January 2014

LER-January-Cover-smCover Story

Foot Orthoses: A distal twist on low back pain management

Increasing numbers of patients are finding relief from chronic low back pain with the use of foot orthoses, but the mechanism underlying the positive outcomes is largely unknown.

By Larry Hand

Editor Message

Out on a limb: Many risky returns

“Something bad is going to happen to Percy Harvin today,” I said to my husband during the first quarter of the January 11 playoff game between Seattle Seahawks and the New Orleans Saints.

Jordana Bieze Foster, Editor


Knee injury prevention: Hip and ankle strategies

Many knee injury prevention programs do not focus on ankle dorsiflexion range of motion and hip adductor activation, but research suggests both distal and proximal variables contribute to alterations in frontal plane knee biomechanics and could affect injury risk.

By Darin A. Padua, PhD, ATC, and Micheal A. Clark, DPT, MS, PES, CES   

Nerve decompression and diabetic neuropathy

Advocates of surgical nerve decompression in a subset of patients with diabetic neuropathy have published some impressive outcomes, but critics of the procedure point to the conspicuous absence of randomized trials. The issue has become one of the most contentious in diabetes care.

By Cary Groner

Painful hip impingement: Functional implications

Physical impairments associated with femoroacetabular impingement include limited range of motion, muscle weakness, and altered biomechanics. Attention to these areas during rehabilitation can improve surgical outcomes and may even reduce the risk of osteoarthritis.

By Jerrad R. Guenther, BSc, Michael K. Gilbart MD, FRCS(C), MEd, and Michael A. Hunt PT, PhD

Achilles tendinopathy and body mass index

Research suggests that obesity influences the development of Achilles tendi­no­pathy to a greater degree than other types of foot and ankle pain. This phenomenon will become increasingly important to lower extremity practitioners as global obesity rates continue to rise.

By Ryan T. Scott, DPM, AACFAS, and Christopher F. Hyer, DPM, MS, FACFAS

A proximal perspective on patellofemoral pain

Hip strengthening can improve short-term outcomes related to patel­lo­­femoral pain syndrome, but further research is needed to determine the underlying mechanism and whether the same approach will also prove effective in managing patello­femoral osteoarthritis.

By Michael B. Pohl, PhD


In the Moment: Sports medicine

By Jordana Bieze Foster

Switch trials: Shoe use, striking affect risk in runners

Switching between different pairs of shoes may help prevent running-related injuries, but switching from a rearfoot strike pattern to a nonrearfoot strike pattern may not, according to two separate studies from Luxembourg and Iowa State University.

Delayed patellar tendon development in teens may lead to overuse injuries

Knee extensor muscle development appears to outpace patellar tendon development in elite male adolescent volleyball players, which may increase their risk of patellar tendinopathy and other overuse injuries, according to research from Berlin, Germany.

In college football, most turf toe cases occur in games, on artificial surfaces

A Stanford University study suggests that turf toe injury rates in collegiate football players are lower than expected, possibly as a result of improvements in synthetic turf technology.

In the Moment: Diabetes

By Greg Gargiulo and Emily Delzell

Fighting falls with feedback: Virtual reality training improves balance

A balance training program featuring a virtual reality feedback component improves postural stability and coordination in patients with diabetic peripheral neuropathy (DPN), which may in turn reduce their risk of falling, according to a study published in the November-December 2013 issue of the Journal of the American Podiatric Medical Association.

Compliance with prescribed footwear depends on perceived clinical benefit

Practitioners should educate patients with diabetes about benefits of custom therapeutic footwear to encourage its use, according to a usability survey conducted by Dutch investigators.

Metatarsal protrusion influences risk of reulceration after surgical resection

First metatarsal (M1) length after metatarsal head resection influences reulceration risk, according to researchers at Complutense University of Madrid.

Market Mechanics

By Emily Delzell

OHI expands position in DME solutions with December acquisition of SafeStep

Ronkonkoma, NY-based Orthotic Holdings Inc. (OHI), a global supplier of lower extremity orthotic devices and durable medical equipment (DME), announced in December the addition of Milford, CT-based SafeStep to its collection of brands, which also includes Langer Biomechanics, Arizona AFO, and The Orthotic Group.

Barbara Campbell, DPM, takes on role of medical director for ComfortFit Labs

Roselle, NJ-based ComfortFit Orthotic Labs announced January 1 that Barbara Campbell, DPM, is the company’s new medical director. Her role includes assistance with product development and education.

Dr. Cool funds physical therapy research

Portsmouth, NH-based Coolcore and its Dr. Cool’s Recovery-on-the-Go wraps, launched in November on drcoolrecovery.com and scheduled for broader distribution this spring, recently joined the Foundation for Physical Therapy’s Partners in the Research Program at the Silver Level, a $5000 annual contribution.

Foot expert joins Noraxon USA team

Jay Segel, DPM, began a collaboration in November with Scottsdale, AZ-based Noraxon USA, joining the motion analysis company as director of applied podiatric biomechanics.

