Category Archives: Feature Article

Featured Issue Article

June 2019

Patient Perspective – Beyond Bunions: Feeling Footloose and Fancy Free 6 Years After Surgery

I’ve never been one to gaze admiringly at my toes while lounging at the beach – or heaven forbid, take pictures of them with a tropical sea background to post on Instagram. I was cursed with ugly feet – wide and stubby (thanks Dad!) – and because of that, I’ve never bothered to try and adorn them with pedicures and polish.

By Karen Bakar Continue reading

June 2019

Inclusion In the Exam Room, In the Locker Room, On the Field

What does an athlete look like? There was a time when the answer to this question was largely homogenous, but today’s athletes have broken every mold and stereotype. They can be tall, short, lean, thick, strong, nimble, brawny, brainy, quick, or deliberate.

By Sarah Kogod Continue reading

June 2019

Bike Fitting Will Come Out From the Shadows and Into Rehab Armamentarium

Many readers may not have heard of it yet, but by the time LER turns 20, I predict it will be a common prescription…at least I hope it will be. I’m talking about bike fitting, of course. The number of individuals choosing cycling as transportation, hobby, sport, or community activity—whether it’s competitive or recreational—is increasing annually—up from around 43 million in 2014 to 47.5 million in 2017.

By Happy Freedman Continue reading

June 2019

Growing Awareness of Unicity Will Drive Sport Science

Like the athletes we study, the field of sport science is always in motion. When combined with medicine, it is a rich and growing environment in which the interaction between daily practice and clinical research contributes to an overall progression in understanding of human performance and biological adaptations.

By Antonio Robustelli, MSc, CSCS Continue reading

June 2019

What’s the Point of 3D Printing Orthotics? Options!

Recently, on the Facebook page of Craig Payne, creator of Podiatryarena.com, there was discussion about a published study that compared running biomechanics and perceived comfort between a 3D-printed orthotic and a traditionally manufactured orthotic. The study showed there were no differences between the two devices.

By Bruce E. Williams, DPM Continue reading

June 2019

Complimentary Approach Grows, But Some Challenges Remain

Lower Extremity Review can be both proud and excited about its 10th anniversary and its participation in all aspects of sports medicine and podiatry, rehab, fitness, and wellness. As for what the next decade holds, I predict implementing the input and expertise from all the medical specialties, along with educators, trainers, and therapists of all backgrounds, will continue to grow.

By Robert A. Weil, DPM Continue reading

June 2019

Explosion of Analytics Will Fuel Growth of Sports Medicine

The field of Sports Medicine has undergone exponential growth over the last few years, but still remains in its infancy. So much research and technology have been added to clinical practice since the simple days of “RICE” (Rest-Ice-Compression-Elevation). The catch phrase for some of this phenomenon is “analytics” and it covers a variety of topics. This is where I believe Sports Medicine is going in the future.

By Howard Osterman, DPM Continue reading

June 2019

Technology Is Inevitably Reinventing Orthotics and Prosthetics

Devices and patient care have changed dramatically through the history of the O & P profession. At first, devices were carved of wood, based on visual inspection, then sewn with leather and bent metal; today, we cast in plaster and pull plastic. If history tells us anything, it’s that, first, newer technology will continuously become…

By Jacob Praga, MSBME Continue reading

June 2019

Objective Data Will Lead the Transformation of Treatment

The future isn’t coming—it’s arriving at an incredible pace! Technology and the data it can supply have reshaped the planet and those who fail to adopt it will be left in the dust. The need for objective data in treatment decisions will become mandatory both by payers and patients alike.

By Kendon Howard Continue reading

June 2019

Proper Diabetes Care Can Reduce Rising Lower Extremity Amputation Rates

In a recent article in the Philadelphia Inquirer, reporter Stacey Burling wrote, “Amputation rates among people with diabetes in the United States dropped for about 15 years, but recent reports issued by the U.S. Centers for Disease Control and Prevention highlight a disturbing trend: Amputation rates have been rising in people under 65 with diabetes since 2009.

By Mark Hinkes, DPM Continue reading

June 2019

Tech Innovation Has Nudged Podiatry Forward More Than Any Other Force

Although it’s difficult to predict future developments, one might extrapolate, to some extent, large changes to a specialty of medicine by looking back on the history of the field and combining it with recent developments and trends.

By Jarrod M. Shapiro, DPM Continue reading

June 2019

To Improve Patient Outcomes, Measure What Matters

Mobility and balance deficits in patients with lower extremity impairments are significant factors for decreased quality of life. To improve outcomes for these patients, clinicians need measures that are evidence-based and scientifically validated; in other words, there is a need to measure things that matter.

By Michael Rowlings, BS Continue reading

June 2019

Foot and Ankle Surgery: A “Minimal” Future

Before pronouncing what I predict will be the single most significant change in foot and ankle surgery in coming years, it’s essential to look back. I asked an orthopedic colleague what he thought the most significant change in orthopedics was over the past 25 years, and he replied, “locking plate technology.” I agree.

