Why elite athletes should wear medical compression

By Prof Charles McCollum, MB ChB, FRCS, MD, Head of Academic Surgery and Professor of Vascular Surgery in the Institute of Cardio-Vascular Research, University of Manchester. Expert in Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE).

Elite sportsmen and women who travel frequently or on long-haul flights are at particular risk of suffering deep vein thrombosis (DVT) or pulmonary embolism (PE). A DVT may destroy their carer in sport. A third of all PEs are fatal.

Many people develop small calf vein DVTs following a long haul trip abroad (Scurr et al, 2001). Sitting still for over four hours or repeated flights in a month allows small DVT to grow and spread into the major deep veins. Once a DVT is large enough to cause symptoms, there will have been permanent damage to the valves in the deep veins of the leg. The result may be long-term swelling with pain on standing, walking and running.

For elite athletes at their peak, this vein damage would normally ruin their careers. This risk is higher following a sporting event or strenuous training session as the calf muscle may be swollen and inflamed following vigorous exercise making DVT more likely.

Falling asleep on the plane after a sporting event or a strenuous training session increases this risk markedly as it causes profound venous stasis in the leg increasing the risk further. Athletes who do this take an unacceptable risk with their future career. A third of PEs are fatal, depriving the family of their principle bread winner.

Research shows higher levels of risk

Asymptomatic calf vein DVT (diagnosed by ultrasound but not big enough to cause symptoms) can be detected in 10% of people completing two 8 hour flights within a month (The Lancet 2001).

Elite athletes have larger calves with big veins to carry the high blood flows of peak exercise, but which cause slow blood flow on sitting still (venous stasis). I have seen many athletes with large calves who developed disabling DVT during coach or aeroplane journeys or simply after falling asleep in a chair.

In a much larger study, symptomatic larger DVTs developed in 1% of people travelling 4+ hours by aircraft (Hughes et al 2003). These patients are likely to have permanent disabilities as a result of these more extensive DVTs.

Repeated flying encourages small asymptomatic calf DVTs to develop into major clots throughout the veins of the leg. In a very large study recruiting thousands of patients, flying for more than 4 hours twice in 8 weeks more than doubled the risk of symptomatic or damaging DVT compared to a single flight (Kuipers et al 2007, McCallum et al 2011). Flying 3 or 4 times in 8 weeks increases the risk more than fourfold; 5 times or more increases the risk more than seven fold.

NHS advises wearing compression that fits

The NHS offers the following advice for long-haul travellers: “It's vital that compression stockings are measured and worn correctly. Ill-fitting stockings could further increase the risk of DVT” (NHS Choices. Prevent DVT when you travel).

It is important to note that independent research shows that standard ‘off-the-shelf’ elastic stockings often do not fit and, in some cases, create a bigger risk.

  • 54% failed to achieve an acceptable pressure gradient
  • 20% had reversed gradients – increasing the risk of DVT
  • High-pressure bands cause swelling of the foot and ankle, frequent when flying (K Bowling et al 2015 and A. J. Best et al 2000).
     

Isobar Compression works with Olympic athletes, professional rugby teams and US colleges and professional teams to offer custom-fit compression for travel.

Why custom-fit flight socks are a must for business travel

Duty of care is a top-three issue for travel managers globally as increasing regulations and security means companies need to ensure their employees are safe when travelling, as well as in the office.

For many, this means considering how to support employees if a security incident occurs but did you know flying employees are more likely to suffer a blood clot while travelling than be involved in a security incident?

1 in 10 people taking a return long-haul flight within a month (4+ hours) will suffer an asymptomatic DVT; a blood clot without symptoms. Immobility through sitting for long period on flights or during coach travel causes the blood to pool in the legs meaning a clot can form, which in extreme cases can be life threatening if the clot travels to the lungs.

A blood clot spells bad news for the employee and their employer: long-term symptoms are common and the employee won’t be able to fly for up to six months, as well as needing two weeks – three months off work to recover.

Professor McCollum, Lawyer Monthly Vascular Expert of the Year 2016 & 2017, comments: “This is a largely avoidable risk. DVT, which is the inevitable precursor to a life-threatening Pulmonary Embolism, can be prevented by well-fitted elastic socks, good hydration, taking aspirin 300 mg with food before flying where this is not contraindicated and by exercising the calf muscles during the flight.”

Isobar Compression produces comfortable and effective flight socks, using a 3D scan of the employee’s limbs to capture an exact picture from which the socks are finely knitted to ensure an exact fit. Independently proven to last 100 washes, they give the employer and the employee peace of mind over travel health – and our customers tell us they reduce jet lag too.

Call us on 02476 284041 to discuss how we can help your business protect its employees with safe travel in 2018.

