet. You should feel an obvious stretch behind the knee. This is stretching the hamstrings and the calf muscles.

Another gentle stretch is keeping your feet and heels planted on the floor, shoulder-width apart whilst keeping the torso straight and upright, bend the knees forward. Aim to get your knees bending over the toes or further. This squatting position is stretching the Achilles nicely.

Footwear

If you have Achilles tendonitis, it is best to avoid wearing high heel as wearing heels puts the Achilles tendon in an excessively shortened position. This leads to premature tightness of the tendon and puts them at higher risk of tendon injury when you exercise. Ensure your running shoes are suitable for your foot type. It is important to wear shoes that support the foot and the motions made by the foot whilst running. If you are thinking of increasing your physical activity do it gradually to avoid stress or inflammatory injuries.

Heel Raises

In-shoe heel raises are suitable for pain relief in Achilles tendonitis. A heel raise is a wedge-shaped foam rubber insert, around 6-10mm in height and is placed in the shoe under the heel. Lifting the heel increases the ankle angle and slightly shortens the Achilles tendon to reduce the strain on the tendon. This allows the tendon to heal. You should also limit intense exercise when you have Achilles tendonitis to aid healing, as you risk putting impact and stress through the tendon which can increase the inflammatory response.

Visit www.oaplshop.com.au to see a range of products used in the treatment of Achilles Tendonitis

Trilaminate Heel Raise (Three in one)	Footbionics Heel Raises (5 Pack)	Bioskin Trilok Ankle Brace

What is Sever’s disease? 

Sever's Disease is a cause of heel pain in children. The disease occurs when the growth plate of the heel is repeatedly injured by excessive forces during adolescence. Typically, sever’s disease is common in physically active growing children. The growth spurt of adolescence commonly occurs anytime between 8-13 for girls and 10-15 for boys and generally, patients will describe a dull ache in the heel, particularly during activity

Common visual symptoms include limping or walking/running with an awkward gait pattern. Parents are usually the first to sight the symptoms, or invariably the child’s coach/teacher. At home, parents can check pain levels when the child rises on to their toes – it will invariably increase. The heel pain is commonly felt on one foot but can be bilateral.

OAPL Plantar Fasciitis Sock for Management of Sever’s Disease

Sever’s disease can be treated with a multifactorial approach. Shock absorption around the heel is paramount during both the early and long-term management of the problem. This helps to reduce the accumulative load on the painful region. Our Plantar Fascia support sock will provide appropriate pressure relief under the heel apparatus with our silicone heel cup. This is designed to provide a cushioned and elevated feel under the heel.

Overall, our sock has the capacity to elevate, compress and alleviate heel symptoms particularly in active children who suffer from sever’s disease. This treatment method would be recommended in addition to regularly icing, resting and stretching; in conjunction with wearing comfortable, well fitted shoes as prescribed by your allied health professional.

For more information on our Plantar Fasciitis Sock call us on 1300 866 275 to book an appointment in one of our clinics or view our online shop. Plus, for a limited time only save 30% when you buy 2 Plantar Fasciitis Socks.

Oapl introduces the RehaGait Analyzer - Part 2

We are excited to introduce the new RehaGait Mobile Gait Analysis System to our customers in Australia and New Zealand. RehaGait is a completely portable system that takes minutes to set up. In just moments, you can record, measure, analyse and report on one’s gait patterns which makes it ideal for clinical analysis on the go.

This blog takes you through the setup and application of the RehaGait. Remember, all you need is your subject and enough space to walk 8-10 steps.

Hints and tips:

Everything we talk about in this article has come from the manual, so if you’re having troubles with your unit, slow down and refer to the manual. Hasomed has provided this in-depth resource to ensure using the device is easy! However, there are some basic things that are easy to forget.

