The most common paradigm in bunion surgery relies on one or more metatarsal osteotomies to correct the 1-2 intermetatarsal angle (IMA) and soft tissue balancing to align the first metatarsophalangeal joint (MTPJ), sesamoid apparatus, and hallux. Additionally, the most common approach…

Roughly 60% of overuse injuries in high school athletes occur in the lower extremities, injuries that are increasing in number as more students participate in sports. Treatment involves rest and correction of biomechanical deficiencies, and should be individualized to each athlete.

By Allison Schroeder; James Onate, PhD, AT, ATC, FNATA; and Thomas Best, MD, PhD

The American Physical Therapy Association has updated its 2008 guidelines on the nonsurgical treatment of heel pain with a bolstered evidence base, but lower extremity practitioners continue to debate the clinical merits and most effective applications of certain newer therapies.

By Hank Black

Psychological factors are responsible for delayed return to sports after anterior cruciate ligament reconstruction in a sig­nificant number of patients despite successful physical rehabilitation, but questions remain as to the most effective ways to address these issues.

By Trevor A. Lentz, PT, SCS, CSCS

Early mobilization and weight bearing after Achilles tendon repair is associated with improved patient satisfaction and faster return to work and sports, with no significant increase in rates of tendon rerupture or postoperative wound and nerve complications.

By David P. Taormina, MD, and Nirmal C. Tejwani, MD

After a year in a fracture boot with a broken foot, I thought my ordeal was over. I was wrong. The broken bone in my foot, sustained after a fall down a staircase in my home, had occurred midway down the fifth metatarsal bone below my little toe—a site that is notoriously difficult to heal, according to my podiatrist.

By Barbara Boughton

Finding the right orthotic design starts with the space limitations presented by cycling shoes, but the challenges for lower extremity practitioners don’t end there. Factors to consider when prescribing foot orthoses include biomechanics, skill level, cycling discipline, and bike technology.

By P.K. Daniel

Foam rolling is a relatively new therapeutic approach, but early research suggests that it can help improve range of motion and muscle performance and aid in recovery after exercise. Questions remain, however, about the extent to which the effects involve myofascial mechanisms.

By Duane C. Button, PhD, CSEP-CEP, and David G. Behm, PhD

As a result of limitations in the fall prevention research to date, investigators and
clinicians are often left to make their best guesses about the effect of foot and ankle interventions based on the effect such strategies have on issues related to falls, rather than on falls themselves.

By Cary Groner

Several patient populations with an increased risk of knee osteoarthritis also are at increased risk for vitamin D deficiency, and research suggests vitamin D levels may be related to knee OA symptoms. The exact nature of the relationship, however, remains perplexing.

By Greg Gargiulo