Category Archives: Feature Article

Featured Issue Article

August 2016

Management of Achilles tendinopathy in runners

Achilles tendinopathy is a common lower extremity injury in athletes as well as nonathletes. The Achilles tendon is often a site of injury in runners and is the second most common running-related musculo­skeletal injury, after medial tibial stress syndrome, with an…

By Howard Kashefsky, DPM Continue reading

August 2016

Uneven terrain: Tactics for orthotic-device users

Helping patients manage an orthotic device can be challenging, but doing so in the face of uneven terrain is a balancing act between stability, mobility, and strength. Device adjustments and rehabilitation pro­tocols can help patients avoid asymmetries and reduce the risk of falling.

By Shalmali Pal Continue reading

August 2016

Foot strike while running and patellofemoral pain

Recent research supports the idea that increased patellofemoral stress is a contributing factor in runners with patello­femoral pain, and that gait retraining to promote a…

By Jenevieve L. Roper, PhD; Deborah L. Doerfler, PT, DPT, PhD; Christine M. Mermier, PhD; and Janet S. Dufek, PhD Continue reading

August 2016

Foot rotation during gait in patients with knee OA

Rotating the foot in or out during gait is associated with significant decreases in frontal plane knee load during early or late stance, respectively, and can be effective for reducing pain and potentially slowing the progression of…

By Kevin Alan Valenzuela, ABD, CSCS; and Hunter Jared Bennett, PhD Continue reading

August 2016

Radiofrequency-based arthroscopy in the ankle

The results of a retrospective chart review suggest that the use of plasma-mediated bipolar radiofrequency-based arthroscopic microdebridement is associated with notable decreases…

By Renato Giorgini, DPM, FACFAS; Stephanie Giles, DPM; Omer Aci, DPM; and Christopher Japour, DPM, MS  Continue reading

July 2016

Understanding turf toe: The role of foot orthoses

Turf toe is a common injury in football players competing on artificial turf, but it also occurs in soccer and baseball players on natural grass and other playing surfaces. Turf toe is a sprain of the capsule of the first metatarsophalangeal (MTP) joint; increasing grades of injury may include…

By Patricia Pande, MClScPT, CSCS, CPed Continue reading

July 2016

New healing factors take ulcer care to the next level

Support is growing, in the medical literature and in clinical practice, for the use of skin substitutes and other advanced biologic therapies in chronic diabetic foot ulcers. But researchers and practitioners remain uncertain as to which of these advanced products are best for…

By Hank Black Continue reading

July 2016

Lower extremity strength and injury risk in runners

Study findings regarding strengthening interventions in runners with patello­femoral pain syndrome have been inconsis­tent, perhaps because specific subgroups are more responsive than others. Preliminary research suggests high school runners may make up…

By Lace Luedke, PT, DPT, PhD, OCS, CSCS Continue reading

July 2016

Limb length discrepancy: When, how to intervene?

Limb length discrepancies (LLDs) as small as 1.5 cm can significantly affect gait, and some clinicians choose to intervene in cases of even smaller discrepancies. Many LLDs can be addressed orthotically, but surgical techniques are becoming less invasive and more effective.

By Cary Groner Continue reading

June 2016

Golf swing biomechanics: Footwear considerations

With the rise of a new crop of young stars and the anticipation of its Olympic debut this year, golf continues to be immensely popular for players and spectators alike. Golfing is a highly coordinated sport that, by its nature, is associated with risk of…

By Patricia Pande, MClScPT, CSCS, CPed Continue reading

June 2016

When knee OA research becomes legal testimony

In worker’s compensation cases, including those involving knee osteoarthritis, an expert witness often will be asked to use his or her knowledge of biomechanics to provide an opinion supporting or refuting a causal relationship between work conditions and an overuse injury.

By Steven T. McCaw, PhD

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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