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June 2014

Patient Perspective: Walking 600 miles is tough; plantar fasciitis is tougher

In 2008 I walked the 500-mile Camino de Santiago, the medieval pilgrimage route through northern Spain leading to the Cathedral of Santiago de Compostela. It was my first long distance walk, and because I completed it without injury, pain, or a blister, I fancied myself a walking superhero, immune to suffering or discomfort.

By Laura Potts Continue reading

June 2014

Evidence-based use of metatarsal pads

Plantar pressure analysis studies are demonstrating the effectiveness of met pads for forefoot offloading and helping clinicians determine which patients are most likely to benefit from different pad designs and placement strategies.

By Greg Gargiulo Continue reading

June 2014

Managing foot and ankle injuries in baseball players

Baseball players at all skill levels routinely suffer from foot and ankle injuries, with position players being afflicted more often than pitchers or catchers. Making the correct initial diagnosis without delay can lead to more rapid and effective treatment, rehabilitation, and return to play.

By Gabriel V. Gambardella, DPM, Jeffrey Delott, DPM, and Zachary J. Korwek Continue reading

June 2014

A virtual reality approach to lower extremity rehab

When commercially available active video games are used in rehabilitation settings, often the level of challenge does not match the patient’s ability level. Customized interventions can address these limitations while capitalizing on the fun and motivating aspects of the technology.

By Rachel Proffitt, OTD, OTR/L Continue reading

June 2014

Cost-benefit data support reconstruction of ACL tears

In both the short term and the long term, anterior cruciate ligament reconstruction produced greater quality of life improvements at a lower cost compared with rehabilitation only, suggesting that limiting access to ACL reconstruction may be harmful to patients and costly to society.

By Richard C. Mather III, MD, and Lane Koenig, PhD Continue reading

June 2014

Effects of targeted exercise on chronic ankle instability

Clinicians and researchers are increasingly utilizing exercise protocols focused on improving proprioception, range of motion, and strength to influence the more active and functional deficits that have been associated with chronic ankle instability in the literature.

By Mark A. Feger, MEd, ATC, and Jay Hertel, PhD, ATC Continue reading

May 2014

Cell games: Clinical use of stem cell therapy is starting to outpace the evidence

Stem cell therapy is rapidly gaining momentum as a clinical option for indi­ca­tions including meniscal injury, wound healing, and osteoarthritis. But high-level research on the tech­nol­ogy’s efficacy and long-term safe­ty is hard to come by.

By Emily Delzell Continue reading

May 2014

ATHLETES AND INJURIES: The global question of prevention

All the countries in the world share the challenge of keeping athletes healthy, and in April, sports medicine experts from across the globe met in Monaco to discuss the best ways to address those challenges at the IOC World Conference on Prevention of Injury & Illness in Sport. LER’s exclusive coverage of this event details clinical and scientific progress toward prevention of lower extremity injuries from ankle sprains to hamstring strains. Continue reading

May 2014

Healing hypoxic wounds: Fighting an uphill battle

A lack of oxygen can negatively affect wound healing in a number of ways, but surgical, pharmacological, and other technological advances are allowing clinicians to enhance oxygen delivery to damaged tissues and…

By Nanjin Park, DPM; Latricia Allen, DPM, MPH; Mary Nametka, MSN, RN, CWS, CWON, FNP-BC; Vickie R. Driver, MS, DPM, FACFAS Continue reading

May 2014

Elastic therapeutic tape: Applications at the ankle

Research on the use of elastic therapeutic tape in patients with chronic ankle instability is limited, but recent findings do suggest that leaving the elastic tape on for several days is associated with improvements in…

By Janet Simon, MS, ATC; Emily Hall, MS, ATC; and Carrie Docherty, PhD, ATC Continue reading

May 2014

Knee OA guidelines take patient-centric approach

Updated guidelines and new appropriate use criteria for nonoperative management of knee osteoarthritis aim to focus more directly on typical knee OA patients, who often have comorbidities that can complicate care and…

By Larry Hand Continue reading

May 2014

Clinicians’ shoes can send mixed message to patients

Patients often look to foot and ankle practitioners for advice about footwear choices. But a recent survey of physicians found that nearly half don’t educate their patients about footwear guidelines, and that only one in…

By Daniel Farber, MD Continue reading

April 2014

Cleat Smarts: Foot posture and injury risk in pitchers

Injuries in baseball are fairly common, with an incidence of 5.8 injuries per 1000 athletic game exposures and 1.9 injuries per 1000 athletic practice exposures in the collegiate ranks.

