Category Archives: Feature Article
August 2016
Foot strike while running and patellofemoral pain
Recent research supports the idea that increased patellofemoral stress is a contributing factor in runners with patellofemoral pain, and that gait retraining to promote a…
By Jenevieve L. Roper, PhD; Deborah L. Doerfler, PT, DPT, PhD; Christine M. Mermier, PhD; and Janet S. Dufek, PhD Continue reading
August 2016
Foot rotation during gait in patients with knee OA
Rotating the foot in or out during gait is associated with significant decreases in frontal plane knee load during early or late stance, respectively, and can be effective for reducing pain and potentially slowing the progression of…
By Kevin Alan Valenzuela, ABD, CSCS; and Hunter Jared Bennett, PhD Continue reading
August 2016
Radiofrequency-based arthroscopy in the ankle
The results of a retrospective chart review suggest that the use of plasma-mediated bipolar radiofrequency-based arthroscopic microdebridement is associated with notable decreases…
By Renato Giorgini, DPM, FACFAS; Stephanie Giles, DPM; Omer Aci, DPM; and Christopher Japour, DPM, MS Continue reading
July 2016
Understanding turf toe: The role of foot orthoses
Turf toe is a common injury in football players competing on artificial turf, but it also occurs in soccer and baseball players on natural grass and other playing surfaces. Turf toe is a sprain of the capsule of the first metatarsophalangeal (MTP) joint; increasing grades of injury may include…
By Patricia Pande, MClScPT, CSCS, CPed Continue reading
July 2016
New healing factors take ulcer care to the next level
Support is growing, in the medical literature and in clinical practice, for the use of skin substitutes and other advanced biologic therapies in chronic diabetic foot ulcers. But researchers and practitioners remain uncertain as to which of these advanced products are best for…
By Hank Black Continue reading
July 2016
Lower extremity strength and injury risk in runners
Study findings regarding strengthening interventions in runners with patellofemoral pain syndrome have been inconsistent, perhaps because specific subgroups are more responsive than others. Preliminary research suggests high school runners may make up…
By Lace Luedke, PT, DPT, PhD, OCS, CSCS Continue reading
July 2016
Limb length discrepancy: When, how to intervene?
Limb length discrepancies (LLDs) as small as 1.5 cm can significantly affect gait, and some clinicians choose to intervene in cases of even smaller discrepancies. Many LLDs can be addressed orthotically, but surgical techniques are becoming less invasive and more effective.
By Cary Groner Continue reading
June 2016
Golf swing biomechanics: Footwear considerations
With the rise of a new crop of young stars and the anticipation of its Olympic debut this year, golf continues to be immensely popular for players and spectators alike. Golfing is a highly coordinated sport that, by its nature, is associated with risk of…
By Patricia Pande, MClScPT, CSCS, CPed Continue reading
June 2016
When knee OA research becomes legal testimony
In worker’s compensation cases, including those involving knee osteoarthritis, an expert witness often will be asked to use his or her knowledge of biomechanics to provide an opinion supporting or refuting a causal relationship between work conditions and an overuse injury.
By Steven T. McCaw, PhD
June 2016
Stroke rehab: Strategies to improve gait velocity
Multiple techniques can help improve gait speed after stroke, from therapeutic exercise to task-specific training to orthotic devices. Despite a growing body of research in this area, however, it is still not clear which intervention is most appropriate for which patients.
By Hank Black
June 2016
Posture-specific strength and landing mechanics
Recent research suggests that training designed to maximize strength at deeper knee flexion angles during landing may be warranted, especially in female athletes, to help reduce the risk of anterior cruciate ligament injury without inadvertently compromising jump height.
By Boyi Dai, PhD; Jacob S. Layer; and Taylour J. Hinshaw
June 2016
Treatment of distal toe calluses and ulcerations
When calluses or ulcers develop on the distal aspect of the lesser toes, offloading pressure from the distal end of the digit is essential for healing to occur. Research suggests that toe crest pads offer an inexpensive but effective means of offloading and healing these distal wounds.
