Category Archives: Feature Article
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
June 2017
Management of painful plantar fat pad atrophy
Aging and a number of medical conditions can lead to atrophy of the fat pads under the heel and forefoot, which often causes considerable pain. Cushioned footwear and orthoses are mainstays of treatment, but research also supports the use of fat grafting in recalcitrant cases.
By Barbara Boughton Continue reading
May 2017
National Biomechanics Day thrills kids worldwide
National Biomechanics Day continued to build momentum in its second year, as scientists from Delaware to New Zealand got a jump on recruiting the next generation of biomechanists by demonstrating a wide range of applications—not to mention just how much fun the field can be.
By Hank Black Continue reading
May 2017
Stress fractures: Lessons from military research
Lower extremity stress fractures are not limited to members of the armed forces, but have been studied extensively in military populations. That body of evidence has important implications for stress fracture prevention and management in runners, other athletes, and even nonathletes.
By Baris K. Gun, DO; Andrew C. McCoy, DPM; Kevin C. Wang, BS; and Brian R. Waterman, MD Continue reading
May 2017
Somatosensory deficits following ACL surgery
Research suggests light touch sensation in the foot and ankle may be negatively affected several years after anterior cruciate ligament (ACL) reconstruction—a finding consistent with studies that have reported decreased somatosensation in patients with other lower extremity conditions.
By Matthew Hoch, PhD, LAT; Steven Morrison, PhD; and Johanna Hoch, PhD, LAT Continue reading
May 2017
Unique orthotic strategies for low-volume footwear
The low-volume shoes worn by cyclists, figure skaters, and others can make orthotic management of these patients challenging. So, lower extremity practitioners have had to develop creative strategies for achieving the desired biomechanical effects while working within a limited space.
By Jill R. Dorson Continue reading
April 2017
Protocol helps improve TKA outcomes, cut costs
A multidisciplinary joint replacement program is improving patient outcomes, decreasing complications, and shortening hospital stays, which helps to lessen clinical anguish following total knee arthroplasty as well as the financial burden on patients and the healthcare system.
By Katie Mullen, SPT; Jon R. Cook, PT, DPT; Meghan Warren, PT, MPH, PhD; and Tarang Jain, PT, PhD, DPT Continue reading
April 2017
Metatarsal morphology and injury risk in runners
Although it has not been shown to be a risk factor for stress fracture in traditional running, the presence of Morton’s foot (a second metatarsal longer than the first) alters running mechanics in ways that may exacerbate the risks of forefoot injury associated with alternative running styles.
By Brian E Stoltenberg, DPT, OCS, CSCS; and Donald L Goss, PT, PhD, OCS, ATC Continue reading
April 2017
The troublesome triad of diabetic ulcer healing
Uncontrolled deformity, deep infection, and ischemia-hypoxia make up the troublesome triad of confounders associated with healing challenges in patients with diabetic foot ulcers. Clinical examination and intervention in nonhealing patients should focus on these three elements.
By Anna Maria M. Tan, DPM; Michael B. Strauss, MD; and Lientra Q. Lu, BS Continue reading
March 2017
Rocker-bottom footwear: effects on balance, gait
Footwear with rocker soles are best known for helping to redistribute plantar pressures during gait in patients with diabetes, but research suggests they also have clinically relevant effects on balance and gait that can be beneficial for some populations but potentially dangerous for others.
By Greg Gargiulo Continue reading
March 2017
Chronic ankle instability and self-reported function
Using patient-reported outcome tools can give lower extremity clinicians insight into the disability experienced by patients with chronic ankle instability. A combination of instruments may be necessary, as different assessments may capture different aspects of the condition.
By Adam B. Rosen PhD, ATC; and Cathleen N. Brown PhD, ATC Continue reading
March 2017
Foot posture, orthoses, and patellofemoral pain
Prescription of foot orthoses for runners with patellofemoral pain (PFP) is often based on the premise that individuals with excessive pronation are among those most likely to have a positive response. However, preliminary analyses indicate this may not be the case.
