Category Archives: Cover Story
November 2018
Vexing Question: How Soon Should Patients Drive After Lower-Extremity Surgery?
The answer doesn’t come easily; official guidelines are lacking. Ultimately, patients bear responsibility for the decision, but you can still offer them valuable advice for keeping safe. “Doctor, when can I start driving again?” That’s a common question patients ask when they’re headed for lower-extremity surgery. But it’s not always an easy one to answer.
By Keith Loria Continue reading
September 2018
Diabetes, Its Impact, and Protection of the Diabetic Foot
Offloading is key to preventing small concerns from becoming life-threatening, but adherence remains less than optimal. The not-so-secret truth: diabetes and its precursor, prediabetes, have reached epidemic status in the United States: More than 100 million Americans are living with the disease.
By Janice T. Radak Continue reading
August 2018
Slip, Trip, Stumble, Fall: An Overview of Falls in the Elderly and How to Prevent Them
When 88-year-old Doris fell getting out of the bathtub late on a Tuesday in the apartment she shared with her 90-year-old husband of 65 years, the ambulance took her to the hospital. As suspected, she had broken her right hip, which was surgically corrected Wednesday morning…
By Janice T. Radak Continue reading
July 2018
Stress Fractures Of the Foot in Football
High-impact sports expose athletes to greater risk of injury overall. Is there a way to prevent such trauma by applying the lessons of sports science? Stress fractures of the foot result from repetitive microtraumas and chronic submaximal loading of tissues. Among football players, the most common are the Jones fracture, a break in the fifth metatarsal between the base and the middle, and the…
By D. Chris Cothern PT, CES, PES Continue reading
June 2018
Ankle-foot orthoses and functional electrical stimulation for foot drop in MS: Pluses, minuses, progress
Assistive ambulation devices for the ankle can bolster walking speed and safety and lessen the risk of injury to the joint. But which of 2 technologies is best for your patient?
By Hank Black Continue reading
May 2018
Hamstring: Trends in preventing and treating hamstring-strain injuries
High relapse rate from preseason injuries presents significant challenge for athletes and sports teams. Hamstring strain injuries are among the most common in sports, often leading to recurring problems or future injury. Marcus Elliott, director of P3 Applied Sports Science and a former muscle-injury specialist for the National Football League’s New England Patriots, conducted…
By Keith Loria Continue reading
April 2018
Limb Salvage or Amputation of the Diabetic Foot?
The decision often hinges on how a given intervention will affect the patient’s quality of life. How, then, to define optimal QoL for your patient, and to agree on the means to achieve it? As clinicians well know, diabetes puts patients at risk of foot ulcers that can lead to poor outcomes, evidenced by the 40% 5-year mortality in patients with newly diagnosed diabetic foot ulcers (DFUs).
By Cary Groner Continue reading
March 2018
What role for eccentric exercises in conservative treatment of achilles tendinopathy
The authors seek answers to clinical questions regarding the optimal program of eccentric exercises: Does type of tendinopathy predict success? What modifications to exercise duration and repetitions make sense? What is the likelihood of long-term pain relief afforded by such a program of exercise?
By Jonathan L. Hook, DPM, MHA, and Curt Martini, DPM Continue reading
February 2018
Assessing Limb Length Discrepancy
Leg-length discrepancy and its sequelae are best considered a syndrome affecting many regions of the body through the closed kinetic chain. Most cases require comprehensive, cross-disciplinary treatment. The authors present a novel scoring system for diagnosis.
By Jay Segel, DPM; Susan Sanford, PT, L.Ac, C.SMA; Sally Crawford, MS; and Lori Yarrow, DC, BPE Continue reading
January 2018
Patellofemoral pain: More activity means more pain — and then less activity?
People with PFP are less physically active than healthy controls, with regard to both steps per day and minutes of mild, moderate, and intense activity. Increases in activity-related pain may cause…
By Neal R. Glaviano, PhD, AT, ATC; Andrea Baellow, MS; and Susan Saliba, PhD, MPT, Med 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
October 2017
HANDLE WITH CARE: How sports equipment affects biomechanics and injury risk
Clinicians know that handling a lacrosse stick or other types of sport-specific equipment can affect an athlete’s movement patterns in potentially harmful ways. Now researchers are beginning to quantify these types of effects and explore their clinical implications.
