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November 2015

Equinus: Its surprising role in foot pathologies

Although milder than the spasticity-induced cases of equinus, limited ankle dorsiflexion in the non-neurological pop­ulation is increasingly recognized as a source of excessive strain throughout the foot and a factor in the pathogenesis of many foot conditions.

By Nicholas V. DiMassa and Jeffrey M. Whitaker DPM, FACFAS    Continue reading

November 2015

Experts revisit hyperbaric oxygen for diabetic ulcers

Recent analyses cautiously recommend the short-term adjunctive use of hyperbaric oxygen therapy (HBOT) for diabetic foot ulcer healing under certain conditions, but in the absence of high-quality clinical trials, experts continue to debate the controversial therapy’s benefits.

By Hank Black Continue reading

November 2015

Quadriceps symmetry after ACL reconstruction

Using muscle function symmetry as an indicator of patient progress after anterior cruciate ligament (ACL) reconstruction can provide insight about potential targets for intervention to improve movement quality, functional performance, and patient outcomes.

By Christopher Kuenze, PhD, ATC; and Adam Kelly, MS, ATC      Continue reading

November 2015

Intermittent claudication: next-generation therapy

Given that existing therapies for intermittent claudication are not appropriate for all patients, researchers are working to develop new therapies focused on improving patients’ ability to compensate for a vascular occlusion by expanding collateral artery pathways.

By Steven J. Miller, PhD; A. George Akingba, MD, PhD; and Joseph L. Unthank, PhD  Continue reading

December 2015

Telemedicine: Going virtual improves communication and outcomes

In addition to his usual daily appointments, meetings, lectures, and surgical procedures, David Armstrong, DPM, MD, PhD, a professor of surgery at the University of Arizona College of Medicine, and director of the Southern Arizona Limb Salvage Alliance (SALSA) in…

By Shalmali Pal Continue reading

October 2015

The mechanistic mysteries of foam rolling

As the popularity of foam rollers escalates, researchers are scrambling to document the therapy’s effects and tease out the possible underlying mechanisms, which now appear to be more complicated than the earliest investigators had hypothesized.

By Cary Groner Continue reading

October 2015

From amputee to clinical prosthetist: four journeys

A number of amputees, many inspired by the expert care they received after losing a limb, have been motivated to pursue careers in prosthetics, where they can provide patients with a unique and personal perspective. Four of these practitioners shared their stories with.

By P.K. Daniel Continue reading

October 2015

Including injury history adds to value of FMS

Multiple studies indicate that poor movement, as assessed using the Functional Movement Screen, and past history of injury are risk factors for future injury, and a recent investigation suggests that risk is…

By MAJ Michael Garrison, PT, DSc, OCS, SCS; and MAJ Richard Westrick, PT, DSc, OCS, SCS Continue reading

October 2015

Running in an exerted state: mechanical effects

Kinematic and kinetic alterations in the lower extremities that researchers have observed during the course of a prolonged run may provide clinically relevant insights into patellofemoral pain and other conditions associated with a gradual onset of symptoms during exercise.

By Lauren Benson, MS; and Kristian O’Connor, PhD Continue reading

October 2015

Post-polio syndrome: It takes a team approach

Along with technical issues related to muscle weakness, fatigue, and pain, the challenges of managing this hetero­gen­eous population include patients’ emotional response to the idea of needing an orthotic device for a disability they thought they had overcome.

By Larry Hand Continue reading

October 2015

Hamstring injuries: The clinical promise of PRP

Preliminary research suggests platelet-rich plasma (PRP) is a safe and effective means of treating hamstring injuries that do not respond to early conservative measures…

By Frank B. Wydra, MD; Ryan R. Fader, MD; Omer Mei-Dan, MD; and Eric C. McCarty, MD Continue reading

September 2015

Health literacy: the challenge of making clinical information accessible to patients

Healthcare education materials for patients are consistently written at a reading level too advanced for a significant number of people–a trend that affects all aspects of lower extremity care and can adversely affect clinical outcomes.

