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April 2014

Cleat Smarts: Foot posture and injury risk in pitchers

Injuries in baseball are fairly common, with an incidence of 5.8 injuries per 1000 athletic game exposures and 1.9 injuries per 1000 athletic practice exposures in the collegiate ranks.

By Luis A. Feigenbaum, PT, DPT, SCS, ATC, LAT, CSCS; Kathryn E. Roach, PT, PhD; Chris Vitolo PT, DPT; Victoria Bown, PT, DPT; Sabine Gempel, PT, DPT; Natalia Sikaczowski, PT, DPT; Kelly Stapf, PT, DPT; and Michelle Whitaker, PT, DPT Continue reading

April 2014

Patient Perspective: Taking an alternative path to chronic foot pain relief

After a year in a fracture boot with a broken foot, I thought my ordeal was over. I was wrong. The broken bone in my foot, sustained after a fall down a staircase in my home, had occurred midway down the fifth metatarsal bone below my little toe—a site that is notoriously difficult to heal, according to my podiatrist.

By Barbara Boughton Continue reading

April 2014

Cyclists and foot orthoses: A unique set of challenges

Finding the right orthotic design starts with the space limitations presented by cycling shoes, but the challenges for lower extremity practitioners don’t end there. Factors to consider when prescribing foot orthoses include biomechanics, skill level, cycling discipline, and bike technology.

By P.K. Daniel

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April 2014

Foam rolling: Early study findings suggest benefits

Foam rolling is a relatively new therapeutic approach, but early research suggests that it can help improve range of motion and muscle performance and aid in recovery after exercise. Questions remain, however, about the extent to which the effects involve myofascial mechanisms.

By Duane C. Button, PhD, CSEP-CEP, and David G. Behm, PhD

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April 2014

Foot and ankle strategies for patients at risk for falls

As a result of limitations in the fall prevention research to date, investigators and
clinicians are often left to make their best guesses about the effect of foot and ankle interventions based on the effect such strategies have on issues related to falls, rather than on falls themselves.

By Cary Groner

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April 2014

Vitamin D and knee OA: Many theories, few answers

Several patient populations with an increased risk of knee osteoarthritis also are at increased risk for vitamin D deficiency, and research suggests vitamin D levels may be related to knee OA symptoms. The exact nature of the relationship, however, remains perplexing.

By Greg Gargiulo Continue reading

March 2014

Ankle sprain prevention in basketball: Why some high schools are opting out

Despite published evidence that bracing and targeted exercises can prevent ankle injuries in high school basketball players, surprisingly few teams have adopted these practices. Barriers to implementation include a lack of awareness and expertise as well as time and money.

By P.K. Daniel

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March 2014

Active Stance: Developing the sustainable knee in an age of early TKA

To sustain is to endure. Knee osteoarthritis (OA) is a considerable worldwide health concern, as it greatly impacts an individual’s quality of life, general health, and societal role participation.

By John Nyland, DPT, SCS, EdD, ATC, CSCS, FACSM, David N.M. Caborn, MD, and Roland Jakob, MD

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March 2014

Functional tests to predict lower extremity injury risk

Adding four functional tests to the preparticipation physical evaluations performed in student athletes may allow clinicians to identify individuals at risk for lower extremity musculoskeletal injury and implement preventive interventions to maximize safe­ty in sports participation.

By Alexis Meister, BS, ATC; Dustin Grooms, MEd, ATC, CSCS; Cambrie Starkel, MS; and James Onate, PhD, ATC, FNATA

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March 2014

Bariatric surgery: Effects on patient gait and function

Existing data suggest bariatric surgery-induced weight loss can lead to rapid improvements in gait and physical function. The surgery may also help to address factors associated with knee osteoarthritis, which itself can affect mobility and function in obese patients.

By Andrew W. Froehle, PhD, Neal Dollin, MS, Richard T. Laughlin, MD, Donovan D. Teel II, MD, Richard J. Sherwood, PhD, and Dana L. Duren, PhD

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March 2014

Influence of stride length on mechanics of pitching

Because power in baseball pitchers is generated from the feet through the core to the throwing arm, the study of stride length and its impact on pitching performance may help define an optimum technique that better protects pitchers from upper extremity injuries.

