November 2013

LER11-13cvr-LRCover Story

Energetics of landing: Effects of ankle instability

A diminished capability for energy dissipation at the knee after ground impact during landing in patients with chronic ankle instability may result in greater demands on the ankle joint. Modifying landing strategies could potentially reduce the risk of musculoskeletal injury.

By Masafumi Terada, MS, ATC, and Phillip A. Gribble, PhD, ATC, FNATA   

Editor Message

out on a limb: Parsing the pain

You know that saying about how a man with a hammer sees everything as a nail? That’s something those who specialize in biomechanics might want to remember when considering patients with chronic pain.

By Jordana Bieze Foster, Editor


Conference coverage: 3rd PFP research retreat

The third International Patellofemoral Pain Research Retreat picked up where previous retreats had left off in examining proximal and distal factors related to PFP and subgroups of patients who might respond to targeted interventions. But this retreat broke some new ground as well.

By Jordana Bieze Foster

Plantar plate repair: New approach to metatarsalgia

Plantar plate pathology in conjunction with metatarsalgia occurs more often than is commonly appreciated, but can be addressed using a combined procedure that involves a dorsal approach to anatomic plantar plate repair and metatarsal realignment.

By Lowell Weil Jr, DPM, FACFAS, and Erin E. Klein, DPM, MS

Studies examine ways to optimize OA bracing

Research continues to suggest that bracing has the ability to improve pain and function in patients with knee osteoarthritis in a controlled setting, but researchers are now working to identify factors that affect bracing outcomes in the real world. Patient expectations are at the top of that list.

By Larry Hand

Achilles tendon rupture: The influence of gender

The literature suggests that women are less likely than men to experience an Achilles tendon rupture. This may be because women are less capable of generating the large eccentric contractions necessary for rupturing the tendon. Estrogen may also play a protective role.

By Joseph L. Laratta, MD, and J. Turner Vosseller, MD

Limited hip flexibility: Mutability and mobility

Myofascial or joint-focused stretches can increase passive hip range of motion in young adult men with limited hip flexibility, but this will not necessarily result in more hip motion actually being utilized during functional activity unless old movement patterns can be unlearned.

By Janice Moreside, PhD

Hamstring strain: Issues facing collegiate athletes

Collegiate athletes who participate in sports associated with sprinting have an increased risk of hamstring strain. Investigators have identified flexibility, strength, and fatigue as potential contributing factors that can be addressed through sport-specific training and rehabilitation.

By Kevin M. Cross, PhD, ATC, PT, Susan Saliba, PhD, ATC, PT, and Jay Hertel, PhD, ATC


In the Moment: Sports medicine

By Greg Gargiulo, Emily Delzell, and Jordana Bieze Foster

Prepare for landing: Bladed cleats may put fifth met at risk

Bladed soccer cleats were associated with increased forefoot loading during a jump-landing task, which may lead to a higher risk of fifth metatarsal stress fractures, according to a study published in the September-October issue of the Journal of Athletic Training.

Leg mechanics, training conditions may predict Achilles pain in runners

Investigators at the University of Tuebingen in Germany have identified alterations in lower leg mechanics and higher impacts caused by “fast” training conditions (e.g., interval training sessions, competitions) as potential risk factors for Achilles tendon pain in runners.

Anterolateral knee ligament ‘discovery’ makes headlines, but is not really new

The media buzz over the apparent discovery of a new knee ligament announced in early November faded quickly as experts pointed out that the finding was not exactly new.

Market Mechanics

By Emily Delzell

ACA may improve preventive O&P care

The Affordable Care Act (ACA), which went into effect on October 1 and has a strong emphasis on preventive care, may help O&P practitioners offer their patients devices that prevent serious sequelae, including drop foot, foot ulcers, and amputation, said William DeToro, LO, CO, CEO of Poland, OH-based Anatomical Concepts Inc (ACI).

