February 2013

LER02-13coverSMCover Story

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

Editor Message

Out on a limb: Forces of habit

One of the best things about visiting Negril, Jamaica, is taking a yoga class from Fanette Johnson. And one of the first things Fanette will do in class is have you sit cross-legged on your mat, then have you re-cross your legs in the manner that feels less natural.

Jordana Bieze Foster, Editor


Assessing alternatives to first MTP joint fusion

Arthrodesis remains effective for most patients with end-stage hallux rigidus, but finding an alternative that allows more range of motion can be challenging. Faced with disappointing arthroplasty outcomes, surgeons have had to get creative.

By Cary Groner

Hemiplegic CP: Effects in the uninvolved limb

In patients with spastic hemiplegic CP, practitioners and researchers tend to focus primarily on the hemiplegic limb. But hemiplegia also leads to impairments in the uninvolved limb, which are important to consider when designing a therapeutic approach.

By Julieanne P. Sees, DO, and Freeman Miller, MD

Footwear properties and football injuries

Excessive rotational traction that occurs at the interface between the shoe and the playing surface, as well as shoe properties such as rotational stiffness, may have the potential to influence the high incidence of lower extremity injuries in athletes.

By Feng Wei, PhD, and Eric G. Meyer, PhD

Trends in materials, part II: Foot orthoses

This two-part series examines trends and techniques in materials development and fabrication. This second installation focuses on technological advances that are likely to affect the structural properties and manufac­­ture of in-shoe foot orthoses.

By Cary Groner

The influence of obesity on ankle fracture risk

Obese patients are more likely than nonobese individuals to sustain an ankle fracture, particularly a severe ankle fracture. Contributing factors may include increased torque on the ankle or low bone mineral density relative to body weight.

By Christy King, DPM, AACFAS



In the Moment: Sports Medicine

By Emily Delzell

Fear factors: ACL-reinjury concerns sideline athletes

A lack of confidence and fear of reinjury after anterior cruciate ligament (ACL) reconstruction is keeping some athletes from returning to play, according to several abstracts presented last month at the American Physical Therapy Association’s 2013 Combined Sections Meeting (CSM) in San Diego.

Study confirms neuromotor alterations in runners with Achilles tendinopathy

A recent study done at the University of Melbourne in Australia supports the theory that, in runners with Achilles tendinopathy (AT), altered neuromotor recruitment patterns of the triceps surae create differential intratendinous loads that lead to pathology.

Soccer simulation data show benefits of ankle supports change over time

Ankle bracing and taping have a limited ability to restrict ankle range of motion (ROM) and improve proprioceptive capability under soccer-specific conditions, according to a small study e-published by the Journal of Sport Rehabilitation in January.

In the Moment: Diabetes

By Emily Delzell

Off balance: Instant total contact casts create instability

Instant total contact casts (iTCCs), which add length and weight to the involved leg, perturb balance in healthy individuals and could increase fall risks in the already–balanced challenged population of individuals with diabetic peripheral neuropathy.

Ulcer location influences healing times, from shortest at toes to longest at heel

A study e-published February 7 by Diabetes/Metabolism Research and Reviews found that time to diabetic foot ulcer healing was dependent on location, increasing progressively from toe to midfoot to heel, but did not differ between plantar and nonplantar ulcers.

Diabetes, cognitive deficits impair gait in older adults, but neuropathy does not

Type 2 diabetes affects gait parameters in older adults, and impaired cognition further reduces performance, according to investigators from Ghent University in Belgium who studied 101 patients living in community and residential care settings.

