MARKET OVERVIEW: The Lower Leg Injury Population
The EZ Step Climber is an aid for those with lower leg injuries, so the current and future size/dynamics of the leg injury market are fundamental to this analysis. There are several varieties of lower leg injuries, and shin splints, ankle injuries, foot fractures, and Achilles tendinitis are the most common[1]. With some 9,125,000 ankle sprains reported in the United States each year[2], ankle injury is the most common lower leg injury in the country. In fact, when that figure is broken down into shorter intervals of time, it amounts to over 17 ankle sprains each minute! Considering that almost everyone has sprained an ankle at least once (and often multiple times), these figures are not entirely surprising. However, they do confirm the large size of the ankle injury market in the United States.
Due to the widespread popularity of recreational jogging, shin splints have become the second most common variety of lower leg injury in the country. The repetitive ground impact of jogging tends to put inordinate stress on the shin bone (the larger of two leg bones directly below the knee) and its surrounding muscle tissue. It is estimated that shin splints afflict over 13% of American joggers/runners on an annual basis[3]. Considering that there are over 15 Million[4] joggers/runners in the United States; that amounts to 1,950,000 shin splints each year. As with ankle injuries, shin splints (especially those involving stress fractures – i.e. micro fractures in the bone) often necessitate extended periods of rest and relative immobility. Clearly, shin splints are a significant component of the domestic lower leg injury population.
While considerably less common, foot fractures are often the most severe and immobilizing of leg injuries. Extrapolating from a 1996 study of foot fracture incidence[5], assuming a general population sample, roughly 25,000 Americans (0.08% of the total U.S. population[6]) suffer a foot fracture each year. Considering that it takes between 6 to 8 weeks for a foot fracture to heal[7], those that suffer from this particular variety of leg injury have the most compelling need for the EZ Step Climber. Mobility is particularly important in this case since a disproportionate number of foot fractures are suffered by elderly women[8] (often with osteoporosis) that fall and suffer a foot fracture. This is a demographic that often lives alone, so restricted mobility can present difficult challenges with expensive solutions. That’s why the foot fracture market, while relatively small, is still a strong market for the EZ Step Climber.
GROWTH DYNAMICS: The Lower Leg Injury Population
Due to a number of powerful demographic factors, all varieties of lower leg injury are exhibiting increased levels of incidence in the United States[9]. To illustrate, at year-end 1998, the domestic population stood at 276 Million[10]. Presently, only 10.75 years later, it is estimated at roughly 308 Million[11]. That number represents aggregate growth of 31 Million residents (over 11% aggregate growth) in little more than a single decade. These figures indicate a significant growth rate. In fact, they represent the highest rate of population growth among all industrialized countries[12] (many of which, like Japan and Germany, are undergoing population declines). Of course, in broad terms, a fast-growing population bodes well for the provision of almost all goods and services; especially those, like mobility aids, with a direct and predictable level of statistical need.
However, what’s particularly significant for the prospects of the EZ Step Climber is the accelerated “graying of America”: In 1900, only 1 of every 25 U.S. residents was aged 65+[13]. 100 years later, that proportion skyrocketed to 1 of 8[14]. Today, with an increasing number of the 80 Million+[15] “baby boomers” (the largest generation in U.S. history in terms of both numbers and affluence) entering the elderly phase of life each year. Most of this demographic shift will take place between 2010 and 2030[16]; when the bulk of the “boomers” reach retirement age. When the last of them mark their 65th year, the proportion of elderly in this country will have reached an astonishing 20%[17] — i.e. one of every five Americans will be a senior citizen. It is also notable that the fastest-growing segment within the elderly demographic is the very elderly – i.e. those aged 85+[18]. Of course, as people age, the incidence of lower leg injury increases dramatically[19].
Another causative factor with direct relevance to the future growth of lower leg injury is the incidence of obesity. As a recent investigation of this issue concluded, “an extra 10 pounds on a person’s frame feels like 60 pounds to the knees[20]”. That, along with the fact that obesity impairs balance (thereby leading to more falls/accidents) is why the growth of obesity among all age groups will ensure steady growth in knee and lower leg injuries for the foreseeable future. A CDC study of state-by-state obesity rates from 1985-2007 revealed a large and fairly consistent year-to-year increase across the country[21]. As of 2007, only one state in the union (Colorado) had an obesity rate that was less than 20%[22]! It is also significant that obesity rates continue to rise across a wide range of age groups, with 26% of all U.S. adults being officially obese[23]. And, according to a comparative analysis of two sets of National Health and Nutrition Examination Survey data (1976-1980 and 2003-2006), between the two periods, the rate of obesity among children aged 2–5 years increased from 5.0% to 12.4%[24]. As for children aged 6–11 years, the rate of obesity leaped from 6.5% to 17.0%[25].
