September 2012

Cover Story

Triple threat: The female athlete triad and injury risk

The Triad’s new definition specifies low energy availability, menstrual irregularity, and low bone mineral density as predictors of future health risks, including lower extremity injuries. This broader definition means far more female athletes may be at risk than previously thought, particularly in the high school setting.

By Jill Thein-Nissenbaum, PT, DSc, SCS, ATC

Editor Message

Out on a limb: Surviving the Triad

I set foot in a gym this summer for the first time in 14 years. I was nervous, but not for the reasons you might think. I wasn’t worried about not knowing how to use the equipment, or being less fit than other members, or the possibility of running into someone I knew.

Jordana Bieze Foster, Editor


Patient Perspective: Communication takes edge off pain of recovery

When I first entered my podiatrist’s office for treatment of a moderately painful case of plantar fasciitis, I never thought that healthcare for my feet could get complicated. I subsequently developed sesamoiditis and my podiatrist prescribed custom orthotics for both my foot conditions. But then came the clincher: one night, I fell down a short flight of stairs and unfortunately landed on my foot.

By Barbara Boughton

Rethinking device design to improve compliance

Reducing the shaft height of a removable cast walker, which results in a lighter device and may also help improve postural stability, can help improve compliance in patients at risk for diabetic foot ulcers without compromising the device’s offloading capability.

By Sai Vikas Yalla, PhD, and Ryan T. Crews, MS, CCRP

Effects of minimalist shoes on running gait

Research suggests that when transitioning to a minimalist running shoe, foot strike pat­tern is key to preventing lower extrem­ity injuries. A transitional minimalist shoe, with slightly thicker and softer soles, may help prevent certain injuries in some runners.

By Everett B. Lohman III, DSc, PT, OCS

Knee OA interventions: A look at value for money

Even if an intervention results in a positive clinical outcome in patients with knee oste­o­­arthritis, another important factor to consider is whether that treatment’s benefits justify its costs. Increasingly, cost effectiveness studies are comparing OA interventions to determine value.

By Daniel Pinto, PT, PhD

Clinical assessment of ankle joint laxity

Ankle joint laxity can be a complicating factor in patients with acute ankle sprains or chronic instability, and testing for excessive laxity can help practitioners choose an appropriate method of treatment. However, not all tests for ankle joint laxity are created equal.

By Theodore Croy, PhD, PT, OCS, and Jay Hertel, PhD, ATC, FNATA


In the Moment: Sports medicine

By Emily Delzell and Jordana Bieze Foster

Lost in transition: Minimalist shoes don’t always alter gait

Barefoot-simulating and minimalist shoes are capturing the imagination of runners who hope to avoid injury and increase performance by adopting a forefoot or midfoot strike pattern, but recent research suggests runners don’t necessarily convert their gait simply by switching shoes.

Lower extremity work contributes to golf swing velocity, performance

Lower extremity work during a golf swing is positively correlated with both club head velocity and golfer skill level, according to research from the Ohio State University in Columbus, OH.

Soccer study explores factors that may link limb dominance to ACL injury risk

Kinematic and kinetic differences between dominant and nondominant limbs during cutting in soccer players could help explain previous findings regarding limb dominance and anterior cruciate ligament (ACL) injury risk, according to research from Ball State University in Muncie, IN.

In the Moment: Retraining

By Jordana Bieze Foster

Ambling modifiers: Finding a patient-friendly gait for knee OA

In the interest of improving compliance, studies of gait modifications to reduce moments and forces at the knee in patients with knee osteoarthritis (OA) are increasingly focusing on gait alterations that will not make patients self-conscious.

Kinetic biofeedback training reduces knee abduction moment on landing

Real-time biofeedback training can help female athletes reduce knee abduction moments (KAM) during landing, which may in turn reduce risk of anterior cruciate ligament injury, according to preliminary research from Cincinnati Children’s Hospital.

Multimodal adaptive rehab improves propulsive impulse in stroke patients

Gait training on a dual-belt treadmill in an adaptive virtual environment can help improve propulsive impulse in the paretic limbs of individuals with hemiparesis following stroke, according to research from the University of North Carolina at Chapel Hill.

