July 2012

Cover Story

The sprinter’s advantage: Thinking outside the blocks

Researchers at The Pennsylvania State University have identified structural char­ac­teristics that distinguish the foot and ankle mechanics of trained sprinters from nonsprinters. Are similar underlying vari­ables responsible for the reductions in mobility that affect older adults?

By Stephen J. Piazza, PhD

Publisher’s Memo

Rich Dubin, Publisher
Publisher’s memo: Embracing change

As a father of four, I knew the day would come when one of them would be moving on. As my wife and I watched our eldest son walk across the stage to receive his high school diploma, I was reminded of how fast life moves and how important it is to have a strong network of support to help embrace that change.

Editor Message

Out on a limb: Power in practice

Healthcare researchers don’t get a lot of instant gratification. Typically it takes years for a study’s findings to have an impact on clinical practice, and often that doesn’t happen until those findings have been replicated by additional studies.


Pediatric obesity weighs on growing bones, joints

Exercise is the standard prescription for obesity. But alterations to joint biome­chan­ics, gait, and anatomical structure in overweight children and teens mean that physical activity comes with its own risks, which practitioners must factor into any clinical recommendations.

By Christina Hall Nettles

Development of the arch: Functional implications

Contrary to the conclusions of early research, recent studies suggest that arch height does indeed affect lower extremity function. The biomechanics associated with different arch heights may provide a basis for treatment and prevention of related injuries.

By Thomas C. Michaud, DC

The evidence for use of gauntlet-style AFOs

Gauntlet-style ankle foot orthoses offer an alternative to a larger rigid therm­oplastic AFO for foot and ankle pathol­ogies requir­ing more stability or im­mo­bili­za­tion than a foot orthosis provides. Materials, trim lines, and fabrication techniques can vary to meet different patients’ needs.

By Holly Tuchscherer Olszewski MS, CPO 

Dialysis treatment takes toll on diabetic foot care

A convergence of comorbidities means diabetic patients on dialysis have an even higher risk of foot ulcers and amputation than those without renal disease. The potential for preventing these complica­tions at dialysis centers is too often underappreciated by practitioners.

By Larry Hand

ACL reconstruction and risk of knee OA, part 2

This two-part series examines the link between ACL injury and the later development of osteoarthritis (OA) and how surgery may strengthen or weaken that link. This second installment explores meniscal damage, proprioception, and what MRI can add to the discussion.

By Cary Groner


In the Moment: Ankle

By Jordana Bieze Foster

Fusion vs replacement: Both improve gait, but well short of normal

Functional outcomes for total ankle re­place­ment (TAR) in patients with end-stage ankle arthritis appear to match or exceed those of ankle fusion, according to research presented in June at the an­nual meeting of the American Ortho­paedic Foot & Ankle Society (AOFAS).

ATFL repair with any of three methods decreases ligament stiffness, strength

Three different methods for repairing the anterior talofibular ligament (ATFL) leave the repaired structure significantly stiffer and weaker than an intact ligament, which may have implications for ankle injury rehabilitation, according to research presented in June at the AOFAS meeting.

Effects on plantar flexor endurance, power linger after gastroc recession

Tasks requiring plantar flexor endurance and push-off power remain difficult for patients long after an otherwise successful gas­tro­cnemius recession for treatment of Achilles tendinopathy, according to findings presented in June at the AOFAS meeting.

Bracing affects plantar pressures and inversion, but not most performance tests

Research presented in June at the annual meeting of the National Athletic Trainers Association shed more light on the biomechanical effects of ankle braces that can help reduce the risk of inversion injury.

In the Moment: Sports medicine

By Jordana Bieze Foster

Concussion conundrum: Chronic postural deficits elude detection

Sophisticated laboratory experiments have documented postural control deficits in athletes with a history of concussion, but research presented in June at the annual meeting of the National Athletic Trainers Association (NATA) suggests clinicians may find it difficult to identify similar deficits in concussed athletes once their other symptoms have resolved.

Hip adduction on landing stands out as predictor of future ACL injury risk

Hip adduction on landing is a significant predictor of anterior cruciate ligament (ACL) injury risk, according to a large pros­pective study from the University of North Carolina at Chapel Hill, presented in June at the NATA meeting.

In patients with patellofemoral pain, hip weakness may be result, not cause

A pain-inducing protocol significantly reduces hip extension strength in patients with patello­fem­oral pain (PFP), suggesting that hip weakness associated with the condition may be a result and not a cause, according to research from the University of Wisconsin-Milwaukee presented in June at the NATA meeting.

In the Moment: Knee OA

By Samantha Rosenblum and Jordana Bieze Foster

Arthroscopy attrition: 2002 study changes practice patterns

The number of knee arthroscopy proce­dures performed in patients with osteo­arthritis (OA) has greatly decreased since the 2002 publication of a high profile New England Journal of Medicine study that questioned the procedure’s effectiveness, according to research from the Cleveland Clinic in Cleveland, OH.

Bone bruises associated with ligament injuries may predict chondral damage

The distribution of bone bruises associated with acute knee ligament injury is consistent with long-term patterns of chondral damage, according to research from the University of Kentucky in Lexington presented in June at the annual meeting of the National Athletic Trainers Association.

