November 2009

Cover Story


BRAINS, SPRAINS, AND CHRONIC PAIN: Concussion consequences may include osteoarthritis

As a growing number of studies report associa­tions between concussion and musculoskeletal injury risk, new research suggests concussed athletes may also have an increased risk of osteoarthritis later in life.

By Robert C. Lynall, PhD, ATC; Timothy C. Mauntel, PhD, ATC; David R. Howell, PhD, ATC; and Thomas A. Buckley, EdD, ATC Continue reading

Mouthguard mysteries: Can wearing one really improve athletic performance?

Multiple studies suggest that mouthguards, designed to protect athletes from dental injuries during contact sports, may also help improve muscle force and power. But plenty of other studies have found no such ben­efits, and even the experts aren’t sure what to believe.

By Cary Groner Continue reading

O&P teams treat limb loss, deformity in developing world

Donating parts, funds aids efforts – Each year, Dino Scanio, CO, LO, and his five-member team of pediatric O&P specialists arrive in Guatemala City to perform a challenging task. In just four days in their most recent clinic in August, for example, they fit nearly 50 young patients with custom devices and…

By Brigid Galloway Continue reading

Biomechanical stress, overuse raise young dancers’ injury risk

Prevention requires team approach – The inclusion of physicians, including specialists in pediatric orthopedic surgery and sports or dance medicine, in a team with teachers, physical therapists, parents, and others could help identify and prevent injuries in growing young dancers, according to…

By Hank Black Continue reading

Foot disability in Down syndrome linked to hallux valgus, narrow shoes

Regular foot checks may curb problems – A recent study published in the Journal of Foot and Ankle Research found that hallux valgus and too-narrow footwear contribute to foot-specific disability in children with Down syndrome. Interestingly, the study found foot posture wasn’t associated with foot-specific disability in the same children.

By Erin Boutwell Continue reading

Barefoot running: Debate moves to developing feet

The most public battles about barefoot running and minimalist footwear have been fought over their use by adult athletes and the clinicians who treat them. There is, however, a separate discussion underway regarding barefoot and minimally shod running in children.

By Cary Groner Continue reading

Biomechanical care for juvenile idiopathic arthritis

Juvenile idiopathic arthritis (JIA) affects nearly a quarter of a million US kids younger than 16 years. The hallmarks of the autoimmune disorder include joint inflammation, stiffening, and damage, as well as changes in joint growth, all of which can prove painful.

By Shalmali Pal
Continue reading

Battles of Achilles II: How the debate is informing clinical practice

Four years later, the ongoing discussion of the relative merits of surgical and nonsurgical management of Achilles tendon rupture is starting to affect practice patterns – even in the US.

By Cary Groner Continue reading

Parents: How to make them your clinical allies

While the patient is always the practitionerʼs first priority, establishing a convivial relationship with a childʼs parents can mean the difference between victory and failure when it comes to diagnosing, treating, and rehabilitating lower extremity problems in pediatric patients.

By Shalmali Pal Continue reading

Rates of chronic ankle instability in children are surprisingly high

Experts push for better sprain rehab – Primary ankle sprains often occur before adulthood, and a recent literature review from Australia suggests that some pediatric populations exhibit a high rate of ankle injury recurrence and chronic ankle instability (CAI).

By P.K. Daniel Continue reading

Gait compensations vary in kids with limb length discrepancies

Location of shortening is key factor – Contrary to popular perceptions, children with limb length discrepancy (LLD) may each use multiple compensatory strategies when they are walking, depending on where their discrepancy is, and those gait patterns may present a dilemma for practitioners.

By Larry Hand Continue reading

Below-knee amputation level has subtle functional effects

Syme, transtibial gaits are similar – The relative functional benefits of transtibial and Syme amputations in adults have been discussed in the medical literature, but few studies have addressed similar issues in pediatric patients.

By Hank Black Continue reading

Toe walking researchers revisit idiopathic label

Two recent literature reviews underscore the lack of high-level evidence to support the various treatments available for idiopathic toe walking. But new research is starting to fill that void, and is also engendering new theories about factors that may contribute to the condition.

By Larry Hand Continue reading

Dorsiflexion and knee injury risk: Implications for ankle bracing

Some evidence suggests that, if ankle braces limit athletes’ motion in the sagittal plane, the risk of knee injury could be increased, but other studies have found no association between ankle bracing and knee injury rates. The conflicting findings have made for a clinical conundrum.

By Cary Groner Continue reading

Energetics of landing: Effects of ankle instability

A diminished capability for energy dissipation at the knee after ground impact during landing in patients with chronic ankle instability may result in greater demands on the ankle joint. Modifying landing strategies could potentially reduce the risk of musculoskeletal injury.

By Masafumi Terada, MS, ATC, and Phillip A. Gribble, PhD, ATC, FNATA   

Continue reading

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

Continue reading

Editor Message


Out on a limb: Low tech, high value

The use of advanced technologies to provide feedback to patients during rehabilitation is all the rage in lower extremity healthcare. But, as exciting as these new modalities can be, it’s important to remember that low-tech feedback strategies can make hi-tech data even more clinically useful.

Jordana Bieze Foster, Editor Continue reading

Out on a limb: Strike pattern revisited

The concept of foot-strike pattern during running—something rarely discussed a decade ago, even in research circles—is now pervasive among runners as well as biomechanics experts and lower extremity clinicians. But that’s not necessarily a good thing.

By Jordana Bieze Foster, Editor Continue reading

O&P teams treat limb loss, deformity in developing world

Donating parts, funds aids efforts – Each year, Dino Scanio, CO, LO, and his five-member team of pediatric O&P specialists arrive in Guatemala City to perform a challenging task. In just four days in their most recent clinic in August, for example, they fit nearly 50 young patients with custom devices and…

By Brigid Galloway Continue reading

Biomechanical stress, overuse raise young dancers’ injury risk

Prevention requires team approach – The inclusion of physicians, including specialists in pediatric orthopedic surgery and sports or dance medicine, in a team with teachers, physical therapists, parents, and others could help identify and prevent injuries in growing young dancers, according to…

By Hank Black Continue reading

Foot disability in Down syndrome linked to hallux valgus, narrow shoes

Regular foot checks may curb problems – A recent study published in the Journal of Foot and Ankle Research found that hallux valgus and too-narrow footwear contribute to foot-specific disability in children with Down syndrome. Interestingly, the study found foot posture wasn’t associated with foot-specific disability in the same children.

By Erin Boutwell Continue reading

Barefoot running: Debate moves to developing feet

The most public battles about barefoot running and minimalist footwear have been fought over their use by adult athletes and the clinicians who treat them. There is, however, a separate discussion underway regarding barefoot and minimally shod running in children.

By Cary Groner Continue reading

Biomechanical care for juvenile idiopathic arthritis

Juvenile idiopathic arthritis (JIA) affects nearly a quarter of a million US kids younger than 16 years. The hallmarks of the autoimmune disorder include joint inflammation, stiffening, and damage, as well as changes in joint growth, all of which can prove painful.

By Shalmali Pal
Continue reading

Out on a limb: Hockey gets hip to FAI

Despite evidence of significant lower extremity injury risks associated with ice hockey, even at youth levels, preventing those types of injuries has never been a priority in that sport. But that may be starting to change.

Jordana Bieze Foster, Editor Continue reading

Parents: How to make them your clinical allies

While the patient is always the practitionerʼs first priority, establishing a convivial relationship with a childʼs parents can mean the difference between victory and failure when it comes to diagnosing, treating, and rehabilitating lower extremity problems in pediatric patients.

By Shalmali Pal Continue reading

Rates of chronic ankle instability in children are surprisingly high

Experts push for better sprain rehab – Primary ankle sprains often occur before adulthood, and a recent literature review from Australia suggests that some pediatric populations exhibit a high rate of ankle injury recurrence and chronic ankle instability (CAI).

By P.K. Daniel Continue reading

Gait compensations vary in kids with limb length discrepancies

Location of shortening is key factor – Contrary to popular perceptions, children with limb length discrepancy (LLD) may each use multiple compensatory strategies when they are walking, depending on where their discrepancy is, and those gait patterns may present a dilemma for practitioners.