 

• The RehaGait works on a Windows tablet so always ensure your tablet is fully charged before use. The battery life differs depending on the programs and functions you are using.
• The Bluetooth Motion sensors have about 11 hours battery life and are charged using a micro USB which plugs into each of the sensor hard cases. Ensure these are always charged before your subject arrives in the clinic to avoid delays in charging them - this will minimise the chance of a sensor switching off during a gait cycle.
• Don’t forget your patient safety. Patients with a high risk of falling are contraindicated for the use of this device. You as the clinician must identify if the patient is able to walk independently, with an aide, or with physical support.
• In the case that you are supporting or holding your patient as they walk, we recommend you have a carry bag for the tablet whilst you are moving.

Application:

• The Rehagait can be used with just the foot sensors or with all 7 sensors. 
• Shoes should be worn throughout gait recordings.
• Shoes shouldn't have a heel height of more than 2 cm (Small/paediatric foot straps are available)
• Foot sensors must be secured well. 

If you are attaching the other five sensors make sure they are secured tightly, and the sensors are on the lateral aspect of the legs. Ensure the lower leg sensors are above the malleoli and the upper leg sensors are clear of the knee.

The sensors should be at the same height on both legs. The middle (hip) strap should sit over L4-L5 and be secure.

Connecting:

The software is intuitive and will prompt you through all processes. 

1. Firstly, log in and set up subject details and notes if required. (We recommend you do this before the client arrives to save time and energy) 
2. Required fields are name, height, gender, and shoe size.
3. Next, with your subject, attach the sensors and turn them on (power buttons on each of the hard Motion Sensor cases). The system will prompt you to connect the sensors to the tablet via Bluetooth. This can take a few seconds as the sensors register one by one. 
4. The system will then prompt you to perform a calibration. This is a two-step process, the subject standing still for 10 secs then the subject has the option to sit or stand for their moving calibration where the torso needs to be tilted back and forth (15deg)  and the legs need to be extended and swung forward 30 deg one by one. Only do this once or twice.
5. Once calibrated you are ready for measurement. Select to record your subject with video or without. The tablet can connect up to 20m away, however must be within 5 meters of the subject for the start and finish. Press start to begin measurement then count down “3,2,1 go”. At the end of the walking cycle the subject stops close to the tablet and waits 3 seconds before the “stop” button is pressed by the clinician.

For more information, technical specifications, demonstrations and costs:

Please call Lainie Plummer at oapl on 0413 629 464 or email lplummer@oapl.com.au to organise a time in your area.

OAPL is excited to launch our NEW Plantar Fasciitis Support sock! It has been designed in-house by our team of podiatrists to offer relief of plantar fascial symptoms, heel and arch pain, and ‘first step’ morning pain.

Designed with multizone compression to relieve swelling and discomfort, our new Plantar Fasciitis sock includes an innovative silicone heel cushion for pressure release and advanced cushioning in every step. Providing you with a product that serves as an all day, everyday management solution for a range of heel and foot conditions.

What is Plantar Fasciitis?

Plantar Fasciitis stands for ‘inflammation of the plantar fascia.’ The fascia runs along the bottom of the foot from the heel bone to the toes. It forms part of the arch of the foot and functions as one of our shock absorbing mechanisms. Unfortunately, the cellular makeup of the fascia is not as elastic as muscle tissue and is limited in its ability to elongate or stretch. Functionally, the cellular makeup of the tissue is prone to breakdown given too much traction placed on the fascia (for multiple reasons) leads to microtears, which in turn leads to irritation; inflammation and ultimately pain.

Symptoms wise, Plantar Fasciitis usually causes discomfort and pain in the heel region. Some people make experience arch pain. Both heel and arch pain discomfort are related to Plantar Fasciitis however pain experienced in the heel is far more common than arch pain.

Key features

• Medical grade compression to reduce swelling and discomfort
• Anatomic silicone heel insert built into the sock to relieve and elevate the heel
• Machine washable, breathable fabric
• Can be worn with or without footwear

Other uses:

• Chronic sore feet when standing for long periods
• Elderly patients suffering from fat pad atrophy in the heel
• Sever’s disease

Sock Care:

The Plantar Fasciitis Support Sock is made from a combination of polyamide, elastane, polyurethane, and cotton. The polyester insert is made from silicone. To ensure correct care of the sock, it is recommended that our sock is hand washed in cool water. The sock should be stored in a cool, dry place away from direct heat or sunlight. It is not suitable for bleaching, ironing, or tumble drying.