Making a difference to patients through innovation

By James Sopper, Chief Technical Officer at Isobar Compression

Our foundation is in innovation, bringing together 3D imaging with leading textile manufacturing to create our custom-fit Isobar Compression garments. We offer a premium experience to our customers and patients – premium service through in-person scanning at their home, office or preferred clinic to premium quality in manufacturing.

It’s important that we keep that premium service and innovation fresh, so my job is to ensure our imaging and production processes are constantly refined. We’ve recently launched a new 3D scanner in the field following feedback from our sales team and clinical partners.

Our existing scanner worked well for able-bodied people and for lower leg compression. But from our work with University Hospital of South Manchester and other medical clinics, we know there is a need for a scanner for patients who cannot stand for long – the elderly, those suffering with leg ulcers or the morbidly obese. We needed a scanner that would work for a patient sitting or lying down.

Plus, a lot of clinicians we work with wanted full leg scanning for thigh-length, custom-fit compression so we needed to change the range of the scans to capture an image of the whole leg. We’ve changed our scanner to a hand-held unit which allows the person scanning to move around a stable limb taking a 3D picture of the whole leg or arm.

When making these refinements, we’ve also managed to cut down the time of the imaging. 18 months ago, when I first started working for Isobar, the scanning process would take two minutes for each leg whereas now it takes just 10 seconds per limb. The software is surprisingly simple to use with a touch screen control.

We have many different people using the scanners across the globe, from strength and conditioning and performance staff in the sports world, to nurses in clinics. It’s so easy to use that one of our partner clinics have trained up the IT manager and receptionist to scan at busy times.

My background is in aeronautical engineering, designing and building pressure measurement systems for racing yachts and producing medical-grade devices where I have learned about quality control, regulations and traceability of parts. With Isobar Compression, I enjoy that such a simple piece of equipment can make such a difference to quality of life for so many people. A lot of medical devices for scanning cost millions of pounds, yet we can relatively cheaply make a real difference through our technology. We could save the NHS millions of pounds and have a real impact on self-care, which is an exciting proposition for us.

How Isobar helped my ankle injury recovery

Practice Manager Viv Taylor turned to Isobar Compression to reduce her ankle swelling after being in plaster for a fractured ankle. Here she explains how she wore Isobar Compression socks under her Aircast boot to allow earlier rehabilitation.

I leapt out of bed one evening to help my husband, who was unwell. My blood pressure must have been low as I fainted, collapsing to the floor and hurting my ankle.  I was in a great deal of pain and went to A&E, where I was diagnosed with a fractured tibia and fibula; vertical fractures going down into the heel.  The Consultant told me it was an unusual fracture and wanted to pin it, although he thought it was 50/50 whether surgery would improve the outcome. I’d had some health problems earlier in the year requiring surgery, so didn’t want further surgery if it wasn’t absolutely necessary. 

I work as a Practice Manager and have worked in healthcare for a long time, so I have reasonable understanding of care. I asked for an Aircast boot, rather than a cast, but was advised that with the type of fracture I’d sustained it would need to be in plaster for at least five weeks.

I work for Professor Charles McCollum (Vascular Surgeon) who was part of the team that created Isobar’s bespoke compression socks. He recommended I should have my leg scanned for a compression sock to fit the left leg, for DVT prophylaxis while I was immobilised with the fractured right ankle.  Isobar came to my house to perform the scan, which was an excellent service as I was having difficulty getting out of the house.

Five weeks later, when the plaster cast was removed, my right ankle hadn’t healed quite as well as the doctors had hoped; but they did now agree to me having an Aircast boot. I asked if I could put a compression sock on under the boot to improve both the swelling and the venous return. The hospital team weren’t happy to agree this as they weren’t aware of the technology (I have since shared the research with them) so, having spoken to Professor McCollum, I put the sock on myself when I got home.

I have some experience of compression stockings as I used to be a midwife and have often struggled to assist women into the traditional TED stockings.  The Isobar stockings are so much easier! They aren’t restrictive like traditional compression stockings.

Immediate results

In the first ten days of wearing the Isobar sock on my injured right ankle the circulation and swelling improved considerably. It was very comfortable to wear under the boot. The enormous advantage was that I could remove the boot to perform my physiotherapy exercises, improving the movement in the ankle joint considerably.

I will be wearing the Isobar socks for a while, until my ankle is back to normal. The black colour of the sock is perfect and they are not nearly as irritating as other compression socks. I have considerable experience with TED stockings and, although the Isobar socks are much more expensive, I think they are superior and would recommend them to other ankle fracture sufferers.

Can Isobar custom-fit compression help you? Get in contact now.