By Ryan L. Crotin, PhD, and Dan K. Ramsey, PhD

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March 2014

The ideal running shoe: An elusive, evolving concept

The body of research that has evaluated running shoe prescription and injury suggests the most important factors to consider when selecting a running shoe are that it fits the foot perfectly and that the midsole is comfortable and appropriate for the individual athlete’s running style.

By Thomas C. Michaud, DC

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February 2014

TKA in obese patients: Weighing the risks vs the benefits

Total knee arthroplasty significantly improves functional outcomes in obese patients, but is also riskier than in normal-weight patients. As the number of obese patients with knee osteoarthritis continues to rise, clinicians are being challenged to find a balance between the risks and the benefits.

By Susan M. Odum, PhD, and Bryan D. Springer, MD

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February 2014

Charcot-Marie-Tooth: AFO mechanics and gait patterns

Patients with Charcot-Marie-Tooth disease showing the greatest increase in speed appear to respond to and utilize the energy storing and releasing properties of a carbon fiber composite ankle foot orthosis differently from those who had smaller increases in walking speed.

By Janet S. Dufek, PhD; Edward S. Neumann, PhD, PE, CP; M. Cameron Hawkins, PhD; and Brendan J. O’Toole, PhD

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February 2014

Exploring treatment options for intermittent claudication

Despite the documented benefits of supervised exercise in patients with claudication, its effect on actual clinical practice has been disappointing due to a lack of reimbursement. But practitioners and research­ers have been investigating other options, with encouraging preliminary results.

By Cary Groner

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February 2014

The brain: A new frontier in ankle instability research

Transcranial magnetic stimulation research suggests cortical excitability may be able to help differentiate healthy, previously injured, and functionally unstable ankle joints, and underscores the need to clinically target both mechanical and proprioceptive deficits in patients with FAI.

By Alan R. Needle, PhD

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February 2014

Variable amputation rates in patients with diabetes

Studies show that lower extremity amputation rates in patients with diabetes vary widely, sometimes even within individual healthcare systems. What’s more difficult to determine is why these variations exist and what can be done to improve access to care for all patients.

By Larry Hand

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February 2014

Epidemiology of Achilles tendon rupture in the US

The etiology of Achilles tendon rupture is multifactorial, but the injury occurs most frequently in the athletic population. Clini­cians still miss 24% of ruptures acutely, particularly in older patients, those in whom sports was not the causative mechanism, and those with high BMIs.

By Steven M. Raikin, MD

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January 2014

Foot Orthoses: A distal twist on low back pain management

Increasing numbers of patients are finding relief from chronic low back pain with the use of foot orthoses, but the mechanism underlying the positive outcomes is largely unknown.

By Larry Hand

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January 2014

Knee injury prevention: Hip and ankle strategies

Many knee injury prevention programs do not focus on ankle dorsiflexion range of motion and hip adductor activation, but research suggests both distal and proximal variables contribute to alterations in frontal plane knee biomechanics and could affect injury risk.

By Darin A. Padua, PhD, ATC, and Micheal A. Clark, DPT, MS, PES, CES   

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January 2014

Nerve decompression and diabetic neuropathy

Advocates of surgical nerve decompression in a subset of patients with diabetic neuropathy have published some impressive outcomes, but critics of the procedure point to the conspicuous absence of randomized trials. The issue has become one of the most contentious in diabetes care.

By Cary Groner

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January 2014

Painful hip impingement: Functional implications

Physical impairments associated with femoroacetabular impingement include limited range of motion, muscle weakness, and altered biomechanics. Attention to these areas during rehabilitation can improve surgical outcomes and may even reduce the risk of osteoarthritis.

By Jerrad R. Guenther, BSc, Michael K. Gilbart MD, FRCS(C), MEd, and Michael A. Hunt PT, PhD

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January 2014

Achilles tendinopathy and body mass index

Research suggests that obesity influences the development of Achilles tendi­no­pathy to a greater degree than other types of foot and ankle pain. This phenomenon will become increasingly important to lower extremity practitioners as global obesity rates continue to rise.

By Ryan T. Scott, DPM, AACFAS, and Christopher F. Hyer, DPM, MS, FACFAS

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January 2014

A proximal perspective on patellofemoral pain

Hip strengthening can improve short-term outcomes related to patel­lo­­femoral pain syndrome, but further research is needed to determine the underlying mechanism and whether the same approach will also prove effective in managing patello­femoral osteoarthritis.

By Michael B. Pohl, PhD

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November 2013

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   

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