Lower Extremity Review
DFCON2019* showcased new technologies coming online to aid in the treatment and prevention of diabetic foot ulcers. Diabetic foot ulcers (DFUs) are the most common complication of diabetes. Up to a quarter of patients with diabetes will suffer at least one DFU in their lifetime which can lead to amputation or death.
By Lynn Soban, PhD, MPH, RN
Often overlooked, lymphedema of the lower extremities is becoming more common as aging, obesity, and cancer therapies all take their toll. Detection is key to getting appropriate treatment. Lymphedema of the lower limbs is a common, complex, and highly treatable disease that begs recognition by healthcare providers.
By Stanley G. Rockson, MD
A legal encounter with a patient led this podiatrist to rethink how and what he communicates with patients. Many of us are increasingly pushed to provide a greater amount of care along with reducing costs or increasing the value of each patient office visit.
By Donald Pelto, DPM
Most patients benefit from nonsurgical care of foot drop. Your task is to identify the optimal bracing options and work closely with the patient to understand their personal treatment expectations and goals.
By Jason Wright, DPM, PGY-2, And Marshall G. Solomon, DPM, FACPM, FACAS
Consider the benefit of arthroscopy for addressing intraarticular pathology at the time initial surgical repair of high-grade ankle fracture is performed. Ankle fractures are a common orthopedic injury. Although surgical repair often yields good results, many cases are nonetheless associated with poor clinical outcome after repair.
By Kevin Burke, DPM and Jonathan Hook, DPM
These authors tap unusual but useful historic data sets to enlighten the search for the mechanisms that cause exercise-associated muscle cramps. Few athletes escape the painful experience of muscle cramps. Cramps that occur during or soon after a bout of physical activity have been termed exercise-associated muscle cramps (EAMC), and these are commonly experienced as a “painful, spasmodic contraction of the…
By Ronald J. Maughan and Susan M. Shirreffs
Introducing the kineticokinematic approach to treating plantar fasciitis. This approach focuses not only on the position of the foot but also on the forces that may be contributing to this highly prevalent foot condition. Heel pain is one of the most common complaints treated by lower extremity specialists, affecting an estimated 10% of the population.
By Pedro Aldape-Esquivel, DPM and Jarrod Shapiro, DPM, FACPM, FACFAS
While most agree it is an overuse injury, treating MTSS (aka shin splints) should involve rest, proper diet, and sometimes avoiding NSAIDS. It’s been decades since I had a case of shin splints, but I remember vividly how painful it was. I was 20 years old and overtraining—especially given the sorry state of my running shoes—and I felt as if I had a burning coal lodged along the medial side of my left shank. Every step hurt.
By Cary Groner
Podiatrists are among the providers targeted by efforts to revise regulation of referral for Medicare services. The goal? Modernize governance of a changing healthcare industry. The federal Physician Self-Referral Law (known commonly as the “Stark Law” or, simply, “Stark”) and its regulations generally prohibit physician referrals of Medicare patients for certain designated healthcare services when the physician has a…
By Daniel F. Shay, Esq.
Children with autism spectrum disorder are often described as “uncoordinated” or “clumsy” and many have clear motor control impairments. Early intervention to address motor deficits may improve physical skills and the difficulties with social functioning that are the hallmark of the disorder. Research among children with autism spectrum disorder (ASD) has traditionally focused on impairments in social skills, the condition’s core deficit.
By Keith Loria
Recent findings from the University of Nevada, Las Vegas (UNLV), add to a growing body of evidence that autism spectrum disorder (ASD) is associated with significant gait asymmetry, suggesting movement quality should be part of the diagnostic and treatment processes for ASD.
By Keith Loria
Neurodevelopmental disorders are frequently associated with motor impairments including locomotion. These study findings highlight the importance of using precise measures to differentiate motor dysfunction in neurodevelopmental disorders.
By Sylvie Goldman, Aston K. McCullough, Sally Dunaway Young, Carly Mueller, Adrianna Stahl, Audrey Zoeller, Laurel Daniels Abbruzzese, Ashwini K. Rao, and Jacqueline Montes.
Down Syndrome is associated with a long list of compensatory gait symptoms due to hypotonia, triplanar foot and ankle misalignments, sagittal and coronal compensation at the knee, proximal weakness, and equinus contractures, all of which need to be treated. How early depends on the individual child.
By Cary Groner
Children with cerebral palsy (CP) typically encounter a host of gait- and balance-related issues associated with spasticity, dyskinesia, and weakness. How severe these are depends on CP type and the individual case. As a result, experts have long debated how early to intervene with bracing strategies that include ankle-foot orthoses (AFOs), and how long to maintain those interventions.
By Cary Groner
Encouraging exercise and appropriate footwear selection may be key in helping patients maintain healthy activity levels. Exercise is recommended for the majority of patients regardless of age, gender, or physical disability. The 2008 Physical Activity Guidelines for Americans1 recommended that all adults perform 150 minutes…
By Audris Tien, DPM, Brad Franklin, DNP, RN, FNP-C, FAANP, and Jarrod Shapiro, DPM, FACFAOM, FACFAS
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