Nonsurgical Approach in Management of Tibialis Posterior Tendinopathy With Combined Radial Shockwave and Foot Core Exercises: A Case Series.

Tibialis posterior tendinopathy is a common debilitating condition seen by foot and ankle providers. Non-operative management is difficult as patients often present in later stages of the disease. This case series evaluated the combination of radial shockwave therapy and a foot core progression exercise regimen on 10 patients who had failed standard conservative treatment techniques. Median follow-up time was 4 months. Clinically important differences in the Foot and Ankle Ability Measure were met in 9 (90%) and 8 (80%) of patients for activities of daily living and sport sub-scores, respectively. No adverse effects were observed.

Efficacy of Extracorporeal Pulse-Activated Therapy in the Management of Lower-Extremity Running-Related Injuries: Findings From a Large Case Cohort.

Running is one of the most popular sports worldwide, with many health benefits. Injuries are also common, with running-related injuries reported in up to 79% of runners annually. Extracorporeal shockwave treatment can be used to treat soft tissue conditions, with the strongest level of evidence for management of plantar fasciitis. However, most studies have focused on nonathletes or studied a single condition, and few investigations have reported outcomes for extracorporeal pulse-activated therapy. In this case series, we evaluated the outcomes of 94 runners receiving extracorporeal pulse-activated therapy for lower-extremity running-related injuries, including plantar fasciitis and lower-extremity tendinopathy (Achilles, posterior tibialis, patellar, hamstring). We hypothesized that most runners with foot and ankle injuries would respond favorably to treatment and that success rates would be similar across conditions. Overall, 74 runners (79%) met their respective minimal clinically important difference for functional outcome measures, with no differences in response by age, sex, body mass index, or chronicity of condition. Further, no differences were noted in proportion achieving the minimal clinically important difference between foot and ankle (Achilles, posterior tibialis, and plantar fascia) compared with proximal injuries (53 [84.3%] versus 31 [72%], p = .15). A mean of 4 treatments resulted in achieving the minimal clinically important difference, with 95% achieving it by 5 treatments. No differences in bars of pressure, frequency, or other aspects of treatments were observed to predict response. Our findings suggest that a majority of runners with lower-extremity injuries respond favorably to extracorporeal pulse-activated therapy, including those with foot and ankle injuries.

The effects of 24-h exposure to carbaryl or atrazine on the locomotor performance and overwinter growth and survival of juvenile spotted salamanders (Ambystoma maculatum).

Understanding the effects of pesticide exposure on organisms throughout their life cycle is critical to predict population-level effects. For many taxa, including amphibians, juveniles are the main dispersal stage and are disproportionally important to population persistence when compared with other life stages. In the present study, we examined the effects of a single 24-h exposure to the insecticide carbaryl or the herbicide atrazine on locomotor performance (endurance, distance traveled, speed, and fatigue) in the laboratory and terrestrial growth and survival through overwintering in field enclosures using recent metamorphs of spotted salamanders (Ambystoma maculatum). We found that neither atrazine nor carbaryl impacted endurance, but fatigue increased with carbaryl exposure, which could leave salamanders less able to escape repeated attacks by predators. Terrestrial growth and overwinter survival were not affected by short-term exposure to carbaryl or atrazine, suggesting that when individuals can overcome acute effects, no long-term consequences result for the endpoints measured.