INDUSTRY OVERVIEW: Mobility Aids
With millions of Americans requiring some kind of mobility assistance at any given moment, it is hardly surprising that the domestic market for mobility aids is a multi-billion dollar industry. In fact, the low-end mobility aid industry segment alone (where the EZ Step Climber, due to its comparatively low cost, would be sold) is projected to reach $1.78 Billion in 2010[26]. Certainly, much of this growth can be attributed to the health/demographic factors discussed above. However, there is another critical factor at play – the decline in health insurance companies’ rates of reimbursement for mobility aids and accessory expenses that has happened during the current decade.
A 2004 report from Frost & Sullivan revealed that “reimbursement cuts by healthcare providers force manufacturers of mobility aids to find innovative ways to increase revenues[27]”. As a consequence of declining reimbursement, patients that suffer from leg injury (and other immobilizing conditions) now bear more of an out-of-pocket burden. This puts high-end expensive walking aids (like automated wheelchairs) far out of reach for a growing number of patients. As concluded by Frost & Sullivan: “although this trend reduces sales for high-margin products, demand is anticipated to increase for lower-end products and create new niche product segments to fill in the gap[28]”. So, this development is actually a very positive development for the market prospects for the EZ Step Climber – an ingeniously simple and affordable niche product for the mobility aid industry.
[1] “Sprains and Strains”, National Institute of Arthritis and Musculoskeletal and Skin Diseases, March 1999
[2] Liebert, Paul L., MD, “Lower Leg Injuries”, Merck Manual, Home Edition, February 2009
[3] Ott, Susan, MD, “Shin Splints: What are they? What causes them?”, Beginner Triathlete, April 3rd, 2005
[4] Weil, Richard, MEd, CDE, & Stoppler, Melissa, MD, “History of Running”, eMedicineHealth.com, December 11th, 2007
[5] “3,676 annual cases in Victoria 1996”, Department of Human Services, Victoria, March 1997
[6] “US Population Clock Projection”, United States Census Bureau, October 2009
[7] “Stress Fractures of the Foot and Ankle”, American Academy of Orthopedic Surgeons, July 2009
[8] Hasselman, CT, et al, “Foot and ankle fractures in elderly white women: Incidence and risk factors”, The Journal of Bone and Joint Surgery, May 2003
[9] Montgomery, Kiersten D., “Understanding an Aging Population”, University of Pittsburgh: School of Nursing, April 2003
[10] “Historical National Population Estimates: 1900-2002”, United States Census Bureau, 2003
[11] “US Population Clock Projection”, United States Census Bureau, October 2009
[12] “Population Growth Rate: Comparative Chart”, Central Intelligence Agency: The World Factbook, July 1st, 2009
[13] Barnard, Tom, “The Elderly Among Us”, Southern Nazarene University, 2007
[14] Ibid.
[15] “Oldest Baby Boomers Turn 60”, United States Census Bureau, January 3, 2006
[16] Ibid.
[17] Campbell, Joy, “Aging Boomers Increase Healthcare Demand, OMHS Executive Says”, McClatchy – Tribune Business News, April 24th, 2009
[18] Barnard, Tom, “The Elderly Among Us”, Southern Nazarene University, 2007
[19] Kannus, P, et al, “Rising incidence of low-trauma fractures of the calcaneus and foot among Finnish older adults”, Journal of Gerontology, June 2008
[20] McManis, Sam, “Knees Wearing Out at Much Quicker Pace”, Sacramento Bee, May 25th, 2009
[21] “Focus on Obesity” Centers for Disease Control and Prevention, 2007
[22] Ibid.
[23] Ibid.
[24] “National Health and Nutrition Examination Survey”, National Center for Health Statistics, 2007
[25] Ibid.
[26] “Boom Time in Low End Mobility Aids Market”, Business Wire, October 11th, 2004
[27] “North American Mobility Aids Market”, Frost & Sullivan, October 2004
[28] “North American Mobility Aids Market”, Frost & Sullivan, October 2004