July 2017

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Cover Story

Tactical athletes: Maximizing their ability to protect and serve

Increasingly, clinicians and researchers are focusing on tactical athletes—including warfighters, firefighters, law enforcement officers, and other professionals—as a unique population with regard to lower extremity injuries.

By Hank Black

Publisher Memo

Rich Dubin, Publisher
Publisher’s memo: Taking stock, taking action

Readers of LER are very familiar with the fact that healthcare is constantly evolving, and that professional success depends in part on the ability to respond to those changes. Similarly, at LER, we also realize the importance of adapting to change—with regard to evolutions in publishing as well as evo­lutions in healthcare.

By Richard Dubin, Publisher

Editor Message

Out on a limb: Back to the evidence

The farther you go up the kinetic chain, the more some things about evidence-based medicine stay the same. The spine differs in many ways from most of the lower extrem­ity segments of the kinetic chain. Obvious differences include the shape and function of the bony structures, the complex roles of the adjacent muscles, and how the spine responds to the demands of movement.

By Jordana Bieze Foster, Editor


How Lower Extremity Care Can Improve Spinal Health

The kinetic chain doesn’t end at the hips, and practitioners know the stability and function of the lower extremities can significantly influence the stability and function of the spine and core. Researchers and clinicians recently have been examining these relationships in more detail, and a growing body of evidence suggests that distal approaches can be effective for preventing and managing spinal conditions across a wide range of patient populations.

Continue Reading →


Recent trends favor use of bracing for knee OA

Experts say new research underscoring the clinical benefits of bracing for patients with knee osteoarthritis (OA), along with more comfortable device designs aimed at improving patient compliance, may help boost the historically low rates of brace utilization in this patient population.

By Barbara Boughton 

An interdisciplinary take on diabetic limb salvage

Developing a multidisciplinary team dedicated to diabetic limb salvage allows for immediate referral, lessens the burdens on individual practitioners, helps remove structural barriers that can delay patient care, and offers a framework in which to organize inpatient care for these patients.

By Brian M. Schmidt, DPM, AACFAS


In the Moment: Sports Medicine

By Jordana Bieze Foster

Ankle sprain and the brain: Experts explore role of CNS function

Research presented in late June at the National Athletic Trainers Association (NATA) annual meeting in Houston, TX, adds to the evidence suggesting alterations in central nervous system (CNS) function play a role in chronic ankle instability (CAI).

By Jordana Bieze Foster

Limited ankle dorsiflexion contributes to odds of plantar fasciitis in runners

College-aged runners with plantar fasciitis are significantly more likely to have limited ankle dorsiflexion than their uninjured counterparts, according to research from Texas State University in San Marcos.

Kinesiophobia risk factors after ACLR differ for high vs low physical activity

Factors contributing to kinesiophobia after anterior cruciate ligament reconstruction (ACLR) appear to differ in patients with high levels of physical activity compared with their less-active counterparts, according to research from the University of Virginia in Charlottesville.

Gluteal effects on landing mechanics depend on activation, not just strength

Gluteal muscle activation—not just strength—is significantly associated with landing biomechanics, according to research from High Point University in North Carolina.


Market Mechanics

By Emily Delzell

NATA inducts hall of famers at 68th expo

The Dallas, TX-based National Athletic Trainers’ Association (NATA) on June 28 inducted seven individuals into its Hall of Fame at the association’s 68th Clinical Symposia and AT Expo in Houston, TX.

Amputee groups air ACA reform concerns

The Alexandria, VA-based American Orthotic & Prosthetic Association (AOPA) and the Amputee Coalition, headquartered in Knox­ville, TN, on June 27 held a news conference to outline the “big three” priority issues in the healthcare reform debate for amputees.

ACR, AAHKS publish TJA drug care recs

Arthritis Care & Research on June 16 epublished guidelines from the American College of Rheumatology (ACR) and American Association of Hip and Knee Surgeons (AAHKS) on perioperative management of antirheumatic medication for patients with rheumatic diseases, such as rheumatoid arthritis, spondyloarthritis, juvenile…

BOC picks first Newberry Award winner

The Owings Mills, MD-based Board of Certification/Accreditation (BOC) in July made Harry J.R. Brandt, BOCO, CO, LO, the inaugural recipient of the Jim Newberry Award for Extraordinary Service.

Panel issues protocols for Össur hip brace

A multidisciplinary panel of clinical experts in June released treatment protocol recommendations for three populations of patients with hip osteoarthritis (OA) that included first-time advice regarding Foothills Ranch, CA-based Össur’s Unloader Hip brace.

ACSM gives first young scientist award

Bloomington, IN-based American College of Sports Medicine (ACSM) at its May 30-June 3 annual meeting in Denver, CO, awarded Allison Gruber, PhD, assistant professor in Indiana University Bloomington’s School of Public Health, its Young Scientist Award.

