February 2012

LER February 2012 Issue CoverCover Story

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

Editor Message

Out on a limb: Amputation ups & downs

Lower extremity practitioners who treat patients with diabetes are finally receiving their 15 minutes of fame. Enjoy it while it lasts. The Centers for Disease Control and Prevention (CDC) finding that nontraumatic lower extremity amputation (NLEA) rates in patients with diabetes decreased by 67% between 1996 and 2008 (see “CDC reports dramatic 12-year drop in diabetic lower limb amputation,” page 15) is unquestionably good news.

By Jordana Bieze Foster, Editor



Wedge orthoses: A distal slant on knee OA therapy

Most conservative measures to reduce knee adduction moment in patients with knee osteoarthritis involve altering proxi­mal bio­mechanics, but research suggests that similar kinetic changes and pain relief can be achieved with the use of wedged foot orthoses.

By Emily Delzell

Use of eccentric exercise for prevention and rehab

Recent interest has focused on the use of Nordic hamstring strengthening exercises to prevent hamstring injuries in athletes, but evi­dence also supports eccentric exercise for managing tendinopathy and for pre­ven­tion and rehabilitation of anter­ior cruciate ligament injury.

By Daniel Lorenz, DPT, PT, ATC/L, CSCS 

Success of hinged AFOs depends on alignment

Misalignment between the mechanical joint of an articulated AFO and the cor­responding anatomical joint can signifi­cant­ly affect the device’s mechanical properties, particularly resistance and stiffness, which can impair AFO effective­ness and negatively affect proximal joints.

By Fan Gao, PhD, and Susan Kapp, MEd, CPO, LPO, FAAOP      

Hip rotation in golfers may determine pathology

Golfers demonstrate significant asym­metries between hips with regard to rotational range of motion and rotational velocity, which can contribute to the development of conditions including low back pain, femoroacetabular impinge­ment, and hip labral degeneration.

By Heather Gulgin, PhD, ATC   

Foot-shoe mismatches leave patients at risk

Survey results suggest that at least one-third of individuals at risk for foot pain or diabetic foot ulcers are wearing shoes that are at least one size too big or too small, which can further increase those risks. Proper shoe fit and foot health start with patient education.

By Stephanie Swensen, BSc, and Ran Schwarzkopf, MD, MSc     

Original research: Taping alters ankle biomechanics

This study found that closed basket-weave ankle taping significantly affects ankle range of motion and time to peak vertical ground reaction force, which can have implications higher up the kinetic chain that appear to vary from one indivi­dual to another.

By Matthew L. Santos-Vitorino, MS, ATC, LAT, Sue Shapiro, EdD, ATC, LAT, Kathy Ludwig, PhD, and Claire Egret, PhD


In the Moment: Footcare

By Emily Delzell and Jordana Bieze Foster

Enhancing balance
Foot orthoses may help prevent falls – Recent research suggests older patients at risk for falls from poor balance may benefit from custom foot orthoses. Report­ed improvements indicate clini­cians could potentially help prevent falls by testing patients’ balance and considering ...
CDC reports dramatic 12-year drop in diabetic lower limb amputation
Lower limb amputations due to complications of diabetes declined 67% from 1996 to 2008 in US adults aged 40 years and older, according to a February report in Diabetes Care by epidemiologists from the Centers for Disease Control and Prevention ...
PRP outperforms corticosteroids for relief of plantar fasciitis pain
A single platelet rich plasma (PRP) injection is more effective than a single corticosteroid injection for improving pain and function in patients with chronic plantar fasciitis who haven’t responded to other conservative treatments, according to research from Nantucket, MA. In a ...

In the Moment: Sports medicine

By Jordana Bieze Foster

Heading off ACL injury
Risks remain high after reconstruction – Female soccer players recovering from anterior cruciate ligament (ACL) recon­struction may benefit from neuro­muscular training to prevent future injury, according to research from St. Louis presented this month at the annual meeting of the ...
Time on sideline after syndesmosis sprain varies in professional football
The 14 days that New England Patriots tight end Rob Gron­kowski missed with a much-publicized syndesmosis sprain prior to the Super Bowl were slightly fewer than one National Football League (NFL) team’s average for such injuries, according to research presented ...
Brain changes on fMRI with patellar taping suggest proprioceptive effect
Functional magnetic resonance imaging (fMRI) findings from the University of Manchester in the UK appear to confirm that patellar taping has a proprioceptive effect. Researchers assessed the blood oxygenation level–dependent (BOLD) response during fMRI in eight healthy male volunteers performing two ...
More evidence indicates imaging findings do not correlate with hip symptoms
Two studies presented this month at the AAOS meeting offered further evidence that magnetic resonance imaging (MRI) findings in the hip often do not correlate with symptoms, even up to two years later. Following up on a study presented a year ...

