Sports Medicine

When people hurt themselves, they don't always go to the doctor. Rolling an ankle while mowing the lawn on a Sunday doesn't always invoke panic. The majority of people would go out, find an ankle brace and wear it until they felt better.

Yet, according to a study by the National Center for Injury Prevention and the Centers for Disease Control, an estimated seven million Americans receive treatment for a sports-related injury every year. The "average person" doesn't have an athletic trainer or physical therapist on hand to offer advice, rehab and the like. In fact, most people who "just twisted their ankle" or suffered a mild sprain or strain would probably not seek medical attention. But they may end up on your doorstep: The HME dealer.

The average sports medicine client can be a junior high school soccer player, an office manager or a retired schoolteacher. In fact, the average client seeking a sports medicine-related product may not be an athlete, or possibly not have even sustained the injury through a sports-related event. The term "sports medicine" can simply mean treating an injured client using a sports medicine perspective.

"You have people who want to be active longer, your 'weekend warriors'. All of this you think a lot of times is directed at the competitive person because we use the term 'sports medicine,'" said Mark Reep, CPM/bone stim manager for Breg Inc., a manufacturer in Vista, Calif. "It's really not. It's really your everyday person. It's your industrial athlete those sustaining injuries in the workplace or those who maintain a high physical level of health for their jobs, or the elderly population that wants to continue to be active."

So what kind of HME dealer or provider does it take to serve up the sports medicine products out there? According to Reep, the pool is wide. "I deal with national companies that carry everything from a Band-Aid to a Hoyer lift, or companies that are just really specific and maybe carry just sports medicine products," he said.

Herb Raschka, vice president of sales and marketing at Mueller Sports Medicine Inc., a manufacturer in Prairie du Sac, Wisc., suggests that dealers looking to get into the sports medicine market analyze where they want their business to go. "It's going to take a little effort to get the information out that you're different than the standard home health dealer," he explained. To tap into the youth market, he recommends contacting local schools and organizations that sponsor youth sports to let them know that sports medicine products are available in their area.

When it comes to finding the products that are right for your store, quality is priority number one.

"One, it's got to fit, and two, it's got to do what it claims to do," said Raschka. "It's got to be quality so that it will wear at least as long as the treatment is required."

Caroline Kraeger, physical therapist, Executive Physical Therapy, Berthoud, Colo., is the author of fitness and health books on topics such as therapeutic exercise. She recommends the standards such as the Swiss ball or exercise ball, "Even though it has been around for a long time I just highly recommend it for anyone."

There are two sides to the product field: Preventive and rehabilitation. Traditionally, the industry has been supported by rehabilitation products such as braces, orthotics and even hot/cold therapy packs, used for therapy and healing and often prescribed by a physician. Preventive products, such as balance boards, elbow pads and exercise balls are designed to prevent injuries through strengthening and exercise or with the case of a preventive pad, to protect an area of the body from injury.

Sports medicine is a category that needs the right selection of products to minimize your inventory but making it attractive without making any huge investment.

Kraeger, who partners with OPTP, a manufacturer in Minneapolis, Minn., said preventive products can be more marketable. She teaches an abdominal pelvic floor 'boot camp' at the Berthoud Athletic Club in Berthoud, Colo. After starting to offer the class a year ago, she's filled four of the sessions. "I can see 48 women in a preventive setting with preventive products, versus the one-on-one contact when a client comes in."

Raschka offers another example. In a more aggressive sport, such as skateboarding, "If you don't have the preventive pads on, you will after the first week."

A challenge of course, is that people generally do not want to use a product unless they've been hurt, a factor prevalent when it comes to amateur athletes. "Sports have gotten kids used to taping instead of using an ankle support brace, even though it costs less to buy a good brace," Raschka explained. "That part of the education has to be done by the retailer. Once there's a conversation, there's no problem."

According to Raschka, Mueller Sports Medicine has been able to convert entire athletic teams to using preventive products. "The University of Iowa now uses ankle braces," he said.

Back To School

Any HME dealer knows that being knowledgeable about their products is essential. So, when looking for a sports medicine product line, find a manufacturer that offers training. Breg Inc. not only offers training classes for its distributors, but they also offer business management training for their group leaders.