How Isobar Compression is helping me with leg ulcer recovery

Alex Grannum contacted Isobar Compression when he couldn't find prescription compression to fit. Here he explains how Isobar custom-fit compression is helping him with venous leg ulcer prevention and recovery.

I’m 52 years old and I live in Southampton. Back in July 2016, I was prescribed compression socks after having been found to have a venous ulcer on my right ankle. I began receiving treatment through antibiotics and four-layer bandages to heal the ulcer. The doctors suggested that surgery was inevitable.

I was given a prescription and told to get compression socks to prevent my left leg suffering the same. I would have to wait for my right leg to heal before I could use the stocking on both feet.

I took the prescription to my local pharmacy and asked for the biggest size socks but they didn’t fit. My wife shopped around and couldn’t find any either. You see, I’m 6ft 7ins and have size 15 feet. There was nothing available that would fit me.

Out of desperation, I found a phone number on the socks I bought and enquired for a larger size. They suggested I contact Isobar Compression. Having googled them, they assured me that they could help me. I can’t describe the wave of relief that came over me. After some discussion, they came to my home, scanned my legs and soon after my socks arrived in the post.

Reassurance and comfort

The socks are fantastic. Sometimes I forget they’re actually on my feet. They are so comfortable and it’s reassuring knowing they’re helping pump the blood back to my heart. I have a friend with the same problem who’s wearing prescribed compression and he cannot believe the quality of my Isobar socks.

Two weeks ago the wound on my right ankle finally healed. As I’m nearly at the end of the treatment, I’m looking forward to finally wearing the other Isobar sock instead of the four-layer bandage, which has been very uncomfortable.

I was told I’d have to wear compression socks for the rest of my life but I don’t mind as I know they will prevent the ulcers appearing again.

 

 

 

Partner scanning centres in Dubai launched

We are pleased to announce a new partnership with Mediclinic City Hospital and Mediclinic Dubai Mall who will become official Isobar Scanning Centres, providing scanning for the world’s most precise 3D manufactured compression garments.

Over 70 million travellers fly via Dubai each year, with many traveling for 4 hours (long-haul) or more to reach their destination. A recent YouGov survey showed many UK passengers are unaware that 1 in 25 will develop DVT. The NHS recommends passengers wear well-fitting compression to reduce this DVT risk.

Isobar produces exact-fit compression garments clinically proven to increase blood return to the heart. This reduces the risk of DVT during long-haul flights as blood clots are less likely to happen.

Professor Charles McCollum, Professor of Surgery and Head of Academic Surgery at the University of Manchester and Isobar Chief Medical Advisor, said: “We are delighted to welcome Mediclinic City Hospital and Mediclinic Dubai Mall as Isobar Scanning Centres in Dubai. Isobar Compression delivers the precise pressures needed for each indication, whether increasing performance and recovery for elite athletes, DVT prevention, or treating lymphedema and leg ulcers. This cannot be achieved by any existing compression stocking or bandaging system and Mediclinic City Hospital and Mediclinic Dubai Mall Medical Centre will be able to exclusively offer this service to their customers.” 

Customers can book their 3D scan under Dr Taohid Oshodi FRCS at the Vascular Clinic at both Mediclinic City Hospital and Mediclinic Dubai Mall Medical Centre by contacting Taohid.oshodi@mediclinic.ae or phoning the numbers below.

Mediclinic City Hospital
+97144359999/+971529084047

Mediclinic Dubai Mall
+97144495111 / +971529084047

Isobar ambassador shatters cycling world record

Ultra-endurance athlete Mark Beaumont has set a new world record, taking one third off the current Guinness World Record (123 days) for circumnavigating the globe, completing the challenge in just 78 days, 14 hours and 40 minutes on the Artemis World Cycle.

Beaumont completed the 18,000-mile cycling challenge at Arc de Triomphe in Paris, where his journey began on July 2nd and had hoped to complete the ride in 80 days. Mark was also awarded the Guinness World Record for Most Miles Cycled in a Month from Paris to Perth in Australia, verified at 7,031 miles (11,315km). Commenting on the achievement Beaumont said: “This was a fantastic milestone to achieve during the challenge of getting around the world in eighty days I hope it is used as a marker for other cyclists to go and smash in the near future.”

Cycling for 16 hours per day (240 miles) Beaumont has travelled through 16 countries throughout his four-stage challenge. The first stage saw him travel through Europe to Russia and Mongolia, culminating in Beijing.

Beaumont’s second phase through Australia and New Zealand led him into stage three starting at Anchorage cycling through to Halifax, flying back over the pond to begin the final stage in Lisbon and back up to Paris.

Over the course of the 78 days, Beaumont has faced numerous physical and mental challenges, including a fall on day nine which could have ended the whole expedition. Pedalling through Australia and New Zealand during the winter season meant Beaumont was continually exposed to sub-zero temperatures, making time on the bike even more gruelling.

