February 2015

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Download the Complete issue as a PDF (12mb)

Cover Story

High-intensity training: assessing injury risks

As increasing numbers of fitness enthusiasts embrace high-intensity training, reports of injuries have sparked a debate among clinicians about the benefits and risks associated with these programs.

By Cary Groner

Editor Message

Out on a limb: imperfect symmetry

Psychologists tell us that the symmetry of a person’s face influences whether he or she is perceived as attractive. But when it comes to rehabilitation of anterior cruciate ligament (ACL) injuries, some types of symmetry are more desirable than others.

By Jordana Bieze Foster, Editor

Special Educational Series: Pediatrics

Pediatric02-15cvr-smFrom the editor: Sizing up the evidence

Evidence-based medicine, defined literally, depends on the existence of studies that justify treatment decisions. But, too often, practitioners who specialize in pediatric lower extremity care find that the only evidence they have to draw on involves studies done in adults, not children.

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Peripheral neuropathy in Lyme disease patients

Reported cases of Lyme disease have been rising steadily over the past 30 years, but its diagnosis can be challenging. Left untreated, patients with Lyme disease can go on to develop neurological symptoms, including those that are characteristic of peripheral neuropathy.

By Greg Gargiulo

An eccentric approach to hamstring injuries

The effectiveness of eccentric training for the prevention and rehabilitation of hamstring strains has been established in the medical literature. The next step is to identify an eccentric hamstring exercise that addresses the limitations of existing…

By Karl F. Orishimo, MS, CSCS, and Takumi Fukunaga, DPT, ATC, CSCS

Chronic ankle instability: effects on quality of life

Patient-reported outcomes can be used to monitor health-related quality of life in patients with chronic ankle instability, and lower extremity practitioners can design rehabilitation approaches to specifically target physical impairments that are known to contribute to quality of life.

By Megan N. Houston, PhD, ATC, and Matthew C. Hoch PhD, ATC

Knee OA brace experts revisit persistent issues

Systematic reviews and meta-analyses show that bracing for knee osteoarthritis (OA) is associated with significant benefits with regard to pain and function. But links to disease progression remain elusive, and the challenges of patient compliance are becoming even more complicated.

By Larry Hand

Achilles rehab: focusing on insertional tendinosis

Research supports eccentric strengthening for treatment of midportion Achilles tendinopathy, but a new study suggests the same approach…

By Lisa H. Jain, DPT, OCS; Kevin J. McCarthy, MD; Michael Williams, PT, OCS; Marie Barron, PT, OCS; Nick Bird, MPT; Brian Blackwell, PT, OCS; G. Andrew Murphy, MD; David R. Richards, MD; Susan Ishikawa, MD; and Margaret Kedia, PhD, DPT


In the Moment: Sports Medicine

By Emily Delzell and Jordana Bieze Foster

All about the ALL: knee ligament stabilizes internal rotation

The anterolateral ligament (ALL) of the knee, a structure not well-documented or consistently reported before the 2013 publication of a Belgian study, is a key stabilizer of internal rotation—though only when the knee is flexed at high angles—and may be…

Female high school basketball players benefit from neuromuscular training

A six-week progressive neuromuscular training program is associated with significant improvement in single-leg balance on unstable surfaces in female high school basketball players, according to research from Bellarmine University in Louisville, KY.

Baseball players maintain improved balance 6 months after UCL surgery

Improved balance in baseball players who have had Tommy John surgery is maintained after their release from physical therapy, according to research from Fort Worth, TX.

By Jordana Bieze Foster

In the Moment: Rehabilitation

By Jordana Bieze Foster

Heel pain gains: Studies support multimodal treatment

Multimodal physical therapy is associated with significant symptom relief in patients with plantar heel pain, but may be most effective for those with symptoms lasting fewer than seven months, according to research presented in February at the annual…

Reason for benefits of balance training eludes ankle instability investigators

Eight pathological factors do not explain the self-reported improvements in perceived disability associated with balance training for functional ankle instability (FAI), according to research from the University of Kansas Medical Center in Kansas City.

Progressive strengthening improves function after total knee arthroplasty

Patients who do progressive strengthening exercises after total knee arthroplasty (TKA) are significantly more likely than those who do conventional rehabilitation to have normal-range functional outcomes at one year, according to research from the University of Delaware.

Market Mechanics

By Emily Delzell

Trial finds Pluristem product safe, improves post-THA muscle strength

A phase I/II trial of Pluristem Therapeutics’ expanded placental cell product for treatment of muscle injury after total hip arthroplasty (THA) found significant improvements in maximal voluntary muscle contraction force six months postsurgery in both operated and nonoperated gluteal muscle.

Sigvaris partners with wound-care expert

Compression garment manufacturer Sigvaris in January partnered with physical therapist and wound care and lymphedema management expert Robyn Bjork, MPT, CWS, WCC, CLT-LANA, CLWT, to help support innovation for patients with lymphedema, chronic venous insuffi­ciency, and venous ulcers.