By Larry Hand Continue reading

Below-knee amputation level has subtle functional effects

Syme, transtibial gaits are similar – The relative functional benefits of transtibial and Syme amputations in adults have been discussed in the medical literature, but few studies have addressed similar issues in pediatric patients.

By Hank Black Continue reading

Out on a limb: In defense of prevention

If athletes knew that decreasing the risk of anterior cruciate ligament (ACL) injury would be accompanied by a slight decrease in athletic performance, how many of them would find that to be a reasonable tradeoff? The findings of a recent study may have lower extremity practitioners asking themselves this question.

By Jordana Bieze Foster, Editor Continue reading

Toe walking researchers revisit idiopathic label

Two recent literature reviews underscore the lack of high-level evidence to support the various treatments available for idiopathic toe walking. But new research is starting to fill that void, and is also engendering new theories about factors that may contribute to the condition.

By Larry Hand Continue reading

out on a limb: Parsing the pain

You know that saying about how a man with a hammer sees everything as a nail? That’s something those who specialize in biomechanics might want to remember when considering patients with chronic pain.

By Jordana Bieze Foster, Editor

Continue reading

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

Continue reading

Departments


From barefoot running to diabetic neuropathy

Because footwear alters sensory perception, research examining the role of cutaneous feedback in barefoot running may provide important insight related to some of the gait changes that occur in patients with…

By Melissa Thompson, PhD, and Kristine Hoffman, DPM, FACFAS Continue reading

Focus on biomechanics helps treat claudication

Lower extremity clinicians say ankle foot orthoses, rocker-soled shoes, and other orthotic interventions can benefit patients with peripheral arterial disease and intermittent claudication by making it easier for them to exercise, and research is starting to demonstrate these benefits.

By Shalmali Pal Continue reading

Assessing runners’ gait using wearable sensors

Wearable sensors allow for the collection of running biomechanics data outside the laboratory in natural training environments, enabling clinicians to collect a large volume of information in a relatively short time to help identify and manage individuals who may be at risk for running-related injuries.

By Rachel Koldenhoven, MEd, ATC; and Alex DeJong, MEd, ATC Continue reading

When a longtime patient dies: How clinicians cope

It’s not unusual for any practitioner to experience complicated emotions when a death or a terminal diagnosis disrupts the personal bond forged with a patient over many years, but experts say lower extremity clinicians often are not well equipped to deal with these emotions.

By Emily Delzell Continue reading

Peroneal tendinopathy management in tennis

Although not as common as Achilles tendinitis, peroneal tendinitis is seen in a certain group of patients with chronic ankle instability or with a cavovarus foot.1 Peroneal tendinitis presents as lateral foot pain and may also be of unknown etiology or associated with an acute inversion injury.

By Patricia Pande, MClScPT, CSCS, CPed Continue reading

AFO stiffness can help optimize patient function

Decisions related to the stiffness of an ankle foot orthosis (AFO)—whether they involve device design or the materials from which it’s fabricated—can help lower extremity clinicians customize stability, biomechanics, and muscle function to meet individual patients’ needs.

By Lori Roniger Continue reading

How foot and ankle injury trends reflect today’s NFL

Professional football players are enduring higher levels of force than ever, and foot and ankle injury rates are increasing as a result. Advances in surgery and rehabili­tation have helped get players back on the field more quickly, but injury prevention remains a significant challenge.

By Will Carroll Continue reading

Adjacent-joint arthritis after ankle arthrodesis

Altered biomechanics after ankle arthro­desis often increase stress on the adjacent joints in the foot, which can cause or exacerbate osteoarthritic degeneration in those joints. Clinicians and researchers are working to better understand this process and how to minimize patients’ risk.

By Cary Groner Continue reading

Psychological aspects of ACL rehabilitation

The ability to identify and treat patients at risk for mental health issues after anterior cruciate ligament (ACL) injury may help improve psychological readiness for reconstructive surgery, attitudes toward postoperative rehabilitation, and successful surgical and rehabilitation outcomes.

By John Reaume, MD, MHSA; Dana Reaume, PsyD; and Melissa A. Christino, MD Continue reading

O&P teams treat limb loss, deformity in developing world

Donating parts, funds aids efforts – Each year, Dino Scanio, CO, LO, and his five-member team of pediatric O&P specialists arrive in Guatemala City to perform a challenging task. In just four days in their most recent clinic in August, for example, they fit nearly 50 young patients with custom devices and…

By Brigid Galloway Continue reading

Biomechanical stress, overuse raise young dancers’ injury risk

Prevention requires team approach – The inclusion of physicians, including specialists in pediatric orthopedic surgery and sports or dance medicine, in a team with teachers, physical therapists, parents, and others could help identify and prevent injuries in growing young dancers, according to…

By Hank Black Continue reading

Foot disability in Down syndrome linked to hallux valgus, narrow shoes

Regular foot checks may curb problems – A recent study published in the Journal of Foot and Ankle Research found that hallux valgus and too-narrow footwear contribute to foot-specific disability in children with Down syndrome. Interestingly, the study found foot posture wasn’t associated with foot-specific disability in the same children.

By Erin Boutwell Continue reading

Barefoot running: Debate moves to developing feet

The most public battles about barefoot running and minimalist footwear have been fought over their use by adult athletes and the clinicians who treat them. There is, however, a separate discussion underway regarding barefoot and minimally shod running in children.

By Cary Groner Continue reading

Biomechanical care for juvenile idiopathic arthritis

Juvenile idiopathic arthritis (JIA) affects nearly a quarter of a million US kids younger than 16 years. The hallmarks of the autoimmune disorder include joint inflammation, stiffening, and damage, as well as changes in joint growth, all of which can prove painful.

By Shalmali Pal
Continue reading

Shear-wave elastography could help optimize Achilles rehab

Researchers at the University of Delaware in Newark are using a new ultrasound-based technique to better understand the effects of rehabilitation on the Achilles tendon, which could help optimize rehab protocols to improve long-term function.

By Cary Groner Continue reading

Surgeon finds himself on other end of scalpel

A meniscal injury gave one practitioner new insight into the patient experience and renewed his belief that healing isn’t just about what happens physically.

By Cary Groner Continue reading

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

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

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

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

Parents: How to make them your clinical allies

While the patient is always the practitionerʼs first priority, establishing a convivial relationship with a childʼs parents can mean the difference between victory and failure when it comes to diagnosing, treating, and rehabilitating lower extremity problems in pediatric patients.

By Shalmali Pal Continue reading

Rates of chronic ankle instability in children are surprisingly high

Experts push for better sprain rehab – Primary ankle sprains often occur before adulthood, and a recent literature review from Australia suggests that some pediatric populations exhibit a high rate of ankle injury recurrence and chronic ankle instability (CAI).

By P.K. Daniel Continue reading

Gait compensations vary in kids with limb length discrepancies

Location of shortening is key factor – Contrary to popular perceptions, children with limb length discrepancy (LLD) may each use multiple compensatory strategies when they are walking, depending on where their discrepancy is, and those gait patterns may present a dilemma for practitioners.

By Larry Hand Continue reading

Below-knee amputation level has subtle functional effects

Syme, transtibial gaits are similar – The relative functional benefits of transtibial and Syme amputations in adults have been discussed in the medical literature, but few studies have addressed similar issues in pediatric patients.

By Hank Black Continue reading

Toe walking researchers revisit idiopathic label

Two recent literature reviews underscore the lack of high-level evidence to support the various treatments available for idiopathic toe walking. But new research is starting to fill that void, and is also engendering new theories about factors that may contribute to the condition.

By Larry Hand Continue reading

Eccentric interventions for Achilles tendinopathy

Multiple descriptive studies have demonstrated the clinical benefits of eccentric exercise interventions in patients with Achilles tendinopathy, but researchers have not yet identified the cause-and-effect mechanisms leading to decreased pain or increased function.

