Category Archives: Cover Story

Cover Story Article

February 2022

Obesity Impacts Clinical/Functional Consequences of Knee Osteoarthritis

These authors found a dose-response relation between body mass index and the clinical consequences of knee osteoarthritis. High physical activity level was associated with low BMI and contributes to preventing the clinical consequences of KOA.

By Benjamin Raud, Chloé Gay, Candy Guiguet-Auclair, Armand Bonnin, Laurent Gerbaud, Bruno Pereira, Martine Duclos, Yves Boirie, and Emmanuel Coudeyre Continue reading

January 2022

A Perfect Bike Fit Starts With the Correct Crank Arm Length

Having performed thousands of bike fits, I now believe that the bicycle’s crank arm length is the most important factor when performing a bike fit. Every other anatomical dimension and joint angle is based upon the length of the crank arms; therefore, this is the first factor to address when performing a bike fit.

By Rick Schultz Continue reading

April 2022

Lymphatic Immunopathy and Its Importance in Chronic Wound Healing

Untreated lymphedema can play a significant role in chronic wounds. Manual Lymph Drainage (MLD), performed by a Certified Lymphedema Therapist (CLT) is standard of care for the management of lymphedema of all types, not just advanced disease.

By James McGuire, DPM; Avnee Jiten Patel, BS; and Ron Michael Adduru, BSN Continue reading

March 2022

Pediatric Osteochondritis Dissecans of the Talus

Active children may play through the micro-traumas creating this potentially damaging condition. Keep OCD in mind when children report pain in the ankle, particularly when BMI is high. Juvenile osteochondritis dissecans (OCD) of the talus is a rare condition in the pediatric population…

By Mark J. Mendeszoon, DPM, FACFAS; and Hayley E. Iosue, DPM, AACFAS Continue reading

November 2021

Ankle Foot Orthoses: The Impact of Appearance, Function, and Fit in Individuals with Stroke

In their own words, 2 stroke survivors who use different AFOs, discuss the mismatched perception of how the ankle foot orthosis represents long-term disability but is a resource for independent safe mobility. Three-fourths of all strokes occur in adults older than 65 and as age increases…

By Jennifaye V. Brown, PT, PhD, NCS, Steven Best, PT, DPT, CSCS, and Julie Suhr, PhD Continue reading

October 2021

A Case for Hypochlorous Acid Solution as a Replacement for NSS in Wound Hygiene: A Review

Given its lack of efficaciousness in decreasing bioburden, normal sterile saline may not be the best solution for this important task. Chronic hard-to-heal wounds pose a significant burden on both patients and the health care system. Chronic wounds, whether pressure, arterial, venous, or wounds from multiple causes…

By James McGuire DPM, LPT, LPed, FAPWHc; Madeline Hobbs, BA, and Yunkyung Jessica Ho, BA Continue reading

September 2021

Recent Advances in the Application of Blood Flow Restriction for Health and Performance

With benefits similar to traditional training practices but with less work, BFR exercise is gaining ground in rehabilitation settings as well as athletic training rooms. The intentional manipulation of blood flow during exercise, commonly referred to as blood flow restriction (BFR) exercise, has piqued the interest of scientists and practitioners alike over the past two decades.

By Chris Pignanelli, PhD(c) Continue reading

August 2021

Changes in Product-related Lower Extremity Injuries Treated at Emergency Departments During the COVID-19 Pandemic

During 2020, emergency department (ED) visits in the United States (US) not related to COVID-19 declined during the COVID-19 pandemic, particularly for certain populations and certain types of illness or injury. This study described product-related lower extremity injuries managed at EDs during 2020 and compared it to previous years.

By Mathias B. Forrester, BS Continue reading

July 2021

2020’s Struggles Shine Light on New Opportunities—for LER and Readers

So much has happened, I don’t even know where to begin. This is time for reflection and appreciation for where we have been and where we are going. All our lives and businesses have been changed forever. This pandemic has affected us in so many ways personally and professionally. In many ways, our eyes and hearts were opened.

By Rich Dubin, Publisher Continue reading

June 2021

Pregnancy Part 1: Is Walking Adequate Fitness During Pregnancy?

There is no question that walking is generally a good form of exercise. However, it is not always appropriate during all phases of pregnancy, nor does it adequately prepare a woman for delivery or the fourth ‘Tornado’ Trimester. Long gone are the days of no lifting and putting your feet up during pregnancy. Pregnancy is the time to ‘train’ for a postnatal marathon that will last several years in a sleep-deprived state.

By Tracie Smith-Beyak Continue reading

May 2021

Pickleball-related Injuries Involving the Lower Extremity Treated in Emergency Departments

Pickleball is a paddle sport that combines many of the elements of tennis, badminton, and ping-pong. It is reported to be increasingly popular in the United States (US), particularly among older adults. There is limited published information on pickleball-related injuries, including those involving the lower extremity.

By Mathias B. Forrester, BS Continue reading

May 2021

The Challenges with Pickleball: A Clinician’s Perspective

Pickleball has exploded in popularity the past decade or so. Especially with seniors! More than 3 million people of all ages in the United States alone play and that number is growing by 10% every year, according to Athletic Business. The allure of the sport, especially for seniors, is that there isn’t a lot of running, but there is a lot of competition.

By Robert Weil, DPM Continue reading

April 2021

Gait and Balance Academy: How Do We Use Gait Analysis to Measure Walking Consistency?