Mueller Sports Medicine is working on an interactive educational product Web site ( sponsored by the nearby University of Wisconsin sports medicine department, and the company includes a full-use instructional guide in every package that features the Mueller product line.

Although knowledge of a particular product is a cornerstone in sales philosophy, having staff with backgrounds in the industry helps. Dashe Orthopedic Supplies in Dallas, for example, has a registered nurse on staff.

"Everyone in our organization is educated in the health care field," said owner Phillip Powell. "It's very important that you know anatomy; it's important that you know the functions in what you're actually trying to achieve with each product. So we try to work closely with PAs and the doctors and find out what they're really, really looking for."

Reimbursement Vs. Cash-And-Carry

Like most HME niches, insurance and reimbursement play a critical role in the sports medicine industry. It is beneficial for HMEs to maintain working relationships with physicians and hospitals for referrals, and provide a selection of cash-and-carry items.

"We have a little bit of soft goods, a lot of functional bracing, CPMs for the shoulder and the knee," Powell said. "That's kind of our little niche; we try to service the orthopedic hospital services and community."

Reep said, "What's driving it is what physicians are willing to write scripts for." Maintaining a relationship with your local clinics can result in referrals and physicians writing prescriptions for specific products--an order you as a dealer can fill.

Currently, many manufacturers in the field including both Mueller Sports Medicine Inc. and ITA-MED Co., San Francisco, have product lines that are reimbursable. But according to ITA-MED Co. President and Ceo Lev Tripolsky, HME dealers that rely on reimbursement are becoming a thing of the past. "The ones dealers who recognize that eventually the growth of this industry will come from retail those types would do very well to compete."

Raschka said of the industry, "It's going to come down to sports medicine being a category that needs the right selection of products, where it minimizes your inventory where it makes it attractive without making any huge investment."

With cost cuts and reimbursement, the reality for some HME dealers may be to stock softgoods, such as braces, preventive pads or blister protectors, which are mainly cash-and-carry. Carrying sports medicine products as cash-and-carry items can be a matter of simplifying business practices. Raschka explained, "It's a cost/benefit issue. How much time and paperwork is it really worth to generate for a $10 or $20 item. Who is going to win on this thing?" He cited an example of a clinic that added a spin rack to their in-house store. When he called to follow up with them, he found out the customers were paying cash for the products. "The top of the line brace we put in there was a $29.99 hinged knee brace. They were just buying them, and there wasn't any shuffling of paperwork. It's when you get into $70, $80--when you're getting into shuffling paperwork--then you've got to weigh whether it's worth it."

Retail For The Masses

If HME dealers sell their sports medicine products on a cash-and-carry basis, what about mass retailer competition? Some manufacturers, like Mueller, offer their products to mass retailers, although, Raschka said of the 1,200 products in the Mueller line, only 60 are offered. "We offer HME dealers full access to our line."

ITA-MED is positioning its sports medicine line for retail by marketing the products as easy and comfortable, and changing the aesthetics of the product packaging. Tripolsky said, "We've designed product more around retail, that's where the future is, reimbursement is going to get cut more and more."

The consensus is that, although walking in to a large discount store or the local drug store to purchase an ankle brace may seem more convenient to the end-user, the advantages of visiting an HME can be far greater. HMEs are more knowledgeable about the features and benefits of the products they carry. Kraeger said it can be a simple liability issue, "It's the quality of the product--when you buy from a medical provider, the quality of their product is much higher; it's one-size-fits-all at mass retailers." She cited the example of an exercise ball that is available in one size, which isn't appropriate for everyone.

In addition to quality of products, HME dealers offer knowledge unmatched by a mass retailer. "DME's don't have the turnover?they don't have hundreds of thousands of products, so they're able to take time to learn the specific capabilities of these products," said Raschka.

The final word is about choosing the right manufacturer to support your sports medicine endeavors. Raschka said, "Choose a vendor that allows you to exchange products without burning you. If you're going to take chances, that manufacturer should be willing to help you take that chance." Find a manufacturer that is going to provide quality products and customer service as well as support your business as you serve your community's sports medicine needs.

