November 2017

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Cover Story

BRAINS, SPRAINS, AND CHRONIC PAIN: Concussion consequences may include osteoarthritis

As a growing number of studies report associa­tions between concussion and musculoskeletal injury risk, new research suggests concussed athletes may also have an increased risk of osteoarthritis later in life.

By Robert C. Lynall, PhD, ATC; Timothy C. Mauntel, PhD, ATC; David R. Howell, PhD, ATC; and Thomas A. Buckley, EdD, ATC

Editor Message

Out on a limb: Low tech, high value

The use of advanced technologies to provide feedback to patients during rehabilitation is all the rage in lower extremity healthcare. But, as exciting as these new modalities can be, it’s important to remember that low-tech feedback strategies can make hi-tech data even more clinically useful.

Jordana Bieze Foster, Editor


BRAINS, SPRAINS, AND CHRONIC PAIN: Concussion consequences may include osteoarthritis

As a growing number of studies report associa­tions between concussion and musculoskeletal injury risk, new research suggests concussed athletes may also have an increased risk of osteoarthritis later in life.

By Robert C. Lynall, PhD, ATC; Timothy C. Mauntel, PhD, ATC; David R. Howell, PhD, ATC; and Thomas A. Buckley, EdD, ATC

From barefoot running to diabetic neuropathy

Because footwear alters sensory perception, research examining the role of cutaneous feedback in barefoot running may provide important insight related to some of the gait changes that occur in patients with…

By Melissa Thompson, PhD, and Kristine Hoffman, DPM, FACFAS

Focus on biomechanics helps treat claudication

Lower extremity clinicians say ankle foot orthoses, rocker-soled shoes, and other orthotic interventions can benefit patients with peripheral arterial disease and intermittent claudication by making it easier for them to exercise, and research is starting to demonstrate these benefits.

By Shalmali Pal

Assessing runners’ gait using wearable sensors

Wearable sensors allow for the collection of running biomechanics data outside the laboratory in natural training environments, enabling clinicians to collect a large volume of information in a relatively short time to help identify and manage individuals who may be at risk for running-related injuries.

By Rachel Koldenhoven, MEd, ATC; and Alex DeJong, MEd, ATC

When a longtime patient dies: How clinicians cope

It’s not unusual for any practitioner to experience complicated emotions when a death or a terminal diagnosis disrupts the personal bond forged with a patient over many years, but experts say lower extremity clinicians often are not well equipped to deal with these emotions.

By Emily Delzell


In the Moment: Sports Medicine

Runners’ knees get a lift: Elevating heel cuts patellofemoral load

Wearing heel lifts in conventional running shoes can help reduce patellofemoral joint loading and may offer an alternative to gait retraining in runners with patello­femoral pain (PFP), according to research conducted at  the University of Wisconsin-La Crosse.

By Jill R. Dorson

Combination of four variables predicts 90% of recurrent lateral ankle sprains

A combination of four variables predicts 90% of cases of recurrent lateral ankle sprain within one year of an initial sprain, according to research from the University of Sydney in Australia.

By Jordana Bieze Foster

Video overlay feedback helps improve biomechanics of sport-specific landing

Video feedback is associated with improved landing mechanics—suggesting a reduced risk of anterior cruciate ligament injury—during a sport-specific task, according to research from the University of Groningen Medical Center in the Netherlands.

By Jordana Bieze Foster

In the Moment: Diabetees

Hot tip to predict ulcer risk: Repeat temperature test for best results

The concept of foot temperature monitoring to identify areas of increased risk of ulceration in patients with diabetes is promising, but new research from the Netherlands suggests clinical use of the technology will require more than a single temperature assessment.

By Keith Loria

Gait findings support focus on proximal muscle function in people with diabetes

Lower extremity muscle force during gait differs significantly among patients with diabetic neuropathy, patients with diabetes but no neuropathy, and controls, according to research from Brazil that underscores the importance of maintaining proximal muscle function in patients with diabetes.

By Jordana Bieze Foster

Variability in glycemic control can help estimate time needed to heal foot ulcers

Glycemic variability—fluctuations in HbA1c level from one visit to another—is significantly associated with foot ulcer healing time in patients with diabetes, according to research from the UK.

By Jordana Bieze Foster

Market Mechanics

By Emily Delzell

AAOS, AJRR create orthopedic database

The Rosemont, IL-based American Academy of Orthopaedic Surgeons (AAOS) in mid-October announced plans to create a national family of clinical data registries for a broad range of orthopedic conditions and procedures.

CMS amends custom diabetic insert coding

The Centers for Medicare and Medicaid Services have amended a recent coding clarification regarding custom-fabricated diabetic shoe inserts, which two specialty organizations had criticized as being unnecessarily strict and a detriment to advanced technology.

Noraxon launches biomech data hub

Scottsdale, AZ-based Noraxon USA, a leader in human movement metrics and biomechanics research solutions, in November introduced the Ultium biomechanics research system.

