Lower Extremity Review
Collegiate athletes who participate in sports associated with sprinting have an increased risk of hamstring strain. Investigators have identified flexibility, strength, and fatigue as potential contributing factors that can be addressed through sport-specific training and rehabilitation.
By Kevin M. Cross, PhD, ATC, PT, Susan Saliba, PhD, ATC, PT, and Jay Hertel, PhD, ATC
Partial foot amputations may not offer a biomechanical advantage over transtibial amputations if the metatarsal heads cannot be retained, and some experts suggest amputation level should be selected based on probability of wound healing instead. But others disagree.
By Cary Groner
Study findings and anecdotal reports suggest that newer-generation total ankle replacement can match or exceed ankle arthrodesis when it comes to gait and range of motion, but neither procedure returns gait to normal. Implant survival has also improved, but continues to be a challenge.
By Barbara Boughton
Total hip arthroplasty can significantly improve quality of life in obese patients, but high body mass index is also associated with higher rates of complications and readmissions than in normal-weight patients. The emerging subgroup of super-obese patients poses additional challenges.
By Raghav Rajgopal, MD, and James L. Howard, MD, MSc, FRCSC
Opportunistic microorganisms called biofilms constitute an age-old diabetic wound care problem that defies traditional antimicrobial therapies. Experts believe interventions customized to individual patients based on molecular diagnostics may be the best line of defense.
By Larry Hand
Patients with chronic refractory lower extremity tendinopathies often continue to have symptoms after exhausting most of their therapeutic options. Preliminary evidence supports the use of platelet-rich plasma in these patients, though higher-level research is needed.
By Ricardo E. Colberg, MD, and Kenneth Mautner, MD
Lower extremity biomechanics can significantly affect the risk of upper extremity injury in overhead throwing athletes, such as baseball and softball pitchers and catchers, and the functional stability of the lumbopelvic-hip complex is essential to preventing those injuries.
By Gretchen D. Oliver, PhD, FACSM, ATC, LAT, Hillary Plummer, MAT, ATC, and Lisa Henning
In patients who undergo a minor foot amputation following a diabetic foot ulcer, severe peripheral arterial disease is the primary risk factor for subsequent major amputation, which underscores the importance of early detection and intervention for PAD in this population.
By Vincent S. Nerone, DPM, Kevin D. Springer, DPM, Darren M. Woodruff, DPM, and Said A. Atway, DPM, AACFAS
The medical literature supports the use of massage for relief of osteoarthritis symptoms, but therapist-administered treatments can be cost-prohibitive. This study found that self-massage can also be effective, even when the initial supervised sessions are continued by patients at home.
By Dorothea Atkins, ThD, RN, and David Eichler, PhD
A growing body of scientific evidence suggests that clinical tests of core strength and stability can help predict risk of lower extremity injury in athletes, which in turn supports the need for a multisegmental approach to the development of injury prevention programs.
By Valerie Snider, MS, ATC, and Gary Wilkerson, EdD, ATC
New research suggests that vasti muscle activation in women varies throughout the menstrual cycle, adding to the growing body of literature pointing to a connection between sex hormones and knee injury risk. The exact nature of that relationship, however, remains unclear.
By Matthew S. Tenan, MA, ATC, and Lisa Griffin, PhD
Practitioners know patients who feel that ankle foot orthoses (AFOs) hinder their sartorial style are less likely to be compliant, but many clinicians feel ill-equipped to give fashion advice. That’s when the expertise of a stylist, seamstress, or personal shopper can come in handy.
By Shalmali Pal
Not only do basketball players have many of the same risk factors for plantar fasciitis as the general population, they also have the added challenge of a grueling season and very little opportunity to rest. That means practitioners have had to be creative when it comes to treatment.
By P.K. Daniel
A number of different gait modifications have been demonstrated to significantly reduce the knee adduction moment in patients with knee osteoarthritis (OA). Now research suggests gait retraining can also help reduce the pain associated with knee OA and improve function.
By Pete B. Shull, PhD
When preventive measures have been exhausted, various surgical approaches can be employed to provide each diabetic patient with a functional, biomechanically sound foot that is free of infection, while minimizing the risk of future lower limb complications.
By Gabriel V. Gambardella, DPM, and Peter A. Blume, DPM, FACFAS
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