Lower Extremity Review
At Lower Extremity Review, we know there are literally thousands of products out there that can help you improve your clinical outcomes. But the existence of all those products doesn’t really do you or your patients much good if you don’t know where to find them.
By, Jordana Bieze Foster, editor
Although the mechanisms behind patellofemoral pain syndrome (PFPS), like those of anterior cruciate ligament (ACL) injuries, are still somewhat elusive, research is shedding new light on the role gender plays in the onset of this chronic overuse condition.
By Linda Weber
The science of treating plantar fasciitis in athletes is evolving to consider the unusual demands these patients put on their feet. Although clinicians continue to rely on conservative management with rest, ice, anti-inflammatory medications, taping, and orthoses, some are embracing new approaches that seem counterintuitive but offer evidence of improved outcomes.
by Cary Groner
With a start-up cost of many tens of thousands of dollars and a steep learning curve, it’s no surprise that many O&P practitioners have been slow to transition to computer-aided design and computer-aided manufacturing (CAD-CAM).
By L.W. Barnes
Epidemiological studies confirm what coaches, trainers, parents, and student athletes already know—that ankle sprains are the most common musculoskeletal injury among high school athletes. A study in the August issue of the American Journal of Sports Medicine bears that out, with recurrent ankle injuries accounting for 28.3% of recurrent traumatic sports injuries in teen athletes.
by Linda Weber
Charles Kuffel, CPO, of Blaine, MN, knows his limitations. If the clinician and father of four is going to keep his referrals happy, get products to his patients on time and have a life outside the office, it means outsourcing some orthotic orders to a central fabricator.
By L.W. Barnes
Shoes with rocker-bottom soles have long been used to alleviate plantar pressures in diabetes patients and others susceptible to forefoot pain or ulceration. The soles move the apex of the toe rocker behind the metatarsal heads, reducing pressure as the patient’s weight transfers forward over the ball of the foot.
by Cary Groner
Clinicians have known for many years that uneven plantar pressures, combined with the loss of sensitivity caused by peripheral neuropathy, are associated with foot ulcers in diabetes patients. Ulcers often occur in different areas than peak pressures do, however. Shear forces, caused by pressure differentials in the foot, may be more to blame than plantar pressures per se.
by Cary Groner
Conditions associated with drop foot are as varied as post-stroke hemiplegia, brain or spinal cord injury, and neuromuscular disorders including multiple sclerosis (MS). Patients with drop foot are unable to use the dorsiflexor muscles to lift the foot clear of the ground during the gait’s swing phase, nor can they control plantar flexion during heel strike. The result is an awkward, unstable gait and a tendency to trip when the toes brush the ground.
by Cary Groner
In recent years, scientific studies have shown that anterior cruciate ligament (ACL) injury in athletes can lead to later osteoarthritis in a large proportion of cases. In fact, some studies have documented osteoarthritis rates of 50% to 100% in former athletes who have experienced ACL injury, when followed for 15 to 20 years.
By Barbara Boughton
Stretching and splinting have long been treatment strategies for plantar fasciitis. However, new research and ongoing clinical experience are calling into question older methodologies and providing evidence for some new approaches.
by Cary Groner
Ongoing research into posterior tibial tendon dysfunction (PTTD) has revealed risk factors that include female sex, increasing age, overweight, unsupportive footwear, and even metabolic syndromes such as diabetes. Although typically associated with older, inactive patients, PTTD is also seen more rarely in young athletes.
by Cary Groner
Clinicians who treat ambulatory cerebral palsy patients rely heavily on ankle-foot orthoses, which are the most effective treatment option for improving gait mechanics. But because CP encompasses such a wide range of symptoms, selecting the most appropriate corrective brace for a patient’s specific gait abnormality or abnormalities can present clinical challenges. Recent studies that shed light on ankle-foot orthoses’ impact on gait are characteristic of crucial ongoing research.
By Linda Weber
Whether it’s rock climbing, triathalons, cycling, running or the high jump, advances in prosthetic design have made high-caliber athletic competition a reality for some amputees. One such athlete testified in the September issue of Prosthetics and Orthotics International, “Snowboarding with the new prosthesis is like it was before the amputation!”
by Barbara Boughton
Achieving full range of motion is a key outcome of any rehabilitation program after ACL reconstruction. But what are the ingredients of a rehabilitation program that produces the best outcomes in terms of ROM?
By Barbara Boughton
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