Foot Science prefab FO reduces injury risk

Contoured prefabricated foot orthoses from Christchurch, New Zealand-based Foot Science International may help reduce the risk of lower extremity injury in naval recruits undergoing basic training, according to research epublished in October by the British Journal of Sports Medicine.

BOC celebrates expanded office space

The Board of Certification/Accreditation (BOC) staff and Board of Directors showcased an expanded new office location in Owings Mills, MD, to business partners and honored guests at a celebratory open house in October.

Bacino is Levy and Rappel sales manager

Saddle Brook, NJ-based Levy and Rappel is once again expanding operations and has hired James Bacino, CPed, as regional sales manager, the company announced in October.

McClain names Langer executive VP

McClain Laboratories, a clinical and research pathology laboratory based in Smithtown, NY, announced in November the appointment of Paul Langer as executive vice president, business development.

Flexion expands mkt for knee OA injectable

Burlington, MA-based Flexion Therapeutics in mid-November announced the full commercial launch of Zilretta (triamcinolone acetonide extended-release injectable suspension), the company’s new therapy for the management of pain associated with osteoarthritis (OA) of the knee.

Claris introduces TKA recovery monitor

Vancouver, Canada-based Claris Healthcare announced in November that it is launching Claris Reflex, a new medical device and patient monitoring system to help orthopedic practices across North America monitor patient recovery after total knee replacement.

GUAES launches gout specialist network

The Pittsburgh, PA-based Gout & Uric Acid Education Society (GUAES) has stepped up to the challenge of helping all patients access faster, better treatment by launching the Gout Specialists Network (GSN), an online physician and medical professional locator and educational resource, the society announced in November.

Navy, Steadman Clinic partner for research

In a benchmark collaboration between two world-class research centers, the Vail, CO-based Steadman Philippon Research Institute/Steadman Clinic and the Naval Medical Research Unit-San Antonio will work together on sophisticated musculoskeletal research, according to a Steadman-Philippon release.

Dr. Scholl’s inserts lower peak VLR

Commercially available insoles from Dr. Scholl’s, a division of Wippany, NJ-based Bayer, are associated with reduced vertical loading rates during running in healthy volunteers, according to a study epublished in October by the Clinical Journal of Sport Medicine.


I-Runner Elite with Velcro

The I-Runner PDAC-approved diabetic shoe family continues to grow. I-Runner proudly introduces its first-ever Velcro closure model, the Elite.Designed by pedorthists, the Elite features a single 1″ strap that sits high on the…

CuraMedix DuoLith SD1 TT

The FDA-approved DuoLith SD1 TT from CuraMedix is the next generation of extracorporeal shock wave therapy (ESWT), with focused CylindricalSource technology, as a nonsurgical treatment for pain associated with chronic proximal plantar fasciitis.

The Funnel Shoe Donning Aid

The FootFunnel from Insightful Products has been re-engineered and rebranded as the Funnel, designed to improve the shoe donning process for those with mobility issues. With a regular shoehorn, the user struggles with coordinating three things at…

Korebalance 3.0 Software

Korebalance, an advanced rehabilitation system for neuro­sensory training and assessment, now features new pre- ­installed software. Version 3.0 includes more and better games to challenge a variety of balance and mTBI (mild traumatic brain injury) issues…

Ease Knee Highs in New Sizes

Therafirm is launching Ease Knee Highs in XL sizes and petite lengths. The Ease line of compression hosiery features construction from ultrastretchy and super soft yarns for comfort and style. Whereas the previous size offerings would accommodate…

Vivobarefoot Ultra III Bloom

Vivobarefoot’s Ultra III Bloom is the industry’s first molded shoe made from algae, with an amphibious, eco-friendly design for adventures on both land and sea. The shoe has been created in collaboration with Bloom, a company that…

Formula Prosthetic Foot

New from Fillauer, the Formula foot is engineered to provide an ideal balance of flexibility and power that is appropriate for a wide range of users due to a posterior mount design. The long, lightweight carbon pylon provides critical energy return through the…

Metatarsal Pad Kits

Tread Labs, a source for semicustom, orthotic insoles, announces the launch of Metatarsal Pad Kits, designed to allow providers to add metatarsal support to any existing Tread Labs insole. Like the company’s the interchangeable insole topcovers, the…

Xelero Matrix One

Now available from Xelero is the Matrix One pedorthic shoe. Designed for walking and light running, the shoe is offered in men’s grey/black mesh and women’s light grey/light blue mesh. The Matrix One features the same technology as…

OPTP io-ball

OPTP is now the official distributer for the io-ball, an inflatable exercise ball with a unique elliptical shape. The compact, lightweight ball can be positioned horizontally or vertically, allowing the user to increase the difficulty of standard movements or…

Corrective Orthotic Station

The Podo USA Corrective Orthotic Station is a fully integrated medically corrective orthotic system that includes plantar pressure analysis and foot and ankle posturology. The system features a 1600-sensor pressure platform, a high-resolution camera…

La Pointique Heel Strap

La Pointique Int’l now offers the new Heel Strap and LP compression socks. The Heel Strap is designed to provide support to the ligaments of the heel and ankle in athletes to improve stability during jumps and shifting movements.