Weeks ago, I discovered a fairly new company based out of New York that was developed by Dr. Barry Katz, a former basketball player and lover of the sport who happens to be also an orthopedic radiologist. His company, Ektio, markets a basketball shoe that does not come with an NBA stars face onto it or a flashy advertising campaign, but rather states include revolutionary design technology that’s specifically aimed at reducing ankle sprains by a mechanism that will specifically limit excessive inversion from the foot, the ankle movement that is accountable for 95% of basketball ankle sprains. It appeared like an intriguing concept in my experience and that i quickly began researching the ideas behind the shoe’s technology, the substance and knowledge behind the claims that were being marketed, and also the overall ingenuity in the product design.
Through the process of researching and learning about the shoe’s concept, design, and reliability, I had been because of the opportunity to speak with/interview both Dr. Barry Katz in addition to former NBA star and hall of famer, Rick Barry, who’s an advocate and spokesman for the company. Though empirical data always means a little more to me than testimonials and spoken claims, it had been great to obtain a chance to ask more questions and truly gain insight into the goals from the company and also the driving forces behind the design.
So before we dive into examining the shoe and the claims regarding ankle sprains which are described by Ektio, why don’t we review ankle sprains with a specific look at ankle sprains in basketball.
When one hears the phrase ankle sprain, most athletes/exercise enthusiasts can envision an individual ‘rolling’ their ankle after which enduring that terrible sharp pain that might seem to nag forever when attempting to plant, pivot, run, etc. Just like most topics in sports medicine, anatomy is essential in breaking down and understanding ankle sprains.
The 4 main movements that the ankle joint accounts for are:
1. Dorsiflexion (Pointing your foot upwards for the shin)
2. Plantarflexion (pointing the food downwards like pushing on a gas pedal)
3. Inversion (Turning the ankle inwards so the side of your foot is facing the ground)
4. Eversion (The alternative of inversion in which the ankle turns the foot outwards)
The rearfoot, also is sometimes referred to as the talocrucal joint, is a hinge joint that is found at the distal end of shin bones (the tibia and fibula) and also the upper a part of among the foot bones called the talus. The ends of the shin bones form an in-depth socket called the maleolar mortise. This deep pocket serves to both stabilize the joint and act as an anatomic pulley to help produce the characteristic motion of the ankle.
As well as the bony stabilization of the ankle joint we have lots of ligamentous structures that actually work to help hold the bones together in a stable pattern and endure the numerous stressors we put on our bodies.
As previously mentioned, most ankle sprains occur as inversion injuries due to the way we have a tendency to twist/roll-over on our weight-bearing leg when we have shoes on. The twisting motion in the joint puts lots of force on areas of the lateral ligaments (outside) called the anterior talofibular (most commonly injured) and also the calcaneofibular (second most commonly injured). These injuries most often increase the risk for pain and swelling externally the ankle that people knowledge about sprains.
The less frequent ankle sprains involve eversion injuries, which occur when we unveil ankles outwards and overstretch a ligament called the deltoid ligament. This can commonly cause pain, swelling, and may cause instability on the inside portion of the ankle.
For additional info on the classification of ankle sprains and customary treatments, you should check out a previous article I wrote a couple of years ago in reaction to our beloved, Rob Gronkowski’s ‘high’ ankle sprain right before the playoffs.
With a better understanding of the anatomy, we are able to discuss ankle sprains in basketball and the thought/theory behind Dr. Katz’s technology. A 2010 study published in JBJS regarding the epidemiology of ankle sprains established that incidence of ankle sprains in america 2.15/1000 people each year. They also stated that overall, there is no improvement in incidence between men and women, but that whenever one examines the population between the ages of 15-24, males have a higher incidence (7.2/1000 people) when compared with females.
