Category Archives: Cover Story

Cover Story Article

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

May 2020

The Utility of External Fixation for Midfoot Charcot Neuroarthropathy

When conservative therapies fail, surgical reconstruction of the foot is often required to restore function, heal ulcerations, and decrease risk of amputation in patients with CN. External fixation remains a reliable method, with plenty of advantages.

By P. Tanner Shaffer, DPM, Jonathan Hook, DPM, FACFAS, and Ben Potter, DPM Continue reading

April 2020

Using The “Reformer,” “Wunda Chair,” and “foot Corrector”: The Pilates Method Enhances Alignment and Core Awareness

A trained Pilates professional in a fully equipped studio can help your patient make significant improvement in strength and flexibility by addressing postural habits and alignment problems. Joseph Hubertus Pilates began development of his method – a body–mind approach to exercise –in the early 1920s. As a child, Pilates suffered from asthma, rickets, and rheumatic fever.

By Marianne Adams, MA, MFA Continue reading

March 2020

Injury Prevention Keeps Dancers on Their Toes

Unique partnership between University Hospitals’ Sports Medicine Team and the Cleveland Ballet focuses on performer preparation to avoid long-term problems. Efficient movement in ballet is easy to recognize, as every step the dancer takes flows seamlessly into the next, representing a perfect balance of muscular engagement and release.

By Douglas J. Guth  Continue reading

February 2020

White Paper: Foot Pronation

Over the past decades, pronation has been discussed as a potential risk factor for injuries or as the mechanism behind impact damping. However, little is understood about pronation. The objectives of this paper were to (a) define and differentiate between the terms of pronation and eversion, (b & c) underline the importance and problematic aspects of pronation.

By Benno Nigg, Anja-Verena Behling, and Joseph Hamill Continue reading

January 2020

Overuse Injuries in Sports Aren’t Wholly Preventable. But They Are Reducible

Empower athletes and work in partnership with them to reduce their risk and severity of overuse injury and keep them at the level of performance they want. Getting better at any sport, at any level, takes practice, commitment—and repetition. Basketball players shoot jump shot after jump shot, soccer players drill footwork, and cross-country athletes log seemingly endless miles.

By Nicole Wetsman Continue reading

October 2019

Needed, Proposed, Designed: An Injury Assessment and Prevention Program for Collegiate Women’s Basketball

Why are female basketball players increasingly at risk of lower-extremity injury? How should an injury prevention program for them be devised and implemented? The authors undertook a team study to find the answers. Knee injuries account for 10% to 25% of sports-related injuries.

By Major Kyle East, PT, DPT, DSC; Lieutenant Commander Lauren Brown, PT, DPT, DSC; and Colonel Donald Goss, PT, PHD Continue reading

September 2019

Vaping: How Smoking E-Cigarettes Affects Physiology and Athletic Performance

Editor’s Note: As of press time, the US Centers for Disease Control has reported 1299 cases of e-cigarette- or vaping-associated lung injury (EVALI) and issued interim guidance to assist with assessment, evaluation, management, and followup. The cases have been reported in 49 states and the Distric of Columbia, with 26 deaths reported across 21 states.

By Nicole Wetsman Continue reading

August 2019

Pregnancy Changes the Body: Here’s What That Means for Gait, Balance, and Falls

About a quarter of women fall during pregnancy and 10% fall more than once. Understanding the biomechanical changes of this transitional period may help researchers find ways to prevent such falls. When Robert Catena’s wife was pregnant and working at a restaurant, she fell. It was scary, he says, but everything was ok.

By Nicole Wetsman Continue reading