January 2012

Cover Story

Breaking pointe: Foot and ankle injuries in dance

Essential to the beauty of dance are the demanding biomechanics of the dancer, particularly at the foot and ankle. Injuries and pain are almost inevitable. But an understanding of the underlying issues—artistic as well as anatomical—can help practitioners keep dancers on their toes for as long as possible.

By Jeffrey A. Russell, PhD, ATC

Editor Message

Out on a limb: Next top model

I grew up in Portland, OR. I live in New England. That means I root against all of the Los Angeles Lakers. But I do find Kobe Bryant’s footwear fascinating.

 Jordana Bieze Foster, Editor


Knee bracing benefits off-road motorcyclists

New research suggests that serious injuries occur as frequently in off-road motorcycle racing as they do in football, but such injuries occur less frequently in riders who wear knee braces.This may be why, although it is not well studied, knee bracing is widespread among off-road motorcycle riders.

By Wesley M.Gladin, BS, Robert A.Cates, BA, and Mark S.Sanders, MD, FACS

Adult acquired flatfoot: Nonoperative options

Adult acquired flatfoot deformity, primarily posterior tibial tendon dysfunction, in many cases can be successfully managed with conservative treatment modalities including early immobilization, long-term bracing, physi­cal therapy, and anti-inflam­matory medications.

By Robert W. Mendicino, DPM, FACFAS, Alan R. Catanzariti, DPM, FACFAS, and Kyle S. Peterson, DPM

Knee OA: The evidence for gait modification

Gait retraining can potentially alter walking biomechanics such that knee adduction moment is reduced, an inexpensive off­loading option that does not require device wear. Gait modification studies to date have primarily focused on foot rotation, trunk lean, and knee medialization.

By Michael A. Hunt, PT, PhD

Biomechanical analysis of ankle sprain ‘copers’

Researchers are investigating why some people develop chronic ankle instabilty after a sprain while others seem to heal normally. Biomechanical differences between the two cohorts may offer clues to the mechanisms underlying CAI and enhance preventive efforts.

By Adam Rosen, MS, ATC, and Cathleen N. Brown, PhD, ATC

Monofilament testing withstands critiques

Experts continue to debate the relative merits of the Semmes-Weinstein mono­fila­ment for assessing diabetic foot ulcer risk, including how many sites on the foot should be tested, and which ones. But it’s tough to argue with the technique’s cost-effectiveness.

By Cary Groner


In the Moment: Gait

By Emily Delzell

Surgical success in CP
Some dorsiflexion gains are surprising – A recent study validates the long-held clinical belief that, in appropriately se­lected children with cerebral palsy (CP), ankle dorsiflexion during swing phase improves after ankle plantar flexor surgery and that postsurgical rehabilitation should include a ...
Charcot-Marie-Tooth patients delay using prescribed ankle foot orthoses
Even if they have a device prescription, individuals with Charcot-Marie-Tooth disease tend to put off wearing ankle-foot orthoses (AFOs) until walking function is impaired, according to research conducted at St. George’s University of London and Kingston University, London. Investigators compared presentation ...
Muscle activation data suggest gap in poststroke gait rehabilitation
Improving gait and coordination among stroke survivors should involve developing rehabilitation techniques that target abnormal muscle timing characteristics, suggests recent research from the Louis Stokes Cleveland VA Medical Center, OH. The study, e-published in December by Rehabilitation Practice and Research, included ...

In the Moment: Footcare

By Emily Delzell and Jordana Bieze Foster

Shear significance
Study delves beyond plantar pressure – Recent research confirms that peak shear and peak pressure points occur at different locations under the foot, shedding some light on the role of shear in diabetic foot ulceration. By Emily Delzell
Metatarsal pads may reduce pain by creating space in the forefoot
A Dutch study suggests that metatarsal pads relieve metatar­salgia pain by creating space between metatarsal heads in addition to reducing plantar pressure. Researchers from St. Maartens Clinic in Nijmegen, the Netherlands, performed motion analysis on 16 feet with primary metatarsalgia and ...
Peroneal response to inversion increases with shoe sole thickness
Wearing thick-soled shoes increases the magnitude of peroneus longus muscle activity required to resist an unanticipated foot inversion, elevating the risk of an ankle sprain, according to research from the University of Dundee in Scotland. Investigators used electromyography to assess peroneus ...

In the Moment: Sports medicine

By Jordana Bieze Foster

Ball sports bolster bones
High-impact history benefits runners – Preliminary findings from Stanford Uni­versity add to the growing body of evi­dence suggesting that playing soccer or basketball at an early age helps lower the risk of stress fracture in athletes who go on to ...
Ball position during overhead catch influences ACL injury risk on landing
When an athlete jumps to catch a ball overhead, the path of the ball relative to the dominant leg affects landing mechanics in ways that could increase risk of anterior cruciate ligament injury, according to research from Griffith University in ...
AFO offloading findings could affect tibial stress fracture management
A corset-style ankle foot orthosis is more effective than a controlled ankle motion walker for offloading the distal lower extremity, according to pilot data from Colorado investigators that could have implications for management of tibial stress fractures in athletes. Researchers from ...

