Category Archives: Feature Article

Featured Issue Article

June 2012

Effects of ankle bracing on athletic performance

Ankle braces help prevent injury by restrict­ing motion, but those restrictions don’t necessarily result in negative effects on athletic performance. Evidence sug­gests that while agility may be affected with use of an ankle brace, vertical jump and balance skills may not.

By Jatin P. Ambegaonkar, PhD, ATC, OT, CSCS; Nelson Cortes, PhD; and Shruti J. Ambegaonkar, MS, PT

Continue reading

June 2012

Amputation vs salvage for lower limb tumors

Studies assessing the relative functional benefits of limb salvage and amputation for lower extremity bone and soft tissue tumors have produced inconsistent re­sults, but the range of subjective and objective tests used in those studies may have influenced the findings.

By Lucy Kupersmith, BA, and Jeremy S. Somerson, MD

Continue reading

May 2012

Active Stance: Minimalist footwear: A risky switch for runners?

For the majority of evolutionary history, runners were either barefoot or wore minimalist footwear lacking the cushioning of today’s running shoes. Barefoot or minimally shod runners demonstrate differences1 in kinematics and impact forces compared with those wearing modern running shoes, and some research suggests barefoot running may confer biomechanical advantages over more cushioned footwear.

By Erik M. Haniuk, BS; LTC Steven J. Svoboda, MD; Karen Y. Peck, MEd, ATC; Kenneth L. Cameron, PhD, MPH, ATC; and LTC Brett D. Owens, MD

Continue reading

May 2012

Preventing hamstring injuries on the gridiron

Hamstring injuries that occur during sprinting are a significant concern in football, not just because of the frequency with which they occur, but also because they are notoriously difficult to rehabilitate, which underscores the need for effective prevention through targeted exercise programs.

By Charles D. Kenyon, MS, RSCC, and Marcus C.C.W. Elliott, MD

Continue reading

May 2012

Selection of amputation level in diabetic patients

Not all patients with diabetes and not all ulcerated limbs are amenable to salvage. When salvage is not an option, amputa­tion can help improve patient function, but a number of factors should be considered when deciding how much of the foot—if any—should be retained.

By Cary Groner

Continue reading

May 2012

Peroneal latency’s role in inversion ankle sprain

A delay in the activation of the peroneus longus and peroneus brevis muscles is thought to contribute to the risk of inver­sion ankle sprain. New research suggests that ankle taping, in addition to providing mechanical stability, also helps reduce this peroneal latency.

By Adam Knight, PhD, and Wendi Weimar, PhD         

Continue reading

May 2012

Patient race contributes to burden of knee OA

Evidence suggests that the prevalence and symptom severity of knee osteo­arthritis are greater in African-American pa­tients, underscoring the need for lower extremity practitioners to implement effec­tive strategies for disease prevention and management in this patient population.

By Kelli D. Allen, PhD

Continue reading

April 2012

When foot-ankle issues complicate knee surgery

A patient presenting with both end-stage knee osteoarthritis and a painful foot-ankle deformity is not uncommon, but the medical literature offers practitioners little guidance as to which condition should be managed first or whether they should be addressed simultaneously.

by Michael S. Pinzur, MD, and William Hopkinson, MD

Continue reading

April 2012

Telemedicine technology propels diabetic foot care

Advances in communications technol­ogy now make it possible for an expert in one location to assess a diabetic foot ulcer in a patient who is miles away. But telehealth efforts face a number of hurdles, the most daunting of which may be patient privacy.

By Emily Delzell

Continue reading

April 2012

Orthotic considerations for foot drop after stroke

When prescribing an ankle foot orthosis or neuroprosthesis for a patient with acute drop foot following stroke, lower extremity practitioners should consider the device’s potential effects on neural plasticity and motor relearning in addition to its potential effects on gait.

By Chad Lairamore, PhD, PT, CBISt

Continue reading

April 2012

OA summit examines therapeutic challenges

Newly published proceedings of an inter­dis­ciplinary osteoarthritis summit hosted by the Hospital for Special Surgery ex­plore how researchers are working to under­stand the complexities of the disease and break down the barriers facing the development of new interventions.

By Cary Groner

Continue reading

April 2012

Clinical management of Lisfranc joint injuries

Indications for operative versus nonoper­ative treatment of tarsometatarsal joint injuries depend on the specific injury pattern and disruption of normal anatomy, which may be evident on physical ex­amin­ation or radiographs but may also present more subtly.

By Andrew Rosenbaum, MD, John DiPreta, MD, and Richard Uhl, MD

Continue reading

March 2012

ACTIVE STANCE: Barefoot balance training for runners

Barefoot training and balance training have each been effective in studies of runners, but combining the methods could lead to even better results.