Sizing

For more information on our new Plantar Fasciitis Sock, you can view the product on our online shops. Alternatively, feel free to call us on 1300 866 275 or email us at info@oapl.com.au 

Oapl Introduces the RehaGait Analyzer - Part 1

We are excited to introduce the new RehaGait Mobile Gait Analysis System to our customers in Australia and New Zealand. RehaGait is a completely portable system that takes minutes to set up. In just moments, you can record, measure, analyse and report on one’s gait patterns which makes it ideal for clinical analysis on the go.

Objective results, combined with integrated video capture function allows you to monitor the patient's condition, determine problem areas, assess the gait quality and identify asymmetries in the lower limbs.

Advantages of RehaGait:

• Intuitive handling                                            
• Mobile use
• Objective data
• Results and course of the therapy are shown graphically
• No need for a gait lab, you can use it outside or on a treadmill
• Give the patient complete freedom of movement

How the system works

RehaGait software

Software comes pre-programmed on the included Windows tablet on purchase, this incredibly intuitive system allows you to perform the recordings quickly and easily and view the gait patterns on the tablet. All the most common functions are presented in an easy to navigate left-hand menu rather than buried in multiple complex menus. A custom report can be generated within 10 minutes of your subject walking through the door!

MotionSensors

The RehaGait Analyzer is equipped with 7 inertial sensors, which record spatio-temporal specific parameters during walking and running. The accuracy is clinically valid according to the gold standard and has been published several times in scientific studies (Schwesig et al., 2010, Donath et al., 2016). 

The motion sensors are attached at 7 points; around the waist, above the knees, above the ankles and on the proximal, lateral aspect of the foot or shoe. 

The motion sensors connect via Bluetooth to the tablet software and can be read from up to 20m away. 

These sensors utilise the inertia of the mass to detect movement changes. The inertial sensors consist of a three-axis accelerometer for recording the linear acceleration, a three-axis gyroscope for recording the angular velocity and a three-axis magnetometer for recording the earth's magnetic field.

What data will I receive after a 10 step cycle?

The analysis of the therapy progression may take some seconds depending on the number of measurement since the measurements are recalculated. After a successful analysis, you will find the flow charts sorted by parameter group. The course of parameters is shown as score model. The recorded value is compared with a maximum of 1.0 to the reference value median of the corresponding parameter. The individual measurement sessions are indicated on the horizontal scale and the corresponding score points are linked to a regression line. Thus, increasing straight lines between the measurement session points show an improvement of the parameter. The selection box allows you to use predefined groups to select gait parameters. The following parameter groups are available here:

Kinematics

The kinematics of the individual steps are displayed for such parameters as foot height, ground clearance, circumduction, velocity and acceleration. The representation of the left side is displayed in blue and for the right side in red. The mean value band (brightened hue of the respective side) represents the respective minimum and maximum of each step, the line representing the corresponding mean value. With the right selection box, you can also display the individual steps next to each other. A grey band in the background represents a reference range that is calculated for each percent in the gait cycle from the respective 5th to 95th percentile of a healthy reference group.

Comparison, a Means of Justification

RehaGait analysis software uses a database for patient management and storage of measurements and analysis results. In this way, the user has at any time access to older measurements in order to compare them to each other or to present and evaluate the therapy progress parameters.

Compare interventions:

Efficiently compare a patient without the device, then with a device or vice versa. Show your patient before and after videos of them walking with different devices and compare which device creates the most aesthetic gait pattern versus the most functional gait pattern.

