September 2016

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Download the Complete issue as a PDF (6.7 mb)

Cover Story

Clinician-patient communication: How personal connections can improve outcomes

Increasingly, lower extremity practitioners are realizing the clinical importance of patient communication. They’re also starting to realize that effective communication requires more than just using the right words.

By Hank Black

Editor Message

Out on a limb: Brains, sprains, & the NFL

National Football League (NFL) players say they worry more about lower extremity injuries than concussions. But a growing body of evidence suggests the latter injury actually increases the likelihood of the former.

By Jordana Bieze Foster, Editor

LER: Foot Health

FootHealthEco-friendly foot care

A growing number of people these days are looking for ways to reduce their carbon footprint and prioritize the environment. And, although they may not realize it, few healthcare professionals are better positioned to help the eco-friendly movement than foot-care specialists.

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Management of athletes with early-stage PTTD

Posterior tibial tendon dysfunction (PTTD), known also as tibialis posterior tendon dysfunction, is one of the leading causes of acquired flatfoot in adults, but the…

By By Frank Layman, PT, DPT, EdD, MT; and April Wilson, PTA, BS, CI, CKTP, IASTM

Support for dry needling builds among clinicians

Dry needling is gaining momentum as an alternative therapy for myofascial pain, and is supported by a small but growing body of research as well as anecdotal evidence. But the training and expertise required to perform the procedure has become a topic of debate.

By P.K. Daniel

Chronic ankle instability, gait, and muscle activity

New research suggests lower extremity clinicians should consider implementing gait training in combination with targeted strengthening of the peroneus longus and gluteus medius muscles to help restore normal gait patterns in patients with chronic ankle instability.

By Rachel Koldenhoven, MEd, ATC

Reducing postoperative thromboembolism risk

Preventing deep venous thrombosis and pulmonary embolism after lower extremity surgery can involve pharmaceutical therapies or mechanical interventions. The type of prophylaxis used depends on the type of surgery, pre-existing risk factors, and patient preference.

By Barbara Boughton

Step-rate manipulation and foot-strike pattern

In distance runners, step-rate manipulation of at least 10% above a runner’s preferred rate may be an effective clinical gait retraining method to decrease the severity of foot inclination angle at heel strike and…

By Darrell J. Allen, PT, DPT, MS, SCS, CSCS; Hollie Heisler, PT, DPT; and Jennifer Mooney, PT, DPT 


In the Moment: Knee OA

Offloading and obesity: Gait study data have OA implications

Gait interventions can alter knee loading in obese patients, which may have implications for knee osteoarthritis (OA), according to three studies presented in August at the annual meeting of the American Society of Biomechanics in Raleigh, NC.

By Katie Bell

Even mild LLD affects gait in ways that could speed knee degeneration

The effects of mild limb-length discrepancy (LLD) on gait in patients with knee osteoarthritis (OA) may contribute to disease progression, according to research epublished in August by Clinical Biomechanics.

By Jordana Bieze Foster

Not all meniscal pathology on MRI is relevant in patients with knee OA

Some—but not all—characteristics of meniscal damage on magnetic resonance imaging (MRI) scans are associated with knee osteoarthritis (OA) severity and two-year progression, according to research from Tufts Medical Center in Boston, MA.

By Jordana Bieze Foster

Market Mechanics

By Emily Delzell

Implant sales rise in developing markets

While the hip and knee reconstruction market struggles to generate significant growth in Europe and the US, the implants are increasingly being commoditized in countries with developing economies such as Brazil, India, and China, and driving their respective markets at a rapid pace…

Exhibit examines arts-prostheses link

A major exhibit at the Henry Moore Institute in Leeds, UK, explores the relationship between visual arts and prostheses. “The Body Extended: Sculpture and Prosthetics” traces how artists have addressed radical changes to the human body.

Mueller outfits top UK soccer team

Prairie du Sac, WI-based Mueller Sports Medicine announced in August that it is now an official team supplier of the UK’s Leicester City Football Club, defending Premier League champions.

Swiss Sigvaris Group acquires BiaCare

Winterthur, Switzerland-based Sigvaris Group announced in late August that the graduated compression company has completed its acquisition of BiaCare, headquartered in Holland, MI.

Rishwain named Vionic global business head

San Rafael, CA-based Vionic on August 15 reported that Connie X. Rishwain, former president of Goleta, CA-based Ugg, has joined Vionic as president of its global business.

AOPA honors Watson for O&P lifework

The Washington, DC-based American Orthotic & Prosthetic Association (AOPA) honored Thomas Watson, CP, with its Lifetime Achievement Award at the 2016 AOPA National Assembly, held September 8-11 in Boston, MA.

ASB schedules 2017 biomechanics event

The American Society of Biomechanics has begun plans for National Biomechanics Day (NBD) 2017, scheduled for April 6.

