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
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. What I feared was that the need to exercise would take over my life. Again.
Jordana Bieze Foster, Editor
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
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
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
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
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
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 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.
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
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.
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.
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.
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 in Asia.
The report, “The Global Advanced Wound Care Market to 2017,” noted that while the international market saw double-digit growth before 2008, the market has slowed more recently, with growth affected by intense competition.
The market is also seeing declines in reimbursement levels as governments reign in healthcare expenditures. According to the report, negative pressure wound therapy is the most valuable sector, with expanding applications for the technology in surgery and other areas and new markets opening in Japan, China, and India, where clinical adoption has been slow. Biologics is another hot area, and novel products such as skin substitutes, growth factors, cell-based therapies, and collagen-based wound care therapies make this ...
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 of Middlebury, CT-based Nolaro24, told LER the office of vice president had gone unfilled for a number of years and his role will be to help ACFAP President Ron Raducanu, DPM, continue to build the organization through its educational activities.
He also noted, “There is a plan for succession too. If everything goes to plan I will take over as president of ACFAP at APMA 2014 in Hawaii.”
ACFAP got some additional help with their educational mission at the 2012 APMA meeting when George Cioe, president and CEO of the Eaton Rapids, MI-based Tetra Corporation, presented the organization with a $5000 unrestricted educational grant.
At the meeting DeCaro commented, “I am honored to ...
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, and clinicians are expected to gather for the meeting, which will be capped by a “Top 10 Innovations” presentation, advances summit experts believe will have a breakthrough impact on healthcare in 2013. Attendees will also hear from athletes who’ve undergone innovative orthopedic procedures to return to competition.
The summit will be held on the Cleveland Clinic’s main campus. For more information or registration, go to www.clevelandclinic.org/innovations/summit.
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 that require a rigid stance. Attendees can earn 16.25 continuing education units at the camp, scheduled for December 6-8. For more information, go to http://jhbootcamp.blogspot.com.
MasterFit University is offering six courses on biomechanics and alignment, orthotic device fabrication, and boot fit modification techniques. The courses are in locations that range from Mt Snow, VT (September 27-28) to Kitzbühel, Austria (October 4-5). Attendees can earn up to 14 continuing education credits.
For registration or more information, go to www.masterfituniversity.com.
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 a successful pedorthic practice. For more information or register, go to www.pedorthics.org and click on the button for the symposium.
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 oandp.com. The integration will allow OPIE Software users and website visitors to view Össur’s digital prosthetics catalog, configure product orders based on specific patient parameters, and place electronic orders for Össur’s prosthetic products. To access these functions you’ll need to register with oandp.com; go to www.oandp.com and click on the “Shop” button to register for free.
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 produces more than 320 products for conditions related to venous disease, lymphedema, musculoskeletal injury, rehabilitation, and lower extremity amputation.
CircAid’s manufacturing and logistical operations will remain in San Diego and medi will incorporate its sales and marketing activities into its US headquarters in North Carolina.
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 children with clubfoot.
A preconference workshop on October 3 that includes an overview of clubfoot treatment and a patient casting session will kick off the main event, which takes places October 4-5.
Physicians can earn up to 10 AMA PRA Category 1 Credits. Register online at www.continuetolearn.uiowa.edu/UIConferences.
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, poron extensions, poron padding, and replacement of most standard accommodations.
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 questions that are answered by a certified practitioner. Visit the revamped site at www.levyandrappel.com.
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 programs, with an onsite survey and re-accreditation every three years. Central fabrication facilities will be measured against 60 standards that correlate with best business practices and process improvement.
ABC reported the new accreditation program will begin accepting applications January 1, 2013, and more details will
be upcoming on its website, www.abcop.org.
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 support a variety of programs and individuals, including sports events that encourage physically challenged individuals to try new activities, a team competing in the National Junior Disability Championships, and sailing instruction.
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 November 10 at Cincinnati Children’s.
Workshop instruction will include the use of 3D motion analysis to teach athlete screening techniques and neuromuscular training methods that focus on proper core and knee control and landing techniques. The day-long course is approved for eight continuing education units. To register, go to www.regonline.com/aclworkshop.