By Matthew Crill, MS, MBA, PT Continue reading

Online tool facilitates use of exercise for knee OA

A pilot study has demonstrated the feasibility and potential success for employing the Internet to deliver targeted individualized exercise routines for patients with knee osteoarthritis, which may help…

By Alison Brooks, MD; Bryan Heiderscheit, PT, PhD; and John E. Beaulieu, PhD Continue reading

The Y Balance Test: Assessing the evidence

The Y Balance Test (YBT) is a reliable tool and may be used to predict injury risk. However, clear cut-points have not been sufficiently defined, and more research investigating the mechanics and muscle activation strategies used during the YBT is needed.

By Craig A. Smith, DPT, and Meghan Warren, PT, MPH, PhD Continue reading

Exercise in individuals with diabetic neuropathy

Patients with diabetes and peripheral neuropathy can benefit from participation in mild to moderate aerobic, resistance, and balance activities. But they must take precautions to ensure exercise is safe as well…

By Steven Morrison, PhD, and Sheri R. Colberg, PhD Continue reading

The role of hip mobility in patellofemoral pain

Findings of an association between hip mobility and patellofemoral pain suggest practitioners may be putting the cart before the horse by implementing strength programs in individuals with PFP without first measuring and addressing deficits in hip extension.

By Sean Roach, PhD, DPT, ATC Continue reading

Onychomycosis remains a major clinical challenge

Despite the ongoing development of new treatments, onychomycosis is still an extremely recalcitrant disease with high rates of relapse and reinfection, and the associated physical and cosmetic implications can negatively affect patients’ quality of life and self esteem.

By Greg Gargiulo Continue reading

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

Continue reading

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

Continue reading

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

Continue reading

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

Continue reading

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

Continue reading

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

Continue reading

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

Continue reading

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

Continue reading

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

Continue reading

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

Continue reading

Achilles tendinopathy: A four-part approach

Treatment program includes patient education, deep friction massage, eccentric exercise, and Mulligan taping.

By Russell Woodman, FSOM,OCS,MCTA, DPT, and Juan C. Garbalosa, PhD, PT

Continue reading

News


Hot tip to predict ulcer risk: Repeat temperature test for best results

The concept of foot temperature monitoring to identify areas of increased risk of ulceration in patients with diabetes is promising, but new research from the Netherlands suggests clinical use of the technology will require more than a single temperature assessment.

By Keith Loria Continue reading

Gait findings support focus on proximal muscle function in people with diabetes

Lower extremity muscle force during gait differs significantly among patients with diabetic neuropathy, patients with diabetes but no neuropathy, and controls, according to research from Brazil that underscores the importance of maintaining proximal muscle function in patients with diabetes.

By Jordana Bieze Foster Continue reading

Variability in glycemic control can help estimate time needed to heal foot ulcers

Glycemic variability—fluctuations in HbA1c level from one visit to another—is significantly associated with foot ulcer healing time in patients with diabetes, according to research from the UK.

By Jordana Bieze Foster Continue reading

Runners’ knees get a lift: Elevating heel cuts patellofemoral load

Wearing heel lifts in conventional running shoes can help reduce patellofemoral joint loading and may offer an alternative to gait retraining in runners with patello­femoral pain (PFP), according to research conducted at  the University of Wisconsin-La Crosse.

By Jill R. Dorson Continue reading

Combination of four variables predicts 90% of recurrent lateral ankle sprains

A combination of four variables predicts 90% of cases of recurrent lateral ankle sprain within one year of an initial sprain, according to research from the University of Sydney in Australia.

By Jordana Bieze Foster Continue reading

Video overlay feedback helps improve biomechanics of sport-specific landing

Video feedback is associated with improved landing mechanics—suggesting a reduced risk of anterior cruciate ligament injury—during a sport-specific task, according to research from the University of Groningen Medical Center in the Netherlands.

By Jordana Bieze Foster Continue reading

ITBS intrigue: Fatigue leads to decreased hip adduction

Women with iliotibial band syndrome (ITBS) independently modify their running gait when fatigued to decrease hip adduction, potentially as a result of pain, according to research from Rutgers University in Newark, NJ, that may have implications for gait retraining.

By Katie Bell Continue reading

Step rate, length differentiate trained from untrained long distance runners

Trained long distance runners have a higher step rate and a shorter step length during running than untrained participants—characteristics that may represent adaptations to reduce injury and improve running economy, according to research from Spain.

By Jordana Bieze Foster Continue reading

Runners with chronic ankle instability demonstrate altered kinetics in study

Chronic ankle instability (CAI) is associated with altered vertical ground reaction forces (vGRF) and loading rates during running, which may be related to altered landing patterns designed to protect the ankle joint, according to research from Indiana University in Bloomington.

By Jordana Bieze Foster Continue reading

Sex and BFR: Too many studies exclude young women

The problematic trend of physiological studies in which young women are underrepresented now extends to research on blood flow restriction (BFR) training, according to a paper epublished in October by Clinical Physiology and Functional Imaging.

By Cary Groner Continue reading

Foot-specific training in older adults helps improve strength and balance

Foot-focused progressive resistance training helps improve toe flexor strength and balance in older adults, which may help reduce the risk of falls, according to research from the University of Wollongong in Australia.

By Jordana Bieze Foster Continue reading

Foam rolling outperforms stretching for quadriceps, hamstring flexibility

Foam rolling is associated with greater acute improvement in quadriceps and hamstrings flexibility compared with static or dynamic stretching, according to research from Taiwan.

By Jordana Bieze Foster Continue reading

O&P teams treat limb loss, deformity in developing world

Donating parts, funds aids efforts – Each year, Dino Scanio, CO, LO, and his five-member team of pediatric O&P specialists arrive in Guatemala City to perform a challenging task. In just four days in their most recent clinic in August, for example, they fit nearly 50 young patients with custom devices and…

By Brigid Galloway Continue reading

Biomechanical stress, overuse raise young dancers’ injury risk

Prevention requires team approach – The inclusion of physicians, including specialists in pediatric orthopedic surgery and sports or dance medicine, in a team with teachers, physical therapists, parents, and others could help identify and prevent injuries in growing young dancers, according to…

By Hank Black Continue reading

Foot disability in Down syndrome linked to hallux valgus, narrow shoes

Regular foot checks may curb problems – A recent study published in the Journal of Foot and Ankle Research found that hallux valgus and too-narrow footwear contribute to foot-specific disability in children with Down syndrome. Interestingly, the study found foot posture wasn’t associated with foot-specific disability in the same children.

By Erin Boutwell Continue reading

Barefoot running: Debate moves to developing feet

The most public battles about barefoot running and minimalist footwear have been fought over their use by adult athletes and the clinicians who treat them. There is, however, a separate discussion underway regarding barefoot and minimally shod running in children.

By Cary Groner Continue reading

Biomechanical care for juvenile idiopathic arthritis

Juvenile idiopathic arthritis (JIA) affects nearly a quarter of a million US kids younger than 16 years. The hallmarks of the autoimmune disorder include joint inflammation, stiffening, and damage, as well as changes in joint growth, all of which can prove painful.

By Shalmali Pal
Continue reading

Fusion and low vitamin D: Two thirds of patients have deficiency

Vitamin D deficiency is prevalent in patients in the northern US undergoing midfoot, hindfoot, and ankle arthrodesis, even in those without predisposing risk factors, according to a recent study from Vermont that may have implications for lower extremity surgery.

By Katie Bell

Continue reading

Intrinsic exercises may help runners safely switch to minimalist footwear

The development of bone marrow edema after transitioning from traditional running shoes to minimalist footwear is associated with small intrinsic foot muscle size, according to research from Brigham Young University in Provo, UT.

By Jordana Bieze Foster

Continue reading

Half shoe outperforms double rocker for offloading, but also impairs gait

A half shoe offloads the forefoot more effectively than a double-rocker full-outsole shoe with an offloading insole, but the half shoe also is more likely to alter gait, according to research from Bologna, Italy.

By Jordana Bieze Foster Continue reading

On the move: Gait training improves limited mobility

Gait training is effective for improving limited mobility in patients with knee osteo­arthritis (OA), according to a recent study, but the immediate benefit is not sustained after training has stopped.

By Lori Roniger

Continue reading

Cartilage thickness study suggests role of kinetics changes with OA severity

Although knee adduction moment (KAM) plays a significant role in patients with severe knee osteoarthritis (OA), knee flexion moment (KFM) may be more important early in the disease process, according to research from Stanford University in California.

