Category Archives: Feature Article

Featured Issue Article

February 2014

Epidemiology of Achilles tendon rupture in the US

The etiology of Achilles tendon rupture is multifactorial, but the injury occurs most frequently in the athletic population. Clini­cians still miss 24% of ruptures acutely, particularly in older patients, those in whom sports was not the causative mechanism, and those with high BMIs.

By Steven M. Raikin, MD

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January 2014

Knee injury prevention: Hip and ankle strategies

Many knee injury prevention programs do not focus on ankle dorsiflexion range of motion and hip adductor activation, but research suggests both distal and proximal variables contribute to alterations in frontal plane knee biomechanics and could affect injury risk.

By Darin A. Padua, PhD, ATC, and Micheal A. Clark, DPT, MS, PES, CES   

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January 2014

Nerve decompression and diabetic neuropathy

Advocates of surgical nerve decompression in a subset of patients with diabetic neuropathy have published some impressive outcomes, but critics of the procedure point to the conspicuous absence of randomized trials. The issue has become one of the most contentious in diabetes care.

By Cary Groner

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January 2014

Painful hip impingement: Functional implications

Physical impairments associated with femoroacetabular impingement include limited range of motion, muscle weakness, and altered biomechanics. Attention to these areas during rehabilitation can improve surgical outcomes and may even reduce the risk of osteoarthritis.

By Jerrad R. Guenther, BSc, Michael K. Gilbart MD, FRCS(C), MEd, and Michael A. Hunt PT, PhD

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January 2014

Achilles tendinopathy and body mass index

Research suggests that obesity influences the development of Achilles tendi­no­pathy to a greater degree than other types of foot and ankle pain. This phenomenon will become increasingly important to lower extremity practitioners as global obesity rates continue to rise.

By Ryan T. Scott, DPM, AACFAS, and Christopher F. Hyer, DPM, MS, FACFAS

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January 2014

A proximal perspective on patellofemoral pain

Hip strengthening can improve short-term outcomes related to patel­lo­­femoral pain syndrome, but further research is needed to determine the underlying mechanism and whether the same approach will also prove effective in managing patello­femoral osteoarthritis.

By Michael B. Pohl, PhD

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November 2013

Conference coverage: 3rd PFP research retreat

The third International Patellofemoral Pain Research Retreat picked up where previous retreats had left off in examining proximal and distal factors related to PFP and subgroups of patients who might respond to targeted interventions. But this retreat broke some new ground as well.

By Jordana Bieze Foster

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November 2013

Plantar plate repair: New approach to metatarsalgia

Plantar plate pathology in conjunction with metatarsalgia occurs more often than is commonly appreciated, but can be addressed using a combined procedure that involves a dorsal approach to anatomic plantar plate repair and metatarsal realignment.

By Lowell Weil Jr, DPM, FACFAS, and Erin E. Klein, DPM, MS

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November 2013

Studies examine ways to optimize OA bracing

Research continues to suggest that bracing has the ability to improve pain and function in patients with knee osteoarthritis in a controlled setting, but researchers are now working to identify factors that affect bracing outcomes in the real world. Patient expectations are at the top of that list.

By Larry Hand

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November 2013

Achilles tendon rupture: The influence of gender

The literature suggests that women are less likely than men to experience an Achilles tendon rupture. This may be because women are less capable of generating the large eccentric contractions necessary for rupturing the tendon. Estrogen may also play a protective role.

By Joseph L. Laratta, MD, and J. Turner Vosseller, MD

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November 2013

Limited hip flexibility: Mutability and mobility

Myofascial or joint-focused stretches can increase passive hip range of motion in young adult men with limited hip flexibility, but this will not necessarily result in more hip motion actually being utilized during functional activity unless old movement patterns can be unlearned.

By Janice Moreside, PhD

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November 2013

Hamstring strain: Issues facing collegiate athletes

Collegiate athletes who participate in sports associated with sprinting have an increased risk of hamstring strain. Investigators have identified flexibility, strength, and fatigue as potential contributing factors that can be addressed through sport-specific training and rehabilitation.

By Kevin M. Cross, PhD, ATC, PT, Susan Saliba, PhD, ATC, PT, and Jay Hertel, PhD, ATC

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October 2013

Debating the complexities of partial foot amputation

Partial foot amputations may not offer a biomechanical advantage over transtibial amputations if the metatarsal heads cannot be retained, and some experts suggest amputation level should be selected based on probability of wound healing instead. But others disagree.