13th DFCon event scheduled for March

The 13th Diabetic Foot Global Conference (DFcon) 2015 is scheduled for March 19-21 at the Loews Hollywood Hotel in Los Angeles.

Hanger revamps peer support program

Birmingham, AL-based Hanger Clinic in early 2015 changed the name of its Amputee Empowerment Partners Peer Support Program to the AMPOWER program (empoweringamputees.org).

PT foundation awards $2.5M COE grant

The Alexandria, VA-based Foundation for Physical Therapy announced February 5 that it has awarded Brown University in Providence, RI, $2.5 million to establish the Center on Health Services Training and Research (CoHSTAR) over the next five years.

Arcopedico donates 2200 pairs of shoes

Sparks, NV-based Arcopedico USA reported on February 3 that it has gifted more than 2200 pairs of its Portuguese-made comfort footwear to young women in villages throughout Haiti.

BOC reaccredited, elects 2015 board

The Board of Certification/Accreditation (BOC) reported February 11 that the National Commission for Certifying Agencies has reaccredited its pedorthist certification program for ano­ther five-year period. Approximately 275 professionals are currently certified as BOC pedorthists (BOCPDs).

PFA welcomes Meanwell memorial fund gifts

The Pedorthic Footcare Association (PFA) invites its members to contribute to a memorial fund for the family of Bill Meanwell, CPed, a longtime PFA member and pedorthist who died on November 14, 2014, in Broken Arrow, OK.

Ottobock awards $1000 photo contest prize

Ottobock North America has named Carlos Gonzalez of San Francisco, CA, winner of its 2014 C-Leg Heroes photo contest grand prize.

FDA clears MedShape’s bone-sparing plate

Atlanta-based MedShape noted on February 2 that the US Food and Drug Administration has given 510(k) clearance to its 3D-printed FastForward Bone Tether Plate, a primary component of the company’s FastForward Bunion Correction System.

Altra introduces smart running shoe

Orem, UT-based Altra introduced its Halo running shoe with an integrated gait-detecting sensor in January at the 2015 International Consumer Electronic Show in Las Vegas.


Sigvaris Merino
 Wool Socks

Sigvaris is pleased to announce that its All Season Merino Wool Socks are joining the Sigvaris Medical collection, designed for men and women who wear 20-30 mmHg medical graduated compression socks every day.

Tommie Copper 
Compression Gear

Tommie Copper’s recovery line of compression products includes multiple colored sleeves, apparel, and accessories such as shorts and tights for all the pain points of the body, designed to be comfortably worn all day and throughout the night.


Sonostics develops and markets “pacemakers for the second heart”—the soleus muscle—to provide nonpharm­- aco­logic relief from unexplained fatigue, swollen feet and ankles, muscle/joint pain, cold hands/feet, dizziness, brain…

Nexus 2

Nexus 2 is the newest version of Vicon’s data capture software for sports, rehabilitation, gait analysis, and biomechanical research. New major updates address speed, methodology, and accuracy challenges faced by both clinicians and…

Fascia Therapy 
Book and Tools

Eric Franklin’s new book, Fascia Release and Balance, educates the reader on how connective tissues integrate the body’s components and facilitate all movements. This knowledge is reinforced by Franklin Method ball-rolling and imagery…

‘Garden Stretches’
 Patient Education

Stretching Inc. presents stretching as a simple, gentle activity that can be done by anyone, anywhere, at any time. “Garden Stretches” provides detailed instructions and illustrations of stretches to do before, during, and after gardening to help…

Squid Cold

Squid, a dynamic cold compression system, combines sequential compression with cold therapy. The cold compression directs edema away from the extremities and toward the heart, promoting venous return and increasing local circulation.

 RockGuards II

Rocktape now offers RockGuards II, designed to protect the shins of the wearer during physical activity such as rope climbs, CrossFit, dead lifts, and cleans and snatches.

Armor1 Ankle
 Roll Guard

The new Armor1 Ankle Roll Guard is designed to prevent ankle sprains by cushioning the ankle during an inversion, or “roll.” Unlike a brace, the Armor1 Ankle Roll Guard…

Orthotimer Wear
Time Monitor

Pro-Tech Orthopedics is the exclusive North American distributor of the Orthotimer, an electronic monitoring system that documents the wear time of orthopedic devices for outpatients. The heart of the Orthotimer system is a small microsensor…

PF Sock
Night Splint

The PF Sock is a specialist-designed night splint that is intended to provide an optimum stretch of the plantar fascia and speed recovery. The PF Sock is designed to hold the ankle joint in a neutral position while dorsiflexing the toes—a combination that can…

Offloading Pulseboot

Pulseboot footwear is designed to improve diabetic foot ulcer healing, reduce limb loss, and help lesions stay healed. Pulseboot offloads pressure using an advanced material (D3O) and contoured insole design. A discreet rigid offloader controls unwanted foot motion…