Category Archives: Home Feature
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
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
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
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
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
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
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