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Train supports in sports physiotherapy Numbers don’t lie

Issue 03/2018

Treating patients is one thing; conducting research and incorporating research results into physiotherapy techniques is something completely different. For Dr. Alli Gokeler from the Netherlands, however, both generally amount to the same thing: prevention.

“Would you like to learn how to prevent sprains?” Physiotherapist Dr. Alli Gokeler from Groningen in the Netherlands always asks this question when he talks to sports clubs, and just about every sports club is interested in what he has to say about the subject. After all , ankle injuries are the most common sports injuries among both professional and amateur athletes. Twisting injuries account for nearly half of all sports injuries worldwide, whereby people who play volleyball and basketball are particularly prone to such injuries. Before asking the question mentioned above, Dr. Gokeler likes to present some figures he’s compiled.

“Sprains generate costs totaling approximately €355 million in the Netherlands every year.”
Dr. Alli Gokeler

Focusing on prevention

Gokeler’s figures are dramatic, and the recognized international expert on sports injuries was also involved in compiling and processing the data they’re based on. Aside from being a practicing physiotherapist , Gokeler also does something unusual for someone from the field of physiotherapy – he conducts research. While he was writing his doctoral dissertation on motor function and neuroplasticity, Gokeler worked with sports scientists at the University of Groningen on injury prevention techniques, in particular preventing the recurrence of an initial injury. These days he’s a frequent speaker at medical and patient events, and he also advises sports clubs and associations. Given his strong scientific background, it’s not surprising that Dr. Gokeler pays close attention to figures.

Risk of recurrence extremely high in the first year

“Sprains generate costs totaling approximately €355 million in the Netherlands every year,” says Gokeler quantifying the economic dimension of this injury problem. A number like that is obviously somewhat abstract for some athletes and their clubs. However, the relevant statistics make a very different impression on trainers, assistants, and club officials, especially in professional sports. “A whole range of studies exist that show the precise progression of the way clubs are negatively impacted by injuries, and the resulting inability of athletes to continue playing.” At this point at the latest , Dr. Gokeler has the full attention of his audience. Moreover, once clubs learn that the risk of recurrence of ankle injuries (and knee injuries) also remains significantly high after the first six months following the initial injury, and can even stay at this very high level for an entire year, they become very interested when Gokeler poses the question: “Would you like to learn how to prevent sprains?”

“Train supports from Bauerfeind offer a high degree of proprioceptive input.”
Dr. Alli Gokeler

Dr. Alli Gokeler is a physiotherapist who also studies ways to prevent the recurrence of sports injuries.
Dr. Alli Gokeler is a physiotherapist who also studies ways to prevent the recurrence of sports injuries.

Preventive effect with MalleoTrain

Gokeler’s rhetorical question is completely legitimate, as it’s based on his work as a researcher and a practician who’s familiar with recurring injuries of various degrees, and the depressed athletes who have to deal with them. Gokeler knows from his many years of experience, in the U.S. and Germany among other places – that without constant motivation and rhetorical skills, it’s virtually impossible to be successful in the battle against recurring injuries. The clubs and athletes he addresses naturally want to do more to prevent such recurrences. Gokeler doesn’t have to pull a rabbit out of a hat here; he’s got something better: “The MalleoTrain ankle support is outstanding when it comes to preventing the recurrence of sprains.” Indeed, the advantages it offers are clear: clubs benefit from a support that is much less expensive than a tape bandage, while athletes appreciate the fact that they can put the aid on themselves quickly and easily – and that the support is easy on the skin.

Supports in physiotherapy

“Train supports from Bauerfeind offer a high degree of proprioceptive input ,” says Gokeler. “During movement , the active supports trigger a mechanism that gives patients a feeling of security.” Another aspect benefits patients in the Netherlands in particular, where it’s a lot easier to obtain the support: unlike the case in Germany and many other countries, physiotherapists in the Netherlands can directly hand out supports. In general , Dutch physiotherapists have more treatment freedom than their counterparts in other countries. “If a patient comes to us directly, we use certain guidelines to determine whether we’re dealing with a physiotherapy case or another type of condition that requires medical clarification,” Gokeler explains. “If the latter is the case, we write up a recommendation that patients can take to their physician.”

Opening the door to mobility

According to Gokeler, the use of supports in physiotherapy is an indispensable return-to-play measure in sports. “The light pressure exerted by the knit ensures comfort , and feelings of instability disappear,” says Gokeler, who also points out another aspect that’s very important: “Many people associate pain with damage and immobility – but with active supports we’re actually opening the door to mobility.” Gokeler has dedicated himself to prevention, even in the case of cruciate ligament injuries. So what’s more important to him1 – science or practice? For Gokeler, the answer is clear: “I try to help my patients using a combination of valid figures, practical skills, and appropriate medical aids.” ?

1 A. Benjaminse, A. Gokeler, A. V. Dowling, A. Faigenbaum, K. R. Ford, T. E. Hewett , J. A. Onate, B. Otten and G. D. Myer (2015). “Optimization of the anterior cruciate ligament injury prevention paradigm: novel feedback techniques to enhance motor learning and reduce injury risk.” J Orthop Sport Phys Ther, 45 (3): 170–182.

Images: Stefan Durstewitz


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