Category Archives: Issues

Current Issue Articles

December 2009

Heel pain relief: Expanding the playbook

The science of treating plantar fasciitis in athletes is evolving to consider the unusual demands these patients put on their feet. Although clinicians continue to rely on conservative management with rest, ice, anti-inflammatory medications, taping, and orthoses, some are embracing new approaches that seem counterintuitive but offer evidence of improved outcomes.

by Cary Groner

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December 2009

Lower extremity O&P warms to CAD-CAM

With a start-up cost of many tens of thousands of dollars and a steep learning curve, it’s no surprise that many O&P practitioners have been slow to transition to computer-aided design and computer-aided manufacturing (CAD-CAM).

By L.W. Barnes

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December 2009

Ankle sprain research focuses on teens

Epidemiological studies confirm what coaches, trainers, parents, and student athletes already know—that ankle sprains are the most common musculoskeletal injury among high school athletes. A study in the August issue of the American Journal of Sports Medicine bears that out, with recurrent ankle injuries accounting for 28.3% of recurrent traumatic sports injuries in teen athletes.

by Linda Weber

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December 2009

CPO seeks central fab: Finding a match

Charles Kuffel, CPO, of Blaine, MN, knows his limitations. If the clinician and father of four is going to keep his referrals happy, get products to his patients on time and have a life outside the office, it means outsourcing some orthotic orders to a central fabricator.

By L.W. Barnes

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December 2009

For those about to rock, we caution you

Shoes with rocker-bottom soles have long been used to alleviate plantar pressures in diabetes patients and others susceptible to forefoot pain or ulceration. The soles move the apex of the toe rocker behind the metatarsal heads, reducing pressure as the patient’s weight transfers forward over the ball of the foot.

by Cary Groner

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December 2009

Shear Madness: Beyond plantar pressure

Clinicians have known for many years that uneven plantar pressures, combined with the loss of sensitivity caused by peripheral neuropathy, are associated with foot ulcers in diabetes patients. Ulcers often occur in different areas than peak pressures do, however. Shear forces, caused by pressure differentials in the foot, may be more to blame than plantar pressures per se.

by Cary Groner

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December 2009

Drop foot mechanics outweigh etiology

Conditions associated with drop foot are as varied as post-stroke hemiplegia, brain or spinal cord injury, and neuromuscular disorders including multiple sclerosis (MS). Patients with drop foot are unable to use the dorsiflexor muscles to lift the foot clear of the ground during the gait’s swing phase, nor can they control plantar flexion during heel strike. The result is an awkward, unstable gait and a tendency to trip when the toes brush the ground.

by Cary Groner

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December 2009

Finding—and breaking—the ACL-OA link

In recent years, scientific studies have shown that anterior cruciate ligament (ACL) injury in athletes can lead to later osteoarthritis in a large proportion of cases. In fact, some studies have documented osteoarthritis rates of 50% to 100% in former athletes who have experienced ACL injury, when followed for 15 to 20 years.

By Barbara Boughton

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December 2009

The Home Stretch: Paths to pain relief

Stretching and splinting have long been treatment strategies for plantar fasciitis. However, new research and ongoing clinical experience are calling into question older methodologies and providing evidence for some new approaches.

by Cary Groner

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December 2009

Underuse, overuse both can lead to PTTD

Ongoing research into posterior tibial tendon dysfunction (PTTD) has revealed risk factors that include female sex, increasing age, overweight, unsupportive footwear, and even metabolic syndromes such as diabetes. Although typically associated with older, inactive patients, PTTD is also seen more rarely in young athletes.

by Cary Groner

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December 2009

CP gait studies document AFO efficacy

Clinicians who treat ambulatory cerebral palsy patients rely heavily on ankle-foot orthoses, which are the most effective treatment option for improving gait mechanics. But because CP encompasses such a wide range of symptoms, selecting the most appropriate corrective brace for a patient’s specific gait abnormality or abnormalities can present clinical challenges. Recent studies that shed light on ankle-foot orthoses’ impact on gait are characteristic of crucial ongoing research.