By Jill R. Dorson Continue reading
September 2017
Running shoes and injury risk: Rethinking the importance of cushioning and pronation
In spite of advancements in research and subsequent modifications to running footwear design, rates of running-related injuries have not decreased. That may be because researchers and designers have been focusing on the wrong variables.
By Joseph Hamill, PhD, and Gillian Weir, PhD Continue reading
August 2017
Flip Flops: Biomechanical critiques resonate with clinicians and designers
It’s no secret by now that traditional flimsy flip flops are associated with gait alterations that can contribute to more serious issues, but for many patients, flip flops are a hard habit to break. A new generation of “comfort” flip flops offers an alternative, but clinicians remain wary.
By Shalmali Pal Continue reading
July 2017
Tactical athletes: Maximizing their ability to protect and serve
Increasingly, clinicians and researchers are focusing on tactical athletes—including warfighters, firefighters, law enforcement officers, and other professionals—as a unique population with regard to lower extremity injuries.
By Hank Black Continue reading
June 2017
Slacklining: Trendy sport takes balance training to new heights
As slacklining’s popularity grows, researchers have begun to uncover physiological and neurological evidence for how and why the activity may be beneficial to people with balance, strength, and mobility issues.
By Brigid Elsken Galloway Continue reading
May 2017
Stepping Up: Orthotic devices help patients boost physical activity levels
Improved mobility with ankle foot orthoses and other devices can help patients experience the multiple health benefits of increased physical activity. But aggressive activity goals— including the oft-cited target of 10,000 steps per day— may still be problematic for some device users.
By Larry Hand Continue reading
April 2017
From prints to prison: Forensic podiatry and gait analysis gain ground
Increasingly, lower extremity experts are being called on to assist with crime scene investigations by analyzing footprints, shoe prints, and the gait patterns of shadowy figures on security videos. For members of this fledgling field, as Sherlock Holmes famously said, the game is afoot.
By Shalmali Pal Continue reading
March 2017
Knee OA in amputees: Biomechanical and technological considerations
The risk of knee osteoarthritis in the intact limb of longtime unilateral amputees is much higher than in nonamputees, and the range of potential contributing factors is even more complex. Optimizing prosthetic fit and function, in addition to more conventional OA interventions, can help address gait issues that contribute to knee joint degeneration.
By Emily Delzell Continue reading
February 2017
3D PRINTING OF FOOT ORTHOSES: Clinical feasibility and cost-benefit analyses
Several technical issues currently limit the cost effectiveness of 3D-printing custom foot orthoses, but these will likely be addressed in the near future with the emergence of larger and faster 3D printers.
By Steven Hoeffner, PhD; Timothy Pruett; Breanne Przestrzelski, MS; Brian Kaluf, CP; Nikki Hooks, CO; Katelyn Ragland; Shannon Hall; Kyle Walker; Dan Ballard, CPed; and John DesJardins, PhD Continue reading
January 2017
Patellofemoral pain subgroups: A critical first step toward personalized clinical intervention
Researchers from the UK have identified three subgroups of individuals with patellofemoral pain (PFP) that can be determined using simple evidence-based clinical tests—a key first step toward developing targeted treatment strategies as part of the ongoing effort to improve PFP outcomes.
By Jessie Janssen, PhD; James Selfe, DSc; Michael Callaghan, PhD; Chris Sutton, PhD; Paola Dey, PhD; and Jim Richards, PhD Continue reading
November 2016
Mouthguard mysteries: Can wearing one really improve athletic performance?
Multiple studies suggest that mouthguards, designed to protect athletes from dental injuries during contact sports, may also help improve muscle force and power. But plenty of other studies have found no such benefits, and even the experts aren’t sure what to believe.
By Cary Groner Continue reading
October 2016
Women’s Work: Overcoming gender barriers in lower extremity specialties
In lower extremity healthcare, as in politics, it hasn’t been easy for women to succeed in traditionally male-dominated roles. The gender demographics have shifted toward parity over time—in some specialties more than others—but challenges still remain.
By Emily Delzell Continue reading
September 2016
Clinician-patient communication: How personal connections can improve outcomes
Increasingly, lower extremity practitioners are realizing the clinical importance of patient communication. They’re also starting to realize that effective communication requires more than just using the right words.
By Hank Black Continue reading
August 2016
Pregnancy and gait: From foot pain to fall prevention
Researchers are investigating how changes during pregnancy may affect the lower extremities in the long term, as well as ways to treat and prevent these issues.
By Lori Roniger Continue reading