Market Mechanics

Physical therapist touched many lives, made significant contributions to field
David Pariser, PT, PhD, 52, of Crestwood, KY, died unexpectedly on January 14 at Audubon Hospital in Louisville. Pariser, who was 52, is survived by his wife, Gina Pariser, PT, PhD, and their twin daughters Ada and Kayla Pariser. Pariser was ...
ACFAS installs new officers, board of directors at its annual conference
The American College of Foot and Ankle Surgeons (ACFAS) installed its 2013-2014 board of directors on February 12 at its 71st Annual Scientific Conference in Las Vegas. Jordan P. Grossman, DPM, FACFAS, is the 62nd president of ACFAS. Grossman practices in ...
Implant firm offers surgical skills courses
Center Valley, PA-based Aesculap Implant Systems and the associated Aesculap Academy are offering three surgical skills courses for US-based orthopedic surgeons that address recent advancements in knee and hip replacement. Each course is led by an experienced surgeon and features a ...
Allard is OPAF’s first 2013 silver sponsor
The Orthotic & Prosthetic Assistance Fund (OPAF) and The First Clinics, which offer adaptive recreational sports programs, announced last month that Rockaway, NJ-based Allard USA is its first silver-level sponsor for 2013. This is Allard’s third consecutive year as an OPAF ...
Medical food benefits patients with DPN
An American Journal of Medicine study published this month suggests that nutritional management of diabetic peripheral neuropathy (DPN) with L-methylfolate, methylcobalamin, and pyridoxal 5′-phosphate, a prescription medical food sold commercially as Metanx, improves total symptoms and health-related quality of life. Investigators ...
High-tech materials group wins contract to develop advanced prosthetics for vets
A new $4.4 million contract with the US Department of Veterans Affairs (VA) will support the High-Performance Materials Institute (HPMI) at Florida State University in Tallahassee in a major effort to develop the next generation of prosthetic limbs for military ...
BOC introduces DME certification
This month the Board of Certification/Accreditation (BOC) began offering a new certification for durable medical equipment (DME) professionals, the Certified DME Specialist (CDME). This role involves equipment delivery, set up, and patient education. CDMEs handle basic repairs and troubleshooting of DME ...
DJO Global continues research support
Vista, CA-based DJO Global renewed its membership in January in the Foundation for Physical Therapy’s Partners in Research program, donating $25,000 to support the foundation’s mission of providing doctoral scholarships, fellowships, and research grants to emerging physical therapist researchers. This is ...
Spenco’s sandal sales skyrocket
Waco, TX-based Spenco Medical Corporation earned the number-one spot on the fastest-growing brand list in the Leisure Trends Group’s 2012 Outdoor RetailTrak report, released in January. Spenco’s sandal lines were recognized for accelerated growth in the outdoor sandal category, yielding a ...
Fundraising begins for diabetes hospital
Kshitij Shankhdhar, MD, a diabetologist from Lucknow, India, is working with the Uttar Pradesh Madhumeh Association (UPMA) to help establish a charitable diabetes hospital in India and is seeking donations to support the project. (Madhumeh is a Hindi word for ...
New software facilitates orthosis design
UK-based CAD-CAM giant Delcam launched the new version of OrthoModel, its design software for custom orthotic insoles, at the annual meeting of the Academy of Orthotists & Prosthetists, held this month in Orlando, FL. The software has developments specifically for accommodative ...


SACH+ Prosthetic Foot
Ottobock announces the SACH+prosthetic foot, a new generation of the traditional SACH (Solid Ankle Cushion Heel) foot. The new SACH+ foot is designed for users at mobility levels K1 and K2, with a durable, robust design featuring a glass-fiber-reinforced contoured ...
RecoveryPump Muscle Therapy
The RecoveryPump delivers medical grade compression to help reduce fatigue, soreness, and inflammation. Intermittent pneumatic compression works with the body to increase blood circulation and achieve in one to two hours the muscle recovery that would take the body 12 ...
Femoral Traction Splint
Rescue Essentials offers the STS Slishman Traction Splint, a fully adjustable traction splint for patients with suspected femoral fractures. The light, compact splint is designed to apply femoral traction to relieve pain and reduce hemorrhage and the possibility of further ...
Nu Wave Nail Products
MVI Footcare, a division of Med-Vet International, is the exclusive national distributor of Nu Wave Antibacterial and Antifungal Nail Enamel. Used at home or taken to a nail salon, the Nu Wave products facilitate nail care that may also establish ...
Prefabricated KAFO System
Anatomical Concepts offers a new multifunctional prefabricated knee-ankle foot orthosis (KAFO) system for functional or fracture applications in the rehabilitation or orthopedic settings. The KAFO system consists of the Pentagon knee orthosis and the Rapo AFO. The Pentagon is a ...
Hersco Partial Foot Prosthesis
Hersco offers the new DLA (durable, lightweight, antimicrobial) Partial Foot Prosthesis (PFP). The DLA PFP combines a thin dynamic-carbon ankle foot orthosis (AFO) and a slightly dorsiflexed socket-type foot orthotic device with toe-filler to assist with rehabilitation after partial foot ...
Cold Snap Footwear
Spenco Medical Corporation offers the Cold Snap, a winterized edition of its popular Siesta Total Support Footwear line. The winter slip-on features a thicker tread for colder conditions and fleece trim for a warmer appearance. Like the Siesta, the Cold ...
Deluxe Lace Up Ankle Brace
Elite Orthopaedics introduces the Deluxe Lace Up Ankle Brace for patients of podiatrists, foot and ankle surgeons, orthotists, and licensed physicians. The new brace features an easy-to-use lace up system and an elastic cuff at the top of the device ...
Clearflex Liner Material
Allied Plastic Supply offers Clearflex, a soft inner liner material that can be thermo-formed and heat-gun molded, has good clarity, and bonds well to itself. Held in place in an ankle foot orthosis (AFO) using a small piece of self-adhesive ...
Modular OrthoticMe
Insightful Products introduces OrthoticMe, a modular foot orthotic device that is fully customizable. OrthoticMe consists of several components that attach to the main sole using Velcro. Each piece is layered, which lets practitioners dial in the optimum amount of corrective ...
ScanCast 3D Foot Scanner
Arizona AFO offers a new custom configured, cost-effective 3D laser imaging technology to replace traditional plaster casting. The ScanCast 3D combines two high speed imaging chips and two imaging lasers in a unified, precalibrated scanning mechanism that scans the foot ...
Diaped Twin-Tip
Algeos USA announces the launch of Diaped Twin-Tip, a dual combination diagnostic device for testing the essential protective functions of thermal (warm/cold) discrimination and sensory perception in the feet of patients with diabetes. The Diaped Twin Tip is made from ...