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September 2014

Compression stockings: Progress and pitfalls

Research supports the use of compression stockings for managing peripheral edema, venous insufficiency, and venous leg ulcers. But, outside the laboratory, issues related to patient compliance and achieving a proper stocking fit remain significant clinical challenges.

By Greg Gargiulo Continue reading

August 2014

Incline walking: An offloading option for patients with knee OA

Incline walking on a treadmill results in less frontal plane knee loading and more gluteus, hamstrings, quadriceps, and triceps surae muscle activation than level walking, and therefore may benefit patients with knee osteoarthritis or those who have undergone knee replacement.

By Henry Wang, PhD, Mason Haggerty, MS, Clark Dickin, PhD, and Jennifer Popps, PhD Continue reading

August 2014

Patient Perspective: The long struggle to get a knee back in the game

It happened about two years ago while I was playing a friendly game of basketball with my teenage sons and friends. I was 49 years old and never felt like slowing down. Like most guys, while playing ball, we would imitate our favorite players.

By Joseph Hayward Continue reading

August 2014

AFO tuning: Balancing function and satisfaction

Tuning of ankle foot orthoses (AFOs) and AFO-footwear combinations can significantly improve gait in patients with neuromuscular impairments. Even so, some pa- t­ients still prefer their untuned devices, which has led researchers and clinicians to reexamine their approach to intervention.

By Cary Groner Continue reading

August 2014

Return of strength after Achilles tendon surgery

Despite excellent subjective outcomes following Achilles tendon repair, significant plantar flexion and dorsiflexion strength deficits often persist. However, modern trends in postoperative rehabilitation represent a progression toward a more functional strength recovery.

By David A. Porter, MD, PhD, Kirk Cleland, MD, and Angela M. Rund, MEd, ATC Continue reading

August 2014

Flexible flatfoot: Foot orthoses and outcomes

Many studies have shown an effect of foot orthoses on biomechanical function in patients with flexible flatfoot, but few studies have focused on patient-centered outcomes. There is a need to investigate the effect of foot orthoses on pain and fatigue in these individuals over time.

By Sarah A. Curran, PhD Continue reading

August 2014

Running shoe mass: Can feet tell any difference?

Research suggests that when trying on athletic shoes in a retail store, an individual’s perceptions of shoe mass primarily come from handling the shoes and less (if at all) from test-wearing them. In addition, the foot’s perception of shoe mass does not appear to improve with practice.

By Joel G. Greenya, BS, Stephen J. Slade, BS, Christopher L. Kliethermes, PhD, and David S. Senchina, PhD Continue reading

August 2014

Dynamic compression for recovery in athletes

US Olympic Committee researchers have found that peristaltic pulse compression of the lower extremities may provide a means of enhancing the rheological properties of the lower extremities without resorting to extreme temperatures, expensive body work, or stretching.

By William A Sands, PhD, FACSM, CSCS Continue reading

July 2014

The rise and fall of minimalist footwear

Once thought by some to be the next big thing in running, minimalist footwear has been scrutinized in recent years by researchers and class-action plaintiffs who claim the shoes do not provide the same benefits as barefoot running…

By Cary Groner Continue reading

July 2014

Functional movement tests and injury risk in athletes

Efficient, low-cost, field-ready functional movement tests may be useful in preparticipation physicals to identify and provide preventive treatment for individuals with an elevated risk of injury, as well as aiding return-to-sport…

By Kathryn Schwartzkopf-Phifer, PT, DPT, OCS, CSCS, and Kyle Kiesel, PT, PhD, ATC Continue reading

July 2014

Studies explore statin use for lower limb indications

A growing body of research suggests that statins may help improve not just cardiovascular outcomes but also those associated with lower extremity conditions such as peripheral arterial disease and knee…

By Larry Hand Continue reading

July 2014

Revisiting the status quo for AFO strap placement

Conventional wisdom says dorsal straps for ankle foot orthoses should be positioned at a certain angle to resist heel rise. Now preliminary research from Georgia Tech is calling that practice into question…

By P.K. Daniel Continue reading

July 2014

Foot ulceration in patients with rheumatoid arthritis

Research has identified ankle-brachial index, loss of sensation, and deformity as predictors of foot ulceration in patients with rheumatoid arthritis, and also suggests that ulceration influences…

By Jill Firth, PhD, BSc (Hons), and Heidi J Siddle, PhD, MSc, BSc (Hons)
Continue reading

June 2014

Patient Perspective: Walking 600 miles is tough; plantar fasciitis is tougher

In 2008 I walked the 500-mile Camino de Santiago, the medieval pilgrimage route through northern Spain leading to the Cathedral of Santiago de Compostela. It was my first long distance walk, and because I completed it without injury, pain, or a blister, I fancied myself a walking superhero, immune to suffering or discomfort.

