Category Archives: Feature Article

Featured Issue Article

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

Continue reading

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

Continue reading

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

Continue reading

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

Continue reading

August 2013

Diabetic limb salvage: Surgeon’s perspective

When preventive measures have been exhausted, various surgical approaches can be employed to provide each diabetic patient with a functional, biomechanically sound foot that is free of infection, while minimizing the risk of future lower limb complications.

By Gabriel V. Gambardella, DPM, and Peter A. Blume, DPM, FACFAS

Continue reading

August 2013

MS and gait: Assessment facilitates opportunity

Significant progress has been made in quantifying gait impairment in patients with multiple sclerosis, but clinician-friendly assessment techniques that are sensitive to mild levels of impairment are needed to facilitate early intervention and in turn improve patient outcomes.

By Douglas A. Wajda and Jacob J. Sosnoff, PhD

Continue reading

July 2013

Patient Perspective: Bunionectomy recovery is more than just healing

I can’t recall exactly when the bunion on my left foot started causing discomfort, but it was probably when I was about 40. I waited some time to get a referral to a podiatrist, and when I finally saw one, life with two kids and a full-time job stalled my pursuit of treatment for another three and half years.

By Karen Bakar

Continue reading

July 2013

Post-traumatic OA: Unique implications for the military

Military populations experience high rates of disability related to post-traumatic osteo­arthritis (PTOA), which does not always originate from combat injury. But military researchers are also uniquely posi­tion­ed to explore therapeutic options to minimize the effect of PTOA.

By Jessica C. Rivera, MD, Joseph C. Wenke, PhD, James R. Ficke, MD, and Anthony E. Johnson, MD

Continue reading

July 2013

A new approach to iliotibial band syndrome in runners

Variables related to iliotibial band strain appear to be important risk factors for development of iliotibial band syndrome (ITBS) in runners, a finding that is beginning to change the way researchers assess the effectiveness of gait retraining interventions to treat or prevent ITBS.

By Stacey Meardon, PT, PhD, ATC, CSCS, and Ross H. Miller, PhD

Continue reading

July 2013

Kicking biomechanics: Importance of balance

Kicking is a whole-body movement that is responsive to a wide range of constraints related to the task, the environment, and the athlete. Preliminary research also suggests that balance control in the support leg plays a key role in athletes’ kicking performance.

By David I. Anderson, PhD, and Ben Sidaway, PT, PhD

Continue reading

June 2013

Inserts improve symmetry, velocity in stroke patients

Learned disuse of the affected limb can lead to weight-bearing asymmetries in patients with stroke-related hemiparesis. Compelled body-weight shift therapy, using shoe inserts to force loading of the affected limb, can help patients achieve a more symmetrical gait.

By Alexander S. Aruin, PhD

Continue reading

June 2013

Retraining fixes faulty gait in injured runners

Although the technique is still in its infancy, early research suggests gait retraining can be used to address medial collapse, primarily in runners with patello­femoral pain (PFP) syndrome, and to reduce impact loading in runners with PFP or tibial stress fracture.

By Ashlin Miller, BS, and Richard W. Willy, PhD, PT, OCS

Continue reading

June 2013

Rockers and rollovers: Implications for AFOs

Practitioners and researchers are redefining rocking and rolling as key components of gait, and designing ankle foot orthoses and other orthotic and prosthetic devices to specifically address impairments in the way certain patients rock and roll.

By Cary Groner

Continue reading

June 2013

Soft tissue composition and bone injury risk

Documenting how shock propagates through the leg and is attenuated by the soft tissues appears to be a critical step toward advancing practitioners’ and researchers’ understanding of lower extremity injury mechanisms related to running and landing activities.

By Timothy A. Burkhart, PhD, EIT, Alison Schinkel-Ivy, MHK, and David M. Andrews, PhD Continue reading

June 2013

Relieving pain in patients with diabetic neuropathy

Given the limitations of pharmacotherapy options for treating painful diabetic peripheral neuropathy, practitioners are also considering the merits of cognitive therapy, orthotic management, and combination therapies to relieve patients’ pain.

By Larry Hand

Continue reading

May 2013

Orthotic management of Charcot-Marie-Tooth

Ankle foot orthoses can help compensate for muscle weakness and accommodate related structural deformities in patients with Charcot-Marie-Tooth disease, but practitioners are constantly looking for ways to improve suboptimal compliance rates.

By Cary Groner

Continue reading

May 2013

Diabetes and altered gait: The role of neuropathy

Researchers have identified gait alterations in patients with diabetic peripheral neuropathy but also in diabetic patients with normal sensation, raising questions about the extent to which factors other than neuropathy might also be affecting gait.

By Cary Groner

Continue reading

May 2013

Concussion assessment: Neuromuscular concerns

Balance testing is already recommended for concussion assessment in athletes, but research suggests the connections between concussion and neuromuscular variables are even more complex, and the opportunities for intervention more numerous.

By Brent Harper, PT, DPT, DSc, OCS, FAAOMPT

Continue reading

May 2013

Artificial surfaces evolve, but safety debate persists

Artificial turf technology has advanced significantly, and some research suggests newer surfaces are as safe as grass, if not safer. But in other reports, including a high-profile NFL study, turf has been associated with higher rates of lower extremity injury.

By P.K. Daniel

Continue reading

April 2013

Microfracture surprises tarnish the experience

US orthopedic surgeons perform more than 25,000 microfractures annually, making the procedure the most common marrow-­stimulating technique used for repair of the cartilage defects that often affect active individuals.1 Although microfracture is a single-stage, low-cost intervention that requires only surgical time and common surgical tools, it requires…

By Emily Delzell

Continue reading

April 2013

Orthosis use in children with Down syndrome

The literature on preschool-aged and older children with Down syndrome tends to be consistent with conventional understanding of orthotic principles, but in very young children clinical decision-making about orthoses must also encompass  neuromotor implications.

By Julia Looper, PT, PhD

Continue reading

April 2013

Diabetic ankle fractures: Surgical considerations

Pittsburgh researchers found that patients with diabetes have higher complication rates than nondiabetic patients following open surgical management of ankle fractures, but also that the rate of major complications in the diabetic patients was relatively low.

By Robert W. Mendicino, DPM, FACFAS; Alan R. Catanzariti, DPM, FACFAS; Brian Dix, DPM; and Phillip Richardson, DPM Continue reading

April 2013

Bone bruises and risk of knee osteoarthritis

Bone bruises are commonly associated with anterior cruciate ligament (ACL) tears, but researchers are only beginning to understand the potential clinical significance of these chondral lesions with regard to knee osteoarthritis (OA) and preventing ACL injury recurrence.

By Cary Groner

Continue reading

April 2013

Poststroke bone changes in patients who use AFOs

The medical literature suggests that changes in bone density and other bone characteristics after stroke persist after patients have regained ambulatorystatus. Whether ankle foot orthoses have a shielding effect on bone remodeling, however, remains unclear.

By Kyle Sherk, MS, CPO

Continue reading

March 2013

Active Stance: Rethinking the concept of excessive pronation

Anterior knee pain is one of the most common injuries affecting runners, accounting for 25% of all running injuries.1 The etiology of anterior knee pain is multifactorial in nature,2 but one of the most commonly cited biomechanical risk factors is excessive rearfoot pronation.

By Pedro Rodrigues, MS, PT, PhD, Trampas TenBroek, PhD, and Joseph Hamill, PhD

Continue reading