Category Archives: Cover Story

Cover Story Article

February 2014

TKA in obese patients: Weighing the risks vs the benefits

Total knee arthroplasty significantly improves functional outcomes in obese patients, but is also riskier than in normal-weight patients. As the number of obese patients with knee osteoarthritis continues to rise, clinicians are being challenged to find a balance between the risks and the benefits.

By Susan M. Odum, PhD, and Bryan D. Springer, MD

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January 2014

Foot Orthoses: A distal twist on low back pain management

Increasing numbers of patients are finding relief from chronic low back pain with the use of foot orthoses, but the mechanism underlying the positive outcomes is largely unknown.

By Larry Hand

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November 2013

Energetics of landing: Effects of ankle instability

A diminished capability for energy dissipation at the knee after ground impact during landing in patients with chronic ankle instability may result in greater demands on the ankle joint. Modifying landing strategies could potentially reduce the risk of musculoskeletal injury.

By Masafumi Terada, MS, ATC, and Phillip A. Gribble, PhD, ATC, FNATA   

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October 2013

Battlefield injuries: Saving lives and limbs throughout history

By understanding how military medicine has evolved and adapted over time, modern practitioners can better appreciate the need to question convention, advance research, and rapidly integrate beneficial new technologies into medical care.

By Christine Miller, DPM, FACCWS, Ashley Finn, and Emily Delzell

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September 2013

Taking an adaptive path to active

Adaptive sports programs offer a fun, social way for people with disability to be more physically active and improve their self-image at the same time, through pursuits ranging from tranquil fly-fishing to intense rock wall climbs.

By Emily Delzell

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August 2013

Digging in to prevent ACL injuries in volleyball

Landing and change of direction in volleyball can put players at risk of anterior cruciate ligament (ACL) injury. Few ACL prevention studies have focused on volleyball, but players can benefit from screening and intervention programs that have been shown to be effective in other sports.

By Joanne L. Parsons, MSc, PT, CAT(C)

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July 2013

Glycemic control and postoperative healing

Researchers have established that elevated levels of glycated hemoglobin in patients with diabetes are associated with poor outcomes after foot and ankle surgery. Now the challenge is to identify an “acceptable” glycated hemoglobin level below which the benefits of surgery outweigh the risk of complications.

By Naohiro Shibuya, DPM, MS, FACFAS, Jon M. Humphers, DPM, and Daniel C. Jupiter, PhD

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June 2013

Knee flexion after TKA: The significance of squatting

The ability to achieve a 90° squat appears to have important functional implications for patients rehabilitating from total knee arthroplasty. However, detecting impairment may require more rigorous methods than conventional sit-to-stand testing.

By Mark D. Rossi, PhD, PT, CSCS, and Denis Brunt, EdD, PT

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May 2013

Medial shin pain in runners: Evidence for orthosis use

Studies of the kinematic variables associated with medial tibial stress syndrome suggest possible targets for prevention and intervention, including the use of foot orthoses.

By Janice K. Loudon, PT, PhD, SCS, ATC, and Michael P. Reiman, PT, DPT, OCS, SCS, ATC, FAAOMPT, CSCS

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April 2013

Ready Patient One: Exer-gaming for rehabilitation

Video gaming technology is finding its way into clinical practice, and research supports its effectiveness for improving balance, strength, and function. But studies also suggest some patient populations may be more responsive to exer-gaming than others.

By Samantha Rosenblum

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March 2013

Kickboxing: A creative approach to improving balance in patients with MS

Kickboxing isn’t just for elite martial artists. In fact, preliminary research suggests the kicks, punches, and knee movements associated with the sport can improve balance and mobility in patients with multiple sclerosis. And as an added bonus, it’s also fun.

By Kurt Jackson PT, PhD, GCS, and Kimberly Edginton-Bigelow, PhD

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February 2013

Over the Edge: Lower extremity injuries in figure skaters

Competitive figure skating today is much less about artistry and much more about athleticism than in years past. Training is longer and harder than ever, while the classic unforgiving skate boot design has remained essentially unchanged. And lower extremity injuries in skaters are on the rise.

By Nathan W. Saunders, MA, and Steven T. Devor, PhD, FACSM

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January 2013

The value of walking in children with CP: A matter of perception

The achievement of independent walking is a major focus of rehabilitation for children with cerebral palsy (CP). Even when mobility could be achieved more easily through the use of assistive technologies such as wheelchairs, independent walking is typically pursued as a major rehabilitation goal and other forms of mobility are often discouraged.

By Barbara E. Gibson, BMR(PT), MSc, PhD

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November 2012

Genetics: The future of injury prevention

Evidence is linking genetic mutations to Achilles tendon and anterior cruciate ligament injuries as researchers try to connect complex motor control processes to small segments of DNA. But genetic testing is still a long way from becoming a clinical tool.

By Larry Hand

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October 2012

London bridges: Clinicians and athletes connect at the 2012 Paralympic Games

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

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September 2012

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

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August 2012

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

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July 2012

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

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June 2012

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

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May 2012

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

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April 2012

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

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March 2012

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

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February 2012

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

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January 2012

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

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November 2011

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

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