By Linda Weber

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December 2009

Sport-specific advances benefit all amputees

Whether it’s rock climbing, triathalons, cycling, running or the high jump, advances in prosthetic design have made high-caliber athletic competition a reality for some amputees. One such athlete testified in the September issue of Prosthetics and Orthotics International, “Snowboarding with the new prosthesis is like it was before the amputation!”

by Barbara Boughton

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December 2009

Early, active ACL rehab maximizes ROM

Achieving full range of motion is a key outcome of any rehabilitation program after ACL reconstruction. But what are the ingredients of a rehabilitation program that produces the best outcomes in terms of ROM?

By Barbara Boughton

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November 2009

Market Mechanics

• Ascent-descent studies show benefits of Proprio-Foot adaptive technology
• WalkAide effects persist for 11 months
• Fillauer expands with OTS acquisition
• ProLab launches orthotic web resource

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November 2009

Orthofeet tie-less lace line

Orthofeet is adding new designs to its Tie-Less Lace line of shoes. This patent-pending system combines laces with hook-and-loop straps that offer an easy way of fastening without the need for tying laces, which can be challenging for patients who … Continue reading

November 2009

Pro-Tec Roller Massager

The Pro-Tec Roller Massager with Trigger Point Release Grips is designed to reduce muscle tightness, soreness, and pain. Features include raised Vynafoam sections that “sink” into soft tissue to roll out tightness, rounded grip ends to provide precision trigger point … Continue reading

November 2009

T505 Cold Therapy Unit

In response to new CMS Never Events Legislation, DeRoyal introduces its T505 Cold Therapy Unit. CMS Never Events Legislation prevents hospitals from being reimbursed for cost of care resulting from preventable injuries. DeRoyal’s ATC (automatic temperature control) Units provide consistent … Continue reading

November 2009

Richie Ulcer Guard

The Richie Ulcer Guard, designed to prevent and treat diabetic foot ulcers, is a patch that can be readily attached to footwear opposite an area of concern on the diabetic foot: a callus, for example. The Richie Ulcer Guard provides … Continue reading

November 2009

Sher E-Z Post Orthotic Kit

Sroufe Healthcare Products offers the Sher Brand E-Z Post orthotic system for lateral or medial posting. The E-Z Post is available as a kit with color-coded posting plates that easily snap in to post the shell accurately at three different … Continue reading

November 2009

Out on a limb: Knowing better

I have a confession to make: I’m one of those women. The kind of woman who is the subject of this month’s cover story on high heels.

By, Jordana Bieze Foster, editor

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November 2009

Balancing Act: A real-world approach to high heels

High heeled shoe wear alters biomechanics over time in undeniable, painful ways. But practitioners also know that asking women to give up their heels is an exercise in futility. Instead, they focus on finding a balance.

By Cary Groner

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November 2009

Managing turf toe in football players

Grade 1 and 2 turf toe hyperextension injuries have good outcomes when treated non-operatively, but the optimal treatment for grade 3 is unclear.

By Seth C. Gamradt, MD, and Robert H. Brophy, MD

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November 2009

Kinematics of PTTD dictate management

Researchers are only starting to examine how orthotic management of PTTD affects foot and ankle kinematics.

By Jeff Houck, PT, PhD, Christopher G. Neville, PT, MS, and Adolph Flemister, MD

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November 2009

Feedback-based rehab could lower risk of OA

Feedback-based gait retraining may help reduce rates of loading by improving joint kinematics and proprioception.

By Jody L. Riskowski, PhD

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November 2009

Diabetes: Offloading difficult wounds

If foot pressures are to be reduced, healing to progress, and prevention of ulceration to be a realistic
goal, offloading is imperative. Part one of two.

By Robert J. Snyder, DPM, FACFAS, CWS, and Karen K. Lanier, CPed

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