Category Archives: Feature Article

Featured Issue Article

June 2016

Stroke rehab: Strategies to improve gait velocity

Multiple techniques can help improve gait speed after stroke, from therapeutic exercise to task-specific training to orthotic devices. Despite a growing body of research in this area, however, it is still not clear which intervention is most appropriate for which patients.

By Hank Black

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June 2016

Posture-specific strength and landing mechanics

Recent research suggests that training designed to maximize strength at deeper knee flexion angles during landing may be warranted, especially in female athletes, to help reduce the risk of anterior cruciate ligament injury without inadvertently compromising jump height.

By Boyi Dai, PhD; Jacob S. Layer; and Taylour J. Hinshaw

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June 2016

Treatment of distal toe calluses and ulcerations

When calluses or ulcers develop on the distal aspect of the lesser toes, offloading pressure from the distal end of the digit is essential for healing to occur. Research suggests that toe crest pads offer an inexpensive but effective means of offloading and healing these distal wounds.   

By Monica Melo, DNP, RN, ACNS-BC, CWOCN, CFCN

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May 2016

Managing metatarsalgia in athletic populations

Metatarsalgia is a common foot disorder. The term metatarsalgia refers to a pain syndrome in the forefoot and not to a specific diagnosis. Pain is confined to the area across the plantar forefoot, including the second through fourth metatarsal heads.

By Howard Kashefsky, DPM, FACFAS Continue reading

May 2016

Skin-care issues related to orthotic device wear

The care and prevention of skin issues may not get as much attention in orthotics as in prosthetics, but such issues can significantly affect patient outcomes. Here, lower extremity experts share the tips and tricks they use to manage dermatological challenges related to orthotic devices.

By Lori Roniger Continue reading

May 2016

Using subsensory noise to improve balance, gait

Using specially designed insoles to deliver stochastic resonance to the plantar surface of the feet has the potential to significantly improve static balance, dynamic balance, and gait mechanics in healthy…

By Daniel Miranda, PhD; Wen-Hao Hsu, ScD; and James Niemi, MS Continue reading

May 2016

Hip strength asymmetry and patellofemoral pain

Hip strength asymmetry has been observed in patients with existing patello­femoral pain syndrome (PFPS) and poten­tially could be used to screen for at-risk individuals.

By Franklin Caldera, DO, MBA; and Christopher Plastaras, MD Continue reading

April 2016

Managing hallux limitus and rigidus in athletes

The terms “hallux limitus” and “hallux rigidus” refer to a degenerative process of the great toe joint that was first described by Davies-Colley1 in 1887 and termed hallux flexus. Cotterill later coined the term hallux rigidus.2 The two terms represent a progression in…

By Howard Kashefsky, DPM, FACFAS Continue reading

April 2016

Achilles experts ponder effects of heel elevation

After an Australian study raised questions about the conventional practice of elevating the heel to decrease Achilles tendon load, researchers and clinicians have been revisiting what is known about the many factors—including pain—that can affect tendon load and function.

by Cary Groner Continue reading

April 2016

Influence of estrogen on the plantar fascia

Reported effects of estrogen on knee ligaments and the Achilles tendon raise questions about how the plantar fascia might be altered during the menstrual cycle and how those changes might affect injury risk.

By Jerrold Petrofsky, PhD, JD; and Haneul Lee, PT, DSc  Continue reading

April 2016

The clinical implications of accelerated knee OA

Accelerated knee osteoarthritis (OA), defined by very rapid radiographic disease progression, is also associated with earlier and more severe symptoms than traditional OA. Identification of…

By Jeffrey B. Driban, PhD, ATC, CSCS Continue reading

April 2016

Emerging treatments for diabetic neuropathy

Strict glycemic control is the most reliable treatment for diabetic peripheral neuropathy, but expanding knowledge of central and peripheral nervous system processes may help identify therapeutic methods…

By Sarnarendra Miranpuri, DPM, MD; Kush Patel; Gurwattan Miranpuri, PhD; Abhishek Chopra; and Ravinderjit Singh Continue reading

March 2016

Plantar fasciitis: Clinical concerns in basketball

Basketball is associated with a high number of lower extremity injuries, often related to footwear and the unique biomechanics and repetitious motion of the sport. This reflects the evolution of basketball from a refined sport to one of extreme physical contact and leverage. At elite levels of competition, the joint loading that comes with…

By Patricia Pande, MClScPT, CSCS, CPed Continue reading

March 2016

Running modifications and reducing injury risk

Evidence suggests that no one foot strike style can be expected to decrease injury risk in all runners, and that switching foot strike patterns can have unintended consequences. Using a shorter stride length, however, can be an effective alternative for some runners.

