Dr. Hayashi, you played a key role in developing the first sports ankle brace…
MH: It was one year before the 1992 Olympic Games in Barcelona. A key player on the national volleyball team suffered a severe ankle injury. To help him recover faster and to prevent him from being injured again, I asked him to wear a medical orthosis.
I wanted a brace with rigid guards on both sides of the ankle to make sure the talocrural joint was stabilized enough to prevent a recurring injury. Unfortunately, the orthosis broke after less than two weeks of intensive training. The material used in the brace was not resistant enough to extreme demands and the product’s shape had not been designed to allow athletic movements, but rather to restrict all motion.
I then began working with ZAMST to develop an ankle brace that could resist extreme movement while protecting the player. We came up with a new product just before the Olympics. All the players on the team wore at least one ankle brace during the Olympic Games and none of our players was injured.
What were the key design changes that you requested ?
MH: It was important for me to provide the player with an ankle brace that could restrict excessive joint motion while not impeding his movements. A volleyball player has to run, jump, move from side to side and front to back, as well as bend his knees and ankles. Consequently, the ankle should be able to retain its full range of motion. We decided to change the material, the thickness and the design of the lateral guards, which had to be rigid but non-breakable. We also modified the thread used to sew up the brace fabric to prevent it from breaking under repeated friction. Then we widened the strap and Velcro fastener and sewed them to the plastic guards to enhance the durability and strength of the fastening system. Last but not least, the plastic guards were attached to the soft brace with rivets to allow the ankle to facilitate plantar flexion and dorsiflexion.
It sounds like the product is very technical. Are all the products available in the market so advanced ?
MH: They should be!
The ideal brace for sports should provide the functionality of a medical brace (to protect the joint in the best way possible) and respect the specificities of athletic movements and limitations, which are quite different from those encountered in daily life! In this respect, the sports orthosis should combine the qualities of a medical brace and the supportive action of taping. When this is achieved, as is the case for ZAMST products, you have a solution that is even better than taping in some aspects. Indeed, while taping is the most anatomically appropriate solution to support the joints, it also has two disadvantages: you need the expertise of a healthcare professional to get a good taping, which is not possible for all athletes, and you can’t adjust the compression level once the taping is in place, which you can do with a well-designed brace.
So what makes the ZAMST products so different ?
MH: To me, ZAMST products are simple, comfortable, functional and easy to use—these are the mandatory characteristics that all braces should have. They are also designed for sports, which means that they freely allow non-harmful movements while restricting dangerous ones. Last but not least, the ZAMST team has excellent medical knowledge and the researchers work closely with doctors, coaches and professional athletes on an ongoing basis to continue improving the quality and effectiveness of the products. Thus these researchers are fully capable of providing detailed information to customers to ensure users get the most out of ZAMST products–-and the ZAMST team works hard to make sure they do.
As a doctor do you recommend that all athletes use this kind of sports orthosis ?
MH: Thinking about the athletes that I monitor on a day-to-day basis, of course I would prefer that they did not use such products. And I’m sure that all the coaches, athletic trainers and doctors who work for sports teams are working to enhance their players’ performance while making them more resistant to injuries. In this respect, I do not recommend wearing orthoses everyday unless you have pathological joint weakness or you’ve already incurred a severe injury. However, even for “perfectly healthy” athletes, there are situations that demand the use of orthoses to supplement the body’s natural protection against injury, such as during a competition (the injury rate during competition is much higher than when training for many sports). Orthoses may also be required during an intensive training camp (when fatigue can be very high) or when the athletes feel they have accumulated too much fatigue during the season. In the end it’s a choice the player has to make, but to make the right decision, he should be informed about his risks, the consequences of an injury (abstention from training, long recovery, residual weakness afterwards, etc.) and the means at his disposal to prevent it (voluntary training, taping, sports orthoses, etc.).
Don’t you think one of the side effects of using sports orthoses is that the body may weaken and lose its capacity for self-protection ?
MH: With sophisticated sports orthoses like those manufactured by ZAMST, this can’t happen. Don’t forget that these supports will preserve freedom of movement and only protect the joint from excessive and dangerous exertion. Therefore, a full injury prevention regimen is necessary even though the athlete is wearing a sports brace. Weight training, proprioceptive training, coordination training and other exercises are indispensable. Think of a sports orthosis as being the last defense when all natural defenses have failed. And in modern sports, with the increased intensity of competition, these defenses fail quite often.