Market Mechanics

Nike, Össur collaborate on running sole for Reinertsen, other amputee athletes
Beaverton, OR-based running shoe giant Nike has introduced the Nike Sole, which uses state-of-the art design to create a lightweight, durable composite sole that interfaces easily with Össur’s Flex-Run prosthetic blade for amputee athletes. Nike designed the new Nike Sole in ...
FootCentric announces therapy course, therapeutic footwear fashion show
Chapel Hill, NC-based education company FootCentric continues its learning events with a two-day course for physical therapists on manual therapy for the foot and ankle. The event is scheduled for April 28-29 at the Comprehensive Physical Therapy Center
 in Chapel ...
Pediped updates styles for spring
Henderson, NV-based Pedi­ped’s spring and summer collection offers more than 75 new styles and color combinations in the company’s three signature lines for children—Originals, Grip ‘n’ Go, and Flex—and has also expanded its Adventure line. Highlights include a new slip-resistant diamond ...
Allard employee, marathoner runs to boost foot drop awareness
Rockaway, NJ-based Allard USA announced its new manager of community outreach, Beth Deloria, will compete in 20 half marathons this year to inspire others with foot drop, which for Deloria was caused by severe spinal trauma and subsequent surgery. Already a ...
New book focuses on healthy feet
Every Woman’s Guide to Foot Pain Relief: The New Science of Healthy Feet is a science-based how-to guide for patients on restoring the musculoskeletal health of the foot. The author, biomechanist Katy Bowman, MS, looks at mechanical contributors to common foot ...
AOPA extends deadline for papers
The American Orthotic and Prosthetic Association (AOPA) is looking for qualified O&P professionals and management specialists who have significant business experience to share their knowledge at the organization’s 2012 national convention. The submission deadline for papers has been extended to March ...


Wave Comfort Foot System
Fillauer offers the Emotis designed Wave Comfort Foot System for the low- to moderate-activity amputee. Tri-spring design elements provide seamless transition and stable progression from heel strike to toe off. Coupled springs react in a compliant manner that promotes a ...
Foot and Ankle Strengthening
PhysioTools announces the new Foot and Ankle Strengthening module for creating personalized exercise and information handouts for patients. This module contains 1426 color photographs and 19 pdf-format posters and covers five levels of progressions from nonweightbearing to advanced foot and ...
Knee Implant Simulation
Virtual Soft Tissue (VST), a highly detailed and programmable computer model from AMTI, accounts for the missing biological structure of the knee during simulation testing of joint implants. The simulator is designed to test the function and durability of implants ...
Antibacterial Silipos Products
Silipos introduces a new line of antibacterial foot care products for a range of indications from foot discomfort to management of traumatic injuries. The antibacterial products have been shown to kill up to 99.9% of bacteria and fungus in independent ...
Slickerz Cast Protectors
Slickerz, the latest product from CastCoverz, offers stylish weather protection for exposed toes, leg casts, and bandages. Slickerz utilizes a made-in-the-USA waterproof fabric to keeps toes, leg casts and bandages from getting wet and dirty due following exposure to rain, ...
EZ Caster System
Smithers Bio-Medical Systems introduces the EZ Caster, an orthotic casting system that facilitates making accurate castings in minimal time. Paired with Bio-Foam Impression Foam, practitioners can increase their number of casting sessions from three per hour to as many as ...
Sure Stick Adhesive
The Ortho Remedy offers Sure Stick, a clear contact adhesive that will permanently bond almost anything to anything. Sure Stick adhesive is appropriate for bonding materials including foams, thermosets, thermoplastics, crepe, vinyl, rubber, cork, Velcro, soling, leather, wovens, non-wovens, urethane, ...
Performance Sleeve
Sigvaris is proud to announce the U.S. release of the Sigvaris Performance Sleeve, which allows athletes to customize their compression and increase circulation during vigorous workouts. The Sigvaris Performance Sleeve provides ankle to calf compression that athletes can wear with ...
Xeleton Knee Brace
The new Xeleton off-the-shelf knee brace from Otto Bock HealthCare facilitates customizable function for sports injuries, pre- or post-surgical stabilization, or therapy for chronic knee joint instabilities. The Xeleton knee brace provides prophylaxis for anterior cruciate ligament injury or rehabilitation ...
Medi-Dyne ProStretch Plus
Medi-Dyne Healthcare Products announces the new ProStretch Plus, an advancement in lower extremity stretching that engages the entire interconnective chain of the lower leg beginning with the hamstring, calves, Achilles tendon, plantar fascia and toes. The strong, lightweight device automatically ...
Walking Boot Accessories
CastMedic Designs offers more than 60 fashion accessory products to accessorize medical walking boots, including faux-fur wraps, decorative socks, flowers,  and themed buttons for children. Wrap-Its are faux-fur cuffs to wrap around the top of the boot. Strap-Its are decorative ...
Lightweight Boot
Orthofeet introduces its Lightweight Boot, which integrates style and biomechanical performance. The boot features include a combination of elastic lace and strap closure for easy donning and doffing and convenient fastening. Its double depth design accommodates thick orthotic devices and ...