September 2017

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Cover Story

Running shoes and injury risk: Rethinking the importance of cushioning and pronation

In spite of advancements in research and subsequent modifications to running footwear design, rates of running-related injuries have not decreased. That may be because researchers and designers have been focusing on the wrong variables.

By Joseph Hamill, PhD, and Gillian Weir, PhD

Editor Message

Out on a limb: Of opioids and outcomes

Recent efforts to reduce utilization of opioid pain medications for lower extremity joint injuries and surgical rehabilitation have mostly focused on reducing the risk of addiction. But there’s another important reason to be concerned about the use of opioids in these patients—and other popular pain medications as well.

By Jordana Bieze Foster, Editor


Hemophilia, ankle pain, and orthotic management

The ankle is a frequent site of arthropathy  in patients with hemophilia, but orthotic devices and orthopedic shoes can help relieve this pain. New research suggests that…

By David Oleson, PT, PCS; Katherine Stribling, PT, DPT, PCS; Jamie Beckwith, PT, DPT; Laura Fox, PT, DPT, PCS; Felicity Case, PT, DPT, PCS; Nancy Durben, MSPT, PCS; and Michael Recht, MD, PhD     

Soft braces: Experts hunt for potential mechanisms

Soft braces are not designed to change lower extremity alignment or joint forces, but research suggests they may influence knee and ankle biomechanics in other ways, including by enhancing proprioception. This line of investigation could open the door to new therapeutic opportunities.

By Stephanie Kramer

SEBT scores and injury risk in collegiate athletes

Anterior-direction Star Excursion Balance Test performance may most appropriately discriminate between collegiate athletes who are and are not at risk for lower extremity injury, though…

By Mikel R. Stiffler-Joachim, MS; David R. Bell, ATC, PhD; and Bryan C. Heiderscheit, PT, PhD

Surgery and ulcer healing in patients with equinus

Achilles tendon lengthening and gastrocnemius recession both increase ankle joint dorsiflexion and reduce plantar forefoot pressures in patients with diabetes and equinus deformity, but experts continue to debate which is best for managing forefoot ulcers and minimizing reulceration.

By Barbara Boughton


In the Moment: Sports Medicine

Achilles prophecy: Early heel rise linked to later outcomes

Single-leg standing heel-rise test performance one year after Achilles tendon rupture is associated with the long-term recovery of ankle biomechanics, according to research from Gothenburg, Sweden. The findings may have implications for rehab­ilitation after Achilles injury, particularly with regard to relatively demanding activities such as jumping.

By Katie Bell

Online education helps reduce injuries in trail runners despite poor compliance

An online program designed to educate trail runners about injury prevention is associated with a significant decrease in running-related injury rate, even if runners don’t significantly change their preventive behaviors, according to research from the Netherlands.

By Jordana Bieze Foster

Navicular injury in college football players slashes odds of NFL success

National Football League (NFL) prospects with a history of navicular injury are significantly less likely to be successful at the professional level than those without such an injury history, according to research that underscores the importance of restoring gait and function after a navicular stress injury in athletes.

By Jordana Bieze Foster

In the Moment: Knee OA

OA accelerants: 4 factors help hasten disease progression

Age and body mass index (BMI)—as well as their interactions with glucose concentration and static femorotibial alignment—contribute to increased risk of accelerated knee osteoarthritis (OA), according to research from Tufts University School of Medicine in Boston that could have implications for early diagnosis and intervention in this population.

By Chris Klingenberg

Study suggests strawberry consumption can benefit obese adults with knee OA

The old adage about an apple a day keeping the doctor away may need to be expanded to include other fruits, in light of new findings that a high level of daily strawberry consumption can relieve pain and reduce markers of disease progression in obese adults with knee osteoarthritis (OA).

By Jordana Bieze Foster

Intraarticular NSAIDs and opioid meds may contribute to cartilage cell death

Treating lower extremity joint pain with intraarticular non­steroidal anti-inflammatory drugs (NSAIDs) and opioid medications may contribute to cartilage cell death, which could accelerate the progression of osteo­arthritis, according to an in vitro study from Stanford University in California.

By Jordana Bieze Foster

Market Mechanics

By Emily Delzell

Lower extremity orgs help hurricane victims

Lower extremity organizations and business stepped up to donate resources and funds to victims of September’s devastating hurricanes, Harvey and Irma. Rockford, MI-based Wolverine Worldwide partnered with the American Red Cross…

G&W Heel Lift celebrates half century

Family owned G&W Heel Lift in August celebrated 50 years of supplying custom heel and foot lifts to its customers. Based in Cuba, MO, the company’s signature product is its cork heel lift, designed to address complications from issues such as altered gait, Achilles tendinitis, and Achilles tendon repair.

Diabetes Council issues shoe guideline

The Diabetes Council, an educational website for people with type 2 diabetes run by healthcare professionals, in August published a guide to buying therapeutic shoes for people with diabetes.