Footwear thesis wins brevity-based award

The University of South Australia in Adelaide announced in August that PhD candidate Joel Fuller won its 3MT (Three Minute Thesis) competition for his work exploring the link between trendy minimalist athletic shoes and injury.

Data detail ConforMis implant benefits

Results from two clinical studies presented at the International Congress for Joint Reconstruction Pan Pacific Orthopaedic Congress, held August 10-13 in Gainesville, FL, show the iTotal CR customized knee replacement made by Bedford, MA-based ConforMis provides superior patient…

Coral scores 100% in surprise FDA audit

Mineral supplement seller Coral reported in August that the Food and Drug Administration (FDA) gave the company a perfect score in a surprise audit.

OPAF hosts First Swing at NAGA event

The Charlotte, NC-based Orthotics & Prosthetics Activities Foundation (OPAF) on August 15 hosted a full-day First Swing Learn to Golf Training and Clinic as the kickoff event of the National Amputee Golf Association (NAGA) Championships at Pumpkin Ridge Golf Club in North Plains, OR.

Cascade Dafo offers virtual decoration

Cascade DAFO reported in August that its DAFO Creation Station, an online interactive tool for choosing colors and patterns for the Ferndale, WA-based company’s custom DAFOs (dynamic ankle foot orthoses) is available at

Athletes undergo Quest biomarker tests

Virginia Polytechnic Institute and State University in Blacksburg reported in August that it plans to use Madison, NJ-based Quest Diagnostics’ blood testing service to look for associations between biomarkers and biomechanics, training, recovery, and other variables relevant to sports injury risk in some of its athletes.

Ability P&O, Freedom Innovations join on study

Exton, PA-based Ability Prosthetics and Orthotics and Freedom Innovations, headquartered in Irvine, CA, in September reported they are collaborating on a study comparing Freedom’s new Kinnex Microprocessor Ankle with a typical carbon fiber prosthetic ankle.

Chaco brings Tread Labs to retailers

Stoneham, MA-based Chaco’s founder and original designer of its sandals, Mark Paigen, announced on August 18 the wholesale launch of Tread Labs, a new line of orthotic insoles. The insoles’ features include four arch heights in sizes for men and women, easily replaceable Velcro top covers, and a lifetime guarantee.

OPIE launches Amplitude resource guide

Gainesville, FL-based OPIE Software announced in August that Amplitude Media Group, headquartered in Northglenn, CO, is an integrated supplier. With this partnership, Amplitude Media’s Limb Loss Resource Guide (LLRG) can now be purchased digitally through the OPIE Software platform.


Custom-milled Orthotic Flip-flops

Footmaxx now offers custom-milled orthotic flip-flops. The orthotic flip flops are hand-crafted from durable materials, including a slip-resistant rubber sole, to support and stabilize the feet and lower extremities. Women’s styles include Rio, with…

Anatomical Concepts Abby AFO

The Abby Articulating Ankle Foot Orthosis (AFO) from Ana­tomical Concepts is a multifunctional, posterior dual-jointed device for the early stages of rehabilitation. With a stable base of support and a new nonskid low-profile plantar surface, it is…

Spinal Solutions EZ-APO

Spinal Solutions announces the availability of the EZ-APO (Atlanta Prosthetics & Orthotics) ankle foot orthosis (AFO). The EZ-APO device is ergonomically designed to optimize fit around the footpad and malleolus and provide tibial tuberosity relief.

Microfiber Shades Now in Heather

For people who need to wear graduated compression every day but want to add a pop of color to their wardrobe, Sigvaris North America is launching two fun new additions to the Microfiber Shades line of compression socks—navy heather and graphite heather socks.

Pro-Roller Soft Half

OPTP has added a new foam roller to its elite Pro-Roller line. The Pro-Roller Soft Half measures 36″ in length and 3″ in diameter. The roller’s unique shape is flat on one side and round on the other. Using the flat side down provides improved stability for balance training and…

Cascade DAFO Creation Station

Cascade DAFO announces the launch of the Creation Station for decorating custom dynamic ankle foot orthoses (DAFOs). With this new online interactive tool, DAFO users can “try on” various transfer patterns, ribbon trims, and strap and padding colors.

FC2 Flexion Control Ankle Joint

Lower Extremity Technology has retooled the FC2 Flexion Control Ankle Joint to simplify fabrication. The multi-axis hinge offers 70° of full range of motion. The new design features an improved hinge axis for strength and durability, and updated casting for more support around the…

Össur Rebound PCL Brace

New from Össur is the Rebound PCL, a dynamic force brace for rehabilitating posterior cruciate ligament (PCL) ruptures. The Rebound PCL is designed to stabilize the knee while providing appropriate levels of physiologic loading force during both knee extension and…