Tamarack Habilitation Technologies is seeking guest bloggers to write orthotic, prosthetic & pedorthic-related blog posts in 2010.

First introduced in May 2009, the Inside Tamarack blog is a resource for news, commentary & insights about foot care & biomechanics information for the orthotic & prosthetic (O&P) industry. We also write topics relevant to consumers seeking advice about athletic & diabetic foot care.

Let us know if you’d like to get involved with the Inside Tamarack blog. E-mail us: info[at]tamarackhti.com

Plagiocephaly (or “Plagio”) is a deformation of the skull caused by repeated & consistent external pressure such as utero constraint, back sleeping or as a result of prematurity or another disorder.

1 in 300 infants exhibit some form of plagiocephaly, although the most serious developmental incidence is just 0.4 to 1 per 1,000 live births. Upon clinical intervention, the average treatment time for most plagio cases is four and a half months¹. The most common treatment technique involves the use of a cranial remolding orthosis, shaped specifically for the user’s specific needs. Proper intervention for plagiocephaly involves clinical evaluation, device fitting, and regular follow up evaluations until sufficient progress has been made.

Cranial Remolding Orthosis Resources:

Clinics & Suppliers*

AriMed Orthotics and Prosthetics (USA) – http://arimed.com

Becker Orthopedic  (USA) – http://www.beckerorthopedic.com

Cranial Technologies (USA & Spain) – www.cranialtech.com

Danmar Products  - (USA)- www.danmarproducts.com

Hanger Prosthetics & Orthotics  - (USA) – www.hanger.com

The London Orthotic Consultancy Ltd (UK) – http://www.londonorthotics.co.uk

Orthomerica (device manufacturing firm only) – www.orthomerica.com

Support Groups & Research

Plagiocephaly Info – www.plagiocephaly.info.

Yahoo Support Group – All About Plagiocephaly.

Tamarack Habilitation Technologies manufactures a simple solution that addresses painful rubbing/dermatological concerns that often occur with users of cranial remolding orthoses. ShearBan® has a slick low-friction surface and durable adhesive backing that applies directly to orthotic devices, creating a smooth interface between the device & skin. Available in both sheet & pre-cut oval patches, ShearBan® provides immediate relief and long-lasting protection from any type of friction-induced skin trauma. For more information, visit www.ShearBan.com.

For more information about plagiocephaly and cranial remolding orthoses, consult your primary care physician.

¹ Statistic courtesy of www.aetna.com

*This list includes just a few resources for cranial orthosis fabrication and fitting. Consult your primary care physician for referral to a qualified practitioner.

An article in the December 2009 issue of O&P Almanac, entitled “University of Michigan Advances Tissue Engineering”, reveals that researchers are identifying ways to recreate the sense of touch with artificial limb users.

Funded by the Department of Defense, the research project developed from the need for better prosthetic devices for wounded troops. Traditional upper-extremity prosthetic limb designs restrict movement and don’t stimulate sensory involvement.

The process is complex, involving the bonding of muscle cells with a biological scaffold to spur the growth of nerve endings. Researchers believe the interface will help relay sensory perceptions back to the brain, helping to improve fine motor skills with prostheses.

For more information about this University of Michigan study, visit www.med.umich.edu.

This news item will not be in our employee recruitment brochure: I was at a conference last Wednesday, the day of the big snowstorm in the Midwest. When I came into my office on Thursday, I found a snow drift in my office. It wasn’t as big as the ones outside, but it did reach four inches tall.

I have an exterior door in my office. We had put up plastic because it gets so cold in the winter in my office. The snow apparently blew through a gap at the bottom of the door and built up behind the plastic.

John Lampe

The American Academy of Orthotists and Prosthetists 36^th Annual Meeting and Symposium is coming up soon – Feb 24-27, 2010 in Chicago, Illinois. You can view the program at www.academyannualmeeting.org.

If you see patients with diabetic / neuropathic foot problems and are looking for an edge in ways to address commonly seen problems, please consider signing up for Technical Workshop 33 titled “Diabetic Foot Problems and Novel Ways to Treat Them with ShearBan^®” on Wednesday 24 February, 2010. The workshop will discuss the biomechanics of the diabetic/neuropathic foot, footwear, pedorthic/orthotic interventions, and friction science. Workshop participants will have the opportunity to install ShearBan using a variety of techniques. The presenters will be Dennis Janisse, CPed from National Pedorthic Services, Inc. and Mark Payette, CO from Tamarack Habilitation Technologies.

Excessive shear stresses on the foot can cause a variety of problems. One of those problems is a condition called metatarsalgia. Metatarsalgia generally refers to pain in the metatarsal region of the foot, i.e., the area in front of the arch and behind your toes that includes the ball of your foot. The primary symptom is pain, especially during the mid-stance and propulsion phases of gait. Excessive calluses often form under the metatarsal heads.

