Category Archives: Feature Article
Physical impairments associated with femoroacetabular impingement include limited range of motion, muscle weakness, and altered biomechanics. Attention to these areas during rehabilitation can improve surgical outcomes and may even reduce the risk of osteoarthritis.
By Jerrad R. Guenther, BSc, Michael K. Gilbart MD, FRCS(C), MEd, and Michael A. Hunt PT, PhD
Research suggests that obesity influences the development of Achilles tendinopathy to a greater degree than other types of foot and ankle pain. This phenomenon will become increasingly important to lower extremity practitioners as global obesity rates continue to rise.
By Ryan T. Scott, DPM, AACFAS, and Christopher F. Hyer, DPM, MS, FACFAS
Hip strengthening can improve short-term outcomes related to patellofemoral pain syndrome, but further research is needed to determine the underlying mechanism and whether the same approach will also prove effective in managing patellofemoral osteoarthritis.
By Michael B. Pohl, PhD
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
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
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
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
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
Partial foot amputations may not offer a biomechanical advantage over transtibial amputations if the metatarsal heads cannot be retained, and some experts suggest amputation level should be selected based on probability of wound healing instead. But others disagree.
By Cary Groner
Study findings and anecdotal reports suggest that newer-generation total ankle replacement can match or exceed ankle arthrodesis when it comes to gait and range of motion, but neither procedure returns gait to normal. Implant survival has also improved, but continues to be a challenge.
By Barbara Boughton
Total hip arthroplasty can significantly improve quality of life in obese patients, but high body mass index is also associated with higher rates of complications and readmissions than in normal-weight patients. The emerging subgroup of super-obese patients poses additional challenges.
By Raghav Rajgopal, MD, and James L. Howard, MD, MSc, FRCSC
Opportunistic microorganisms called biofilms constitute an age-old diabetic wound care problem that defies traditional antimicrobial therapies. Experts believe interventions customized to individual patients based on molecular diagnostics may be the best line of defense.
By Larry Hand
Patients with chronic refractory lower extremity tendinopathies often continue to have symptoms after exhausting most of their therapeutic options. Preliminary evidence supports the use of platelet-rich plasma in these patients, though higher-level research is needed.
By Ricardo E. Colberg, MD, and Kenneth Mautner, MD
Lower extremity biomechanics can significantly affect the risk of upper extremity injury in overhead throwing athletes, such as baseball and softball pitchers and catchers, and the functional stability of the lumbopelvic-hip complex is essential to preventing those injuries.
By Gretchen D. Oliver, PhD, FACSM, ATC, LAT, Hillary Plummer, MAT, ATC, and Lisa Henning
In patients who undergo a minor foot amputation following a diabetic foot ulcer, severe peripheral arterial disease is the primary risk factor for subsequent major amputation, which underscores the importance of early detection and intervention for PAD in this population.
By Vincent S. Nerone, DPM, Kevin D. Springer, DPM, Darren M. Woodruff, DPM, and Said A. Atway, DPM, AACFAS
The medical literature supports the use of massage for relief of osteoarthritis symptoms, but therapist-administered treatments can be cost-prohibitive. This study found that self-massage can also be effective, even when the initial supervised sessions are continued by patients at home.
By Dorothea Atkins, ThD, RN, and David Eichler, PhD
A growing body of scientific evidence suggests that clinical tests of core strength and stability can help predict risk of lower extremity injury in athletes, which in turn supports the need for a multisegmental approach to the development of injury prevention programs.
By Valerie Snider, MS, ATC, and Gary Wilkerson, EdD, ATC
New research suggests that vasti muscle activation in women varies throughout the menstrual cycle, adding to the growing body of literature pointing to a connection between sex hormones and knee injury risk. The exact nature of that relationship, however, remains unclear.
By Matthew S. Tenan, MA, ATC, and Lisa Griffin, PhD
Practitioners know patients who feel that ankle foot orthoses (AFOs) hinder their sartorial style are less likely to be compliant, but many clinicians feel ill-equipped to give fashion advice. That’s when the expertise of a stylist, seamstress, or personal shopper can come in handy.
By Shalmali Pal
Not only do basketball players have many of the same risk factors for plantar fasciitis as the general population, they also have the added challenge of a grueling season and very little opportunity to rest. That means practitioners have had to be creative when it comes to treatment.
By P.K. Daniel
A number of different gait modifications have been demonstrated to significantly reduce the knee adduction moment in patients with knee osteoarthritis (OA). Now research suggests gait retraining can also help reduce the pain associated with knee OA and improve function.
By Pete B. Shull, PhD
When preventive measures have been exhausted, various surgical approaches can be employed to provide each diabetic patient with a functional, biomechanically sound foot that is free of infection, while minimizing the risk of future lower limb complications.
By Gabriel V. Gambardella, DPM, and Peter A. Blume, DPM, FACFAS
Significant progress has been made in quantifying gait impairment in patients with multiple sclerosis, but clinician-friendly assessment techniques that are sensitive to mild levels of impairment are needed to facilitate early intervention and in turn improve patient outcomes.
By Douglas A. Wajda and Jacob J. Sosnoff, PhD
I can’t recall exactly when the bunion on my left foot started causing discomfort, but it was probably when I was about 40. I waited some time to get a referral to a podiatrist, and when I finally saw one, life with two kids and a full-time job stalled my pursuit of treatment for another three and half years.
By Karen Bakar