Category Archives: Feature Article

Featured Issue Article

May 2018

AA vs TAA: Update on ankle arthroplasty

End-stage arthritis of the ankle joint affects more than 50,000 people in the US. When conservative treatments do not provide enough relief, surgical options should be considered. Patient selection is key when choosing between ankle arthrodesis (fusion) and total ankle arthroplasty (replacement).

By Vicki Foerster, MD, MSc Continue reading

April 2018

Making the most of resistance training in the management of knee osteoarthritis

Most physical therapists maintain that resistance training is beneficial to patients with knee osteoarthritis, but evidence from trials that have been designed with consistency is lacking. Experts discuss how to create an effective regimen given this information vacuum.

By Jill R. Dorson Continue reading

April 2018

Gait therapy in osteoarthritis of the hip: An assessment

Although clinicians and researchers have been gathering data for the use of gait therapy in patients with knee OA for some time, its use in hip OA is less far along, but shows promise. Does correcting for gait abnormalities have a role in the treatment of hip osteoarthritis (OA)?

By Nicole Wetsman Continue reading

April 2018

Does athletes’ divided attention affect mechanics associated with ACL injury?

We might be falling short in our efforts to prevent ACL injury by allowing athletes to focus on how they are moving during screening. Almost 8 million athletes participate in high school sports each year in the United States, and an additional 490,000 compete at the intercollegiate level.

By Sarah Marie Tighe, SPT, and Thomas Gus Almonroeder, PT, DPT, PhD Continue reading

April 2018

The future is now— Implications of 3D technology for orthoses

2018 is shaping up as a breakthrough year for 3D printing in orthoses, as the industry moves from promise to reality. Experts agree: Three-dimensional printing will deliver custom clinical products, designed for individual patients at an affordable price.

By Keith Loria Continue reading

March 2018

The effect of footwear on the management of pain caused by disorders of the knee joint

Clinical studies have demonstrated that properly fitted footwear may alleviate knee pain resulting from osteoarthritis or other joint disease processes, while the wrong shoe can exacerbate the condition. How can practitioners help patients with knee pain make the distinction?

By Keith Loria Continue reading

March 2018

Function meets fashion in modern therapeutic devices

Unattractive therapeutic devices do not benefit patients if they won’t wear them. Leading practitioners discuss how, over the past decade, manufacturers have made significant strides in turning the solely functional into the truly fabulous.

By Jill R. Dorson Continue reading

March 2018

Is it the foot— or the footwear? Considerations for protecting a diabetic foot

In diabetes, assessing the mechanical properties of the patient’s soft tissues and the properties of footwear and orthoses comes before drafting a management plan.

By Nachiappan Chockalingam, PhD Continue reading

March 2018

The effect of sensory stimulation on movement accuracy

The author explores the sensory aspects of the foot, and footwear, on patient movement accuracy, joint stabilization, and perception of pain. An integrative approach to the dynamics of human movement is discussed.

By Emily Splichal, DPM Continue reading

February 2018

Implications of asymmetry in the treatment of injured athletes

Given that many uninjured, successful athletes have some degree of asymmetry, how do clinicians interpret asymmetry in athletes recovering from injury?

By Cary Groner Continue reading

February 2018

Patient comfort vs diabetic wound healing: confronting nonadherence associated with removeable offloading devices

Patient adherence to consistent use of removeable offloading and immobilization devices is central to promote healing and prevent infection in diabetic foot ulcers, yet the tradeoff of removability easily compromises adherence. Choosing and customizing the right device is key.

By Barbara Boughton Continue reading

February 2018

Do specialty shoes boost weightlifting performance?

Sport-specific shoes may protect athletes from injury or enhance their performance. Do specialty weightlifting shoes offer these same benefits? What effect do the shoes have on posture, rearfoot force production, ankle range of motion, the ability to bend the knee deeply,  and other para­meters? Research is mixed.

By Jill R. Dorson Continue reading

January 2018

The effect of copper- impregnated socks on tinea pedis in football players

In a study of collegiate football players, who are at high risk of tinea pedis due to their training environment, copper-impregnated socks were associated with a high rate of tinea pedis symptom resolution and a low rate of new cases—supporting claims of the socks’ antifungal potential.

