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No matter which biomechanical principles we utilize to prescribe and produce custom foot orthoses for our patients, we all must admit that prescribing footwear interventions is not like prescribing medication – no one knows the right dose. How stiff should the shell be? How high should the arch be? How much rearfoot or forefoot posting is optimal for that specific patient? An experienced practitioner can make reasonable inferences and often produce a beneficial...
By Paul Langer, DPM
Dirty Truth #4: Shock Absorption is Energy Loss–Understanding Loading in Gait Analysis
Perhaps the most surprising and unintuitive of all the dirty truths is number four, “Shock absorption via cushion is energy loss.” At first blush, cushion seems like a no-brainer benefit. When we delve into this idea a bit deeper, applying our structure, the forces acting on the lower limbs, and applying the physics that we talked about in the last three dirty truths, the truth of number four becomes clear.
By Jay Segel, DPM; Sally Crawford, MS
Integrating targeted exercises focused on AH strengthening, both pre- and post-surgery, offers a comprehensive approach to HV management. The abductor hallucis (AH) is the most important muscle in the...
By Giacomo Farì, Laura Dell’Anna, Francesco Paolo Bianchi, Rachele Mancini, Enrica Chiaia Noya, Carlo De Serio, Riccardo Marvulli, Luisa De Palma, Danilo Donati, Roberto Tedeschi, Maurizio Ranieri, Marisa Megna, and Andrea Bernetti
Emergency medical services (EMS) calls accounted for 65.2% of all incidents to which United States (US) fire departments responded in 2023. A portion of fire department EMS calls are likely to involve lower extremity injuries. The objective of this study was to describe the pattern of these lower extremity injuries.
By Mathias B. Forrester, BS
Ankle joint-position sense (A-JPS) is the body’s awareness of the ankle’s position in space—more commonly known as ankle proprioception. A-JPS plays a crucial role in balance and stability, particularly in sports. This research team wanted to understand if static stretching could improve A-JPS in soccer players.
Ankle fractures are common, and although treatment is generally successful, up to 50% of patients experience long-term functional issues. One potential cause is the presence of hidden osteochondral talar lesions (OCTLs), which may not be easily detected with traditional imaging methods like MRI. While MRI is widely used, it often reveals OCTLs that are not related to symptoms, making clinical interpretation difficult.
Researchers in Singapore explored how different exergaming modes affect exercise intentions, fear of falling, and emotional well-being in older adults, particularly those from low socioeconomic backgrounds—a group often overlooked in such research. 48 participants took part in a four-week community-based intervention, divided into 4 groups...
Electric biking (E-biking) has been growing in popularity. High-impact injuries are linked to this new recreational and transportation source. A new study brings light to the growth of E-bike related injuries and details the distribution between age, sex and the primary source of E-bike related injuries in the US.
Lisfranc injuries, once described fracture-dislocations of the tarsometatarsal joints and considered rare, are now recognized to occur more frequently and in subtler forms due to advancements in imaging. These injuries vary significantly in severity and anatomical presentation. Early diagnosis is critical for favorable outcomes. Traditional anatomy-based classification systems have limited treatment utility
A new retrospective study evaluated 74 feet in 57 rheumatoid arthritis patients with severe hallux valgus (HV) deformity (Larsen grade ≥3), comparing first metatarsophalangeal (MTP) joint arthrodesis (27 feet) and joint-preserving surgery (47 feet). Procedures were performed at Japan’s Kyushu University Hospital between 2008 and 2022. Clinical outcomes were assessed using the...
Impaired balance and functional deficits are common in individuals with Charcot–Marie–Tooth disease (CMT). Many individuals with CMT use ankle foot orthoses (AFOs) to improve their balance and function. The aim of this study was to evaluate the fall frequency, perceived effect of AFOs on balance, and balance confidence of individuals with CMT who currently use AFOs.
Ankle sprains are among today’s most common injuries. They can range from mild with no loss of function to debilitating and even disabling. And while a significant number of patients will go on to develop chronic ankle instability (CAI), there remains no ideal management. Conservative therapy is the first line, with surgical interventions used as a last resort.
Patients undergoing below-knee amputation may experience considerable postoperative mortality risk, particularly in the presence of comorbid conditions. The aim of this study was to present a newly developed risk index and scoring system to predict 1 year mortality, morbidity, and functional independence in patients undergoing below-knee amputation.
Footwear is often recommended in the management of plantar heel pain (PHP), theoretically to reduce tissue stress during standing and walking. However, limited data exist to guide footwear design and recommendations. The aim of this study was to investigate the effect of both shoe and shoe insert designs on in-shoe plantar pressures, vertical ground reaction force and underfoot comfort in individuals with PHP.
At least 10% of all patients with knee osteoarthritis (OA) undergo treatment with injectable corticosteroids or hyaluronic acid (HA). Although both have been shown to help with symptomatic pain relief, their long-term effects on knee OA progression remain inconclusive. The overall aim of this study was to investigate the association between intra-articular knee injections, specifically with corticosteroids and...
The foot and ankle are frequently affected in rheumatic and musculoskeletal diseases (RMDs), yet there is a lack of high-quality evidence to determine the effectiveness of treatments. Outcomes in research are often inconsistently measured, impeding evidence synthesis. Additionally, clinical decisions are based on research outcomes, but these are...
Chronic, hard-to-heal wounds are a major aspect of care in most podiatric offices, which is why antimicrobial resistance (AMR) is an escalating concern for healthcare practitioners. AMR is not only a growing concern for patient health but also poses potential legal and economic ramifications for healthcare providers.
By Windy Cole, DPM, CWSP, FAPWH
The Pedorthic Footcare Association (PFA) announced that its board’s executive committee has nominated Teresa Alpert, CO, CPed, BOCO, BOCPD, CMF, to continue her service to PFA as the next executive director effective May 31. Simultaneous to her presidency ending, Jeffery Rich, CPed, will take over as the next PFA president.
Researchers at the Technical University of Munich (TUM) have developed robotic shorts—dubbed WalkON—that enable people to walk more easily while expending measurably less energy. The aim is to keep frail individuals and in particular the elderly mobile and healthy for longer.
Researchers from China have successfully developed an artificial muscle with mechanical properties similar to natural muscle tissue. They utilized molecular design to synthesize the artificial muscle through block copolymerization of biocompatible perfluoropolyether (PFPE) and polycaprolactone diol (PCL). By precisely tuning the intra- and intermolecular interactions of...
Electrical stimulation of the spinal cord is a promising strategy for reestablishing walking after spinal cord injury (SCI), recent studies show. But for patients suffering from muscle spasms, the stimulation protocols have a limited effect due to the unpredictable behavior of involuntary muscle stiffness related to spasticity. Muscle spasticity affects almost 70% of patients with SCI.
A team of researchers in the United Kingdom has developed a smart insole system that can accurately measure the body’s interaction with the ground, opening new possibilities in sports science and healthcare by estimating ground reaction forces (GRFs).
Associate Professor Ronnapee Chaichaowarat, PhD, faculty of engineering, Chulalongkorn University, Thailand, has developed an Exoskeleton Wheelchair prototype for the elderly and people with mobility problems so they can leave their wheelchair behind to stand and walk with 1 robot.
ACL match injuries sustained in Germany's first women's league during the 2016-2017 to 2022- 2023 seasons were prospectively analysed. A high proportion of 80% of ACL injuries occurred during horizontal movements such as sprinting, stopping, change- of-direction manoeuvres and lunging.