Reporting Back to a Referrer

The system gives the practitioner the ability to export information and send to referrers or other practitioners working in a multidisciplinary sense. To report your results, you can create and print a report. The report is created for the analysed measurement of the selected patient. If you have analysed two measurements for a comparison, both measurements are shown in the report.

Studies

• Validity and reliability of a portable gait analysis system for measuring spatiotemporal gait characteristics: comparison to an instrumented treadmil. Schwesig R., Leuchte S., Fischer D., Ullmann R., Kluttig A. Gait & Posture 33 (2011), Issue 4, 673–678, Elsevier 2011. Donath L., Faude O., Lichtenstein E., Nüesch C., Mündermann A. J Neuroeng Rehabil. 2016 Jan 20;13:6. doi: 10.1186/s12984-016-0115-z
• Spatiotemporal gait parameters during dual task walking in need of care elderly and young adults. A cross-sectional study. Agner S., Bernet J., Brülhart Y., Radlinger L., Rogan S. Z Gerontol Geriatr. 2015 Dec;48(8):740-6. doi: 10.1007/s00391-015-0884-1. Epub 2015 Apr 16
• Amplitude-oriented exercise in Parkinson‘s disease: a randomized study comparing LSVT-BIG and a short training protocol. Ebersbach G., Grust U., Ebersbach A., Wegner B., Gandor F., Kühn AA J Neural Transm (Vienna). 2015 Feb;122(2):253-6. doi: 10.1007/s00702-014-1245-8. Epub 2014 May 29
• Inertial sensor based reference gait data for healthy subjects. Schwesig R., Leuchte S., Fischer D., Ullmann R., Kluttig A. Gait & Posture 33 (2011), Issue 4, 673–678, Elsevier 2011

For more information, technical specifications, demonstrations and costs:

Please call Lainie Plummer at oapl on 0413 629 464 or email lplummer@oapl.com.au to organise a time in your area.

Check back in on Friday the 17^th for a video on how to apply and use the RehaGait Analyzer in a clinical setting.

Oapl would like to introduce Liam, Senior Orthotist from our Sunshine Paediatric and Flemington clinics.

Liam has been treating children with Deformational Plagiocephaly for 8 years and has previously spent over 3 years at the Royal Children's Hospital in Melbourne learning and developing treatment methods for paediatric patients. He has seen the development of new technologies such as 3D scanning systems and foam carving replace the old and dated plaster mould methods. Here is Liam describing the process of developing plagiocephaly helmets and the technology used in our oapl clinics…..

"Now In my fourth year treating across a range of oapl clinics, I am very excited to introduce the STARband® system from Orthomerica. This is a non-invasive and supremely accurate treatment method used to fabricate a cranial remodeling helmet. The process begins with an initial scan, which only takes minutes to complete and is done by taking a series of still photographs with a Samsung phone camera. There is no radiation or lasers and as such the process is pain free and relatively stress free for both the child and parent.

Once the scan is taken, a 3D image is generated and can be modified and viewed on a PC. The Measurement and Comparison Unit (MCU) is a state-of-the-art software package that an orthotist can use to provide concise and objective measurements of a child's head shape. Whether treating conservatively, with a helmet or just monitoring for growth, the MCU will show comparative changes in growth and symmetry. Using the MCU software a pdf report can be generated to clearly illustrate changes over time which can be communicated with parents and other health professionals.

The STARband® has been used to treat over 300,000 patients in the USA and is only available in Australia through oapl. We currently offer a wide range of cranial remolding orthosis designs, each created to effectively manage a variety of head shape deformities, levels of severity, and clinical indications. Treatment with a remodeling helmet usually begins at around 6 months of age and takes around 3-4 months depending on the patients age and severity. Due to the precise nature of the scan, a custom fabricated helmet ensures accurate fitting and enables much more symmetrical growth than alternative fabrication methods.