By Hank Black Continue reading

September 2015

Knee OA, biomechanics, and progression to TKA

The frontal and sagittal plane gait bio­mechanics associated with progression to total joint replacement in patients with knee osteoarthritis, particularly variables related to sustained loading, may be promising…

By Cheryl Hubley-Kozey, PhD, and Gillian Hatfield, PT, PhD Continue reading

September 2015

Tibial stress fractures: an evidence-based approach

Study findings suggest that increased loading rates and tibial acceleration are associated with an increased risk of sustaining a tibial stress fracture. Interventions directed at reducing these impact…

By CPT Jamie B. Morris, DPT, OCS, CSCS, and LTC Donald L. Goss, PT, PhD, OCS, ATC Continue reading

September 2015

Fifth met fractures and osteoporosis in women

Given that older women are at increased risk for osteoporosis, an increased incidence of fifth metatarsal fractures with increasing age in women suggests that such injuries could serve as an early point of entry into osteoporosis treatment and fracture prevention.

By David Beck, MD, Justin Kane, MD, and David Pedowitz, MD    Continue reading

September 2015

Cryotherapy and muscle recovery after exercise

Research utilizing contrast-enhanced ultrasound suggests that, although cryo­therapy effectively decreases the pain associated with exercise-related muscle damage, those symptomatic effects are not associated with decreased blood flow in the affected skeletal muscle.

By Noelle M. Selkow, PhD, ATC, and Susan A. Saliba, PhD, MPT, ATC Continue reading

September 2015

Surface EMG: A how-to guide for practitioners

With evidence-based protocols in hand, practitioners can feel more comfortable clinically integrating surface electromyography (sEMG) assessment, creating more sophisticated sEMG treatment protocols, and demonstrating the effectiveness of interventions.

By Rachelle Bordlee, sDPT, and Christopher Kevin Wong, PT, PhD Continue reading

August 2015

Sports compression garments: the expectations vs the evidence

Research suggests that compression garments can be effective for improving muscle recovery after fatiguing exercise, but has found little to indicate an athletic performance benefit.

By P.K. Daniel Continue reading

August 2015

Running modifications to alter PFJ contact force

Patellofemoral pain interventions have increasingly focused on running technique and training approaches—such as utilization of a forefoot strike pattern, a shortened step length, and manipulations to training pace—to reduce patellofemoral joint loading parameters.

By Collin D. Bowersock, BS, and John D. Willson, PT, PhD Continue reading

August 2015

Researchers inch toward understanding of PTTD

In recent years, studies have elucidated aspects of the biomechanical effects of posterior tibial tendon dysfunction that may ultimately lead to improvements in treatment. But it isn’t always clear which factors contribute to PTTD and which
develop in response.

By Cary Groner Continue reading

August 2015

Vitamin D deficiency and risk of fracture in football players

Many US football players have lower than adequate serum vitamin D levels, but questions remain about the potential benefits of proactive treatment with supplementation to address vitamin D deficiency and reduce the risk of fracture in this
patient population.

By Mark A. Duca, MD; Christina M. Mathyssek, PhD; Jeffrey W. Bost, PA-C; and Joseph C. Maroon, MD Continue reading

August 2015

Contributors to pediatric ACL surgery outcomes

Different factors influence outcomes after anterior cruciate ligament reconstruction in younger and older pediatric patients, but regardless of age, a delay to surgery is correlated with more severe additional injuries and the need for additional surgical procedures.

By Justin T. Newman, MD Continue reading

July 2015

Driving safety: The effects of lower extremity impairment

The question of when or if it’s safe for patients to drive after surgery or while wearing a lower extremity orthotic device is one practitioners should address. But, in the absence of formal guide­lines, clinicians’ advice is often inconsistent.

By Hank Black Continue reading

July 2015

Iliotibial band syndrome and running mechanics

The mixed findings of several cross-sectional studies seem to suggest that no specific biomechanical variables are unequivocally associated with iliotibial band syndrome in either men or women, which underscores the importance of assessing each patient individually

By Eric Foch, PhD Continue reading

July 2015

Diabetic foot conference weighs offloading issues

Offloading was a hot topic at the recent meeting of the International Working Group on the Diabetic Foot in the Netherlands. Diabetic foot experts in attendance discussed new research on offloading strategies and updated the organization’s practice recommendations.

By Cary Groner Continue reading