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 response to activity and overall physical performance. Kevin Ford, PhD, associate professor of physical therapy, is lab director. In the future, the university reported, the lab will be used to help develop physical therapy and physician assistant graduate programs.
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 practitioners.
The Journal of Medical Devices will publish all accepted papers as two-page technical briefs. Conference registration and participation in the conference poster session is required for publication.
Preliminary papers have a tentative due date of October 24. For more information go to the conference website at www.dmd.umn.edu. Author instructions can be found in the “Call for Papers” section.
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 sizes, adjustability, and accessories help it fit a range of needs. The Walk Star is a folding gait trainer that comes in five sizes and three colors and fits kids as young as two years old. Telescoping frame tubes allow the Walk Star to grow with the child. Its swivel front wheels allow for quick turns, while locked front wheels make the system more stable.
Otto Bock USA
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 linked to corresponding ultrasound scans for specific transducer positions to provide a practical guide and daily reference for interpretation and orientation. More than 50 clinical topics are covered, including bursitis, tendon tears and ruptures, muscle tears, fractures, cysts, and many more commonly presenting conditions and injuries of the lower limb.
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 facilitates a clean, close shave and reduces skin irritation, razor burn, ingrown hairs, and minor nicks. Because it can be used without water, Smooth Shave Gel is convenient and quick to use in treatment rooms. It can also be used as a soothing skin balm. Available in an 8-g trial size, a 4-oz tube (single or case of 12), and 16-oz pump.
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 moisturizers and antioxidants present in healthy, young skin. Urea penetrates the skin to attract, absorb, and hold moisture. Alpha hydroxy and malic acids remove the dead skin. Pure silk protein (amino acid) improves skin tone and luster. The cream is most effective when used immediately after bathing. It is fragrance free, latex free, and dye free. Available in 5-oz jars.
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 socks are worn with the dividers at the tips of the toes for 15 to 20 minutes per day. The dividers are gradually moved down between the toes and worn for longer periods of time, so that within weeks the socks can be worn overnight. The socks are available in a variety of colors, at a cost of $19.95 for one pair or $16.95 per pair for three or more pairs.
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 aircraft-grade aluminum. The OA Nano incorporates DonJoy Adjuster off-loading technology to decrease pressure on the affected areas of the knee, allowing patients to enjoy physical activities with less pain and more stability. The malleable magnesium frame allows for cuff adjustments for a better fit, which is a key factor in improving compliance.
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 technology increases distal blood flow mechanically and by promoting arteriogenesis, the opening of collateral vessels that bypass obstructed arteries. The device is intended for patients with PAD, ischemic diabetic foot ulcers, arterial ulcers, intermittent claudication, or rest pain. Typical usage is three hours per day for at least three months.
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 a protective pocket equipped with straps to attach the pad to affected anatomical areas; extension straps can help accommodate large patients or hard-to-wrap areas. Refreezing time is only 1.5 hours. Applications include relief of swelling, inflammation, bruising, and discomfort associated with athletic injuries or medical procedures. Available in small or large sizes.
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 and lateral joint axes. The unique high strength inner filament core prevents elongation and ensures precise hinging action. The joints provide the motion assist power of metal joints but without the disadvantages of coil springs. Available in three sizes, three durometers, and in Free Motion Assist or Dorsiflexion Assist models.
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 pain. Features include raised Vynafoam sections that sink into soft tissues to roll out tightness and rounded grip ends to provide precision trigger-point release. At 17.5” long, the travel size roller fits in most carry-on bags. Each unit comes with a full-color instruction manual covering 20 massage and trigger point release exercises and techniques.
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 shock absorption and motion control, for athletes at all levels. The Total Support Thin is designed for athletes who need semi-flexible arch support and stability in a low-profile insole. The Total Support Max, for athletes who need maximum stability and support, features the company’s most supportive and rigid arch. All three insoles retail for $36.99 per pair.
Spenco Medical Corporation
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 volleyball, girls’ basketball, soccer, and football season. On the field or on the court, the Ultra Zoom is designed to help prevent ankle injuries. Performathane technology enables the brace to form to the ankle for a comfortable, low-profile fit. Available in white or black, the Ultra Zoom comes in two sizes with universal left/right design to keep inventory low. Suggested HCPCS code: L1902.