By Monica Melo, DNP, RN, ACNS-BC, CWOCN, CFCN
May 2016
Managing metatarsalgia in athletic populations
Metatarsalgia is a common foot disorder. The term metatarsalgia refers to a pain syndrome in the forefoot and not to a specific diagnosis. Pain is confined to the area across the plantar forefoot, including the second through fourth metatarsal heads.
By Howard Kashefsky, DPM, FACFAS Continue reading
May 2016
Skin-care issues related to orthotic device wear
The care and prevention of skin issues may not get as much attention in orthotics as in prosthetics, but such issues can significantly affect patient outcomes. Here, lower extremity experts share the tips and tricks they use to manage dermatological challenges related to orthotic devices.
By Lori Roniger Continue reading
May 2016
Using subsensory noise to improve balance, gait
Using specially designed insoles to deliver stochastic resonance to the plantar surface of the feet has the potential to significantly improve static balance, dynamic balance, and gait mechanics in healthy…
By Daniel Miranda, PhD; Wen-Hao Hsu, ScD; and James Niemi, MS Continue reading
May 2016
Hip strength asymmetry and patellofemoral pain
Hip strength asymmetry has been observed in patients with existing patellofemoral pain syndrome (PFPS) and potentially could be used to screen for at-risk individuals.
By Franklin Caldera, DO, MBA; and Christopher Plastaras, MD Continue reading
April 2016
Managing hallux limitus and rigidus in athletes
The terms “hallux limitus” and “hallux rigidus” refer to a degenerative process of the great toe joint that was first described by Davies-Colley1 in 1887 and termed hallux flexus. Cotterill later coined the term hallux rigidus.2 The two terms represent a progression in…
By Howard Kashefsky, DPM, FACFAS Continue reading
April 2016
Achilles experts ponder effects of heel elevation
After an Australian study raised questions about the conventional practice of elevating the heel to decrease Achilles tendon load, researchers and clinicians have been revisiting what is known about the many factors—including pain—that can affect tendon load and function.
by Cary Groner Continue reading
April 2016
Influence of estrogen on the plantar fascia
Reported effects of estrogen on knee ligaments and the Achilles tendon raise questions about how the plantar fascia might be altered during the menstrual cycle and how those changes might affect injury risk.
By Jerrold Petrofsky, PhD, JD; and Haneul Lee, PT, DSc Continue reading
April 2016
The clinical implications of accelerated knee OA
Accelerated knee osteoarthritis (OA), defined by very rapid radiographic disease progression, is also associated with earlier and more severe symptoms than traditional OA. Identification of…
By Jeffrey B. Driban, PhD, ATC, CSCS Continue reading
April 2016
Emerging treatments for diabetic neuropathy
Strict glycemic control is the most reliable treatment for diabetic peripheral neuropathy, but expanding knowledge of central and peripheral nervous system processes may help identify therapeutic methods…
By Sarnarendra Miranpuri, DPM, MD; Kush Patel; Gurwattan Miranpuri, PhD; Abhishek Chopra; and Ravinderjit Singh Continue reading
February 2016
Plantar fasciitis: clinical concerns in cleated sports
Cleated sports are associated with a high incidence of lower extremity injuries. American football and soccer are particularly troublesome due to unique risk factors involving footwear design, loading patterns, and sport-specific biomechanics.
By Patricia Pande, MClScPT, CSCS, CPed Continue reading
February 2016
Active Stance: Patients with at-risk feet need collaborative care
In a recent editorial in The Lancet Diabetes-Endocrinology,1 Lipsky and colleagues wrote that diabetic foot disease “…is not a one doctor disease—it demands multidisciplinary care. Furthermore, as a notoriously unglamorous problem, the disease depends on…
By Terrence P. Sheehan, MD
February 2016
Biomechanists explore effect of obesity on falls
Obese patients have an increased risk for falls and fall-related injury, not just because of the loads involved, but also because of the strategies they use to recover from a trip or slip. Findings from a growing body of research will help in developing interventions to minimize that risk.
By Hank Black Continue reading
February 2016
Dynamic load analysis for injury prevention
Identifying loading patterns associated with Jones fractures and other common sports-related injuries can assist with the development of custom modifications to footwear, insoles, and training programs to help reduce injury rates and enhance athletic careers.
By Yannick Goeb, Nate Wilcox-Fogel, and Kenneth J. Hunt, MD Continue reading