By Cary Groner

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October 2013

Ankle arthroplasty makes strides, but issues remain

Study findings and anecdotal reports suggest that newer-generation total ankle replacement can match or exceed ankle arthrodesis when it comes to gait and range of motion, but neither procedure returns gait to normal. Implant survival has also improved, but continues to be a challenge.

By Barbara Boughton

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October 2013

Total hip arthroplasty: Obesity and outcomes

Total hip arthroplasty can significantly improve quality of life in obese patients, but high body mass index is also associated with higher rates of complications and re­admissions than in normal-weight patients. The emerging subgroup of super-obese patients poses additional challenges.

By Raghav Rajgopal, MD, and James L. Howard, MD, MSc, FRCSC

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October 2013

Biofilms: Diabetic foot ulcer care gets personal

Opportunistic microorganisms called bio­films constitute an age-old diabetic wound care problem that defies traditional anti­microbial therapies. Experts believe interventions customized to individual patients based on molecular diagnostics may be the best line of defense.

By Larry Hand

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October 2013

Platelet-rich plasma: An option for tendinopathy

Patients with chronic refractory lower extremity tendinopathies often continue to have symptoms after exhausting most of their therapeutic options. Preliminary evidence supports the use of platelet-rich plasma in these patients, though higher-level research is needed.

By Ricardo E. Colberg, MD, and Kenneth Mautner, MD

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September 2013

Lower body mechanics bolster overhead throws

Lower extremity biomechanics  can significantly affect the risk of upper extremity injury in overhead throwing athletes, such as baseball and softball pitchers and catchers, and the functional stability of the lumbopelvic-hip  complex is essential to preventing those injuries.

By Gretchen D. Oliver, PhD, FACSM, ATC, LAT, Hillary Plummer, MAT, ATC, and Lisa Henning

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September 2013

PAD and reamputation in patients with diabetes

In patients who undergo a minor foot amputation following a diabetic foot ulcer, severe peripheral arterial disease is the primary risk factor for subsequent major amputation, which underscores the importance of early detection and intervention for PAD in this population.

By Vincent S. Nerone, DPM, Kevin D. Springer, DPM, Darren M. Woodruff, DPM, and Said A. Atway, DPM, AACFAS

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September 2013

Original research: Knee self-massage for OA pain

The medical literature supports the use of massage for relief of osteoarthritis symptoms, but therapist-administered treatments can be cost-prohibitive. This study found that self-massage can also be effective, even when the initial supervised sessions are continued by patients at home.

By Dorothea Atkins, ThD, RN, and David Eichler, PhD

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September 2013

Core stability and lower extremity injury risk

A growing body of scientific evidence suggests that clinical tests of core strength and stability can help predict risk of lower extremity injury in athletes, which in turn supports the need for a multisegmental approach to the development of injury prevention programs.

By Valerie Snider, MS, ATC, and Gary Wilkerson, EdD, ATC

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September 2013

Effect of sex hormones on incidence of knee pain

New research suggests that vasti muscle activation in women varies throughout the menstrual cycle, adding to the growing body of literature pointing to a connection between sex hormones and knee injury risk. The exact nature of that relationship, however, remains unclear.

By Matthew S. Tenan, MA, ATC, and Lisa Griffin, PhD

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August 2013

Finding fashion options that accommodate AFOs

Practitioners know patients who feel that ankle foot orthoses (AFOs) hinder their sartorial style are less likely to be compliant, but many clinicians feel ill-equipped to give fashion advice. That’s when the expertise of a stylist, seamstress, or personal shopper can come in handy.

By Shalmali Pal

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August 2013

Plantar fasciitis: Unique challenges in basketball

Not only do basketball players have many of the same risk factors for plantar fasciitis as the general population, they also have the added challenge of a grueling season and very little opportunity to rest. That means practitioners have had to be creative when it comes to treatment.

By P.K. Daniel

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August 2013

Gait retraining improves symptoms of knee OA

A number of different gait modifications have been demonstrated to significantly reduce the knee adduction moment in patients with knee osteoarthritis (OA). Now research suggests gait retraining can also help reduce the pain associated with knee OA and improve function.

By Pete B. Shull, PhD

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