There were no medals for the orthotists, prosthetists, and other lower extremity specialists in attendance at the 2012 games in London. But thousands of world-class athletes couldn’t have succeeded without them.
By Emily Delzell
Cover Story
Lower Extremity Review
Triple threat: The female athlete triad and injury risk
The Triad’s new definition specifies low energy availability, menstrual irregularity, and low bone mineral density as predictors of future health risks, including lower extremity injuries. This broader definition means far more female athletes may be at risk than previously thought, particularly in the high school setting.
By Jill Thein-Nissenbaum, PT, DSc, SCS, ATC
Can AFOs help prevent falls?
Studies suggest that ankle foot orthoses can improve balance in some individuals, so it might seem logical that they would also help prevent falls. But the medical literature has yet to reveal a direct connection between AFOs and falls risk, and as a result the issue has become a magnet for debate.
By Cary Groner
The sprinter’s advantage: Thinking outside the blocks
Researchers at The Pennsylvania State University have identified structural characteristics that distinguish the foot and ankle mechanics of trained sprinters from nonsprinters. Are similar underlying variables responsible for the reductions in mobility that affect older adults?
By Stephen J. Piazza, PhD
ACL injury and OA risk: Surgery’s complicated role
Given the accumulating evidence linking anterior cruciate ligament injury to early-onset osteoarthritis, one might reason that surgical repair of the injured joint would decrease that risk. But too often that isn’t the case. This two-part series explores the complicated ways, both negative and positive, that surgery can influence OA risk.
By Cary Groner
Healing in the dark: Night use of orthoses
Night splinting for plantar fasciitis gets the lion’s share of attention, but lower extremity practitioners are also seeing positive results with night use of orthoses for conditions ranging from cerebral palsy to AIDS.
By Larry Hand
Algorithms and views: Whats, whens, and whys of plantar fasciitis care
Published guidelines for management of plantar fasciitis don’t cover every detail of which interventions to try, in what order, and for how long. As a result, every practitioner tends to interpret the gray areas just a little differently.
By Cary Groner
Finding a formula for the optimal AFO
Quantitative research from The Netherlands suggests that for every ankle foot orthosis, there is an optimal stiffness associated with the lowest energy cost of walking for a given set of gait-related impairments. Achieving this optimal device stiffness in practice, however, may require clinicians to rethink conventional approaches to AFO prescription.
By Daan J.J. Bregman, PhD
Odd couple: Linking ACL injury and patellofemoral pain
One is an acute injury, the other a chronic condition. But researchers believe it’s no coincidence that anterior cruciate ligament injury and patellofemoral pain syndrome share many of the same risk factors. The next step is to determine if a single intervention can effectively prevent both.
By Cary Groner
Breaking pointe: Foot and ankle injuries in dance
Essential to the beauty of dance are the demanding biomechanics of the dancer, particularly at the foot and ankle. Injuries and pain are almost inevitable. But an understanding of the underlying issues—artistic as well as anatomical—can help practitioners keep dancers on their toes for as long as possible.
By Jeffrey A. Russell, PhD, ATC
Pretty pathways to pain: Muscle activation in high-heeled shoes
Researchers from New York University have found that wearing high heels increases muscle activation, which can have painful ramifications throughout the kinetic chain. Some individuals, however, seem to adapt to high heels more effectively than others.
By Smita Rao, PT, PhD, and Renata Ripa, MA
FUTURE SHOCK: Youth sports and osteoarthritis risk
There’s no question that exercise is good for kids. But the trauma associated with some youth sports can dramatically increase the risk that those kids will develop knee or ankle osteoarthritis by the time they reach adulthood. The key next step is to determine what can be done about it.
By Yvonne M. Golightly, PT, PhD, Stephen W. Marshall, PhD, and Dennis J. Caine, PhD
Keeping O&P compliance in check
A recent paper suggests that a checklist system can help practitioners educate caregivers about orthotic device use in children with CP, which could improve compliance. But experts differ as to whether such checklists make sense in the complex world of O&P devices.
By Larry Hand
Momentous adaptations: Offloading the knee through gait modification
Changing the way people walk can significantly decrease knee external adduction moments, which in turn appears to relieve pain and possibly slow the progression of osteoarthritis. The challenge, however, is finding a gait modification that feels and appears natural to patients.
By Lydia Caldwell, BS, and Joaquin Barrios, PT, DPT, PhD
EXERCISE AND NEUROPATHY: Not mutually exclusive
Exercise is a cornerstone of treatment for diabetes, but for years patients with peripheral neuropathy have been discouraged from weight-bearing exercise for fear of further increasing ulceration risks. Now new research is turning that advice on its head.
By Cary Groner
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