Sigvaris taps new head of US operations

International medical device developer and distributor Sigvaris, headquartered in Winterthur, Switzerland, named Scot J. Dubè president and CEO of Sigvaris North America, based in Peach­tree City, GA.

Vionic launches Spring 2014 line, website

San Rafael, CA-based Vionic in January merged its footwear brands, which include Orthaheel and Dr. Andrew Weil Integrative Footwear, into a single brand, Vionic.

Delcam doubles up for 2014 tech forums, to become Autodesk subsidiary in 2015

Birmingham, UK-based CAD-CAM software supplier Delcam will hold its Orthotics Technology Forum (OTF) on both sides of the Atlantic for the first time in 2014.

Solana implant system begins rollout

Memphis, TN-based Solana Surgical’s new implant system began commercialization this month following its December clearance by the US Food and Drug Administration.

Tekscan offers computerized BESS test

Boston-based Tekscan’s late-2013 release of the MobileMat BESS paired its pressure-sensing platform with software for quantifying balance errors during the standard or modified Balance Error Scoring System (BESS) test, which is widely used in sports concussion assessment.

BOC installs new chair, exec committee

James L. Hewlett, BOCO, took the reins as Board of Certification/Accreditation (BOC) chair on January 1, the same day a new Executive Committee began its term.

PFA invites abstracts for 2014 meeting

The Pedorthic Footcare Association (PFA) issued a call for abstracts on January 13 for its 55th Annual Symposium & Exhibition, scheduled for October 24-26 in Orlando, FL.

OPAF honored for adaptive tennis events

A United States Tennis Association’s state affiliate, USTA North Carolina, will present the Orthotic & Prosthetic Activities Foundation (OPAF) and Bridge II Sports with the 2013 Special Tennis Event of the Year award at its annual tennis weekend in Pinehurst, NC, scheduled for January 23-26.

Allard video features foot drop team

San Rafael, CA-based Vionic in January merged its footwear brands, which include Orthaheel and Dr. Andrew Weil Integrative Footwear, into a single brand, Vionic.


DynAdapt Prosthetic Foot

Freedom Innovations has officially launched its new DynAdapt foot–a slim profile, lightweight carbon fiber foot system for amputees. DynAdapt has a slender, anatomic design for easy fit and finish and its advanced multiaxial function is designed to provide maximum comfort.

Slim Fit Original Insole

Foot Management is a custom orthotic laboratory with more than 35 years of experience manufacturing custom foot orthoses. Now, Foot Management offers the new Slim Fit Original insole, a shock absorbing orthotic device for low impact sports and patients suffering from foot fatigue.

Dynamic Tape

Dynamic Tape is a unique, strongly elastic tape, developed by an Australian musculoskeletal physiotherapist, which helps reduce tendon load. Dynamic Tape allows the wearer to move through full range of motion without limitation but with strong biomechanical assistance (as opposed to a primary neurophysiological approach).

Empi Phoenix

DJO Global announces the launch of the Empi Phoenix, an electrical stimulator designed to help simplify treatment of muscle atrophy as a supplement to physical therapy before and after surgery for total knee replacement or anterior cruciate ligament repair.

OrthoModel Enhanced for EVA

Delcam has introduced an enhanced version of its OrthoModel design software for ethylene vinyl acetate (EVA) custom insoles, now with options for corrective orthotic devices in addition to accommodative devices.

Duraflex Thermoplastic

Duraflex is a soft, transparent, pliable thermoplastic that combines comfort, durability, and strength. Suitable for both adult and pediatric devices, Duraflex is extremely strong but also very soft.

Saebo MyoTrac Infiniti

The Saebo MyoTrac Infiniti, developed jointly by Saebo and Thought Technology, is a portable all-in-one biofeedback stimulation clinical solution with two new features. The first-of-its-kind Reciprocal EMG Triggered Stimulation (RETS) is for patients with increased tone.

TORCH Walker

The TORCH (total contact orthotic restraining custom hybrid) Walker from ComfortFit Labs combines the support and positioning of a traditional ankle foot orthosis with the accommodation and functionality of custom footwear.

Elevate Drop Foot Brace

FootMind introduces the Elevate Drop Foot Brace. Boa technology, built into a breathable neoprene ankle strap, facilitates a custom lift through cords that hook into the eyelets of a shoe.

Hatfield Strap

The Hatfield Strap was created by former Kansas City Royals trainer Keith Hatfield, ATC, to combine the benefits of a night splint and an incline board for patients with plantar fasciitis.

Lifestyles Foot Orthoses

Earthwalk offers Lifestyles custom foot orthoses, a high-tech, low-cost solution for mild to moderate biomechanical deformities. The hand-posted, hand-pressed devices feature a polypropylene shell and an ethylene vinyl acetate (EVA) top and bottom cover.

Ventopedic Offloading Boot

Tetra announces the Ventopedic Offloading Boot (Tetra item number TV-19). This offloading boot redistributes pressure to help prevent pressure ulcers, reduce the risk of infection, and promote healing.