By Elizabeth Boyer, PhD, and Tim Derrick, PhD Continue reading

March 2016

Strength training: Bone health benefits for men

Men with low bone mass are much less likely than their female counterparts to receive treatment. But research suggests that resistance exercise is a safe and effect­­ive way to improve bone mineral density in men and, in turn, reduce the risk of fracture and related complications

By Pamela S. Hinton, PhD Continue reading

March 2016

Ankle instability rehab emphasizes individuality

Research presented at the most recent International Ankle Symposium indicates that rehabilitation for chronic ankle instability is evolving from a one-size-fits-all approach to an increased focus on matching specific interventions to the patients who are most likely to benefit.

By Lori Roniger Continue reading

March 2016

Flexible flat foot: Effects of orthoses during gait

In this original investigation, researchers analyzed the biomechanical effects of a foot orthosis in patients with flexible flat foot during walking and the extent to which those functional effects are consistent with proposed theories about the device’s mechanism of action.

By Bruce Elliott, PT, DPT, COMT, and Juan Garbalosa, PhD, PT Continue reading

February 2016

Plantar fasciitis: clinical concerns in cleated sports

Cleated sports are associated with a high incidence of lower extremity injuries. American football and soccer are particularly troublesome due to unique risk factors involving footwear design, loading patterns, and sport-specific biomechanics.

By Patricia Pande, MClScPT, CSCS, CPed Continue reading

February 2016

Active Stance: Patients with at-risk feet need collaborative care

In a recent editorial in The Lancet Diabetes-Endocrinology,1 Lipsky and colleagues wrote that diabetic foot disease “…is not a one doctor disease—it demands multidisciplinary care. Furthermore, as a notoriously unglamorous problem, the disease depends on…

By Terrence P. Sheehan, MD

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February 2016

Biomechanists explore effect of obesity on falls

Obese patients have an increased risk for falls and fall-related injury, not just because of the loads involved, but also because of the strategies they use to recover from a trip or slip. Findings from a growing body of research will help in developing interventions to minimize that risk.

By Hank Black Continue reading

February 2016

Dynamic load analysis for injury prevention

Identifying loading patterns associated with Jones fractures and other common sports-related injuries can assist with the development of custom modifications to footwear, insoles, and training programs to help reduce injury rates and enhance athletic careers.

By Yannick Goeb, Nate Wilcox-Fogel, and Kenneth J. Hunt, MD Continue reading

January 2016

Plantar fasciitis: Clinical considerations in runners

Clinicians should advocate for the cost-effective, judicious use of foot orthoses for runners with plantar fasciitis, in accordance with the present body of knowledge.

By Patricia Pande, MClScPT, CSCS, CPed Continue reading

January 2016

Conference coverage: 4th PFP research retreat

Studies presented at the Patellofemoral Pain Research Retreat in Manchester, UK, illustrate the progress researchers are making toward the ultimate goal of being able to tailor exercise protocols and other interventions to best address the needs of specific patient subgroups.

By Jordana Bieze Foster Continue reading

January 2016

Footwear, traction, and the risk of athletic injury

High degrees of rotational traction associated with athletic footwear can increase the risk of noncontact lower extremity injury following an unexpected neuromuscular perturbation, possibly by increasing biomechanical joint loading at the ankle and knee.

By John W. Wannop, PhD; Ryan Madden, MSc; and Darren J. Stefanyshyn, PhD, PEng Continue reading

January 2016

Yoga for knee OA pain: a mind-body approach

Although the medical literature has not yet provided definitive evidence of effectiveness, a number of existing studies suggest that yoga interventions are associated with improved physical and mental health outcomes among adults with knee osteoarthritis.

By Monica R. Maly, PT, PhD Continue reading