By Thomas Gus Almonroeder, DPT; and John Willson, PT, PhD Continue reading
March 2017
Putting prehab to the test highlights inconsistencies
The growing popularity of prehabilitation contrasts with mixed findings in the lower extremity literature: Specifically, the approach seems to be more effective in patients undergoing anterior cruciate ligament (ACL) reconstruction than those undergoing hip or knee replacement.
By Cary Groner Continue reading
February 2017
Does history of running protect against knee OA?
Running may increase the risk of knee osteoarthritis (OA) onset or progression for some people, but in many others the knees will be safe during running; in such individuals, the benefits of physical activity can positively affect weight management and other means of reducing OA risk.
By Nicole M. Cattano, PhD, LAT, ATC; and Jeffrey B. Driban, PhD, ATC, CSCS Continue reading
February 2017
Managing O&P patients who are hard on devices
Even patients who obediently wear their O&P devices can pose a clinical challenge if they wear their devices past the point of breakdown. Experts offer suggestions for dealing with patients who are hard on devices—including those who are very large, very active, or very frugal.
By Shalmali Pal Continue reading
February 2017
Basketball shoe trends favor fashion over feet
Several confounding factors make it difficult to determine statistical associations between footwear and injuries in basketball, but attitudes toward shoes among National Basketball Association (NBA) players suggest both positive and negative trends with regard to potential injury risk.
By Will Carroll Continue reading
February 2017
Jump mechanics and risk of patellar tendinopathy
To understand the association between jumping biomechanics and transmission of forces through the patellar tendon, practitioners must have a working knowledge of the anatomy of the knee, as well as the biomechanical factors that determine force transmission through the knee.
By Rob Halle, PT, DPT, OCS, CSCS Continue reading
January 2017
Influence of mental health on diabetic foot outcomes
As evidence accumulates suggesting negative effects of depression, dementia, and other mental health issues on gait and foot-related outcomes in people with diabetes, researchers are looking at ways to screen for risk factors and psychosocial issues earlier in the continuum of care.
By Hank Black Continue reading
January 2017
The role of hip extensor strength during cutting
Although most clinicians tend to emphasize hip abductor and external rotator muscle strengthening in injury prevention and rehabilitation, recent research suggests exercises to increase explosive hip extensor strength may be critical for controlling frontal plane motion during cutting tasks.
By Marc Norcross, PhD, ATC, and Sam Johnson, PhD, ATC Continue reading
January 2017
Using wearable sensors to characterize CP gait
Inertial measurement units (IMUs) facilitate the creation of a gait analysis system that is portable and suited for use in the clinic. Research suggests IMUs can be used to measure clinically important gait metrics in children with cerebral palsy, which may improve patient outcomes.
By Mahmoud El-Gohary, PhD; Sean Pearson, BS; Paul Vasilyev, BS; James McNames, PhD; and James Carollo, PhD, PE Continue reading
January 2017
Fluoroquinolones and risk of tendon damage
As ciprofloxacin and other fluoroquinolones are prescribed more frequently, tendon-related adverse effects are also becoming more common. Experts often do not recommend these drugs, particularly for athletes or elderly patients, and emphasize that all patients should know the risks.
By Barbara Boughton Continue reading
November 2016
Peroneal tendinopathy management in tennis
Although not as common as Achilles tendinitis, peroneal tendinitis is seen in a certain group of patients with chronic ankle instability or with a cavovarus foot.1 Peroneal tendinitis presents as lateral foot pain and may also be of unknown etiology or associated with an acute inversion injury.
By Patricia Pande, MClScPT, CSCS, CPed Continue reading
November 2016
AFO stiffness can help optimize patient function
Decisions related to the stiffness of an ankle foot orthosis (AFO)—whether they involve device design or the materials from which it’s fabricated—can help lower extremity clinicians customize stability, biomechanics, and muscle function to meet individual patients’ needs.
By Lori Roniger Continue reading
