Orthosis/ Sports injuries/ Supports

Acute care is crucial

Returning to sports in orthopedics

From Bauerfeind Life Magazin

In short Dr. med. Sebastian Mittelhaus is a Specialist in Orthopedics and Trauma Surgery in Berlin and a DOSB Functional Coach. He has been supporting the athletes of the German Deaf Sports Association as team physician since 2012 and as the association’s chief physician since 2014. In May 2022, he accompanied the German national team at the 24th Deaflympics in Brazil. His companion during the games: the Bauerfeind emergency case to ensure safe care of the athletes. Depending on the competition, deaf athletes sometimes suffer different injuries compared to hearing athletes. They are more likely to suffer unexpected injuries, especially in contact sports, resulting in specific fall patterns because they lack acoustic signals and warnings. When an athlete gets injured during competitions, it is important to get to obtain a precise diagnosis and provide appropriate acute care to allow them to “return to their sport” as soon as possible. The braces in the Bauerfeind emergency case were used for the entire range of typical sports injuries. The revised AirLoc ankle brace for limiting pronation and supination has been very well received by athletes due to its easy handling and great comfort in the shoe.

Held every four years, the Deaflympics are a major sporting event that challenges athletes and medical professionals alike. Dr. Sebastian Mittelhaus supported the German team as Chief Physician. With the help of the Bauerfeind emergency case, he and his crew were able to allow most athletes to continue in the tournament even after sustaining an injury.

life: People associate a certain background noise with sporting events. What do Deaflympics sound like?

Dr. Sebastian Mittelhaus: The Deaflympics are by no means “silent games”, there are far too many people present – coaches, referees, support staff and the audience. And you need to remember that most athletes either have a cochlear implant or a high-performance hearing aid. For the competitions, the regulations specify that all hearing aids must be removed, but otherwise, athletes also communicate verbally, unless they’re using internationally recognized sign language as the primary means of communication. That depends on the degree of hearing impairment.

Dr. med. Sebastian ­Mittelhaus, Specialist in Orthopedics and Trauma Surgery

Who was in your team and what equipment did you take with you to Caxias do Sul, Brazil, this year?

Dr. Sebastian Mittelhaus: We were two physicians, a general practitioner and myself as an orthopedic and trauma surgeon, as well as ten physical therapists. From a medical point of view, it is a great challenge to adequately care for the athletes in such a competition, given the small size of the medical team compared to regular Olympic Games. This is where acute care services are crucial because “returning to sports” takes top priority: after all, the athletes have put in many years of intensive preparatory training to compete for these few days. The Bauerfeind emergency case with supports and braces was a valuable asset for us.

Two weeks, 11 disciplines, 75 athletes – how did you divide up your team’s resources?

Dr. Sebastian Mittelhaus: We, the two physicians, focused on providing care for contact sports such as football and handball at the competition venues. We know from experience that we get more injuries here compared to swimming or sport shooting. So, wherever we couldn’t be present, a lot of responsibility lay with our physiotherapists, who remained in close contact with us. Due to budget constraints, our team was small, but still highly focused and professional despite the typically long hours.

Do deaf athletes tend to have different injuries compared to hearing athletes?

Dr. Sebastian Mittelhaus: Yes, that’s indeed the case in some sports, because there is some acoustic information that is not conveyed, such as warning calls or verbal coordination between players. This comes into play especially in contact sports, for example, when an athlete cannot hear an opponent running up behind them. This results in enormous potential for unexpected injuries. The injuries are not necessarily more severe, but they have slightly different characteristics, for example, the fall pattern is different. For instance, in case of unexpected counter-contact from behind or after a duel in mid-air and loss of balance, a deaf athlete will fall differently in certain situations compared to someone who might anticipate that fall.

On their way to the Deaflympics together: Athletes and support staff of the German Deaf Sports Association, where Dr. Sebastian Mittelhaus takes on the role of the association’s Chief Physician.

“’Returning to sports’ takes top priority: after all, the athletes have put in many years of intensive preparatory training to compete for these few days.”

Dr. med. Sebastian ­Mittelhaus

How badly was the national team affected by injuries?

Dr. Sebastian Mittelhaus: In terms of trauma, the most serious injuries in the entire delegation were a tibial head fracture, a ruptured anterior cruciate ligament, a meniscus tear and a muscle bundle tear. We had to withdraw the injured athletes from the competition. Typical standard cases in sports include, of course, muscle injuries and dislocation traumas to the knee and ankle. After an initial check of the ligament stability and diagnostic X-ray imaging, we were always able to provide appropriate acute treatment in these cases using the Bauerfeind braces, which contributed to pain reduction and stabilization of the injured body part. We were also well equipped to provide medication and physical support using electrotherapy or ultrasound therapy. This allowed us to clear most of the athletes to compete again. The advantage you have with competitive athletes is that they are often already experienced in dealing with injuries. And many already know some of the products, so we didn’t have to explain much at all.

Which Bauerfeind braces were used?

Dr. Sebastian Mittelhaus: The emergency case covers the entire range of typical sports injuries, and we actually used everything. There were dislocated shoulders, which we reduced on site and immobilized with the OmoLoc. Equally important for us was the GenuLoc following dislocation trauma to the knee. In terms of acute care, the AirLoc for the ankle was definitely one of our top picks: the athletes took it right out of my hand and put it on themselves so well that it fit almost perfectly. The entire handling of the AirLoc is extremely user-friendly. A huge plus is the soft inner surface with the air cushion for self-adjustment as well as the fact that the brace can be used both the left and right foot. A compression bandage with the AirLoc on top ensures appropriate acute care and prevents a larger hematoma from developing in the first place.

You have been a team physician for the German Deaf Sports Association (DGSV) since 2012. How does your experience working with deaf athletes impact your day-to-day professional practice?

Dr. Sebastian Mittelhaus: In my practice, I see quite a number of hard of hearing patients. This sort of happened over the years. They tend to be recreational and also competitive athletes, but also other normal patients. There is still lack of awareness in the medical profession in general for dealing with the hard of hearing. This applies to very simple things such as properly visible lip movements when speaking and remembering not to explain something while standing behind the patient or while turned toward the screen. Wearing masks in everyday life hasn’t exactly made this any easier, which underlines the importance of clear, ‘face-to-face’ communication.

Braces in cases of emergency

Bauerfeind is a reliable partner for competitive athletes. The focus is on “returning to sports”, meaning stabilization and pain reduction to enable the athlete to continue participating in the competition even after getting injured. The Bauerfeind emergency case is equipped with a wide range of small stabilizing braces, perfectly suited for dislocation injuries that we frequently see in sports: AirLoc, GenuLoc, OmoLoc, ManuLoc long and RhizoLoc.

The new AirLoc

The air-cushioned AirLoc ankle brace has recently been revised and further improved to provide even more comfort. The new generation is available in a universal size that can be worn on both the right and left foot. For compression and individualized adjustment to match the state of swelling, an air cushion is integrated on the lateral side, which can be easily regulated from the outside via a pump and a valve. This brace can be worn for up to six weeks after the trauma to protect against recurring sprain injuries.

Images: Bauerfeind, Manuel Tennert, Anton Schneid/Schneid & Kleinert, Quelle DGSV e.V.

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