By Jordana Bieze Foster

Continue reading

Patient-reported function, kinematics predict response to hip strengthening

Patient-reported function and lower extremity kinematics can predict response to a hip strength­ening intervention in patients with knee osteoarthritis (OA), according to research from the University of Calgary in Alberta, Canada.

By Jordana Bieze Foster

Continue reading

Parents: How to make them your clinical allies

While the patient is always the practitionerʼs first priority, establishing a convivial relationship with a childʼs parents can mean the difference between victory and failure when it comes to diagnosing, treating, and rehabilitating lower extremity problems in pediatric patients.

By Shalmali Pal Continue reading

Rates of chronic ankle instability in children are surprisingly high

Experts push for better sprain rehab – Primary ankle sprains often occur before adulthood, and a recent literature review from Australia suggests that some pediatric populations exhibit a high rate of ankle injury recurrence and chronic ankle instability (CAI).

By P.K. Daniel Continue reading

Gait compensations vary in kids with limb length discrepancies

Location of shortening is key factor – Contrary to popular perceptions, children with limb length discrepancy (LLD) may each use multiple compensatory strategies when they are walking, depending on where their discrepancy is, and those gait patterns may present a dilemma for practitioners.

By Larry Hand Continue reading

Below-knee amputation level has subtle functional effects

Syme, transtibial gaits are similar – The relative functional benefits of transtibial and Syme amputations in adults have been discussed in the medical literature, but few studies have addressed similar issues in pediatric patients.

By Hank Black Continue reading

Resistance is useful: Ankle band activates hip during landing

Wearing a resistance band around the ankles during jump landings is associated with increased hip abduction moments and gluteus medius activation, and may be a more functional alternative to the therapeutic exercises typically used to train the same muscles, according… Continue reading

Training to increase running cadence alters biomechanics but not efficiency

Six weeks of training to increase running cadence is associated with significant changes in kinematics and vertical loading rate, but does not affect running efficiency, according to research from the University of Massachusetts Amherst. Continue reading

ATFL data suggest ligament thickening after sprain does not cause instability

Both ankle sprain copers and patients with chronic ankle instability have thickened anterior talofibular ligaments (ATFL), suggesting that these structural changes are not the cause of chronic instability, according to research from the University of Evansville in Indiana. Continue reading

Toe walking researchers revisit idiopathic label

Two recent literature reviews underscore the lack of high-level evidence to support the various treatments available for idiopathic toe walking. But new research is starting to fill that void, and is also engendering new theories about factors that may contribute to the condition.

By Larry Hand Continue reading

Prepare for landing: Bladed cleats may put fifth met at risk

Bladed soccer cleats were associated with increased forefoot loading during a jump-landing task, which may lead to a higher risk of fifth metatarsal stress fractures, according to a study published in the September-October issue of the Journal of Athletic Training.

Continue reading

Leg mechanics, training conditions may predict Achilles pain in runners

Investigators at the University of Tuebingen in Germany have identified alterations in lower leg mechanics and higher impacts caused by “fast” training conditions (e.g., interval training sessions, competitions) as potential risk factors for Achilles tendon pain in runners.

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Anterolateral knee ligament ‘discovery’ makes headlines, but is not really new

The media buzz over the apparent discovery of a new knee ligament announced in early November faded quickly as experts pointed out that the finding was not exactly new.

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In the Moment: Sports Medicine

PFPS responds to exercise
Plus: • Sprinter giveaways • Hamstring injury risks

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In the Moment: Foot Care

Wedges assist stroke rehab
Plus: • Kids, footwear and gait • Teens and running shoes

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In the Moment: O&P

Orthoses improve CP gait
Plus: • Valgus knee bracing • Achilles outcomes

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Market Mechanics


AAOS, AJRR create orthopedic database

The Rosemont, IL-based American Academy of Orthopaedic Surgeons (AAOS) in mid-October announced plans to create a national family of clinical data registries for a broad range of orthopedic conditions and procedures. Continue reading

CMS amends custom diabetic insert coding

The Centers for Medicare and Medicaid Services have amended a recent coding clarification regarding custom-fabricated diabetic shoe inserts, which two specialty organizations had criticized as being unnecessarily strict and a detriment to advanced technology. Continue reading

Noraxon launches biomech data hub

Scottsdale, AZ-based Noraxon USA, a leader in human movement metrics and biomechanics research solutions, in November introduced the Ultium biomechanics research system. Continue reading

Foot Science prefab FO reduces injury risk

Contoured prefabricated foot orthoses from Christchurch, New Zealand-based Foot Science International may help reduce the risk of lower extremity injury in naval recruits undergoing basic training, according to research epublished in October by the British Journal of Sports Medicine. Continue reading

BOC celebrates expanded office space

The Board of Certification/Accreditation (BOC) staff and Board of Directors showcased an expanded new office location in Owings Mills, MD, to business partners and honored guests at a celebratory open house in October. Continue reading

Bacino is Levy and Rappel sales manager

Saddle Brook, NJ-based Levy and Rappel is once again expanding operations and has hired James Bacino, CPed, as regional sales manager, the company announced in October. Continue reading

McClain names Langer executive VP

McClain Laboratories, a clinical and research pathology laboratory based in Smithtown, NY, announced in November the appointment of Paul Langer as executive vice president, business development. Continue reading

Flexion expands mkt for knee OA injectable

Burlington, MA-based Flexion Therapeutics in mid-November announced the full commercial launch of Zilretta (triamcinolone acetonide extended-release injectable suspension), the company’s new therapy for the management of pain associated with osteoarthritis (OA) of the knee. Continue reading

Claris introduces TKA recovery monitor

Vancouver, Canada-based Claris Healthcare announced in November that it is launching Claris Reflex, a new medical device and patient monitoring system to help orthopedic practices across North America monitor patient recovery after total knee replacement. Continue reading

GUAES launches gout specialist network

The Pittsburgh, PA-based Gout & Uric Acid Education Society (GUAES) has stepped up to the challenge of helping all patients access faster, better treatment by launching the Gout Specialists Network (GSN), an online physician and medical professional locator and educational resource, the society announced in November. Continue reading

Navy, Steadman Clinic partner for research

In a benchmark collaboration between two world-class research centers, the Vail, CO-based Steadman Philippon Research Institute/Steadman Clinic and the Naval Medical Research Unit-San Antonio will work together on sophisticated musculoskeletal research, according to a Steadman-Philippon release. Continue reading

Dr. Scholl’s inserts lower peak VLR

Commercially available insoles from Dr. Scholl’s, a division of Wippany, NJ-based Bayer, are associated with reduced vertical loading rates during running in healthy volunteers, according to a study epublished in October by the Clinical Journal of Sport Medicine. Continue reading

Hanger foundation funds 2016 grants

The Austin, TX-based Hanger Charitable Foundation in October awarded $17,500 to four grant recipients, concluding its third round of 2016 grants. Continue reading

biodesigns socket ups walking distance

Westlake Village, CA-based biodesigns in November reported a recent 13-patient study showed its alternative transfemoral socket outperformed a standard-of-care socket in improving amputees’ balance confidence and walking capacity. Continue reading

Spenco sends shoes to disaster victims

Waco, TX-based Spenco Foot­wear donated 1000 pairs of shoes, sandals, and slippers to Haitian victims of Hurricane Matthew, which devastated the island nation in early October. Continue reading

NBA, AT orgs join to grow youth access

The New York, NY-based National Basketball Strength and Conditioning Coaches Association (NBSCA) in October announced it would form a scientific advisory panel of four experts from various fields within the strength and conditioning community to provide continuing education and sharing of best practices to its members. Continue reading

Össur users sweep medals in Cybathlon

Reykjavik, Iceland-based Össur reported in October that amputees wearing its technologies dominated the lower limb competition at the inaugural Cybathlon games in Zurich, Switzerland, claiming all three medals in the leg prosthesis race. The Cybathlon is the first global competition… Continue reading

Curbell names Airlite vendor of the year

Orchard Park, NY-based Curbell Plastics in October named Airlite Plastics its 2015 Vendor of the Year. Omaha, NE-based Airlite  makes plastic packaging as well as a variety of extruded plastic sheet materials for the O&P industry. Continue reading