We are continually finding more and more clinical evidence that supports the positive results of helmet therapy. In 2015 Steinberg et al in the Plastic and Reconstructive Surgery Journal showed that conservative and helmet therapy were both found to be effective in the correction of plagiocephaly. The usage of a helmet eliminated the factors that lead to failure in conservative management and may be more preferable from the outset. It was also highlighted that any delay in helmeting due to trialing conservative treatment does not ruin the chance of future correction as long as the helmet therapy is begun during growth stages at around 6-8 months of age."

For more information on the STARband® range and our clinical services please contact us. Alternatively, you can read more about Plagiocephaly here: http://www.oapl.com.au/plagiocephaly-helmet-therapy

OAPL is excited to announce the addition of Medstock wound care dressings into our range.

Medstock is an Australian owned and manufactured range of basic and advanced wound care products designed by a group of general practitioners. Commencing their operations in 2011, their motto is to support the healthcare community through a new approach to wound care; convenient and low cost products at a reasonable price.

We have introduced six styles of the Medstock range (see flyer below)

Here are four examples of pathologies where Medstock could be used within your clinics:

⇒

MEDSTOCK SILICONE FOAM

• MINOR SKIN TEARS                               
• PARTIAL THICKNESS BURNS
• FRAGILE SKIN

   ⇒

MEDSTOCK FOAM

• PARTIAL TO FULL THICKNESS LOW TO MODERATE EXUDATING WOUNDS       
• PARTIAL THICKNESS BURNS
• ADAPTIVE TO DIFFERENT PHASES OF WOUND HEALING  

⇒

MEDSTOCK ALGINATE

• ACUTE AND CHRONIC HAEMORRHAGIC WOUNDS
• MODERATE AND HEAVY EXUDATING WOUNDS
• SKIN DONOR SITES

⇒

MEDSTOCK HYDROCOLLOID

• LOW EXUDATE WOUNDS ONLY    
• GRANULATING AND EPITHELIASING WOUNDS
• SUPERFICIAL AND SMALL BURNS
• NOT RECOMMENDED FOR INFECTED WOUNDS

To purchase the range of Medstock dressings visit our online shop. You can also compare the full range of Medstock dressings by viewing the below comparative sheet.

Meet Len Elliot, the first ever above knee amputee to pass the QLD Police Force Functional Capacity Test

Len Elliot is a Queensland Police Officer that was hit by a motorcycle during an RBT on the 14^th April 2014 on the Sunshine Coast. The motorcycle was travelling at 180 km/h and the impact resulted in Len becoming an above knee amputee.

Such a life changing event would have made many people think of a career change. However, Len is not like most people.

The first prosthesis was fitted to Len in October of 2014, he could walk with the prosthesis however felt that he was not reaching his full potential.

In March 2016, a new team began working with Len. The new team was comprised of Saul Geffen (Rehabilitation Specialist), Jacqui O’Sullivan (Physiotherapist) and the team at OAPL prosthetics in Brisbane. Working closely with Gabriel form Work Cover and Sue form the Queensland Police a new plan was established.

A new prosthesis was fitted and a new gait training program commenced. Len experienced an immediate improvement. He became more active, started running and cycling again. The improvement was so great that he began competing regularly in triathlons towards the end of 2016.

On the 7^th of March 2017, Len Elliot became the first above knee amputee to pass the Functional Capacity Test in Queensland, a requirement if he is to return to active duty in the Police force.

Undoubtedly the effort has come predominately from himself, however as Len stated, he has not worked in ‘isolation” and this achievement would not have been possible without the support from the professionals he began with early in 2016.

We wish you all the best in your future endeavours Len and congratulations on your amazing achievements so far!

 

YPSILON FLOW

Recommended application:
Foot drop in combination with no spasticity to moderate spasticity. Limb proprioception deficit and mild proximal deficit.

Contraindications:
Severe edema, leg ulcers, moderate to severe spasticity, medial-lateral instability.

Other:
Interface and strap included. More information about product selection and customisation can be found below.
Please note the Original Ypsilon is still available for you current users.

Resting Hand Orthosis

S.O.T is a resting splint for the spastic and paretic hand, when the goal is to maintain or increase the mobility of the hand.