By Patrick A. DeHeer, DPM Continue reading

June 2019

OUTCOMES COULD BE AFFECTED: Is Reimbursement Reduction Imminent for Most Off-the-Shelf Braces?

My perspective on the future reflects my professional interest in lower-extremity injuries and conditions that can be treated by knee braces and by ankle-foot and knee-ankle-foot orthoses. An aging population and other market demographics seem to indicate there is an increasing need for braces; new manufacturing methods, including interesting composite materials and 3D printing, seem to point toward a future of technical innovation.

By Rick Riley Continue reading

June 2019

“Capstone” Research Has Great Value to Orthotics and Prosthetics

Georgia Institute of Technology initiated its Masters of Science in Prosthetics and Orthotics (MSPO) program in 2002, knowing that considerable advances in the profession would be possible if research was an emphasis in clinical education. Students entering the program came with added bases of knowledge, dominated by…

By Geza F. Kogler, PHD Continue reading

June 2019

Embrace Mobile Technology to Meet Challenges of a Growing Older Population

Modern day times not only see us living longer, but enjoying a wide array of advances in lifestyle, medicine, health, and social care, as well as the fast-paced changes in technology. Currently, 13% of the global population is over age 60, a figure which is increasing by 3% each year.1

By Sarah A. Curran, PhD Continue reading

June 2019

Harnessing Emerging Technologies to Standardize Prosthetic and Orthotic Clinical Care Into the Future

Prosthetic and orthotic clinical care involves using custom-made devices to assist in the rehabilitation of people with physical impairments and disabilities. As such, it has long relied on the craftsmanship of prosthetists and orthotists. Although the results of such craftsmanship can be of tremendous benefit to the patient…

By Stefania Fatone, PhD, Ryan Caldwell, CP, FAAOP, and Julia Quinlan, PhD Continue reading

June 2019

BRIEF NATURAL HISTORY: The Essential Human Pedal Arch

The foot ranks high among the most ill-constructed elements of the modern human musculoskeletal system—an observation that necessarily begs the question: Why is this so? Upright, bipedal gait is the defining characteristic of our lineage; humans and our immediate ancestors have been practicing it for at least 5 million years. Why hasn’t evolution perfected this hallmark adaptation?

By Bruce Latimer, PhD Continue reading

May 2019

Is Medical Cannabis an Appropriate Treatment for Joint Pain?

While many states have rushed to legalize cannabis, evidence for its medicinal use remains ‘paltry.’ However, physicians must be willing to talk with patients who want to use it. With medical and recreational cannabis legal across most of the United States and Canada, patients are turning to the drug as an alternative treatment for a wide range of ailments, including arthritis and other types of joint pain.

By Nicole Wetsman Continue reading

May 2019

EXCERPT: Do alterations in muscle strength, flexibility, range of motion, and alignment predict lower extremity injury in runners: a systematic review

Strategies for preventing running-related injury are lacking. These authors examine the evidence supporting use of musculoskeletal clinical assessments to predict runners at risk. Injury in runners is common, affecting 19.4 to 94.4% of runners annually.

By Shefali M. Christopher, Jeremy McCullough, Suzanne J. Snodgrass, and Chad Cook Continue reading

April 2019

Therapeutic Shoes Work for People with Diabetes. Why Doesn’t Every Patient Use Them?

Patients are unaware or reluctant, and some providers hesitate to engage in what can be a burdensome prescribing and procuring process—helping explain why uptake of this valuable preventative is disappointing. As allied healthcare professionals, we are, of course, acutely aware of the ever-growing diabetes epidemic in the United States.

By Erick Janisse, CO, CPED Continue reading

April 2019

Can Stabilization Training Help Minimize Risk of Injury in Adolescent Female Athletes?

5.5 million children and adolescents are injured playing sports annually. Most of these injuries are preventable, the CDC says. More than 30 million children and adolescents participate in organized sports in the United States; according to the Centers for the Disease Control and Prevention (CDC), that number is on the rise.

By Warren J. Potash Continue reading

April 2019

It’s Not Limb Salvage…It’s Life Salvage

New research invigorates arguments about limb salvage vs. more proximal amputations. A recent paper from researchers in Australia has reignited the ongoing debate about the relative merits of partial-foot versus transtibial amputations, particularly in diabetes patients.

By Cary Groner Continue reading

March 2019

Bone Stimulation Represents New Frontier for Optimizing Patient Outcomes

Limited research into electromagnetic and ultrasound bone stimulation devices complicates efforts to determine efficacy. For the majority of people, lower-limb fractures and fractures in other parts of the body heal well and reliably. However, some people experience complications that may cause significant harm.

By Nicole Wetsman Continue reading

March 2019

A REVIEW FOR LOWER-EXTREMITY SPECIALISTS: Mitigating the Opioid Crisis with Pain Management Regimens in a Multimodal Approach

For help limiting the number of opioid tablets you prescribe—and to still treat postop pain successfully—turn to practice guidelines, evidence from the literature about local and regional anesthesia techniques, and constraints of the law.

By Robert G. Smith, DPM, MSc, RPh, CPed, CPRS Continue reading