The research also showed that 49.3% of ankle sprains were related to sports as well as those ankle sport-related ankle sprains, an overwhelming 41.1% of these were basketball related. To further illustrate sport-specific data regarding ankle sprains, research in the British Journal of Sports Medicine that examined sport-related ankle sprain epidemiology reported that 70% of basketball players described past ankle sprain and that 80% of them reported multiple sprains. Using the growing rapidly popularity and marketing of basketball over the past many years, this number is probably a little higher and the quantity of chronic ankle injuries may be under-represented.
Chronic ankle problems typically lead to increased residual symptoms such as pain, muscular weakness, instability (easy giving way), swelling, stiffness, and crepitus (cracking). Furthermore, numerous studies show that recurrence seems to be fairly high, giving way to a sports athlete who seems to perpetually be sidelined with ankle troubles.
While this is certainly not surprising to anyone who has ever played basketball, it definitely shows that from the sports medicine standpoint that concentrate on ankle injury prevention in basketball is crucial to keeping player on the court and healthy. Sure, we are able to treat ankle sprains rest, ice, elevation, compression, anti-inflammatories, braces, or even surgery, however the the easy way help a sports athlete would be to prevent them in general.
This is when Dr. Katz thought he could do something to assist. Together with his experience playing basketball and his understanding of orthopedic anatomy, he remarked that the easiest method to approach ankle sprains is as simple as redesigning the most critical piece of equipment that the basketball player uses, the shoe.
In every sport, footwear is critical to performance. We’ve sport-specific footwear for from wrestling to ballet, yet with ankle sprains being so common in basketball, the basic style of the shoes haven’t really changed an excessive amount of over the past decade.
Since the creation of ‘Chuck Taylors,’ basketball shoes will always be high-topped shoes with about adding extra ankle stability. While the higher support does help in lessening the rolling over motion of the ankle, it does not really help an excessive amount of with preventing inversion, which as we’ve mentioned before is the culprit to 95% of basketball sprains.
Dr. Katz describes the importance of shoes in ankle sprains, by indicating that the reason one commonly sprains an ankle would be that the feet are a separate object from the shoes. When the shoe becomes inverted, the ankle slides inside the shoe, inducing the lateral side from the foot being almost parallel to the floor. His fix for your problem ended up being to add several strategically placed straps inside the shoe that aim to secure the wearers foot towards the shoe.
Specifically, the first strap wraps around the walls of the shoe to aid the lateral aspects of the ankle, whereas the second strap lays directly over the ankle mortise to avoid the wearer’s foot motionless within the shoe, thus attempting to get rid of the aforementioned phenomenon from the foot sliding within the shoe.
In addition to the two straps, the sole from the shoe includes a lateral piece of rubber placed on the exterior from the shoe that serves as bumper, to help prevent roll-over injuries.
The same is true the shoe work? Well, in the limit data that’s available, it seems that the shoe does a pretty decent job at preventing inversion from the ankle. After being sent the draft of the unpublished study performed at Drexel University, we’ve got the technology put on the shoe certainly looks promising. The study was limited, only using five subjects and examining the right ankle. Subjects were tested both in their standard basketball shoe as well as the Ektio shoe and an Ankle Flexibility Tester (device that enables cyclic load-unloading torque to become applied) was put on test inversion, eversion, and internal/external rotation.
Their results established that the shoe limited inversion from the ankle to less than 30 degrees, that is significant in that most ankle sprains occur at angles of inversion more than 30 degrees. Furthermore, it seems that the elevated stability using the Ektio shoe in terms of limiting inversion was between 14-20% as when compared to standard shoe. While there is a statistically significant increase in stability limiting ankle inversion, this research did not seem to significantly limit any of the other 5 motions within the ankle, which are essential in performing the required movements for achievement in basketball for example pivoting, shifting running and jumping.
Although the study is unquestionably interesting and promising for this new technology, it is significantly weakened by the small sample size and could certainly display a heightened power if more subjects were added to the research design later on. Furthermore, it wasn’t indicated whether the standard basketball shoe was exactly the same make/brand on each one of the players. In a study examining shoes, it is really an important variable to address.