Phoenix launches to sell molded devices

Lake Placid, FL-based Phoenix Molded Shoes, Inserts, and Braces opened its doors on September 12. The manufacturer is emphasizing communication with its practitioner customers about its services and lower extremity custom devices, which include accommodative and functional orthoses. Continue reading

O&P teams treat limb loss, deformity in developing world

Donating parts, funds aids efforts – Each year, Dino Scanio, CO, LO, and his five-member team of pediatric O&P specialists arrive in Guatemala City to perform a challenging task. In just four days in their most recent clinic in August, for example, they fit nearly 50 young patients with custom devices and…

By Brigid Galloway Continue reading

Biomechanical stress, overuse raise young dancers’ injury risk

Prevention requires team approach – The inclusion of physicians, including specialists in pediatric orthopedic surgery and sports or dance medicine, in a team with teachers, physical therapists, parents, and others could help identify and prevent injuries in growing young dancers, according to…

By Hank Black Continue reading

Foot disability in Down syndrome linked to hallux valgus, narrow shoes

Regular foot checks may curb problems – A recent study published in the Journal of Foot and Ankle Research found that hallux valgus and too-narrow footwear contribute to foot-specific disability in children with Down syndrome. Interestingly, the study found foot posture wasn’t associated with foot-specific disability in the same children.

By Erin Boutwell Continue reading

Barefoot running: Debate moves to developing feet

The most public battles about barefoot running and minimalist footwear have been fought over their use by adult athletes and the clinicians who treat them. There is, however, a separate discussion underway regarding barefoot and minimally shod running in children.

By Cary Groner Continue reading

Biomechanical care for juvenile idiopathic arthritis

Juvenile idiopathic arthritis (JIA) affects nearly a quarter of a million US kids younger than 16 years. The hallmarks of the autoimmune disorder include joint inflammation, stiffening, and damage, as well as changes in joint growth, all of which can prove painful.

By Shalmali Pal
Continue reading

CMS stays prosthetic coverage draft; AOPA calls the decision a ‘partial win’

The White House announced on November 2 that the Centers for Medicare & Medicaid Services (CMS) will not finalize a controversial draft policy concerning coverage determinations for lower limb prostheses. Continue reading

Judges weigh murder charge for Pistorius

Five South African judges are considering the fate of Oscar Pistorius after a November 3 hearing in the Supreme Court of 
Appeal in Bloemfontein. Continue reading

AMP1 team showcases stand-up skills

AMP1, the stand-up amputee basketball team sponsored by Irvine, CA-based Freedom Innovations, showcased its skills in the October “Duel In The Desert” event in Phoenix, AZ. A red AMP1 team played its blue counterpart, with… Continue reading

Ossur hosts Boston bombing survivors

Boston Marathon bombing survivors Patrick Downes and Jessica Kensky in September visited Össur’s global headquarters in Reykjavik, Iceland, to discuss their experiences as recent amputees and to learn about innovations in prosthetic limbs. Continue reading

AAOS clarifies guidance for ACL injuries

The Rosemont, IL-based American Academy of Orthopaedic Surgeons (AAOS) in October released a new appropriate use guideline for anterior cruciate ligament (ACL) injury to clarify recommendations from its 2014 ACL injury guidelines. Continue reading

Kingetics awarded for advanced materials

The American Composite Manufacturing Association and the Society for the Advancement of Material and Process Engineering honored Kingetics for its creativity with application of advanced materials at the Composites and Advanced Materials Expo (CAMX) in October in Dallas, TX. Continue reading

OHI acquires custom orthotic lab Footbon

Ronkonkoma, NY-based Orthotic Holdings (OHI) in October acquired the custom foot orthotic laboratory Footbo ̄n. Paul Langer, who founded Huntington, NY-based Footbo ̄n in 2009, has joined OHI’s Langer Biomechanics as… Continue reading

Dates set for World Congress of Podiatry

The International Federation of Podiatrists and the Canadian Podiatric Medical Association in October announced that the 2016 World Congress of Podiatry is scheduled for May 26-28 in Montreal, Canada. Continue reading

Cadence Kickstart studied for stroke rehab

Seattle, WA-based Cadence Biomedical in October announced a National Institutes of Health-funded research collaboration with the University of Nebraska-Omaha (UNO) to study stroke survivors’ ability to adapt and… Continue reading

Tamarack wins business award for textiles

Minneapolis-based Minnesota Business Magazine in September awarded Tamarack Habilitation Technologies its Minnesota Manufacturing Award in the New Products: Textiles category. Continue reading

Parents: How to make them your clinical allies

While the patient is always the practitionerʼs first priority, establishing a convivial relationship with a childʼs parents can mean the difference between victory and failure when it comes to diagnosing, treating, and rehabilitating lower extremity problems in pediatric patients.

By Shalmali Pal Continue reading

Rates of chronic ankle instability in children are surprisingly high

Experts push for better sprain rehab – Primary ankle sprains often occur before adulthood, and a recent literature review from Australia suggests that some pediatric populations exhibit a high rate of ankle injury recurrence and chronic ankle instability (CAI).

By P.K. Daniel Continue reading

Gait compensations vary in kids with limb length discrepancies

Location of shortening is key factor – Contrary to popular perceptions, children with limb length discrepancy (LLD) may each use multiple compensatory strategies when they are walking, depending on where their discrepancy is, and those gait patterns may present a dilemma for practitioners.

By Larry Hand Continue reading

Below-knee amputation level has subtle functional effects

Syme, transtibial gaits are similar – The relative functional benefits of transtibial and Syme amputations in adults have been discussed in the medical literature, but few studies have addressed similar issues in pediatric patients.

By Hank Black Continue reading

Study finds Langer brace immediately improves balance among older adults

A custom ankle foot orthosis (AFO) made by Ronkonkoma, NY-based Langer Biomechanics produced immediate improvements in postural sway and lower extremity coordination in older adults without limiting functional performance, according to a study epublished October 29 by Clinical Biomechanics. Continue reading

Darco marks ‘Stop Pressure Ulcer Day’

Huntington, WV-based Darco International has joined with Spanish research organizations to raise awareness of the physical, emotional, and financial consequences of pressure ulcers with the November 20 “Stop Pressure Ulcer Day.” Continue reading

dicks.com offers Ektio basketball shoe

Pittsburgh, PA-based Dick’s Sporting Goods is now selling Ektio’s newest basketball shoe at its online store, dicks.com. The Alexio is New York City-based Ektio’s latest offering in its line of basketball shoes designed to prevent ankle sprains… Continue reading

MobileMat BESS is consistent, reliable

Boston, MA-based TekScan’s automated balance error scoring system (BESS) produces results in good agreement with trained human raters, according to a study epublished on October 7 by the Journal of Sport Rehabilitation. Continue reading

Whitmore joins Allard foot drop team

Rockaway, NJ-based Allard USA in November introduced ESPY award winner Jamie Whitmore as one of the newest members of TeamUp, Allard’s national team for people with limited mobility due to foot drop. Continue reading

Ottobock acquires Ekso bionics patents

Duderstadt, Germany-based Ottobock and Ekso Bionics, headquartered in Richmond, CA, formalized an intellectual property licensing agreement in November that will allow Ottobock to make use of Ekso’s wearable bionics technology in its next-generation prosthetic devices. Continue reading

APMA, PFA merge 2015 meetings

The American Podiatric Medical Association (APMA) and the Pedorthic Footcare Association (PFA) announced in November that next year the PFA will hold its Annual Symposium in conjunction with APMA’s Annual Scientific Meeting. Continue reading

Beattie directs EMU O&P grad program

Eastern Michigan University (EMU) in Ypsilanti in October named Wendy Fischl Beattie, CPO, FAAOP, new program director and clinical coordinator of its graduate program in orthotics and prosthetics. Continue reading

APMA joins CDC anti-infection campaign

The American Podiatric Medical Association (APMA) reported on October 7 that it has joined the Centers for Disease Control and Prevention’s “One & Only Campaign.” Continue reading