AAOS offers Pain Awareness Month tips

The Rosemont, IL-based American Academy of Orthopaedic Surgeons (AAOS) is marking September as Pain Awareness Month by offering comprehensive tips for safe and effective pain relief and safe disposal of prescription pain medications to help minimize opioid use and misuse.

Amgen drug beats osteoporosis standard

The New England Journal of Medicine on September 11 epublished the results of a trial of more than 4000 postmeno­pausal women with osteoporosis and a previous fragility fracture, in which a monoclonal antibody made by Thousand Oaks, CA-based Amgen outperformed a commonly used and effective osteoporosis medication in preventing new fractures.

Dr. Comfort prototype improves balance

BMC Geriatrics on September 11 epublished a study examining the effects of prototype footwear made by Mequon, WI-based Dr. Comfort used with textured insoles on balance in older women.

Rand study backs advanced device use

The Santa Monica, CA-based nonprofit Rand Health in September epublished a study showing advanced prostheses used by transfemoral amputees produce significant improvements in physical function and significant reductions in the incidence of falls and…

NBA, GE give bone injury grants to HSS

The National Basketball Association (NBA) and GE Healthcare Orthopedics and Sports Medicine Collaboration announced in September they were awarding almost $400,000 for the study of bone stress injuries to two research teams at the Hospital for Special Surgery (HSS) in Manhattan.

AOPA awards Zahedi, others at congress

The Alexandria, VA-based American Orthotic and Prosthetic Association (AOPA) honored Saeed Zahedi, OBE, FREng, BSc, PhD, FIMechE, CEng, RDI, with its Lifetime Achievement Award at its September World Congress in Las Vegas.

HP, Superfeet pilot 3D retail platform

Palo Alto, CA-based Hewlett Packard (HP) in September announced Ferndale, WA-based Superfeet is piloting in select stores its new retail foot scanning platform that performs dynamic gait analysis of customers’ feet with a combination of 3D scanning and pressure plate technology

Ottobock develops pediatric knee joint

Austin, TX-based Ottobock HealthCare in September reported it has developed the first everyday prosthesis with hydraulic swing phase control specifically for children.


Unloader One Lite Brace

Össur has launched its Unloader One Lite Brace, for patients suffering from mild to moderate knee pain associated with osteoarthritis and degenerative meniscal tears. The Unloader One Lite is based on the technology behind the original Unloader brace, including the 3-Points of…

ProtecTozz Cleat Guard

New to the market is the ProtecTozz Cleat Guard, developed and field-tested over five years by Mark Tozzi, DPM, and his son Michael Tozzi, former captain of the John Carroll University football team in University Heights, OH. Made of polycarbonate material, the ProtecTozz is lightweight (1.5 oz) and…

Dr. Comfort Cara Chukka

New from Dr. Comfort, the women’s Cara chukka boot features a roomy, protective toe box to help prevent skin irritation and toe stubbing. With a firm heel counter, this stylish lace-up ankle bootie provides extra medial and lateral support and stability.

OPTP Joint Distractor

OPTP has introduced a new product for use as an adjunct to manual therapy methods: the OPTP Joint Distractor. The product’s hook-and-loop strap design fastens a patient’s ankle securely in place, allowing for complete isodynamic joint distraction for the lower extremities.

Silhouette Wound Imaging

Aranz Medical has announced the availability of Silhouette version 3.19, a camera and software package for lower extremity wound imaging, 3D measure­ment, and documentation. The three-part Silhouette package includes SilhouetteStar…

Fillauer AllPro Foot

The AllPro prosthetic foot from Fillauer crosses all boundaries, combining high flexibility and dynamic performance to allow the user to work and play like a pro. This “do-it-all” foot easily transitions from the gym to tennis and basketball courts, as…

Pediatric Triple Action Joint

Developed by Becker Orthopedic, the Pediatric Triple Action Ankle Joint is designed to provide control of the lower limb through all phases of gait. This advanced orthotic ankle joint is engineered to keep pace with active patients…

TayCo Ankle Brace

The TayCo ankle brace is an external, over-the-shoe ankle foot orthosis for adults and teens. Developed by a University of Notre Dame team physician and trainer, it is an easy-to-use alternative to walking boots or in-shoe AFOs.

Maverick Fiberglass Feet

Freedom Innovations has released the complete portfolio of its Maverick fiberglass prosthetic feet, showcasing the durability and flexibility of fiberglass. These include the Maverick Xtreme and Xtreme AT feet for use in extreme activities, such as…

Venodol Analgesic

Caretta Therapeutics is intro­ducing Venodol, a nonaddictive alternative to opioid and steroi­dal analgesics for patients with moderate to severe chronic pain associated with inflammation.

Feetz 3D-Printed Shoes

Feetz is a shoe company that leverages advanced technology to produce a full 3D-printed, wearable shoe using a customized app. Clients can customize the color and arch support on any available Feetz styles.