DJO Global signs Olympic gold medalist

Vista, CA-based DJO Global announced on October 30 that Megan Rapinoe, Olympic gold medalist for the US Women’s Soccer Team and a National Women’s Soccer League player for the Seattle Reign FC, is partnering with them to help educate young athletes about the value of bracing in injury prevention and returning to play.

O&P site makes user-friendly updates

O&P Social relaunched its website,, in November. The newly designed site gives O&P clinicians and other allied health professionals easy-to-use navigation, an educational forum with Medi­care updates and tips for a more effective practice, a list of national and international O&P events, and a forum for interaction among O&P professionals.

Steadman organizations name CEO

J. Richard Steadman, MD, managing partner and founder of The Steadman Clinic, and Marc Philippon, MD, managing partner of Steadman Philippon Research Institute (SPRI), announced on October 16 that Tom Mars, a former Walmart executive and SPRI board member, is new chief executive officer of both organizations, located in Vail, CO.

Combination therapy eases OA pain

Combining Irving, CA-based VQ OrthoCare’s BioniCare transcutaneous electrical joint stimulator with an unloading knee brace improves OA symptoms significantly more than electrical stimulation alone, according to a multicenter study published in October in The American Journal of Orthopedics.

Pedors launches 24/7 B2B portal

Hiram, GA-based Pedors launched, its new 24/7 business-to-business portal where practitioners can place, review, and track orders, invoice balances, and order history, at the 54th Pedorthic Footcare Association Symposium held in Boston October 31-November 2.

Ankle sprain trial supports Traumeel

A multicenter randomized controlled noninferiority trial published in October in The International Journal of Clinical Practice found a topical homeopathic gel and ointment made by Albuquerque, NM-based Heel Inc are as effective as the current standard of care for reducing pain and improving function in patients with acute ankle sprains.

Ottobock wins communications award

German prosthetics company Ottobock, headquartered in Dusseldorf, announced on October 29 that it had won the 2013 Econ Award for excellence in public relations for its London 2012 “Passion for Paralympics” campaign.


Contender Post-op Brace

Corflex announces the release of its Contender Post-Operative Knee Brace. The ZipTrak, X-Flex, and QuikZip systems work together to ensure the Contender knee brace stays in place, which maximizes its ability to control range of motion to aid in healing and rehabilitation following an injury or a surgical procedure.

MaxxLife Custom Orthosis

Footmaxx offers the MaxxLife premium custom-made foot orthosis for comfort and stability. The MaxxLife features a natural leather topcover, a low-profile Duramaxx semirigid orthotic module, a polyurethane mid-layer reinforced with a suede bottom, and a polyurethane heel cushion and cap.

MxXpress Software

ModulaRx Orthotics Corp has introduced a new computer technology, MxXpress, to facilitate the accurate design and manufacture of customized foot orthoses based on plantar pressure measurements.

Arch Suspender AFO Modification

Hersco announces availability of the Arch Suspender from Richie Labs as an ankle foot orthosis modification to control the midtarsal joint and hindfoot. The Medial Arch Suspender is an adjustable lifting strap under the talonavicular joint to resist collapse of the medial arch as well as eversion of the ankle and hindfoot.

bodyblock Limb Support

The bodyblock is a light, comfortable multipurpose support block that can be used to elevate a limb or as a spacer between the knees. Made of polyurethane, it weighs just 300 g and can be easily cleaned and disinfected between patients.

Topical Gear ACL Tube

Topical Gear has released the ACL Tube. Inventor Bill Bue and his team developed the light- weight (2 oz) brace that applies topical pressure on the medial quadriceps and hamstring muscles.

PressureGuardian Data Collector

PressureGuardian, developed by Tillges Technologies, is a compact portable pressure sensor device with a compatible data-collecting app. The information can be used to adjust orthotic and prosthetic devices to offload pressure on a diabetic wound or inside a prosthetic socket.

New Options OA Brace

The New Option OA is a pull-up, buttressed, “soft” brace for patients with mild to moderate knee osteoarthritis. The buttressed sleeve aids in knee alignment, provides compression, and is easy to apply.