Neurotech Kneehab shows benefit in MS

A pilot study epublished on October 9 found Minnetonka, MN-based Neurotech North America’s neuromuscular electro-stimulation device is feasible for home use and, when added to progressive resistance training (PRT), improves fatigue in people with multiple sclerosis… Continue reading

Cytomedix begins Aurix rebranding effort

Gaithersburg, MD-based Cytomedix announced on October 14 that it has relaunched its AutoloGel chronic wound care system under the Aurix brand. Continue reading

Pistorius receives five-year sentence

South African Judge Thokozile Masipa on October 21 sentenced double-amputee Olym­pic runner Oscar Pistorius to five years in prison for killing his girlfriend Reeva Steenkamp. Continue reading

Cascade Dafo offers free online courses

Ferndale, WA-based Cascade Dafo announced in November the release of six free online continuing education courses designed for pediatric O&P practitioners and approved for up to 6.25 continuing education credits by the American Board for Certification in Orthotics, Prosthetics, and Pedorthics. Continue reading

PBS airs Sigvaris leg healthcare video

PBS in October began airing an educational video segment on chronic venous disorders and benefits of graduated compression made in collaboration with Peachtree City, GA-based Sigvaris and Ariel Soffer, MD, of the Vein Experts Training Academy in Hallandale Beach, FL. Continue reading

Delcam updates CAD-CAM software

Birmingham, UK-based Delcam Crispin in September launched a new version of its Engineer Pro software for orthopedic footwear manufacturing, which the company said allows creation of bespoke footwear designs in the shortest possible time. Continue reading

Toe walking researchers revisit idiopathic label

Two recent literature reviews underscore the lack of high-level evidence to support the various treatments available for idiopathic toe walking. But new research is starting to fill that void, and is also engendering new theories about factors that may contribute to the condition.

By Larry Hand Continue reading

ACA may improve preventive O&P care

The Affordable Care Act (ACA), which went into effect on October 1 and has a strong emphasis on preventive care, may help O&P practitioners offer their patients devices that prevent serious sequelae, including drop foot, foot ulcers, and amputation, said William DeToro, LO, CO, CEO of Poland, OH-based Anatomical Concepts Inc (ACI).

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DJO Global signs Olympic gold medalist

Vista, CA-based DJO Global announced on October 30 that Megan Rapinoe, Olympic gold medalist for the US Women’s Soccer Team and a National Women’s Soccer League player for the Seattle Reign FC, is partnering with them to help educate young athletes about the value of bracing in injury prevention and returning to play.

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O&P site makes user-friendly updates

O&P Social relaunched its website, oandpsocial.com, in November. The newly designed site gives O&P clinicians and other allied health professionals easy-to-use navigation, an educational forum with Medi­care updates and tips for a more effective practice, a list of national and international O&P events, and a forum for interaction among O&P professionals.

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Steadman organizations name CEO

J. Richard Steadman, MD, managing partner and founder of The Steadman Clinic, and Marc Philippon, MD, managing partner of Steadman Philippon Research Institute (SPRI), announced on October 16 that Tom Mars, a former Walmart executive and SPRI board member, is new chief executive officer of both organizations, located in Vail, CO.

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Combination therapy eases OA pain

Combining Irving, CA-based VQ OrthoCare’s BioniCare transcutaneous electrical joint stimulator with an unloading knee brace improves OA symptoms significantly more than electrical stimulation alone, according to a multicenter study published in October in The American Journal of Orthopedics.

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Pedors launches 24/7 B2B portal

Hiram, GA-based Pedors launched pedors247.com, its new 24/7 business-to-business portal where practitioners can place, review, and track orders, invoice balances, and order history, at the 54th Pedorthic Footcare Association Symposium held in Boston October 31-November 2.

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Ankle sprain trial supports Traumeel

A multicenter randomized controlled noninferiority trial published in October in The International Journal of Clinical Practice found a topical homeopathic gel and ointment made by Albuquerque, NM-based Heel Inc are as effective as the current standard of care for reducing pain and improving function in patients with acute ankle sprains.

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Ottobock wins communications award

German prosthetics company Ottobock, headquartered in Dusseldorf, announced on October 29 that it had won the 2013 Econ Award for excellence in public relations for its London 2012 “Passion for Paralympics” campaign.

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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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Products


Xelero Matrix One

Now available from Xelero is the Matrix One pedorthic shoe. Designed for walking and light running, the shoe is offered in men’s grey/black mesh and women’s light grey/light blue mesh. The Matrix One features the same technology as… Continue reading

La Pointique Heel Strap

La Pointique Int’l now offers the new Heel Strap and LP compression socks. The Heel Strap is designed to provide support to the ligaments of the heel and ankle in athletes to improve stability during jumps and shifting movements. Continue reading

OPTP io-ball

OPTP is now the official distributer for the io-ball, an inflatable exercise ball with a unique elliptical shape. The compact, lightweight ball can be positioned horizontally or vertically, allowing the user to increase the difficulty of standard movements or… Continue reading

Corrective Orthotic Station

The Podo USA Corrective Orthotic Station is a fully integrated medically corrective orthotic system that includes plantar pressure analysis and foot and ankle posturology. The system features a 1600-sensor pressure platform, a high-resolution camera… Continue reading

Ease Knee Highs in New Sizes

Therafirm is launching Ease Knee Highs in XL sizes and petite lengths. The Ease line of compression hosiery features construction from ultrastretchy and super soft yarns for comfort and style. Whereas the previous size offerings would accommodate… Continue reading

I-Runner Elite with Velcro

The I-Runner PDAC-approved diabetic shoe family continues to grow. I-Runner proudly introduces its first-ever Velcro closure model, the Elite.Designed by pedorthists, the Elite features a single 1″ strap that sits high on the… Continue reading

Metatarsal Pad Kits

Tread Labs, a source for semicustom, orthotic insoles, announces the launch of Metatarsal Pad Kits, designed to allow providers to add metatarsal support to any existing Tread Labs insole. Like the company’s the interchangeable insole topcovers, the… Continue reading

Vivobarefoot Ultra III Bloom

Vivobarefoot’s Ultra III Bloom is the industry’s first molded shoe made from algae, with an amphibious, eco-friendly design for adventures on both land and sea. The shoe has been created in collaboration with Bloom, a company that… Continue reading

CuraMedix DuoLith SD1 TT

The FDA-approved DuoLith SD1 TT from CuraMedix is the next generation of extracorporeal shock wave therapy (ESWT), with focused CylindricalSource technology, as a nonsurgical treatment for pain associated with chronic proximal plantar fasciitis. Continue reading

Formula Prosthetic Foot

New from Fillauer, the Formula foot is engineered to provide an ideal balance of flexibility and power that is appropriate for a wide range of users due to a posterior mount design. The long, lightweight carbon pylon provides critical energy return through the… Continue reading

The Funnel Shoe Donning Aid

The FootFunnel from Insightful Products has been re-engineered and rebranded as the Funnel, designed to improve the shoe donning process for those with mobility issues. With a regular shoehorn, the user struggles with coordinating three things at… Continue reading

Korebalance 3.0 Software

Korebalance, an advanced rehabilitation system for neuro­sensory training and assessment, now features new pre- ­installed software. Version 3.0 includes more and better games to challenge a variety of balance and mTBI (mild traumatic brain injury) issues… Continue reading

Dalco Premium Air Walker

Dalco International’s new Premium Air Walker, the company’s most advanced walker, immobilizes and protects the leg and foot following injury or surgery. Similar to Dalco’s traditional Air Walker, the boot utilizes an inflatable bladder to ensure compression and fit. Continue reading

Spenco Styles For Professionals

Spenco introduces its Professional Collection of attractive footwear for people whose professions require long hours of standing or walking. The new styles incorporate Spenco’s Total Support Contour and orthotic-grade arch support, along with… Continue reading

Arizona Mezzo Brace

Arizona AFO introduces the Arizona Mezzo brace. Developed by Wisconsin-based Wilson Janisse Group, the Arizona Mezzo is a happy medium between a UCBL (University of California Biomechanics Laboratory) orthosis and the original Arizona AFO (ankle foot orthosis). Continue reading

