Category Archives: Feature Article

Featured Issue Article

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 Rowling, 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

March 2019

Tape Use to Prevent Blisters: Does It Really Do What We Think It Does?

Taping is a mainstay of preventive foot blister management in athletes and active people. Its use is based on the premise that rubbing causes blisters, and that tape protects the skin from this rubbing and/or provides thermal insulation from the heat generated by rubbing.

By Rebecca Rushton, Bsc(Pod) Continue reading

March 2019

The Therapeutic Power of Elastic Bands

Here’s why resistance therapy with these low-tech tools is gaining prominence—for youth soccer players, geriatric patients, and everyone in between. Elastic resistance bands are increasingly popular in physical therapy as the modality is being used to treat a wide number of lower-extremity problems on a diverse patient population that covers everyone from youth sports players to seniors.

By Keith Loria Continue reading

February 2019

Conservative Management of Freiberg’s Disease

Key options include immobilization, weight bearing restrictions, NSAIDS, orthotics, padding, and shoe modifications. The first report of osteochondrosis of the second metatarsal head was in a series of six cases presented by Dr. Alfred H. Freiberg at the Southern Surgical and Gynecological Association in 1913. The data was published the following year.

By Kerry Sweet, DPM, FACFAS; Rebecca Omana-Daniels, DPM; and Valerie Marmolejo, DPM Continue reading

February 2019

Gait and Balance Dysfunction in Older Adults: Challenges and Interventions

Falls are a significant—yet preventable—health issue among older adults. Each year, 3 million older Americans over the age of 65 are treated in emergency departments for fall-related injuries which often result in disability, loss of independence, reduced quality of life, and death.1 The number of falls is expected to rise as Americans live longer and the number of older adults continues to grow at an unprecedented rate.

By Aisha Cobbs, PhD Continue reading

February 2019

Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults Now Available

The 2019 AGS Beers Criteria® includes 5 lists of nearly 100 medications or medication classes to avoid or use with caution for some or all older adults. The American Geriatrics Society (AGS) recently unveiled its latest update to one of geriatrics’ most frequently cited reference tools: The AGS Beers Criteria® for Potentially Inappropriate… Continue reading

January 2019

Case: A Woman with Blistering, Erythema, and Scaling of the Feet

What’s causing the worsening signs and symptoms that are eroding the patient’s quality of life? Once that question is answered, what treatment should be pursued? In this case study, we describe the work-up and management of a woman whose illness was characterized by multiple vesicles and pustules and itching, scaling, and redness of the feet (as well as the hands), that progressed over months.

By Carla Benson, DPM Continue reading

January 2019

The Invisible Effect of Body Weight on Tendons

While the predominant view on the relationship between an elevated body weight and its effect on tendons, muscles, bones, and joints is grounded in the physical stress effects of body weight, the role of inflammation is becoming better understood.

By Robert Creighton, DPM Continue reading

January 2019

Dynamical Properties of Postural Control in Obese Community-Dwelling Older Adults

Does obesity affect balance and serve as an indicator of fall risk in this vulnerable population? The burden of obesity is rising at an alarming rate for older adults.

Excerpt By Thurmon E. Lockhart Continue reading

November 2018

Exploring Stability and Freedom with the GYROKINESIS® Method

New somatic practice uses repeated movements, breath awareness and rhythmic patterns to loosen joints and ease muscle tension. The GYROKINESIS® Method* is a unique form of somatic practice that is gaining popularity around the world. The Gyrokinesis Method promotes a holistic approach to health and well-being that could be useful to a variety of populations.

By Marianne Adams, MA, MFA Continue reading