By Laura Potts Continue reading

June 2014

Evidence-based use of metatarsal pads

Plantar pressure analysis studies are demonstrating the effectiveness of met pads for forefoot offloading and helping clinicians determine which patients are most likely to benefit from different pad designs and placement strategies.

By Greg Gargiulo Continue reading

June 2014

Managing foot and ankle injuries in baseball players

Baseball players at all skill levels routinely suffer from foot and ankle injuries, with position players being afflicted more often than pitchers or catchers. Making the correct initial diagnosis without delay can lead to more rapid and effective treatment, rehabilitation, and return to play.

By Gabriel V. Gambardella, DPM, Jeffrey Delott, DPM, and Zachary J. Korwek Continue reading

June 2014

A virtual reality approach to lower extremity rehab

When commercially available active video games are used in rehabilitation settings, often the level of challenge does not match the patient’s ability level. Customized interventions can address these limitations while capitalizing on the fun and motivating aspects of the technology.

By Rachel Proffitt, OTD, OTR/L Continue reading

June 2014

Cost-benefit data support reconstruction of ACL tears

In both the short term and the long term, anterior cruciate ligament reconstruction produced greater quality of life improvements at a lower cost compared with rehabilitation only, suggesting that limiting access to ACL reconstruction may be harmful to patients and costly to society.

By Richard C. Mather III, MD, and Lane Koenig, PhD Continue reading

June 2014

Effects of targeted exercise on chronic ankle instability

Clinicians and researchers are increasingly utilizing exercise protocols focused on improving proprioception, range of motion, and strength to influence the more active and functional deficits that have been associated with chronic ankle instability in the literature.

By Mark A. Feger, MEd, ATC, and Jay Hertel, PhD, ATC Continue reading

May 2014

Cell games: Clinical use of stem cell therapy is starting to outpace the evidence

Stem cell therapy is rapidly gaining momentum as a clinical option for indi­ca­tions including meniscal injury, wound healing, and osteoarthritis. But high-level research on the tech­nol­ogy’s efficacy and long-term safe­ty is hard to come by.

By Emily Delzell Continue reading

May 2014

ATHLETES AND INJURIES: The global question of prevention

All the countries in the world share the challenge of keeping athletes healthy, and in April, sports medicine experts from across the globe met in Monaco to discuss the best ways to address those challenges at the IOC World Conference on Prevention of Injury & Illness in Sport. LER’s exclusive coverage of this event details clinical and scientific progress toward prevention of lower extremity injuries from ankle sprains to hamstring strains. Continue reading

May 2014

Healing hypoxic wounds: Fighting an uphill battle

A lack of oxygen can negatively affect wound healing in a number of ways, but surgical, pharmacological, and other technological advances are allowing clinicians to enhance oxygen delivery to damaged tissues and…

By Nanjin Park, DPM; Latricia Allen, DPM, MPH; Mary Nametka, MSN, RN, CWS, CWON, FNP-BC; Vickie R. Driver, MS, DPM, FACFAS Continue reading

May 2014

Elastic therapeutic tape: Applications at the ankle

Research on the use of elastic therapeutic tape in patients with chronic ankle instability is limited, but recent findings do suggest that leaving the elastic tape on for several days is associated with improvements in…

By Janet Simon, MS, ATC; Emily Hall, MS, ATC; and Carrie Docherty, PhD, ATC Continue reading

May 2014

Knee OA guidelines take patient-centric approach

Updated guidelines and new appropriate use criteria for nonoperative management of knee osteoarthritis aim to focus more directly on typical knee OA patients, who often have comorbidities that can complicate care and…

By Larry Hand Continue reading

May 2014

Clinicians’ shoes can send mixed message to patients

Patients often look to foot and ankle practitioners for advice about footwear choices. But a recent survey of physicians found that nearly half don’t educate their patients about footwear guidelines, and that only one in…

By Daniel Farber, MD Continue reading