Soccer training intensity affects levels of biomarker for cartilage degradation

Increased exercise duration is associated with elevated levels of a serum biomarker previously found to be an indicator of cartilage damage, according to research from the University of Kentucky in Lexington presented in June at the annual meeting of the National Athletic Trainers Association.

Market Mechanics

Study shows adjustable AFO reduces pain, allows return to active lifestyle
The Revolution ankle foot or­thosis (AFO) from Brooklyn, NY-based American Orthopedics Manufacturing Corporation (AOMC) improves symptoms of pain and associated disability and helps patients return to activity, according to a case series from researchers at Gifford Medical Center’s Sharon Sports ...
Pressure-sensing insole for diabetic neuropathy poised to enter market
Canadian medical technology company Orpyx will release its first product, the SurroSense Rx, later this year, reported the company’s CEO and president, Breanne Everett, MD, a resident in the Division of Plastic and Reconstructive Surgery at the University of Calgary. The ...
BOC introduces emeritus designation
The Board of Certification/Accreditation, International (BOC) is recognizing the knowledge that comes from years of hands-on O&P experience with the introduction of its Emeritus status category. Emeritus status, given to those who are no longer practicing but still retain the certification ...
Program educates hammertoe patients
Arlington, TN-based Wright Medical Group last month launched its MiToe patient outreach program to increase patients’ awareness of treatment options for hammertoes. Wright introduced the program to practitioners at the June meeting of the American Orthopaedic Foot & Ankle Society, held ...
Track continuing ed credits online
Health and fitness professionals can now go online to earn continuing education credits (CECs) from the American College of Sports Medicine (ACSM). The ACSM’s new education platform, at www.onlinelearning-acsm.org, offers a wide selection of continuing education opportunities, including multimedia video ...
AOPA hosts Medicare coding seminar
The American Orthotic & Prosthetic Association (AOPA) is hosting its popular “Mastering Medicare: Coding” course in downtown Seattle August 6-7. Participants will learn about how to code new complex devices through interactive discussions with AOPA experts, billing rules for Medicare and ...


Premiere Ankle Braces
Townsend has redefined and expanded its line of custom Premier Ankle Braces to achieve mobility benefits for a wider range of patients. The Standard Premier Ankle Brace includes a tibia shell and ankle joints made from pre-preg carbon fiber with ...
Roland Sandal
Oasis Footwear introduces the Roland, a fisherman-style sandal for men. The Roland is approved by PDAC (Medicare’s Pricing, Data Analysis, and Coding) and, when prescribed by a physician, its cost qualifies as a Part B benefit under the Therapeutic Shoe ...
Advantage FS Air Walker
Elite Orthopaedics introduces the new short/low-top version of the Advantage FS Air Walker, designed for patients suffering from Grade 2 or 3 ankle sprains, stable foot and ankle fractures, or trauma. The  full circumferential shell and detachable softgood lining toe ...
Keeping Pace Children’s Shoes
The 2012 shoe lines from KeepingPace integrate a wider, deeper heel and toe box for accommodating orthotic devices without being oversized. Designed with input from orthotists and therapeutic footwear designers, all styles offer three adjustable innersoles for a precise fit, ...
Bionic Ankle For AK Users
iWalk announces the availability of its new Biom bionic lower limb system for above-knee amputees (Biom AK). The new Biom AK is an ankle system that that works with select microprocessor knees to restore natural motion through personalized bionic technology. ...
Adventure Boots
Apis Footwear Company offers the AM5605 and AM5615 Adventure Boots as part of its Mt. Emey Therapeutic Line, suitable for athletic walking or simply improving patients’ general comfort. Designed to accommodate rather than correct, the Adventure Boots are genuine leather ...
Walking Boot Covers
re:covers walking boot covers solve practical day-to-day issues such as brace wear and tear, skin scrapes, and snagging of compression hose. They also address patients’ very real cosmetic concerns with colors and patterns that disguise the walking boot and showcase ...
Full-Length KidZerts
KidZerts has released a full-length version of its popular three-quarter length insole for kids. Like the three-quarter length version, the full-length insoles feature an ethyl vinyl acetate (EVA) sublayer that molds slowly to the plantar surface of the foot during ...
Washable Carter Shoe
Dr. Comfort’s new Carter style shoe for men is a machine washable, double-depth diabetic shoe. Made of lightweight stretch Lycra with a two-way Velcro closure for extra flexibility, this shoe is designed to accommodate foot deformities such as bunions or ...
Total Support Quartet Sandal
Spenco Medical Corporation introduces a new toe-post sandal style: the Total Support Quartet. The Quartet is designed with a sporty strap that secures the foot in the sandal and offloads pressure from the ball of the foot. The style offers ...
Adult PTTD Orthotic
Earthwalk Orthotics offers the new Adult PTTD Orthotic. The orthosis is designed for healthy adults with such conditions as posterior tibial tendon dysfunction, tarsal coalition, severe pronation, midtarsal joint function limitations, and extreme plantar fasciitis. The design features a polypropylene ...
Postoperative Socket System
The APOPPS (Adjustable Post-Operative Preparatory Prosthetic System) features volume reduction, medial and lateral compression, easy access to bandages, and early weightbearing when using a Universal Frame Outer Socket (UFOS). The three-part adjustable socket system provides postoperative, early, and preparatory prosthetic ...