By Gary M. Rothenberg, DPM, CDE, CWS Continue reading

January 2018

Saying ‘PTTD’ is misleading: It’s time for a new lexicon to distinguish pathologies

The author applies his experience designing ankle foot orthoses to propose that, instead of using diagnostic language to describe medial column ligamentous failure, practitioners learn a new, descriptive language to understand the nature of a patient’s pathology.

By Ian Engelman, MS, CPO Continue reading

January 2018

Promoting postsurgical weight loss and activity to address joint pain

Strategies to help patients lose weight and become active after surgery need to be individualized, multifaceted, and re­inforced long-term. Many people who suffer from chronic joint pain are unable to exercise; as a result of this inactivity, they gain weight, which…

By Keith Loria Continue reading

January 2018

Can minimalist shoes protect against injury by increasing foot-muscle thickness?

Improvement in abductor hallucis muscle size associated with a gradual transition to minimalist running shoes suggests that this type of strength-based approach can help improve foot structure and stability, which may…

By Nicholas A. Campitelli, DPM, FACFAS; and Scott A. Spencer, DPM Continue reading

November 2017

BRAINS, SPRAINS, AND CHRONIC PAIN: Concussion consequences may include osteoarthritis

As a growing number of studies report associa­tions between concussion and musculoskeletal injury risk, new research suggests concussed athletes may also have an increased risk of osteoarthritis later in life.

By Robert C. Lynall, PhD, ATC; Timothy C. Mauntel, PhD, ATC; David R. Howell, PhD, ATC; and Thomas A. Buckley, EdD, ATC Continue reading

November 2017

From barefoot running to diabetic neuropathy

Because footwear alters sensory perception, research examining the role of cutaneous feedback in barefoot running may provide important insight related to some of the gait changes that occur in patients with…

By Melissa Thompson, PhD, and Kristine Hoffman, DPM, FACFAS Continue reading

November 2017

Focus on biomechanics helps treat claudication

Lower extremity clinicians say ankle foot orthoses, rocker-soled shoes, and other orthotic interventions can benefit patients with peripheral arterial disease and intermittent claudication by making it easier for them to exercise, and research is starting to demonstrate these benefits.

By Shalmali Pal Continue reading

November 2017

Assessing runners’ gait using wearable sensors

Wearable sensors allow for the collection of running biomechanics data outside the laboratory in natural training environments, enabling clinicians to collect a large volume of information in a relatively short time to help identify and manage individuals who may be at risk for running-related injuries.

By Rachel Koldenhoven, MEd, ATC; and Alex DeJong, MEd, ATC Continue reading

November 2017

When a longtime patient dies: How clinicians cope

It’s not unusual for any practitioner to experience complicated emotions when a death or a terminal diagnosis disrupts the personal bond forged with a patient over many years, but experts say lower extremity clinicians often are not well equipped to deal with these emotions.

By Emily Delzell Continue reading

October 2017

Lower extremity clinicians absorb hurricanes’ impact

Clinicians in areas affected by hurricanes Harvey and Irma were prepared for issues involving preexisting lower extremity concerns, but were surprised by the number of cases they saw in the storm’s aftermath involving healthy people trying to function under extraordinary conditions.

By Nancy Shohet West Continue reading

October 2017

Implications of high ankle sprains in college athletes

High ankle sprains in collegiate athletes differ from lateral or medial ankle sprains in multiple clinically relevant ways. These include loss of sports participation time, mechanism of injury, rates of injury during competition versus practices, and the possible long-term risk of osteoarthritis.

By Timothy C. Mauntel, PhD, ATC; and Zachary Y. Kerr, PhD, MPH Continue reading

October 2017

Orthotic management tactics for hallux limitus

Orthotic devices for hallux limitus are designed to limit first metatarsophalangeal joint motion while providing cushioning and plantar pressure distribution. A lack of quality research on conservative treatment of the disorder, however, forces clinicians to rely on their own experience.

By Hank Black Continue reading

October 2017

Return-to-play concerns following Achilles tears

Achilles tendon ruptures are severe injuries that are associated with a long recovery and significantly affect an athlete’s ability to function at a high level. In devising strategies for rehabilitation and return to play, the goal of clinicians and athletes alike is to try to minimize this impact.

By J. Turner Vosseller, MD Continue reading