By Luis A. Feigenbaum, PT, DPT, SCS, ATC, LAT, CSCS; Kathryn E. Roach, PT, PhD; Chris Vitolo PT, DPT; Victoria Bown, PT, DPT; Sabine Gempel, PT, DPT; Natalia Sikaczowski, PT, DPT; Kelly Stapf, PT, DPT; and Michelle Whitaker, PT, DPT Continue reading

April 2014

Patient Perspective: Taking an alternative path to chronic foot pain relief

After a year in a fracture boot with a broken foot, I thought my ordeal was over. I was wrong. The broken bone in my foot, sustained after a fall down a staircase in my home, had occurred midway down the fifth metatarsal bone below my little toe—a site that is notoriously difficult to heal, according to my podiatrist.

By Barbara Boughton Continue reading

April 2014

Cyclists and foot orthoses: A unique set of challenges

Finding the right orthotic design starts with the space limitations presented by cycling shoes, but the challenges for lower extremity practitioners don’t end there. Factors to consider when prescribing foot orthoses include biomechanics, skill level, cycling discipline, and bike technology.

By P.K. Daniel

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April 2014

Foam rolling: Early study findings suggest benefits

Foam rolling is a relatively new therapeutic approach, but early research suggests that it can help improve range of motion and muscle performance and aid in recovery after exercise. Questions remain, however, about the extent to which the effects involve myofascial mechanisms.

By Duane C. Button, PhD, CSEP-CEP, and David G. Behm, PhD

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April 2014

Foot and ankle strategies for patients at risk for falls

As a result of limitations in the fall prevention research to date, investigators and
clinicians are often left to make their best guesses about the effect of foot and ankle interventions based on the effect such strategies have on issues related to falls, rather than on falls themselves.

By Cary Groner

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April 2014

Vitamin D and knee OA: Many theories, few answers

Several patient populations with an increased risk of knee osteoarthritis also are at increased risk for vitamin D deficiency, and research suggests vitamin D levels may be related to knee OA symptoms. The exact nature of the relationship, however, remains perplexing.

By Greg Gargiulo Continue reading

March 2014

Ankle sprain prevention in basketball: Why some high schools are opting out

Despite published evidence that bracing and targeted exercises can prevent ankle injuries in high school basketball players, surprisingly few teams have adopted these practices. Barriers to implementation include a lack of awareness and expertise as well as time and money.

By P.K. Daniel

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March 2014

Active Stance: Developing the sustainable knee in an age of early TKA

To sustain is to endure. Knee osteoarthritis (OA) is a considerable worldwide health concern, as it greatly impacts an individual’s quality of life, general health, and societal role participation.

By John Nyland, DPT, SCS, EdD, ATC, CSCS, FACSM, David N.M. Caborn, MD, and Roland Jakob, MD

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March 2014

Functional tests to predict lower extremity injury risk

Adding four functional tests to the preparticipation physical evaluations performed in student athletes may allow clinicians to identify individuals at risk for lower extremity musculoskeletal injury and implement preventive interventions to maximize safe­ty in sports participation.

By Alexis Meister, BS, ATC; Dustin Grooms, MEd, ATC, CSCS; Cambrie Starkel, MS; and James Onate, PhD, ATC, FNATA Continue reading

March 2014

Bariatric surgery: Effects on patient gait and function

Existing data suggest bariatric surgery-induced weight loss can lead to rapid improvements in gait and physical function. The surgery may also help to address factors associated with knee osteoarthritis, which itself can affect mobility and function in obese patients.

By Andrew W. Froehle, PhD, Neal Dollin, MS, Richard T. Laughlin, MD, Donovan D. Teel II, MD, Richard J. Sherwood, PhD, and Dana L. Duren, PhD

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March 2014

Influence of stride length on mechanics of pitching

Because power in baseball pitchers is generated from the feet through the core to the throwing arm, the study of stride length and its impact on pitching performance may help define an optimum technique that better protects pitchers from upper extremity injuries.

By Ryan L. Crotin, PhD, and Dan K. Ramsey, PhD

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March 2014

The ideal running shoe: An elusive, evolving concept

The body of research that has evaluated running shoe prescription and injury suggests the most important factors to consider when selecting a running shoe are that it fits the foot perfectly and that the midsole is comfortable and appropriate for the individual athlete’s running style.

By Thomas C. Michaud, DC

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February 2014

TKA in obese patients: Weighing the risks vs the benefits

Total knee arthroplasty significantly improves functional outcomes in obese patients, but is also riskier than in normal-weight patients. As the number of obese patients with knee osteoarthritis continues to rise, clinicians are being challenged to find a balance between the risks and the benefits.

By Susan M. Odum, PhD, and Bryan D. Springer, MD

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