Market Mechanics

ABC names new officers, launches interactive state licensure map
The Board of Directors for the Alexandria, VA-based American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC) named Donald D. Virostek, CPO, president of the organization on December 1. Virostek, director of orthotics at the Texas Scottish Rite Hospital for ...
PAL Health manufacturing goes mobile with tablet technology
Pekin, IL-based PAL Health Technologies reports that taking its fabrication management mobile has resulted in a 13% increase in productivity and 2% reduction in internal product rejects after six months. PAL Health’s production data software for Apple’s iPad allows managers to ...
OPAF clinics get O&P patients moving
The Orthotic & Prosthetic Activities Foundation (OPAF) has signed two significant 2012 sponsors for its First Clinic series of no-cost, introductory adaptive recreational clinics for individuals served by the O&P community. Owings Mills, MD-based Board of Certification International has upped its ...
New CPT codes relate to Dermagraft
The American Medical Association (AMA) has assigned two new procedure codes for the application of living skin cell product Dermagraft, according to Westport, CT-based  manufacturer Advanced BioHealing. Dermagraft is approved by the Food and Drug Administration (FDA) for up to ...
Pedors Shoes wins PFA award
The Pedorthic Footcare Association (PFA) presented Marietta, GA-based Pedors Shoes with the Pedorthic Footwear Vendor/ Manufacturer of the Year award at its 2011 symposium, held last November in Albuquerque, NM. The PFA’s annual award goes to a company the association’s Board ...
KineMedics inks deal to distribute AFX foot-ankle strengthening system
Ottawa, Ontario-based Kine­Medics has signed a deal with another Canadian company, Port Moody, BC-based Progressive Health Innovations (PHI) to distribute PHI’s AFX (Ankle Foot Maximizer), a strengthening system for the ankle and foot complex. The AFX system’s variety of resistance bands ...
PT foundation funds scholarship, signs DJO Global as research partner
The Alexandria, VA-based Foundation for Physical Therapy granted several awards in December. Two physical therapists each received $40,000 research grants and three won $5000 each as recipients of the Florence P. Kendall Doctoral Scholarships for the 2011-2012 academic year. Kristin Archer, ...
IOC names Oslo as site of fourth Advanced Team Physician Course
The International Olympic Committee’s fourth Advanced Team Physician Course is scheduled for May 30-June 1 at the Soria Moria Hotel in Oslo, Norway. The course, geared toward the practical issues of working with high-level athletes in a team sports setting, is ...
RehabTech Asia will debut in 2013
RehabTech Asia is the region’s only trade gathering for the assistive technology, integrated care, and rehabilitation engineering industries. The inaugural event, which includes a trade exhibition, conference, hosted buyer program, and business forums, is scheduled for February 27-March 31, 2013 at ...
AOPA hosts 2012 audio conferences
Practitioners who want to learn the latest in O&P and earn CE credits can dial in to the American Orthotic and Prosthetic Association’s (AOPA) telephone seminars the second Wednesday of each month at 1 pm EST. Practitioners can receive 1.5 CEs ...
COPA reprises educational event
The California Orthotic & Prosthetic Association (COPA) will hold its second annual COPA Educational Event on Friday, March 2, at California State University, Dominguez Hills’s O&P Program in Long Beach. The one-day event will include three concurrent tracks: a prosthetic ...


Ponseti AFOs with PFS/Toe Stilt
MD Orthopaedics offers the Ponseti AFO Toe Stilt, Ponseti AFO/PFS, and Ponseti  AFO/PFS Toe Stilt, all compatible with the Ponseti abduction bar. The AFO Toe Stilt features a severe permanent wedge to keep the foot in 10° of dorsiflexion during standing. The ...
PAL Platinum Trim Gauntlet
The Platinum Trim Gauntlet, now available from PAL Health Technologies, is a slender, less rigid alternative to the standard Platinum Gauntlet. The custom AFO is designed for management of such conditions as PTTD and chronic ankle instability, and in particular ...
Tensegrity K3 Promoter
Tensegrity Prosthetics has announced the availability of its K3 Promoter, a prosthetic foot designed to give amputees the flexibility and mobility of a natural limb. Anecdotally, testers of the K3 Promoter report a responsive and lively feeling associated with its ...
BioSculptor AFO Vacuum Box
The AFO Vacuum Box from BioSculptor Corporation is designed for capturing weight-bearing or semi weight-bearing scans for products such as AFOs, foot orthotics, and custom shoes. The vacuum box is used when the most accurate scans are needed, as it allows ...
Masterflex Black Material
In response to customer demand, Euro International’s product line now includes Masterflex Black, exclusively distributed by the company for applications such as the production of flexible inner sockets. The color and material properties are designed to help increase productivity and ...
AquaHeal Bandages
Spenco Medical Corporation has introduced 2nd Skin AqualHeal Hydrogel Bandages, an easy-to-use, durable first aid solution that combines a sterile dressing and cooling technology to speed healing for a variety of wounds. A waterproof polyurethane film adhesive seals out bacteria ...
DynaFlange Posting System
DynaFlange, new from Langer Biomechanics, is a patent pending rearfoot posting system that dynamically manages pathologic motion during gait. First, DynaFlange addresses the deleterious effects of pronation by storing ground reaction forces, then dynamically returns the stored energy when needed ...
Polyester/Lycra Casting Socks
The STS Company of Mill Valley, CA, announces the release of a new and improved line of tubular polyester/Lycra casting socks. The new material provides a detailed, accurate, and precise negative mold of the lower extremity (foot, leg and thigh) ...