Visit from Storz Medical

Visit to Storz medical

Visiting these days STORZ MEDICAL AG in Switzerland.

The purpose of the visit is to get an update on technology, knowledge and to expand the good cooperation we have, in terms of equipment and teaching.

When I'm in the factory, I have the opportunity to talk to product specialists, developers, engineers, sales and market things, where I can expand my knowledge in terms of knowledge and technology.

At the same time, I have the opportunity to bring my experience back to them, which can be translated into the development of products and concepts, together with the other reference specialists they have in their network. Things that may end up in new protocols, or changes in functionality on the product side.

Last night I had the pleasure of being to dinner some of the ESWT founding fathers and where that I especially with Prof. Dr. med. Jens Rassweiler(also a guest at Storz these days), had a great chat about the possibilities and what direction we might need to look in relation to treating peyronies and erection problems with shockwave.

It has been a really good trip and the next foreign workshop trip will probably be to Dubai with focus on Urological shockwave and orthopedic indications (muscles and tendons)

Dinner with founding fathers and Storz representatives

Interview mit Shockwave

Last week Michael was interviewed by an English shockwave expert, in relation to the use of shockwave, and the various issues he works with

Watch the full interview here, please note it is in English

Case study in Scoliosis and shockwave

Shockwave and scoliosis

Scoliosis is a frequent problem for wheelchair users with cerebral palsy (CP), and has a direct impact on their quality of life. It also has an impact on how long they can sit upright in their wheelchair. Therefore I did 2 shockwave treatments in the clinic on 2 young (17 and 23 years) wheelchair users with scoliosis. The aim was to see how the treatment affected their quality of life with 3 treatments using a standard protocol, inspired by a studie made ofMirea A¹, Onose G², Padure L¹ and Rosulescu E³. It looked at how to improve function and reduce pain in affected muscles. Their conclusion was as follows:

ESWT, applied in 3 sessions, with 0.15 mJ/ mm2, using 500 shocks/ min and 10 Hz as frequency may decrease children spasticity level and pain caused by it and improve the gross motor function.

Test setup

The trial I set up was with 3 treatments with a protocol that focused on the muscles that affected the curvature of the back, that is, the muscles with the greatest degree of hypertonus. Her blev brugt en protokol på 2000 skud med fokuseret shockwave med en intensitet på 0.20 mJ/mm. Work was done around the long straight back stretcher and adjacent muscles that affected each patient. Then 500 shots of focused shockwave with an intensity of 0.20 mJ/mm were fired into the illacus (the muscle that attaches to the hip socket) of the most affected side. Finally, 2000 shots of radiating shockwave were fired into the psoas major (deep hip flexor) at an intensity of 2.0 bar. We did this 3 times, one week apart. Follow-up was then carried out 1 and 2 months after the end of treatment.

I have previously done a more intensive case study within the same group, which showed a positive improvement. Here, however, the course was with 8 treatments over 4 weeks.

The equipment for the treatment has been a Storz Duolith SD1 T-Top Ultra and a Storz Masterpuls MP50 Ultra.

Result

Both participants are in the category of severe scoliosis, and thus have impaired digestion and breathing. This means that there are still different pain symptoms, which can be difficult to distinguish. However, the parents of the 2 patients noticed less muscle tone and more flexibility in everyday life. This increased the sitting time in the wheelchair. Motivation to exercise/sit is controlled by the level of pain, and the course of illness after the treatments related to digestion and flu in the participants, has made it difficult to assess 100% on the set parameters related to motivation and sitting time.

The patient group with CP is often affected by disease, which can make it difficult to make a 100% clinical assessment based on established criteria. As in other studies done on CP and Shockwave, it is seen to have a positive impact on pain and functional level in particular.

The same dose and intensity are used for all treatments. This should be varied from person to person, as well as in response to the respective pain level, in future courses of treatment. This will be to ensure maximum impact of the programme.

Conclusion

3 treatments, one week apart, provide a reduction in pain level and muscle tone for up to 2 months after completion of treatment, for wheelchair users with scoliosis and CP

Achilles and patellar tendon injuries

New knowledge

Last Friday I attended the 15th Sportfisio symposium, where the focus was on Achilles tendon and patellar tendon injuries. It was a day of introducing the latest research in the field, and particularly in relation to the whole rehabilitation component. The main theme that ran through the day was that in order to effectively get back into sport, you need to train. It must be relevant training and it must be structured.

A good expression is use it or lose it. It is a very good indication of the strategy to be chosen once the damage has been done. Australian Ebonie Rio has done a number of studies in the context of injuries to tendons in the knee and Achilles, and has created the concept Tendon Neuroplastic training . The concept, in its simplicity, is to create a strength training programme appropriate to the injury in question, with the pace controlled by a metronome. This is done to stimulate the brain and bring quality to the exercises. If you do not train after an injury, the good normal fibre structure of the tendon will not be rebuilt. This could cause repercussions and reduce the possibility of good functioning over time.

MS Insight-Ansatz

My approach to Achilles tendon and patella tendon injuries consists of 2 elements, treatment and training.

Treatment in the clinic to reduce pain levels and stimulate biological healing processes in the tissue using shockwave and laser.

In addition, a targeted strength programme should be designed to ensure an effective return to the sport of primary focus. Here, we work from a functional perspective, and not solely from a time perspective.

When should I do something?

As soon as you start suspecting an injury, it’s about taking action on it. It prolongs the process by thinking it will pass on its own. So be as proactive as you are when training or buying equipment for your sport. It is a good investment in your body to get effective help from the start.