May 2016

Download the Complete issue as a PDF (8.4mb)

Download the Complete issue as a PDF (8.4mb)

Cover Story

Smoking & knee OA: From clinical controversy to therapeutic possibility

Experts say perplexing studies suggesting that smoking may be protective against the development of knee osteoarthritis (OA) should not deter clinicians’ efforts to discourage smoking—even in patients who are at risk for OA.

By Barbara Boughton

Editor Message

Out on a limb: Stumping for SR in sports

Platelet-rich plasma injections. Kinesiology tape. Foam rolling. Compression garments. Blood-flow restriction training. Elite athletes have always been at the leading edge of the latest tech­niques believed to help speed recovery from injury, often long before they’ve been…

By Jordana Bieze Foster, Editor

LER Pediatrics

LER: May PediatricsThe weight problem

Many, many stories in both LER: Pediatrics and its parent publication, Lower Extremity Review, highlight the biomechanical and physiological effects of being over­weight or obese.

Continue Reading →


Managing metatarsalgia in athletic populations

Metatarsalgia is a common foot disorder. The term metatarsalgia refers to a pain syndrome in the forefoot and not to a specific diagnosis. Pain is confined to the area across the plantar forefoot, including the second through fourth metatarsal heads.

By Howard Kashefsky, DPM, FACFAS

Skin-care issues related to orthotic device wear

The care and prevention of skin issues may not get as much attention in orthotics as in prosthetics, but such issues can significantly affect patient outcomes. Here, lower extremity experts share the tips and tricks they use to manage dermatological challenges related to orthotic devices.

By Lori Roniger

Using subsensory noise to improve balance, gait

Using specially designed insoles to deliver stochastic resonance to the plantar surface of the feet has the potential to significantly improve static balance, dynamic balance, and gait mechanics in healthy…

By Daniel Miranda, PhD; Wen-Hao Hsu, ScD; and James Niemi, MS

Hip strength asymmetry and patellofemoral pain

Hip strength asymmetry has been observed in patients with existing patello­femoral pain syndrome (PFPS) and poten­tially could be used to screen for at-risk individuals.

By Franklin Caldera, DO, MBA; and Christopher Plastaras, MD


In the Moment: Sports Medicine

CAI and the CNS: Excitability may influence instability

For individuals with chronic ankle instability (CAI), the somatosensory feedback necessary for postural adjustments, walking, and running may be hampered by a decrease in soleus spinal reflex excitability, according to a new study in the Journal of Athletic Training.

By Larry Hand

Strength training in runners has bonus benefits for physiological performance

Long-term periodized strength training has physiological performance benefits in distance runners, according to research from the University of Limerick in Ireland.

By Jordana Bieze Foster

fMRI study supports use of multiple exercises to prevent hamstring injury

A multicenter functional magnetic resonance imaging (fMRI) study indicates that no single exercise activates all of the hamstring and synergist muscles in professional soccer players, suggesting a combination of exercises may be optimal for hamstring injury prevention.

By Jordana Bieze Foster

In the Moment: Rehabilitation

Gender, gait, and knee OA: Kinematic data have rehab implications

Women with and without knee osteo­arthritis (OA) demonstrate greater knee abduction and hip adduction during gait than their male counterparts, according to research from Canada that supports the concept of gender-specific rehabilitation in this population.

By Katie Bell

Leg strength, velocity predict functional issues in older adults with poor mobility

Leg strength and speed of leg movement are predictive of functional decline in older adults with poor mobility, according to research from Boston, MA.

By Jordana Bieze Foster

Metabolic activity suggests Achilles tendons are still healing at 6 months

Metabolic activity evident six months after an Achilles tendon rupture—when rehabilitation protocols typically allow running and other high-load activities—suggests the tendon is still healing at that time, according to research from Denmark.

By Jordana Bieze Foster

Market Mechanics

By Emily Delzell

AOPA continues to fight amputee coverage limitations at policy forum

The Washington, DC-based American Orthotic & Prosthetic Association (AOPA) on May 2 wrapped up its 2016 Policy Forum with its first-ever O&P Legislation-writing Congress.

IOF evaluates osteoporosis medications

The International Osteoporosis Foundation (IOF) Fracture Working Group in April published its conclusions on the effect of osteoporosis medications on fracture healing.

BOC to drop O&P, pedorthic certifications

The Owings Mills, MD-based Board of Certification/Accreditation (BOC)’s Board of Directors in May approved a plan to sunset the acceptance of new applications for its orthotist (BOCO), prosthetist (BOCP), and pedorthist (BOCPD) certifications.

Homisak joins OHI central casting

Hauppauge, NY-based OHI on May 3 announced the appointment of Lynn Homisak, PRT, CHC, as central casting program consultant for the company’s on-demand pedorthic service.

Nolaro24 continues live web series

Middlebury, CT-based Nolaro24 in May announced dates for its upcoming live webinar series on biomechanics. The six new webinars, which the ABC (American Board for Certification in Orthotics, Prosthetics, & Pedorthics)…

ING gives $60K to fund RMPI tuition

The Elwood, IN-based Robert M. Palmer, MD, Institute of Biomechanics (RMPI) reported that OrthoSleeve brand maker ING Source has committed to a second year of scholarship support for students of the nonprofit institute.