Tread Labs Stride Insoles

Tread Labs introduces Stride orthotic insoles. The two-part system features a molded poly­propylene arch support and a replaceable topcover, which attaches to the arch support with low-profile Velcro to make replacement or modification fast and easy. Continue reading

ProTech Control Met Orthosis

Powerstep’s new ProTech Control Met orthosis offers the stability, support, and comfort of its ProTech Control Full Length, but has the added benefit of a built-in metatarsal pad. The Poron met pad helps to spread and cushion the metatarsal heads to… Continue reading

RevoFit Lanyard

Click Medical introduces the RevoFit Lanyard, a simple-to-use system that allows amputees to easily draw and lock their residual limb into a prosthetic socket. Unlike traditional lanyards, the RevoFit Lanyard can be used with suction and seal-in systems. Continue reading

AF7 Ankle Bracing Sleeve

New from Allied OSI Labs is the AF7 Ankle Bracing Sleeve, a flexible two-in-one ankle brace for treating acute ankle sprains and Achilles tendinitis or peroneal tendinopathy. The AF7 combines elements of a compression sleeve and an ankle brace, designed to stabilize the ankle without… Continue reading

Customizable Tensitube Shrinker

Paceline introduces the new customizable Tensitube Blue Shrinker, an elastic postoperative residual limb shrinker that applies controlled compression to help provide pain relief and reduce hypertrophic scarring and edema in lower extremity amputees. Continue reading

Swede-O Ankle Foot Stabilizer

Swede-O announces the launch of the Ankle Foot Stabilizer (AFS), the newest addition to the MVT2 (Micro Ventilated Thermal) Technology line of products. The AFS includes medial and lateral stabilizers, an adjustable closure strap for greater support, and a nonslip safety sole to help prevent slipping. Continue reading

Orfitrans Medium Soft

Orfit Industries introduces Orfitrans Medium Soft, made of a stronger thermoplastic material for optimal patient comfort. Orfitrans Medium Soft can be used for transtibial check sockets as well as for lower limb orthoses. Continue reading

Little Feet For Children

TRS has responded to requests from the O&P profession by introducing two new sizes (14 cm and 15 cm) of its Little Feet for infants and young children. Little Feet are functional, economical prosthetic feet in sizes now ranging in 1-cm increments from 10 cm to 15 cm. Continue reading

BiowaveHome Neurostimulation

Biowave prescription neuro­stimulation is now available in a system that can be used at home or while traveling. Bio­waveHome delivers therapeutic high frequency electrical signals through the skin to the surface of nociceptive pain fibers, blocking the transmission of pain… Continue reading

Footmaxx MyFit Orthoses

The vast majority of Footmaxx orthotic devices are custom, carefully crafted based on a patient’s unique prescription. Now Footmaxx also offers the MyFit line of nonprescription foot orthoses as an economical solution to foot, arch, and heel pain. Continue reading

Össur Pro-Flex Prosthetic Foot

Össur has launched Pro-Flex, a new foot designed to help reduce joint pain among amputees who engage in low-to-moderate impact activities. Pro-Flex is designed to address many comorbidities often found in lower limb amputees, including altered gait dynamics that can… Continue reading

Pain Posters From OPTP

OPTP has partnered with Adriaan Louw, PT, PhD, CSMT, to create a new set of posters focused on neuroscience pain education. The Pain Neuroscience Posters are now available as a set of four 17.75″ x 24″ posters suitable for display in therapy clinics or rehabilitation centers. Continue reading

Darco Pro Term Walker

Darco International announces the addition of the Body Armor Pro Term Walker to its product line. The Pro Term Walker is an interim orthosis for conservative follow-up treatment following Chopart and Lisfranc amputations, among other indications. Continue reading

O&P teams treat limb loss, deformity in developing world

Donating parts, funds aids efforts – Each year, Dino Scanio, CO, LO, and his five-member team of pediatric O&P specialists arrive in Guatemala City to perform a challenging task. In just four days in their most recent clinic in August, for example, they fit nearly 50 young patients with custom devices and…

By Brigid Galloway Continue reading

Biomechanical stress, overuse raise young dancers’ injury risk

Prevention requires team approach – The inclusion of physicians, including specialists in pediatric orthopedic surgery and sports or dance medicine, in a team with teachers, physical therapists, parents, and others could help identify and prevent injuries in growing young dancers, according to…

By Hank Black Continue reading

Foot disability in Down syndrome linked to hallux valgus, narrow shoes

Regular foot checks may curb problems – A recent study published in the Journal of Foot and Ankle Research found that hallux valgus and too-narrow footwear contribute to foot-specific disability in children with Down syndrome. Interestingly, the study found foot posture wasn’t associated with foot-specific disability in the same children.

By Erin Boutwell Continue reading

Barefoot running: Debate moves to developing feet

The most public battles about barefoot running and minimalist footwear have been fought over their use by adult athletes and the clinicians who treat them. There is, however, a separate discussion underway regarding barefoot and minimally shod running in children.

By Cary Groner Continue reading

Biomechanical care for juvenile idiopathic arthritis

Juvenile idiopathic arthritis (JIA) affects nearly a quarter of a million US kids younger than 16 years. The hallmarks of the autoimmune disorder include joint inflammation, stiffening, and damage, as well as changes in joint growth, all of which can prove painful.

By Shalmali Pal
Continue reading

Terion K2 
Prosthetic Foot

Durable with a 385-lb weight limit and lightweight at just 325 g, the new Terion K2 1C11 from Ottobock is an adjustable, low-profile prosthetic foot with a split-toe design for use by level K2 amputees. Continue reading

Endevr StrengthTape

StrengthTape, a new therapeutic elastic tape from Endevr, is designed to be an ideal blend of stretch and stick that supports lower extremity muscles and joints without limiting movement or falling off. Continue reading

MineralRich
 Concentrate

Maximum Living Quality Supplements now offers its new Maximum Living MineralRich Concentrate. Designed to be added to healthful smoothies, fresh juice, or water, the liquid supplement provides pH balancing… Continue reading

OPTP 
Pro-Roller Soft

OPTP has introduced a new foam roller to its signature line of Pro-Roller products. The 18″ x 6″ Pro-Roller Soft is the first of its kind in the Pro-Roller family. The 18″ length and compact size make it easy to carry or… Continue reading

Integrated 
Uprights

MultiMotion contracture management Corrective and Free Motion joints from Allard USA are now available with integrated uprights. Choose from a combination of proximal and distal straight uprights or… Continue reading

CalluStop 
Cream

CalluStop cream from Dr. Swaim’s Natural Skin Care is infused with keratolytics and essential oils to maximize the moisture content in human skin. Naturally derived urea and lactic acid help soften skin and promote exfoliation while… Continue reading

JAFO BK 
Freedom Cover

The BK Freedom Cover from JAFO is a lightweight, easy-on, easy-off custom neoprene prosthetic cover that provides a shapeable foam to replicate the calf on below knee amputees. The BK Freedom Cover is available in three heights… Continue reading

Sols Flex 
Insoles

Sols introduces Sols Flex, 3D-printed customized foot orthoses now available directly to consumers. Sols Flex insoles follow the contours of each wearer’s foot to achieve a fit that is intended to be perfect for the wearer, for his or her shoes, and… Continue reading

Triple Action
 Ankle Joint

Becker Orthopedic is proud to introduce the Triple Action Stance/Swing Control ankle joint. This new component offers high stiffness in the coronal and transverse planes, and is intended for individuals with neuromuscular pathologies. Continue reading

Levy Diabetic Econ Orthoses

Levy & Rappel introduces the new Levy Diabetic Econ I and Econ II foot orthoses. Both of these custom foot orthoses for patients with diabetes are manufactured using plaster casts, foam impressions, or 3D scans of the patient’s foot. Continue reading

TheraSport
 Athletic Socks

Therafirm, a brand of Knit-Rite, has launched the TheraSport line of gradient compression athletic performance and recovery socks. TheraSport athletic socks are engineered to improve circulation and provide more energy for… Continue reading

Airshift OA 
Knee Brace

The new AirShift OA knee brace from Medical Specialties uses an air bladder system to comfortably unload the opposite compartment of the knee. The AirShift is primarily used to treat unicompartmental knee osteo­arthritis, but… Continue reading