Market Mechanics

Wound care market sees slow growth, NPWT and biologics are strong areas
A new study by market analysis company Espicom, headquartered in Chichester, UK, suggests advanced wound care products are not reaching their potential value or audience and that their use is constrained by tightened healthcare spending and slow clinical adoption, particularly ...
Foot and ankle group names new VP, receives funds for educational mission
The American College of Foot and Ankle Pediatrics (ACFAP) appointed Louis J. DeCaro, DPM, West Hatfield, MA, vice president at the American Podiatric Medical Association’s (APMA) national convention, held last month in Washington DC. Decaro, who is medical director and co-owner ...
Register for “Innovative to the Bone”
On October 29 and 30 the Cleveland Clinic will hold its 10th annual Medical Innovation Summit, which this year focuses on advances in orthopedic technology, including those in concussion detection, joint replacement, and regenerative medicine. More than 1000 executives, investors, entrepreneurs, ...
Ski country hosts bootfitting courses
Jackson Hole Boot Camp, based in Jackson Hole, WY, is a fitting and medical education program that blends pedorthics and sports medicine to help medical professionals and gear industry employees learn biomechanics and advanced ski boot fitting skills for sports ...
PFA plans for Little Rock symposium
The Pedorthic Footcare Association will hold its 53rd annual symposium November 1-3 in Little Rock, AR. Symposium guests can earn continuing education credits while checking out more than 100 exhibitors between educational sessions covering topics from wound care to running ...
Össur Americas partners with OPIE
Gainesville, FL-based OPIE Software announced in September that Össur Americas, based in Foothill Ranch, CA, has agreed to be an integrated supplier within the OPIE Software system and on the website The integration will allow OPIE Software users and ...
German group grows compression division
Bayreuth, Germany-based medi, a medical device company that produces a variety of products, has bought San Diego-based CircAid to expand its compression therapy division. CircAid specializes in compression garments for treatment of lymphedema, venous disease, and other edema-related disorders while medi ...
Symposium highlights Ponseti method
The University of Iowa in Iowa City will host the Ponseti International Association’s 2012 International Clubfoot Symposium, which focuses on approaches, treatment, and outcomes of the Ponseti method and promotes community building among healthcare providers involved in the treatment of ...
ComfortFit offers flat-rate repair prices
Roselle, NJ-based ComfortFit Labs new single flat-rate repair price of $30 includes repair and refurbishing of foot orthoses made by any lab with all work guaranteed for six months. Repair services include new top and bottom covers, new posting, arch fill, ...
Levy & Rappel launches new website
Saddle Brook, NJ-based Levy & Rappel’s new website went live the first week of September. Its new features include an easily navigable design, a section on the use of its foam impression product, LevyFoam, and a mechanism for submitting e-mail ...
ABC creates new accreditation program
The American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC) has developed the first comprehensive accreditation program for central fabrication facilities in the orthotic, prosthetic, and pedorthic professions. The new program will follow the same model as ABC’s current accreditation ...
Dralla announces awards for 2012
The Rockaway, NJ-based Dralla Foundation in August awarded its third round of grants to nonprofits that share the foundation’s mission of supporting the aspirations of children and adults with disabilities. Dralla will provide $35,000 in funds to 23 US organizations to ...
ACL workshop scheduled for November
The Sports Medicine Biodynamics Center at Cincinnati Children’s Hospital and The Ohio State University Sports Medicine program are scheduled to hold their 10th annual workshop on prevention, training, and rehabilitation for athletes at risk for anterior cruciate ligament injuries on ...
University adds advanced biomech lab
High Point University in NC is creating an advanced biomechanics and human physiology/ performance lab. The 13,150 square-foot lab is under construction and will facilitate study of injury prevention and rehabilitation methods as well as methods to improve human physiologic ...
Medical device conference seeks papers
University of Minnesota organizers of the Design of Medical Devices Conference, scheduled for April 9-11, 2013, in Minneapolis, are seeking original two-page papers that demonstrate new technologies and applications in medical device design from academic and industry researchers, clinicians, and ...


Pediatric Walkers
Otto Bock offers the Yogi Anterior Walker and Walk Star Posterior Walker pediatric mobility products. The light, functional Yogi features caster swivel locks and a friction brake for gait stability and extra-low hand grips for young children, while its two ...
Lower Limb Ultrasound DVD
Primal Pictures introduces a new DVD-ROM, “3D Anatomy for MSK Ultrasound: Lower Limb,” a training or reference tool for practitioners who use ultrasound to diagnose and treat conditions of the hip, knee and foot. Detailed, interactive 3D anatomical images are ...
Corganics Shave Gel
Corganics offers Smooth Shave Gel, which can be used to shave patients’ lower extremities prior to medical procedures. The therapeutic formula includes essential oils, vitamins, antioxidants, and aloe vera. Appropriate for any skin type, including sensitive skin, the shave gel ...
Dr Jack’s Skin Cream
Active Feet offers Dr. Jack’s Extra Strength Skin Care Crème for use on dry and cracked skin, including feet, heels, and knees. The cream is both a keratolytic and an emollient, engineered with ingredients that are similar to the natural ...
Alignment Socks
My-Happy Feet offers Foot Alignment Socks, featuring dividers that separate the toes to improve alignment and help relieve foot pain. Designed to be worn while sleeping, the socks stretch the foot muscles, spread the metatarsals, and encourage circulation. Initially the ...
OA Nano Knee Brace
DJO Global has launched the OA Nano, the company’s lightest off-loading knee brace, for patients with mild-to-moderate osteoarthritis. Sold under the DonJoy brand, the 14.2-oz brace is manufactured using nanoMag, a metal as light as magnesium with the strength of ...
ArtAssist Compression
The ArtAssist, a home-use device for treating peripheral arterial disease (PAD), applies intermittent pneumatic compression to the foot, ankle, and calf. The compression regimen is designed to simulate the vascular benefits of brisk walking, but without pain. The arterial pump ...
Intelligent Ice Cold Therapy
Intelligent Ice is a temperature controlled cooling solution from Intelligent Inventions. Intelligent Ice can be used for up to four hours at a safe temperature of 7°-8° C to minimize tissue and nerve damage. Each reusable, solution-filled pad comes with ...
Black Tamarack Flexure Joint
With the recent growth in the use of black thermoplastic and carbon fiber materials for ankle foot orthoses (AFOs), Becker Orthopedic offers a new matching thermoformable joint option: the Black Tamarack Flexure Joint. Tamarack Flexure Joints self co-align the medial ...
Travel Size Roller Massager
Pro-Tec Athletics offers the new Pro-Tec Travel Size Roller Massager with Trigger Point Release Grips, the newest addition to the company’s full line of sports medicine products. The travel size roller massager is designed to reduce muscle tightness, soreness, and ...
Total Support Thin and Max
Building on the success of its original Total Support insoles, Spenco Medical Corporation now debuts the Total Support Thin and Total Support Max insoles. The insoles are designed to provide advanced support for the heel and arch, combined with increased ...
Ultra Zoom in White
Understated and high performing, the Ultra Zoom ankle brace is now available in white. At the request of customers, Breg is offering this popular brace in a color that won’t stand out when worn with team uniforms—just in time for ...