Shear is an underappreciated cause of metatarsalgia. This article: McPoil TG, Schuit D, Management of Metatarsalgia Secondary to Biomechanical Disorders, Physical Therapy, 1986;66(6):970-72 (available for free) discusses how shear stresses are transmitted through the forefoot during gait. The presence of calluses under the metatarsal heads confirms that friction and shear are present at the forefoot. ShearBan® or ENGO® patches can be used to reduce the friction and lower the shear stresses. The locations of the calluses should guide you in deciding where to locate the patch of ENGO or ShearBan. For example, in the metatarsalgia case study by McPoil and Schuit, the callusing on the patient’s foot occurred under the second and third metatarsal heads (i.e., in the middle of the metatarsal region. ShearBan or ENGO should be placed on the insole of the shoe opposite this region of the metatarsal heads.

We discussed the disadvantages of moleskin for treating skin trauma in an earlier blog entry, Moleskin: Review of an Outdated Foot Care Remedy. In Blogs, Listservs, and other locations, however, we continue to read recommendations from orthotists to use moleskin to manage skin irritation caused by orthotic devices. Moleskin has three disadvantages: First, it is bulky and stiff and doesn’t conform well to surfaces. Second, its fuzzy material is a haven for dirt and bacteria. Third, moleskin forms interfaces with socks, for example, that have a really high coefficient of friction (COF).

John Vonhof has served on medical teams around the world for many of the largest ultramarathons such as the Western States 100 Mile Endurance Run. He has treated thousands of sore feet. He is the authority behind FixingYourFeet.com. As Vonhof says in his blog entry, Moleskin Galore, “You will never find moleskin on my foot care box.”

Even if you don’t use a specialized interface material like ShearBan® to manage friction, don’t use moleskin. As the accompanying graph shows, in terms of producing a high COF, moleskin may be the worst! Therefore, the material you are covering with the moleskin is probably better at managing friction than the moleskin.

We’re pleased to announce the official launch of our

new ShearBan® Ovals product – a variation of the

original ShearBan 9″x12″ sheets.

For over 15 years, Tamarack^™ has been committed to the research, testing and development of low-friction technologies, including our ShearBan® and ENGO® product lines. ShearBan® offers a long-lasting solution in the clinical setting to friction-induced blisters, calluses and diabetic foot ulcers.

ShearBan® Ovals now provide a shape ideal for preventing and treating the diabetic foot. The Ovals are particularly suited for placement in footwear under the metatarsal heads or next to the big toe, where most ulcers develop. ShearBan® is effective, affordable, and easy to use for ulcer prevention and relief.

ShearBan® Ovals are now available from Becker Orthopedic, worldwide distributor of Tamarack™ products.

For purchasing information, call (800) 521-2192 toll free, or visit www.BeckerOrthopedic.com.

For general inquiries about ShearBan, visit www.ShearBan.com.

Phil Stevens, M.Ed, CPO, FAAOP, just completed a technical note entitled: “The use of ShearBan® in addressing dermatological concerns encountered in the management of deformational plagiocephaly.”

Orthotists often fabricate cranial remodeling helmets (aka cranial molding helmets) for infants who have deformational plagiocephaly. Deformational plagiocephaly refers to a misshapen head caused by repeated pressure to an area of the head. An infant may be born with deformational plagiocephaly or, more commonly, develops it because the head remains in one position on a surface for long periods of time.

For the remodeling therapy, infants must wear the helmets for extended periods of time. Because of this, an infant often develops erythema (skin redness) on certain areas of the skin that contact the helmet. In his technical note, Phil cogently explains how ShearBan® can be used on the inside of the helmet to reduce skin trauma.

Phil Stevens is a certified prosthetist and orthotist practicing in Salt Lake City, Utah. He has authored numerous articles and speaks extensively domestically and internationally. He specializes in pediatric orthotics, cranial remolding, and upper extremity prostheses. For his completion of this technical note, Tamarack is donating $500 in Phil’s name to the Orthotics and Prosthetics Education and Research Foundation (OPERF)

With an emergent international customer base, Tamarack Habilitation Technologies has updated the distributors’ page at www.tamarackhti.com/distributors to include the entire list of Tamarack^™ product distributors worldwide.

From the Tamarack Flexure Joint^™, Clevisphere Joint^™ and fabrication tools, to our ShearBan^® Friction Relief Sheets & all-new Oval patches, we want to ensure our customers can locate an orthotic / prosthetic distributor to service your clinic or central fabrication facilities needs.

If you’d like help with finding an O&P product supplier in your area, email: info [at] tamarackhti.com.