Category Archives: Feature Article
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
September 2017
Hemophilia, ankle pain, and orthotic management
The ankle is a frequent site of arthropathy in patients with hemophilia, but orthotic devices and orthopedic shoes can help relieve this pain. New research suggests that…
By David Oleson, PT, PCS; Katherine Stribling, PT, DPT, PCS; Jamie Beckwith, PT, DPT; Laura Fox, PT, DPT, PCS; Felicity Case, PT, DPT, PCS; Nancy Durben, MSPT, PCS; and Michael Recht, MD, PhD Continue reading
September 2017
Soft braces: Experts hunt for potential mechanisms
Soft braces are not designed to change lower extremity alignment or joint forces, but research suggests they may influence knee and ankle biomechanics in other ways, including by enhancing proprioception. This line of investigation could open the door to new therapeutic opportunities.
By Stephanie Kramer Continue reading
September 2017
SEBT scores and injury risk in collegiate athletes
Anterior-direction Star Excursion Balance Test performance may most appropriately discriminate between collegiate athletes who are and are not at risk for lower extremity injury, though…
By Mikel R. Stiffler-Joachim, MS; David R. Bell, ATC, PhD; and Bryan C. Heiderscheit, PT, PhD Continue reading
September 2017
Surgery and ulcer healing in patients with equinus
Achilles tendon lengthening and gastrocnemius recession both increase ankle joint dorsiflexion and reduce plantar forefoot pressures in patients with diabetes and equinus deformity, but experts continue to debate which is best for managing forefoot ulcers and minimizing reulceration.
By Barbara Boughton Continue reading
August 2017
Frontal plane kinematics and risk of ankle sprain
Research suggests that a simple step-down task has a strong relationship with frontal plane ankle kinematics during walking and jump landing, and may be one method of screening or assessing for increased inversion—and, in turn, increased risk of future ankle sprain—in clinical settings.
By Luke Donovan, PhD, ATC; and Mark A. Feger, PhD, ATC Continue reading
August 2017
AFOs and balance issues in peripheral neuropathy
At a symposium in Cape Town, South Africa, an orthotist demonstrated his technique for treating balance issues in patients with peripheral neuropathy using ankle foot orthoses (AFOs), and a team of researchers theorized about evidence-based concepts that could help explain his findings.
By Cary Groner Continue reading
August 2017
Biomechanics of femoral neck fractures in runners
Factors related to joint loading during running contribute to the development of stress fractures in the femoral neck and other lower extremity structures. Research suggests these loading parameters can be reduced by altering running foot strike pattern, stride length, speed, and step rate.
By Mark Riebel, PT, DSc, OCS, SCS Continue reading
August 2017
Clinical prediction rules: Finding a middle ground
Clinical prediction rules (CPRs) are intended to improve patient care, but critics have suggested that—for a number of reasons—the opposite may be true. Lower extremity experts interviewed by are in agreement that, ultimately, even the best CPRs should be only one piece of the clinical puzzle.
By Cary Groner Continue reading
July 2017
Recent trends favor use of bracing for knee OA
Experts say new research underscoring the clinical benefits of bracing for patients with knee osteoarthritis (OA), along with more comfortable device designs aimed at improving patient compliance, may help boost the historically low rates of brace utilization in this patient population.
By Barbara Boughton Continue reading
July 2017
An interdisciplinary take on diabetic limb salvage
Developing a multidisciplinary team dedicated to diabetic limb salvage allows for immediate referral, lessens the burdens on individual practitioners, helps remove structural barriers that can delay patient care, and offers a framework in which to organize inpatient care for these patients.
By Brian M. Schmidt, DPM, AACFAS Continue reading
June 2017
Study challenging Root concepts reignites debate
The latest paper to challenge biomechanics-based foot orthotic management concepts developed decades ago has revitalized a long-running discussion among foot specialists about how to define normal structure and function and which assessments should be used in prescribing foot orthoses.
By Cary Groner Continue reading
June 2017
Minimalist shoes: Risks and benefits for runners
Although there may be benefits to a change in running footwear, there are also risks associated with a switch to minimalist running shoes. Alterations in anatomy, physiology, and biomechanics associated with transitioning to minimalist footwear are likely to be unique to each runner.
By J. Todd Walker, MD; Donna Moxley Scarborough, PT, MS; Eric M. Berkson, MD; and Matthew J. Salzler, MD Continue reading
