He is the inventor of GenuTrain. Professor Dr. med. Heinrich Hess gives his opinion on the knit, hoops and padding of the new GenuTrain.

What is special about the new generation of GenuTrain knitting?

Prof. Hess: It's more structured now. Fixation with the skin has been improved, thus maximizing the stabilizing effect of the support. The hamstring (back of the knee) solution is my favorite element. It's an area that challenges all supports. We've managed to create the hip area to be pleasantly soft and breathable, while not losing hold.

Hoops are often underrated.

Prof. Hess: And that's wrong. Hoops are an essential part of the product that ensures its proper support and functioning. Now they are made of special plastic and the durability of this material has been specially tested. Hoops withstand an unlimited number of different types of movement, bending and stretching without deforming or damaging them.

Omega upholstery now received a "+" rating.

Prof. Hess: We are particularly proud of that. Our patented pad already has two "pain trigger points": meniscal wings on both sides of the kneecap at the height of the joint cavity and Hoffa pads below the kneecap. Now they have integrated moving silicone elements. It's new, and that's the plus side. As before, the meniscal wings provide pain-relieving micro-massage while walking. Meanwhile, Hoffa points interact with the so-called Hoffa adipose tissue pad. Its functions are known and incredibly diverse. It's not just a pad of fat. It performs stretching, pressure and pain-sensing functions (see also interview with Prof. Hammer (Hammer), pages 20-21). In Chinese acupuncture, it is referred to as the eye of the knee joint. I would call it a knee bodyguard. With our Omega + Pad, we are also able to promote self-healing, anti-inflammatory metabolic processes, all attributed to the Hoffa adipose tissue pad. This is an absolutely unique feature.

----------------------------------------------------- ---------

Proprioception

New supports, new annoyances?

Professor Dr. med. Niels Hammer from the Department of Anatomy at the University of Otago/New Zealand sees new treatments in proprioception research, especially in neuromechanics

diseases of the skeletal-muscular system.

Professor Dr. med. Niels Hammer.

How would you describe proprioception?

Prof. Hammer: Proprioception can be described as the body's ability to sense and coordinate its position and movement in space. In medicine, especially in orthopedics and rehabilitation, it mostly refers to the ability to perceive the relative position and position of joints, limbs or body parts. Proprioception is primarily a protective function. In addition, it has the most important stimulus for coordinating complex movement processes, for example, walking.

Can proprioception be measured?

Prof. Hammer: We didn't have many of these options until a few years ago. Today's new methods, for example, functional magnetic resonance images and transcranial magnetic stimulation, allow us to receive interesting insights. Promising development can also be seen in sensor technology, with which it is possible to determine muscle response and subconscious positional reflexes with relative accuracy.

How can you describe the situation on the road?

Prof. Hammer: The knee has a very dense network of nerves. It mainly affects a certain type of receptor, namely mechanoreceptors. They are mostly concentrated in tendons and ligaments. In the knee, mechanoreceptors can be found in the cruciate ligaments and lateral ligaments, as well as in the surrounding tendons, also near the menisci and even in places close to the joint surface.

Is there a difference in sensitivity?

Prof. Hammer: The sensitivity depends mainly on the type of receptor. Free nerve endings, as well as Pacinian and Golgi receptors, are mostly specialized in sensing larger force and length changes. Ruffini nerve endings and neuromuscular spindles respond to even small changes in position and position. With the exception of tendon receptors, all of these receptor types can be found in ligaments; Ruffini, Pacini and Golgi receptors - in addition also in the menisci, besides, the free nerve endings are located close to the surface of the joints and in Hoffa's adipose tissue pads.

A complex neural situation on the road.

Prof. Hammer: The complexity of the joints in the knee becomes clear by looking at two principles: The three peripheral nerves in the knee joint, the so-called Nervi articulares, only care about the knee joint. There are other nerves that supply the surrounding muscles, as well as nerve endings that extend to the joint capsule. This dense network of nerves means that most tendons and ligaments are connected by at least two different nerves, one at each end. When one realizes how complex the knee joint is as an organ with two asymmetric articular surfaces, two condyles of different sizes, and the patella as an additional articular part, this special care seems even necessary. Neuromechanics becomes the key word in this context – it is the interface and connection between the nervous system and the movement apparatus. Here, along with new training methods, various possibilities in the treatment of diseases of the musculoskeletal system open up.

What role can support play here?

Prof. Hammer: Clinical experimental research on supports in this context is relatively new. What is clear is that medically effective support compression not only distributes, but also changes the pressure on the joint, thereby affecting both mechanoreceptors and hemoreceptors. The mobility of the skin is altered in relation to the underlying muscle fascia and ligaments, which also leads to the formation of new irritations. The supports also change the mobility of the soft tissue parts and in addition encourage combinations of new irritations. Thus, supports are very likely to create new irritations and cause combinations of new irritations.

Is it possible to avoid possible habituation effects by changing stimuli with support, eg the new GenuTrain?

Prof. Hammer: It also depends a lot on the type of receptor. Ruffini's nerve endings, for example, adapt very slowly, which means that the habituation effect for a certain joint position will develop only after some time. In contrast, Golgi receptors and neuromuscular spindles adapt extremely quickly to stimuli. Along with the receptor that causes irritation, the spinal cord and control centers play an important role. In the case of this complex system, habituation effects exist at the receptor, spinal cord, and cerebral cortex levels. They can be overcome by stopping the irritation for a while or by changing the type of irritation. Thus, it is possible to prevent them.

Mechanoreceptors are located in the dermal layers of the skin and respond to correspondingly different physical influences: Meissner's corpuscles register how quickly the skin is pushed into the site of irritation. Ruffini corpuscles are sensors of skin stretch strength. Merkel cell receptors respond to sustained touch, and Pacini corpuscles to vibration. There are also free nerve endings that register injuries, chemical and thermal irritations and create pain perception in the brain.

 

www.navlaikasapem.lv