ROMP climbs highlight amputee issues

The Denver, CO-based Range of Mobility Project (ROMP) in July announced it is encouraging groups of supporters across the globe to organize climbs to back the nonprofit’s mission of providing high-quality prosthetic care in underserved populations.

Orpyx smart insoles used in wound healing

Plastic Surgery Case Studies on June 28 epublished a report detailing the use of Calgary, Canada-based Orpyx’s smart insole system in the management of loss of protective sensation in a patient with a degloving injury of the foot reconstructed with a latissimus dorsi free flap and skin graft.

Ottobock to assist Invictus Games athletes

Austin, Texas-based Ottobock reported in July it will provide O&P technical services for the Invictus Games for the third year since the event’s 2014 inaugural competition in London, UK.

NYSPMA installs Caribbean-born president

The New York State Podiatric Medical Association (NYSPMA) announced in June it has installed Patricia Nicholas, DPM, as the 75th president of the association. Nicholas, in private practice in Wading River, NY, is the first Caribbean-born woman to serve as president.

AOPA plans week on compliance, ethics

The Alexandria, VA-based American Orthotic & Prosthetic Association (AOPA) announced in June the association and its members will celebrate Healthcare Compliance & Ethics Week (HCEW) November 5-11 in Phoenix, AZ.

Upstep sells custom orthoses to patients

Upstep, founded by entrepreneurs in Rishon LeZion, Israel, is launching an online service that lets US customers order custom foot orthoses online. Upstep sends customers a footprint kit with simple instructions for making an imprint that’s mailed back to the company, which uses 3D technology to scan the footprint.


DryPro Probiotic Cast Relief Spray

DryPro, a division of DryCorp, introduces Cast Relief Probiotic spray. The new Cast Relief formula is engineered to allow users of all ages to remain itch and odor free while wearing a lower extremity cast. Probiotic Cast Relief is designed to be safe, natural, chemical free, eco-friendly, and biodegradable.

Convertible TPD AFO

The new Convertible Mueller TPD AFO (tibialis posterior dysfunction ankle foot orthosis) is a detachable, dynamic AFO for staged treatment of TPD and related pathologies, including ten­dinopathy, desmopathy, and dysfunctional flatfoot.

Korebalance Rehab System

The Korebalance is an advanced rehabilitation system for professional use with interactive technology for neurosensory training and assessment. The Korebalance offers clinicians accurate and objective tools to assess and improve patients’ balance, posture, coordination, stability, and…

AirShift OA Knee Brace

Newly redesigned, the AirShift OA Knee Brace from Med Spec uses the power of air to comfortably relieve pain associated with unicompartmental osteo­arthritis. The durable air bladder system allows patients and practitioners to easily adjust the level of unloading.

OLT Footcare Scanner

OLT Footcare offers modern scanning technology to facilitate orthotic device design for practitioners who treat patients with foot, ankle, knee, and hip problems. OLT Footcare’s new scanner takes only two seconds per foot, and records a 3D image along with all measurement of…

Sure Stabilizer Ankle Brace

Niagara Brace and Tru-Mold Shoes have combined their more than 60 years of shoemaking experience and computer-assisted design and manufacturing technology to create the new custom-molded Sure Stabilizer Brace for patients who have had difficulty with…

MatPlus Advanced Manufacturing

MatPlus announces its manufacturing capabilities now include fabric lamination and compression cutting. New equipment allows the company to adhere many porous materials to foams via a dry lamination process, which helps address the challenges associated with…

Jack and Jill Diabetic Footwear

Ped-Lite introduces Jack and Jill athletic footwear for patients with diabetes. The athletic shoes are designed with an ultra-light sole and breathable mesh upper to bring comfort to the diabetic foot. Double depth and elastic-lace closure provide a quality fit and help…

Brooks Beast 16 Running Shoes

Brooks Sports offers the Beast ’16 and newly updated Beast ’16 LE (limited edition) running shoes. The Beast ’16 LE has a new no-sew upper for added comfort and a sleeker fit. The Beast ’16 features adaptive midsole cushioning technology, an extended progressive diagonal roll…

Sheer Ease Hosiery

Therafirm has added new Sheer Ease Patterns to its Ease line of compression hosiery. The new sheer patterns include a scallop pattern for knee high styles and a diamond pattern for thigh highs and pantyhose, and are available in several colors.

HotShot Drink for Muscle Cramps

HotShot is a 1.7-oz sports beverage for the prevention and treatment of exercise-related muscle cramps. Invented by a Nobel Prize-winning neuroscientist and endurance athlete, in collaboration with a Harvard Medical School neurobiology professor, HotShot is designed to…

Knee Glide Therapy Tool

OPTP has partnered with two physical therapists to offer the Knee Glide physical therapy exercise tool. For lower extremity indications, patients place a foot on the Knee Glide plate for easy movement back and forth along the track.