By Emily Splichal, DPM, MS, CPT

Continue reading

March 2012

The role of proprioception in knee OA management

Demonstrated associations between im­paired proprioception and knee osteo­arthritis suggest some interventions that help relieve painful symptoms in patients with knee osteoarthritis , such as exercise and bracing, do so by positively affecting joint position sense.

By Barbara Boughton

Continue reading

March 2012

Lower extremity focus helps cut risk of falls

Falls are common, disabling and costly. Causes are multifactorial but include foot disorders, ill-fitting footwear, and poor bal­ance. Recent research supports a multi­dis­ci­plinary approach to falls prevention and indicates that lower extremity practi­tioners can play an important role.

By Hylton B. Menz, PhD, and Martin J. Spink, BPod(Hons) Continue reading

March 2012

Taking a team approach to diabetic limb salvage

Hospitals with multidisciplinary diabetic foot care programs have found that adding vascular surgeons to the team makes their amputation prevention efforts more effective, but also adds an extra layer of challenges in terms of coordinat­ion and communication.

By Cary Groner

Continue reading

March 2012

Connecting instability and ankle osteoarthritis

Not all patients with chronic ankle in­stability develop ankle osteoarthritis, but evidence suggests the two con­ditions are related, which in turn sug­gests that ankle sprain prevention and management could help reduce ankle replacement rates.

By Larry Hand

Continue reading

March 2012

Compartment syndrome following tibia fracture

Acute compartment syndrome can devel­op after open or closed tibial fractures, even those that appear to be benign. Early diagnosis of increased compart­mental pres­­sure and timely surgical intervention can prevent adverse out­comes including nerve injury and muscle necrosis.

By Langdon A. Hartsock, MD, and William R. Barfield, PhD Continue reading

February 2012

Wedge orthoses: A distal slant on knee OA therapy

Most conservative measures to reduce knee adduction moment in patients with knee osteoarthritis involve altering proxi­mal bio­mechanics, but research suggests that similar kinetic changes and pain relief can be achieved with the use of wedged foot orthoses.

By Emily Delzell

Continue reading

February 2012

Use of eccentric exercise for prevention and rehab

Recent interest has focused on the use of Nordic hamstring strengthening exercises to prevent hamstring injuries in athletes, but evi­dence also supports eccentric exercise for managing tendinopathy and for pre­ven­tion and rehabilitation of anter­ior cruciate ligament injury.

By Daniel Lorenz, DPT, PT, ATC/L, CSCS 

Continue reading

February 2012

Success of hinged AFOs depends on alignment

Misalignment between the mechanical joint of an articulated AFO and the cor­responding anatomical joint can signifi­cant­ly affect the device’s mechanical properties, particularly resistance and stiffness, which can impair AFO effective­ness and negatively affect proximal joints.

By Fan Gao, PhD, and Susan Kapp, MEd, CPO, LPO, FAAOP      

Continue reading

February 2012

Hip rotation in golfers may determine pathology

Golfers demonstrate significant asym­metries between hips with regard to rotational range of motion and rotational velocity, which can contribute to the development of conditions including low back pain, femoroacetabular impinge­ment, and hip labral degeneration.

By Heather Gulgin, PhD, ATC   

Continue reading

February 2012

Foot-shoe mismatches leave patients at risk

Survey results suggest that at least one-third of individuals at risk for foot pain or diabetic foot ulcers are wearing shoes that are at least one size too big or too small, which can further increase those risks. Proper shoe fit and foot health start with patient education.

By Stephanie Swensen, BSc, and Ran Schwarzkopf, MD, MSc     

Continue reading

February 2012

Original research: Taping alters ankle biomechanics

This study found that closed basket-weave ankle taping significantly affects ankle range of motion and time to peak vertical ground reaction force, which can have implications higher up the kinetic chain that appear to vary from one indivi­dual to another.

By Matthew L. Santos-Vitorino, MS, ATC, LAT, Sue Shapiro, EdD, ATC, LAT, Kathy Ludwig, PhD, and Claire Egret, PhD

Continue reading

January 2012

Knee bracing benefits off-road motorcyclists

New research suggests that serious injuries occur as frequently in off-road motorcycle racing as they do in football, but such injuries occur less frequently in riders who wear knee braces.This may be why, although it is not well studied, knee bracing is widespread among off-road motorcycle riders.

By Wesley M.Gladin, BS, Robert A.Cates, BA, and Mark S.Sanders, MD, FACS

Continue reading