Lower Extremity Review
After a year in a fracture boot with a broken foot, I thought my ordeal was over. I was wrong. The broken bone in my foot, sustained after a fall down a staircase in my home, had occurred midway down the fifth metatarsal bone below my little toe—a site that is notoriously difficult to heal, according to my podiatrist.
By Barbara Boughton
Finding the right orthotic design starts with the space limitations presented by cycling shoes, but the challenges for lower extremity practitioners don’t end there. Factors to consider when prescribing foot orthoses include biomechanics, skill level, cycling discipline, and bike technology.
By P.K. Daniel
Foam rolling is a relatively new therapeutic approach, but early research suggests that it can help improve range of motion and muscle performance and aid in recovery after exercise. Questions remain, however, about the extent to which the effects involve myofascial mechanisms.
By Duane C. Button, PhD, CSEP-CEP, and David G. Behm, PhD
As a result of limitations in the fall prevention research to date, investigators and
clinicians are often left to make their best guesses about the effect of foot and ankle interventions based on the effect such strategies have on issues related to falls, rather than on falls themselves.
By Cary Groner
Several patient populations with an increased risk of knee osteoarthritis also are at increased risk for vitamin D deficiency, and research suggests vitamin D levels may be related to knee OA symptoms. The exact nature of the relationship, however, remains perplexing.
By Greg Gargiulo
To sustain is to endure. Knee osteoarthritis (OA) is a considerable worldwide health concern, as it greatly impacts an individual’s quality of life, general health, and societal role participation.
By John Nyland, DPT, SCS, EdD, ATC, CSCS, FACSM, David N.M. Caborn, MD, and Roland Jakob, MD
Adding four functional tests to the preparticipation physical evaluations performed in student athletes may allow clinicians to identify individuals at risk for lower extremity musculoskeletal injury and implement preventive interventions to maximize safety in sports participation.
By Alexis Meister, BS, ATC; Dustin Grooms, MEd, ATC, CSCS; Cambrie Starkel, MS; and James Onate, PhD, ATC, FNATA
Existing data suggest bariatric surgery-induced weight loss can lead to rapid improvements in gait and physical function. The surgery may also help to address factors associated with knee osteoarthritis, which itself can affect mobility and function in obese patients.
By Andrew W. Froehle, PhD, Neal Dollin, MS, Richard T. Laughlin, MD, Donovan D. Teel II, MD, Richard J. Sherwood, PhD, and Dana L. Duren, PhD
Because power in baseball pitchers is generated from the feet through the core to the throwing arm, the study of stride length and its impact on pitching performance may help define an optimum technique that better protects pitchers from upper extremity injuries.
By Ryan L. Crotin, PhD, and Dan K. Ramsey, PhD
The body of research that has evaluated running shoe prescription and injury suggests the most important factors to consider when selecting a running shoe are that it fits the foot perfectly and that the midsole is comfortable and appropriate for the individual athlete’s running style.
By Thomas C. Michaud, DC
Patients with Charcot-Marie-Tooth disease showing the greatest increase in speed appear to respond to and utilize the energy storing and releasing properties of a carbon fiber composite ankle foot orthosis differently from those who had smaller increases in walking speed.
By Janet S. Dufek, PhD; Edward S. Neumann, PhD, PE, CP; M. Cameron Hawkins, PhD; and Brendan J. O’Toole, PhD
Despite the documented benefits of supervised exercise in patients with claudication, its effect on actual clinical practice has been disappointing due to a lack of reimbursement. But practitioners and researchers have been investigating other options, with encouraging preliminary results.
By Cary Groner
Transcranial magnetic stimulation research suggests cortical excitability may be able to help differentiate healthy, previously injured, and functionally unstable ankle joints, and underscores the need to clinically target both mechanical and proprioceptive deficits in patients with FAI.
By Alan R. Needle, PhD
Studies show that lower extremity amputation rates in patients with diabetes vary widely, sometimes even within individual healthcare systems. What’s more difficult to determine is why these variations exist and what can be done to improve access to care for all patients.
By Larry Hand
The etiology of Achilles tendon rupture is multifactorial, but the injury occurs most frequently in the athletic population. Clinicians still miss 24% of ruptures acutely, particularly in older patients, those in whom sports was not the causative mechanism, and those with high BMIs.
By Steven M. Raikin, MD
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