Have you ever asked yourself this simple question: why do we measure and analyze gait? Overall, the answers will revolve around the same ideas: to gauge the functional status of a person; to follow-up the natural history of a disease; to determine immediate or long-term treatment requirement and effects.

By Arnaud Gouelle, PhD, and Patrick Roscher, MS Continue reading

March 2021

Guest Perspective: Why We Participate In National Biomechanics Day

National Biomechanics Day (NBD)—April 7, 2021—is a worldwide celebration of biomechanics in its many forms for high school students and teachers. Sponsored by The Biomechanics Initiative, NBD is in its 6th year of celebrating all things biomechanics. NBD’s goal is to accelerate the growth and impact of biomechanics science and application by introducing biomechanics to young people, namely high school students. Continue reading

February 2021

BEHOLD the Human Arch! Biomechanics of Longitudinal Arch Load-Sharing System of the Foot

The human foot is an engineering marvel, consisting of 26 bones, 33 joints, and more than 100 muscles, tendons, and ligaments. But it is the unique and elegant load-sharing system of the longitudinal arch that makes human locomotion possible. This author explains how.

By Kevin A. Kirby, DPM Continue reading

January 2021

Skiing-Related Injuries: Who, What, How, When, And a Bit of Prevention 

More popular than ever, skiing remains a complex sport with a high risk of injury. Here we detail some of the pertinent data. Skiing, a sport that has been around since Cro-Magnon man, is among the most popular winter sports in the United States. There were nearly 15 million skiers in the US in 2017 alone.

By Janice T. Radak Continue reading

November 2020

Clinical Applications of Custom 3D Printed Implants in Complex Lower Extremity Reconstruction

The authors present four cases of complex lower extremity reconstruction involving segmental bone loss and deformity – failed total ankle arthroplasty, talus avascular necrosis, ballistic trauma, and nonunion of a tibial osteotomy.

By Rishin J. Kadakia, MD, Colleen M. Wixted, Nicholas B. Allen, Andrew E. Hanselman, MD, and Samuel B. Adams, MD Continue reading

October 2020

Foot Drop: A Primer

Foot drop, a complex condition that can have a significant impact on independent ambulation, can have many causes. Treatment options vary by cause. These authors provide a review of the condition from etiology through treatment. Foot drop (also known as steppage gait) is an inability to lift the forefoot due to the weakness of dorsiflexors of the foot. This, in turn, can lead to an unsafe antalgic gait, potentially resulting in falls.

By Subhadra L. Nori, MD, and Michael F. Stretanski, DO Continue reading

October 2020

A New Ankle–Foot Orthosis Using Wire for Stroke Patients with Foot Drop

Researchers from Korea have developed a new type of AFO that uses neoprene and a novel wire configuration for use with foot drop after stroke. Foot drop can be a sequela of stroke. An ankle–foot orthosis (AFO) is the most widely used method to prevent foot drop in patients with stroke, and is used during weight-bearing training of the limb on the affected side or when there is ankle spasticity or deformity.

By Jung-Hoon Lee, Im-Rak Choi, and Hyun-Su Choi Continue reading

September 2020

Expanding Our Understanding of Chronic Ankle Instability

Research is showing that it’s not “just an ankle sprain,” but rather the first step on a perilous journey to physical instability and lower quality of life. The clinical presentation of chronic ankle instability (CAI) has been defined as the perceived or subjective instability with feelings of giving way, pain, and recurrent sprains. Continue reading

September 2020

Gait Biofeedback and Impairment-based Rehabilitation

In a study that debuted at the National Athletic Trainers Association virtual meeting and was subsequently published later, a multidisciplinary team of clinicians sought to analyze the effects of visual gait biofeedback along with impairment-based rehabilitation on gait biomechanics in a group of patients with chronic ankle instability (CAI). Continue reading

August 2020

An Update on Peripheral Artery Disease (PAD): Part I

This 2-part series examines the current state of peripheral artery disease. This article focuses on disease burden, risk factors, and clinical presentation. Part 2, which will appear next month, will examine current recommendations for diagnosis and treatment.

By Aisha Cobbs, PhD Continue reading

August 2020

Diagnostic Accuracy of PADnet Xpress® in the Detection of Peripheral Artery Disease

With existing knowledge, much of the cardiovascular risk burden of peripheral artery disease (PAD) is preventable. PAD is a common atherosclerotic syndrome that is estimated to affect 12.5 million Americans and 237 million people worldwide.1 One in five Americans over the age of 65 has PAD.2 Based on national treatment patterns, more than half of all patients with PAD do not know they have it.

By Sue Duval, PhD Continue reading

July 2020

Functional Ankle Instability Prevalence and Associated Risk Factors in Male Football Players

Reported incidence rates for ankle sprains range from 15% to 45%. This study looked at self-reported ankle instability in regional European football players and found that age and injury repetition as well as exposure time and position on the field were associated with instability rates, suggesting the need for specific prevention strategies.

By A. Cruz, R. Oliveira, A.G. Silva

Continue reading

June 2020

Manipulation of the Myofascia: Motivations, Methods, and Mechanisms

Foam rolling and roller massage, instrument-assisted soft tissue mobilization, and percussion massage are all the rage amongst consumers all along today’s fitness continuum. But what is the evidence base for the countless claims proponents offer? These authors provide a review of the peer-reviewed literature.

By Linden A. Lechner, BSc; Michael A. Rosenblat, PT, PhD(c), CEP; and Leanne M. Ramer, PhD Continue reading