As Mark cycled through Canada and USA, he was faced with the prospect of weathering secondary storms of Hurricane Irma as he travelled east towards Halifax to complete stage three. But despite all of these trials, Beaumont completed the momentous challenge on schedule.

Mark is an Isobar Compression ambassador and used Isobar garments for recovery, as well as travel socks for his inter-continental flights to reduce his risk of DVT. Active athletes with well-developed muscles are at a greater risk of DVT when sitting immobile for hours.

On completing the expedition, the double Guinness World Record holder commented: “This has been, without doubt, the most punishing challenge I have ever put my body and mind through. The physical and mental stamina required for each day was a challenge in itself, but I had an amazing support team around me.

“The success of cycling around the world in 78 days shows that what seemed impossible is possible and has redefined the limits of endurance sport. Each stage brought different challenges including different climates, which I had to adjust to quickly. Stage one through Russia and Mongolia was unknown territory, so to complete this phase and come out with a second Guinness World Record is a real achievement.

“I am very grateful for the support I’ve received from people all over the world, from fellow cyclists joining me on the road to messages and wishes online. The experience has been incredible, and I’m excited to share this journey for years to come.”

Craig Glenday, Editor-in-Chief at Guinness World Records added: “Mark has once again proved himself to be Officially Amazing! He’s added not one but two world-beating achievements to his existing record for Fastest bicycle journey from Cairo to Cape Town. Beating this iconic circumnavigation record places Mark into an elite category of multiple record holders and firmly establishes him as one of the most dedicated and determined Guinness World Records title holders."

I thought flight socks were for grannies

Andy Tucker is 25 and as a self-confessed fidget, didn’t think to buy flight socks for his worldwide travels earlier this year. The London-based estate agent takes time to move around on flights but despite this he suffered a debilitating blood clot on a flight back from New Zealand.

Andy flew to South Africa for a week’s holiday, then shortly after had a week in New Zealand flying via Dubai. It was on his return to Dubai from New Zealand that he noticed the pain in his right leg.

“My calf began to hurt after I woke from sleeping,” Andy explained. “I stretched it and walked about, as it felt like I’d had cramp in my sleep and it was aching. But it didn’t seem to get any better with the stretching and it hurt for the rest of the flight, then again on the connecting flight from Dubai to London. I was sitting in economy and it was difficult to stretch my leg and get comfortable.

“Once I got back to London I went home to bed, then to work the next morning. I had been sitting down for an hour and a half, and the pain was troubling me so I knew something wasn’t right. The thought that it was a DVT was at the back of my mind and I called NHS 111 to tell them about my symptoms. They told me to go straight to A&E. I had a blood test at A&E then was sent for a scan, which confirmed it was a DVT. I was put on blood thinners for three months and told I should wear flight socks un the future, as well as having blood thinning drugs prior to flying.”

A blood clot or deep-vein thrombosis (DVT) is usually formed in the leg when sitting immobile for hours, such as on a long-haul flight. DVT is dubbed ‘economy-class syndrome’ due to travellers sitting in cramped conditions and not able to move their legs to keep the blood flow returning back to the heart. The blood starts to clot hampering the ability of blood to flow around the clot which causes pain. Symptoms include aching, soreness and a red colour to the skin area.

In severe conditions, the blood clot can travel through the veins to the heart and can cause a blockage – a Pulmonary Embolism – which can be fatal if it travels to the lung. There are 67,000 known cases of DVT in the UK every year, but more worrying a 2016 report showed 4% of those flying over four hours suffer an asymptomatic DVT – suffering a DVT without symptom and the risk increases the more often you fly.

The NHS advises people travelling by plane should wear well-fitting compression stockings and there is a warning about ensuring the right fit – one study showed that off-the-shelf compression socks failed to fit 98% patients. Well-fitting compression helps by squeezing the blood from the outer veins into the deep veins in your calf and helping the blood flow back to your heart.

Vascular expert Professor Charles McCollum of the University of Manchester Hospital advises: “Well-fitting socks should be worn from the morning of your flight as there can be a lot of sitting around waiting at airports. I would advise avoiding alcohol and drinking plenty of water to stay hydrated as well as moving around every hour on the plane. Just a short trip to the toilet and back aids your blood flow. Keep the compression socks on for a couple of hours after the flight. The compression will stop any swelling in your legs and will help with that ‘heavy leg’ jet lag feeling.”

Andy won’t be taking any chances in the future. “I thought flight socks were for grannies. It didn’t even cross my mind that I would need to wear them and I’d never had any problems before. I will always wear flight socks in the future. Even my mum, dad and brother are getting them now after seeing what happened to me!”