Book focuses on pain biomechanics

Stuart Goldman, DPM, a board-certified foot and ankle surgeon who practices at Help for Your Feet in Owing Mills, MD, recently published his book, Walking Well Again: Neutralize the Hidden Causes of Pain.

Össur’s new hip OA brace reduces pain

Results from a small study of Reykjavik, Iceland-based Össur’s new Hip Unloader brace published in April showed nine of the 14 participants with unilateral symptomatic hip osteoarthritis (OA) reported an immediate reduction in pain with application of the device.

Diabetes drug Invokana under scrutiny

Beerse, Belgium-based Janssen Pharmaceutical’s top-selling diabetes drug Invokana (canagli­flozin) continued to come under scrutiny in April and May with new lawsuits filed, along with questioning from the European Medicines Agency (EMA) about serious potential adverse effects.

Freedom Innovations taps new CEO

Freedom Innovation’s Board of Directors on April 26 named David A. Smith chair and CEO of the Irvine, CA-based company.

JAS acquires Empi Advance ROM line

Effingham, IL-based Joint Active Systems (JAS) reported on May 3 that it has acquired the Empi Advance ROM line of dynamic braces from Empi, a subsidiary of San Diego-based DJO Global. JAS plans to reintroduce the Empi Advance ROM line by July.

Vorum, Nia join for 3D-printed devices

Vancouver, Canada-based CAD-CAM software company Vorum in May announced a partnership with Nia Technologies to deliver 3D-printed orthotics and prosthetics to children in developing countries.

Bauerfeind teams up with Mavs’ Nowitzki

Tampa, FL-based Bauerfeind USA in April hosted healthcare professionals and business partners in Dallas for a two-day event featuring Dirk Nowitzki, star forward for the Dallas Mavericks and Bauerfeind global brand ambassador.


Coral Bone Supplements

Coral, a leading brand of coral minerals, now offers Coral Complex3 and Daily D, two supplements to help support healthy bones. Daily D provides 500 IU (1250% DV) of the “sunshine vitamin”, vitamin D3. In addition, it provides 100 mg of coral calcium per capsule.

Cloudflyer Footwear

The Cloudflyer from Swiss footwear company On features a low-profile outsole, a wide platform, and an active wedge in the medial heel and lateral forefoot to give pronation guidance without static features such as posting and dual-density foam

Jellyfeet Foot Covers

Jellyfeet occlusive foot covers are reusable, multiuse products that offer protection, aid in treatment, and enhance moisturization. They serve as a barrier between the skin and dirt or other harmful agents on the ground. Because they are water resistant and impermeable to lotions and…

Vantage Camera From Vicon

Vicon’s new flagship camera, Vantage, combines technology with accessible design to open up motion capture to a broader audience. The camera’s individual components have been designed to work together to provide up-to-the-minute informa­tion so the user can make adjustments in real time.

Quell Nerve Stimulation

Quell utilizes NeuroMetrix’s patented, wearable intensive nerve stimulation (WINS) technology to provide drug free, widespread relief from chronic pain. Worn just below the knee and activated by clicking a button, Quell stimulates the sensory nerves to trigger the body’s natural pain relief system and block pain signals in the body.

Contender Post-op Knee Brace

Corflex introduces the Contender Post-Op Knee Brace. The brace features a simple adjustment system to minimize fit time after surgery and weighs just 27 oz. The ZipTrak Telescoping System adjusts brace length from 18″-26″ in 1/8″ increments and allows for the adjustment of intermediate cuffs to help avoid incision sites.

Apex Spring Shoes and Boots

New from Apex is the 2016 Spring Collection of shoes and boots, designed with a fresh focus on style. Spring boots include the Black A4000M and Brown A4100M, which include an ankle strap for adjustability, bungee lace detailing, 5/16″ removable depth, a full grain leather upper…

Össur Unloader Hip OA Brace

Össur announces the launch of the Unloader Hip, a unique brace intended to provide relief for patients with mild-to-moderate hip osteoarthritis (OA). The Unloader Hip is designed to improve mobility by using compression to encourage external rotation and abduction of the femoral head during gait…

BetterDoctor Websites

BetterDoctor helps healthcare practices create and manage their online presence and builds tools to bring trust, confidence, and transparency to the process of finding a doctor. The company works to fix incorrect contact information across the internet and get reviews on applicable industry websites.

Structured Memory Foam Footwear

New for spring, Spenco has launched a line of structured memory foam footwear, with the initial softness of memory foam and the added benefit of structural integrity. The new styles that feature memory foam are the Pure Sandal for men and women and the Thrust Slide for men.

ActivMotion Bar From OPTP

OPTP (Orthopedic Physical Therapy Products) has partnered with ActivMotion to expand its line of therapy and fitness products. Exclusive to OPTP, the new 4-foot, 4.5-lb ActivMotion Bar features…

X-Trac Knee Support

Pro-Tec Athletics is proud to introduce the X-Trac dual-strap knee support. Built to enhance comfort and durability, the X-Trac is designed to stabilize the patella and improve patellar tracking in patients with patellar or quadriceps tendinitis as well as patellar tracking disorders that can cause chondromalacia and…