This leads someone to ask another question, if the footwear is limiting inversion, do the wearers feel that the shoe is different than the standard shoes they are utilised to? I was because of the opportunity to speak with former NBA player, hall of famer, and spokesperson for Ektio, Rick Barry, who established that he didn’t feel any improvement in wearing the shoe. He stated that when he was contacted concerning the shoe concept, he was intrigued and wanted to try it out. When he realized the way the shoe felt cheap i felt like it could make a real difference in relation to preventing ankle injuries, he desired to jump in to advertise it. Mr. Barry also joked with me, stating that he can with certainty state that the shoe doesn’t feel very different than other basketball shoes because his youngest son, who’s quite picky, wears them without any complaints.
Though anecdotal evidence is nice to hear, it’s always safer to see empiric data. This really is were research in the Hospital for Special Surgery comes in. They examined the Ektio shoe versus bare feet, standard basketball shoe, and a standard shoe by having an ankle brace, while participants were involved in normal basketball activities such as running, jumping, and pivoting and recorded muscle firing patterns within the gastrocnemius/soleus complex, the tibialis anterior, and the peroneus longus muscles. Out of this data, they concluded that there have been no significant differences between your Ektio shoe and also the standard shoe or barefoot, which indicates there seems to be no compensatory stress on the other aspects of the ankle or leg because of the limitation of inversion to under 25-30 degrees. Additionally, it might point to the athlete isn’t performing any differently in the game with this shoe.
Regardless of the small size and also the rawness from the data presented in these preliminary studies, the concept of the shoe and also the construct from the technologies are promising to hopefully help in reducing ankle sprains in a sport by which ankle sprains affect over fifty percent of the participants.
Through my conversation with Dr. Katz and Rick Barry, it seemed these individuals wish to produce a shoe and promote something that not just performs well on the court, but additionally helps to keep the athlete safe. Rick Barry said, ‘Any current player would be stupid to not want to get their on the job these.’ He indicated frustration using the proven fact that it is not easy to get a shoe to be worn in the NBA due to the multi-million dollar contracts that larger companies can provide teams and players to wear their product.
So what’s next for this product and also the way forward for Dr. Katz’s technology? I asked Dr. Katz if he thought about expanding his design construct with other sports and possibly conducting a larger study. He explained he certainly would like to expand and modify his construct to use to other sports where ankle injuries are prevalent such as football. Furthermore, he stated that he also offers an interest in including his construct in military combat boots to help prevent ankle sprains in our soldiers who currently are exposed to difficult terrain and incredible stress on the ankle and legs.
Overall, the Ektio shoe appears to be an encouraging product having a well thought out design and construct. It’s refreshing to determine footwear being marketed by a small company with a specific objective of helping keep your athlete safer instead of the more common, overly expensive shoes with flashy colors and an athlete’s name branded throughout them. Though I cannot say set up data in the preliminary studies continues to carry true inside a more comprehensive study with more participants and tighter controlled variables, the preliminary data is really intriguing and something to help keep track of as Dr. Katz is constantly on the attempt to gain ground within the tough realm of marketing an outdoor equipment.
Transpire in writing this piece wasn’t to advertise a specific product, or suggest that every athlete needs a particular shoe. This is really not true. Every player is slightly different in terms of his or her ankle construct and biomechanics, and should select equipment that most closely fits his or her needs. It is, however, my estimation that being best informed concerning the options that are offered, especially the ones that don’t get billboard or magazine advertising, is essential when deciding on the best products for one’s physical and structural needs. Reducing ankle sprains in sports (especially basketball) continues to be an important topic in sports medicine for quite a while. As with any sports injury, there aren’t any items that can completely prevent something from occurring and that we must be aware of injuries because they occur and treat them within the easiest ways possible. Adequate training both off and on the arena or court, as well as appropriate rest and recovery are critical in any sport. Adjunctive products offer benefits in prevention and management of injuries, but remember to seek adequate assessment of any injury by a qualified doctor.