Heel Entry 
Pediatric Shoe

KeepingPace Children’s Orthopedic Footwear now offers its new pediatric heel entry shoe. The new pediatric shoe features triple width and double depth, so it can be worn easily with ankle foot orthoses as well as… Continue reading

TaloStabil
 Ankle Support

The new Bort Select TaloStabil (#054 700) from Bort-Swiss Orthopedic Supply is an active ankle support. Constructed of anatomical 3D knitted fabric, the ankle support provides class II compression and incorporates two… Continue reading

SmartPuck 
Internal Vacuum

The SmartPuck from 5280 Prosthetics is an internal vacuum system that represents a new generation of smart socket technology. The entire unit is designed to fit inside the prosthetic socket, eliminating vacuum leaks from… Continue reading

Arch Rival
 Orthosis

DJO Global offers the new Arch Rival, a prefabricated orthosis designed to treat subtle cavus foot. The Arch Rival promotes natural foot function by improving stability, adding shock absorption, and alleviating pain. Continue reading

Parents: How to make them your clinical allies

While the patient is always the practitionerʼs first priority, establishing a convivial relationship with a childʼs parents can mean the difference between victory and failure when it comes to diagnosing, treating, and rehabilitating lower extremity problems in pediatric patients.

By Shalmali Pal Continue reading

Rates of chronic ankle instability in children are surprisingly high

Experts push for better sprain rehab – Primary ankle sprains often occur before adulthood, and a recent literature review from Australia suggests that some pediatric populations exhibit a high rate of ankle injury recurrence and chronic ankle instability (CAI).

By P.K. Daniel Continue reading

Gait compensations vary in kids with limb length discrepancies

Location of shortening is key factor – Contrary to popular perceptions, children with limb length discrepancy (LLD) may each use multiple compensatory strategies when they are walking, depending on where their discrepancy is, and those gait patterns may present a dilemma for practitioners.

By Larry Hand Continue reading

Below-knee amputation level has subtle functional effects

Syme, transtibial gaits are similar – The relative functional benefits of transtibial and Syme amputations in adults have been discussed in the medical literature, but few studies have addressed similar issues in pediatric patients.

By Hank Black Continue reading

New igli Junior Insoles

Medi USA introduces two new igli Junior carbon insoles in the igli carbon insole series: the Junior Orange and Junior Blue C+ for children. The customizable igli insoles feature a carbon clip on the underside of the insole and… Continue reading

FootMat Software

Tekscan introduces FootMat software, which allows clinicians to analyze static or dynamic pressure data and generate objective, evidence-based reports for patient education and to document treatment effects. Continue reading

Performance RX Orthoses

SOLO Laboratories has announced the release of Performance RX, a new material now available as an option for the company’s orthotic products. Performance RX is an engineered nylon plate material that does not fatigue… Continue reading

MiniTrax Pediatric Boot

DJO Global introduces its new MiniTrax pediatric walking boot, designed for small patients with mild to severe foot and ankle injuries. MiniTrax features kid-friendly design elements that make wearing the boot less… Continue reading

PolySoft and Gentle Padding

Ambra Le Roy announces the addition of PolySoft stockinette and Gentle Padding to its Lymphedema Care line. The Polysoft stockinette is made from soft, comfortable synthetic fibers with no elastic yarns. Continue reading

Rocktape Knee Caps

Knee Caps from Rocktape are designed to help protect the knees during complex fitness movements, such as dead lifts, pistols, and squats. Knee Caps are designed to offer compression, warmth, and lateral stability… Continue reading

Deluxe Gel Bunion Sleeve

Silipos introduces a new option for patients suffering from bunion pain. The Deluxe Gel Bunion Sleeve is a comfortable, elastic sleeve with a soft gel pad that sits easily around the painful and sensitive bony… Continue reading

Lunatur 18 Walnut

Nora Systems introduces Lunatur 18 Walnut, an eco-friendly and sustainable material that is soft and highly elastic, with good bedding and resilience characteristics. Nora Lunatur 18 Walnut contains more than 20% finely… Continue reading

Krutch Kaddy

Designed for maximum comfort, efficiency, durability, and safety, the Krutch Kaddy provides individuals on crutches with a safe, secure, and convenient hands-free solution to carrying essential personal items. Continue reading

AFTR DC Brace

The AFTR DC (Ankle & Foot Trauma Rehabilitation Dorsal Closure) from Bio Skin provides stabilization and adjustable compression for nonoperative and postoperative treatment. Continue reading

Orthomonitor Sensing Device

Kinematix has introduced the Orthomonitor, a wearable sensing device that can be embedded in orthotic and prosthetic devices to measure wear-time compliance and provide evidence of clinical efficacy. Continue reading

Sea Island Cotton Socks

Sigvaris announces that Sea Island Cotton socks for women are joining the Zurich Collection. The Sea Island Cotton socks are constructed from cotton that is lightweight, strong, and durable and has a cashmere-like softness. Continue reading

Toe walking researchers revisit idiopathic label

Two recent literature reviews underscore the lack of high-level evidence to support the various treatments available for idiopathic toe walking. But new research is starting to fill that void, and is also engendering new theories about factors that may contribute to the condition.

By Larry Hand Continue reading

Contender Post-op Brace

Corflex announces the release of its Contender Post-Operative Knee Brace. The ZipTrak, X-Flex, and QuikZip systems work together to ensure the Contender knee brace stays in place, which maximizes its ability to control range of motion to aid in healing and rehabilitation following an injury or a surgical procedure.

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MaxxLife Custom Orthosis

Footmaxx offers the MaxxLife premium custom-made foot orthosis for comfort and stability. The MaxxLife features a natural leather topcover, a low-profile Duramaxx semirigid orthotic module, a polyurethane mid-layer reinforced with a suede bottom, and a polyurethane heel cushion and cap.

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MxXpress Software

ModulaRx Orthotics Corp has introduced a new computer technology, MxXpress, to facilitate the accurate design and manufacture of customized foot orthoses based on plantar pressure measurements.

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Arch Suspender AFO Modification

Hersco announces availability of the Arch Suspender from Richie Labs as an ankle foot orthosis modification to control the midtarsal joint and hindfoot. The Medial Arch Suspender is an adjustable lifting strap under the talonavicular joint to resist collapse of the medial arch as well as eversion of the ankle and hindfoot.

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bodyblock Limb Support

The bodyblock is a light, comfortable multipurpose support block that can be used to elevate a limb or as a spacer between the knees. Made of polyurethane, it weighs just 300 g and can be easily cleaned and disinfected between patients.

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Topical Gear ACL Tube

Topical Gear has released the ACL Tube. Inventor Bill Bue and his team developed the light- weight (2 oz) brace that applies topical pressure on the medial quadriceps and hamstring muscles.

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PressureGuardian Data Collector

PressureGuardian, developed by Tillges Technologies, is a compact portable pressure sensor device with a compatible data-collecting app. The information can be used to adjust orthotic and prosthetic devices to offload pressure on a diabetic wound or inside a prosthetic socket.

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New Options OA Brace

The New Option OA is a pull-up, buttressed, “soft” brace for patients with mild to moderate knee osteoarthritis. The buttressed sleeve aids in knee alignment, provides compression, and is easy to apply.

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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

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

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

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

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

Alpha Medial Midfoot Brace

Alpha Orthotics announces the launch of its Medial Mid-foot Brace in the United States. It provides longitudinal arch support, relieving mid-foot pain caused by general foot stress and strain, including splayfoot and fallen arch. The Medial Mid-foot Brace system consists … Continue reading

OAK Orthotic Knee Joint

The OAK (Osteo-Arthritis Knee) polycentric orthotic knee joint is engineered to provide motion that better approximates normal physiologic knee movement for use in a custom Osteoarthritic Knee Orthosis. Unlike simple pivot knee joints, the polycentric action of the OAK provides … Continue reading

SureFit Adventure Series

SureFit, a division of SPS, has designed its new Adventure Series footwear collection as a marriage of originality and classically inspired styling. The new footwear collection has rich colors with innovative detailing, in designs that deliver unbeatable comfort with SureFit’s … Continue reading