Lower Extremity Review
The non-weight-bearing examination is the foundation of a comprehensive biomechanical assessment. It allows the clinician to evaluate intrinsic structure, available joint range of motion, and inherent pathomechanics without the confounding influence of body weight and compensation. Isolating individual joints and segments in an unloaded state is critical for identifying pathology, determining…
By Patrick DeHeer, DPM FACFAS, FFPM RCPS (Glasg)
Orthotic prescription involves a nuanced understanding of various modifications designed to influence lower extremity biomechanics, particularly focusing on the rear foot, midfoot, and forefoot. For lower extremity clinicians, mastering these options allows for tailored patient solutions, enhancing stability, addressing discrepancies, and improving overall function.
By Karen A. Langone DPM
Avascular necrosis (AVN) of the talus presents one of the most complex and challenging problems in foot and ankle surgery, particularly in the aftermath of talar fractures. As podiatric specialists, understanding its nuances–from its unique anatomical predisposition to the evolving landscape of its management–is crucial for optimizing patient outcomes.
By Christy M. King DPM, FACFAS
Returning to a sport after an injury involves healing tissue while restoring strength, stability and confidence. Athletes face the challenge of balancing physical recovery with mental readiness, and their decisions carry significant implications for long-term health and the risk of reinjury. Understanding which criteria best predict successful outcomes helps clinicians support athletes effectively.
By Jack Shaw
Pain in the foot and ankle is rarely a riddle. Patients may not know the name of a tendon, ligament, or nerve, but they almost always know where it hurts. They point with 1 finger, not their whole hand. They tell you whether it burns, stabs, aches, feels electric, or stiffens after rest.
By Dr. Hooman Mir, DPM, MSci, FAPWCA
According to Robert Weil, DPM, a sports podiatrist and expert in injury-free exercise, we should be advocating for a holistic approach to tackling the rise of type 2 diabetes. Often called “Dr. Bob” by his followers, he points out that a common contributor to this health crisis is a sedentary lifestyle, which Dr. Bob addresses through his long-standing work with athletes and the general public. The “new medicine,” as seen through his lens, moves beyond simple prescription and…
By Dr. Robert Weil, DPM and Lawrence Rubin, DPM
When you’re in the middle of a major medical crisis, there can be a lot of information to process. And what if you’ve never even heard of an ankle foot orthosis (AFO), don’t know what it’s for, how it works or how to use it. I’ve been there. (But as LER Magazine’s editor, I had heard of an AFO.) I recently had a completely unexpected medical emergency that resulted in an extended hospital stay, physical therapy and a physical therapist handing me an AFO and saying, “Try this.”
By January Shoaf, ler Magazine Editor
Each year, hundreds of thousands of Americans lose a limb due to non-traumatic amputation, most of which could have been prevented. Peripheral artery disease (PAD) and its most severe form, critical limb-threatening ischemia (CLTI), continue to devastate lives, particularly among…
By Dr. Laiq Raja, MD, FACC, FSCAI, Interventional Cardiologist and Endovascular specialist, Founder of The Limb Savers Society 501 c(3) Non-profit organization and the CLIF Conference.
Over the course of my career, I have operated at the crossroads of bioengineering and clinical orthotics, a combination that has provided me with a unique perspective on addressing challenges in prosthetics and orthotics. I collaborated with Georgia Institute of Technology to develop the curriculum for the first Master of Science in Prosthetics and Orthotics program.
By Géza F. Kogler, Ph.D, CO
Early assessment and intervention of acquired adult flatfoot, particularly concerning Posterior Tibial Tendon Dysfunction (PTTD) is essential. I’ll be discussing proactive management, emphasizing the importance of early intervention, comprehensive foot assessment, and the strategic application of orthotic devices to prevent the progression of PTTD and improve long-term patient outcomes.
By Dr. James McGuire DPM, LPT, LPed, FAPWHc
Charcot neuroarthropathy is a complex condition that often leads to considerable challenges due to its complex nature. One primary concern is the management of soft tissue complications, including chronic wounds and surgical dehiscence, which are prevalent among Charcot patients. These complications can significantly impact limb functionality and…
By Kelsey Millonig, DPM, MPH, FACFAS, DABPM, DABFAS
Falls are a major public health concern, causing millions of injuries in the United States (US) each year. A portion of injuries caused by falls are likely to involve the lower extremity. The objective of this study was to describe lower extremity injuries caused by falls treated at US hospital emergency departments (EDs).
By Mathias B. Forrester, BS
We all know we will not live forever, but perhaps a good goal would be to not outlive your health. We also know that there are elements of our health we can control and those we can’t. Aging is a simple fact, though we often don’t consider it at the functional microscopic level. We can’t do much about the ending, but we have much to say and…
By Jay Segel, DPM; Sally Crawford, MS
Over the last few decades, clinicians have debated the merits of traditional plaster casting versus modern 3D scanning in orthotic capture. Amid continuing discourse, 1 principle holds: the clinician’s grasp of anatomical data and its impact on device design is critical to success. Equally as vital is the orthotic lab’s role in translating clinical intent into design.
By Dr. Dean Hartley (Podiatrist & Adjunct Engineering Fellow–University of Queensland)
Orthokine® is the proprietary name for a German-developed autologous conditioned serum (ACS) therapy now advanced in musculoskeletal medicine for joint pain. In scientific literature and clinical contexts, Orthokine is used interchangeably with the generic designation autologous conditioned serum (ACS), with…
By Dr. Hooman Mir, DPM, MSci, FAPWCA
UTRGV, School of Podiatric Medicine
Department of Podiatric Medicine, Surgery & Biomechanics
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