The Kids Have It

Amateur sports has not left the spotlight, and the most active portion of our population?children, teenagers and young adults?are a hot topic. And with rising obesity statistics for children exercise is becoming a necessity, but with such emphasis comes the risk for injury.

The National Athletic Trainers' Association (NATA) and American Academy of Orthopaedic Surgeons (AAOS) have teamed up for a 2005 public service campaign to raise awareness about youth sport injuries. The year-long campaign kicked off in March 2005 with advertisements featuring kids playing baseball, and the headline: "What will they have longer, their trophies or their injuries?"

"The National Athletic Trainers' Association and American Academy of Orthopaedic Surgeons are excited to partner on a timely youth sport injury public service campaign. It was created to educate parents, coaches, athletes and media on how to prevent, treat and rehabilitate such injuries and avoid a lifetime of chronic conditions," said Chuck Kimmel, president, National Athletic Trainers' Association.

Rx for Your Home After a Sports Injury

Ten tips for creating a healthy home while you recover

Share these tips with your customers on how to create a safer living environment after an injury.

To make sure a home is in tip-top shape during recovery, consider installing a few items and making some changes around your home that will ease the ability to function while recuperating.

1. The First Priority--The Bath

The room to be most concerned about is the bath. It's the one room that everyone needs to use, no matter how extensive your injuries. Some of the first tips will make your time here a lot more comfortable.

2. Grab Bars

Consider installing a grab bar in your shower. Look for one strong enough to withstand the stress that will be placed upon it?most grab bars can withstand up to 300 pounds of pressure. The bar should be long and wide enough to grasp easily, and have a surface that can withstand a moist environment. Generally, grab bars come in a number of sizes between 12 inches and 42 inches in length.

3. Shower Chairs

Another welcome addition to the bath for a wounded "weekend warrior" is a shower chair. Look for a chair with non-slip rubber feet to enhance stability and prevent nicks and scratches to the tub floor.

4. Hand-Held Showers

If you are seated while bathing, consider using a hand-held shower to more easily control the water flow. You won't have to worry about reaching to the top of the shower to change the force or direction of the water.

5. Transfer Benches

For those who find stepping over a bath tub wall impossible or impractical, consider using a transfer bench. With two legs outside the tub and two legs inside, a transfer bench allows people to sit down outside of the tub and easily slider over, keeping all of their weight off their injury and allowing for a safe, fluid motion into the shower. A transfer bench is perfect for anyone who has a cast on their foot.

6. Elevated Toilet Seat

If your ankle, knee or any other part of your leg is affected by injury, consider an elevated toilet seat. Standard toilet seats measure 14 inches to 15 inches off the floor?a low height for even a healthy individual to bend to. Elevated toilet seats hook or rest onto the bowl and raise the seat three to six inches. Ones that lock into place provide added security and optional handles make sitting down and standing up with an injury much easier.

7. Bathroom Finishing Touches

Items for someone with limited reach include long-handled bath brushes and sponges as well as long-handled lotion applicators. These are helpful anyone with a rotator cuff injury or other injury to the arm, which limits their range of motion. Also consider non-slip mats for both inside and outside of the tub to prevent a spill while your balance is still off-kilter.

8. Secure Railings and Mats

Beyond the bathroom, make sure other areas of your home are conducive to your lessened-mobility state. Ensure that all railings and banisters on stairs are secure. If there is any wobble, enlist someone to tighten them soundly. Make sure that there are no loose rugs or mats anywhere in the home, nor loose wires?both can cause a slip for someone with crutches, a cane or a cast.

9. Vanquish Clutter and Keep Rooms Well-Lit

Eliminate clutter on the floor and keep all furniture with protruding legs out of the way. Lastly, make sure all rooms are well-lit so there are no dark areas to venture through with your injury.

Take it easy while you're on the mend and return to normal activities only when you are fully healed to prevent re-injury. With a safe home, you should be able to rest assured that sitting back and allowing the healing process to occur is the only thing left to do!

This article originally appeared in the May 2005 issue of HME Business.

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