Two different concentrations of benzoyl peroxide gel can be used to treat pitted keratolysis

Press Release:

Topical benzoyl peroxide gel 2.5% and 5% can both be used to treat pitted keratolysis according to study results presented at the American Academy of Dermatology virtual meeting in June, 2020.

Pitted keratolysis (PK), a common skin disease, is frequently accompanied by pitted lesions on the feet and malodor,” Charussri Leeyaphan, MD, of the department of dermatology, faculty of medicine at the Siriraj Hospital, Mahidol University in Bangkok, and colleagues wrote. “The over-the-counter drug topical benzoyl peroxide gel (BP) is used as a medication for PK. However, the appropriate dosage and duration of BP treatment of PK is controversial.”

Topical benzoyl peroxide gel 2.5% and 5% can both be used treat pitted keratolysis.
In a prospective randomized, controlled trial to assess the safety and effectiveness of topical 2.5% BP and 5% BP, 89 subjects diagnosed with PK were analyzed. Subjects were assigned either 2.5% or 5% BP and were asked to apply the topical medication once daily for 2 weeks. Safety and effectiveness were evaluated 2 weeks after treatment via clinical examinations and self-assessments.

Of the 42 subjects that were treated with 2.5% BP, self-evaluation of foot odor using a visual analog scale showed a significant decrease from 5.4 to 3.7 (P < .001). Of 47 subjects treated with 5% BP, the decrease was from 5.4 to 3.5 (P .001).

Pitted lesions were evaluated by treatment-blinded dermatologists, with a 69% improvement for the 2.5% BP group vs. a 63.8% improvement for the 5% BP group. Side effects were not statistically different between the groups, and moderate to high levels of satisfactions were reported from almost all subjects.

“This study demonstrated that either 2.5% or 5% BP can be used for the treatment of PK and foot malodor,” Leeyaphan and colleagues wrote. “Due to the similarities in their efficacies and side effects, the use of 2.5% BP may be preferable.”

New Balance Golf Shoes

Press release:

Boston, Mass., March 6, 2020 – New Balance Golf has added two new styles to its Fresh Foam LinksSL collection for spring.

New Balance’s Fresh Foam technology was first introduced in the company’s performance running shoes and is now used across almost all categories of New Balance footwear.

Fresh Foam Technology

CUSH+ – A molded insole for superior comfort and lateral stability.

FRESH FOAM – An innovative midsole with a data-driven design that identified zones in the midsole where altering levels of compression and resistance are aligned to provide ultra-soft cushioning and lateral stability.

SMART RUBBER OUTSOLE – The spikeless outsole on the Fresh Foam LinksSL has omni-directional traction lugs with pressure mapping colors to highlight key performance zones.

Fresh Foam LinksSL

The Fresh Foam LinksSL features a waterproof performance mesh upper and a spikeless smart rubber outsole. The smart rubber outsole has pressure mapping colors to highlight key performance zones during the swing. The suggested retail is $99.95. The green and white colorway is available March 15th and the red, white and blue colorway will be available May 1st.

About New Balance

New Balance, headquartered in Boston, MA has the following mission: Demonstrating responsible leadership, we build global brands that athletes are proud to wear, associates are proud to create and communities are proud to host. Manufactured in the U.S. for over 75 years and representing a limited portion of our U.S. sales, New Balance Made U.S. is a premium collection that contains a domestic value of 70% or greater. New Balance owns five factories in New England and one in Flimby, U.K. New Balance employs more than 6,000 associates around the globe, and in 2018 reported worldwide sales of $4.1 billion. To learn more about New Balance, please visit www.newbalance.com.

More on injuries in golf.

Paratrooper™ Plantar Plate System Receives 510(k) Clearance – 1st Dedicated System Allowing Surgeons to Repair the Plantar Plate Through Either a Dorsal or Plantar Approach

ENGLEWOOD, Colo., Feb. 7, 2020 /PRNewswire/ — The Paratrooper™ Plantar Plate Repair System was developed to allow surgeons to use a dorsal or plantar approach to the plantar plate repair procedure using a single, all-inclusive kit.

The Paratrooper™ Plantar Plate Repair System uses an all-suture anchor implant that can be fixed into bone or soft tissue. By using an all-suture implant, the surgeon can perform the plantar plate repair using a variety of fixation and approach techniques, while preserving surrounding bone and tissue. When the Paratrooper™ suture implant is inserted and tensioned, the implanted suture “sock” will contract and form into a low profile, flat anchor that will prevent the implant from pulling out of the site.

Surgeons face a variety of challenges and complications in plantar plate repair using the dorsal and plantar approach:

  • Exposure to the plantar plate from the dorsal approach
  • Difficulty implanting into bone or soft tissue
  • Step-heavy procedure with complicated instrumentation

The Paratrooper™ Plantar Plate Repair System was designed with these challenges in mind.

The system includes all instrumentation necessary to gain adequate exposure to the plantar plate from either the dorsal or plantar approach.  Paragon 28® designed the Paratrooper™ Plantar Plate implant and instruments to allow for simple insertion into tissue and bone through use of an innovative insertion tip, custom needle, and delivery method. Instrumentation is provided to directly address plantar plate deficiency and is included within one kit and is used to facilitate exposure, drilling, and implant placement within a small, limited vascularization environment.  The Paratrooper™ Plantar Plate Repair System was specifically designed to facilitate proper step execution and limit complications intraoperatively.

Paragon 28® is planning for full commercial launch of the Paratrooper™ Plantar Plating System in June 2020.

Concussions Increase Risk Of Lower Extremity Injuries

Press Release:

A new study shows that college athletes who sustain concussions are more likely to have a lower extremity injury in the same season after they return from the concussion.

Dr. Daniel Herman, a fellow in primary care sports medicine at the University of Florida, presented this research at the American Medical Society for Sports Medicine conference in San Diego, California. Athletes with concussions were 3.79 times more likely to get a muscle or ligament injury than their non-concussed teammates. The severity of the injuries was not statistically different between the two groups. This research takes the popular topic of concussions in a direction that many people have not thought about.

“These results may have clinical implications ranging from pre-season injury risk stratification to post-concussion rehabilitation practices to return to play considerations, said Dr. Herman. My colleagues and I are working to develop additional studies investigating the impact of neurocognitive performance on musculoskeletal injuries.”

Dr. Daniel Herman, a fellow in primary care sports medicine at the University of Florida, received his MD and PhD (Biomedical Engineering) at the University of North Carolina, and completed his residency in Physical Medicine and Rehabilitation at the University of Virginia. His research focuses on neuromuscular and neurocognitive risk factors for musculoskeletal injury, and he is a prior recipient of the American Orthopedic Society for Sports Medicine’s O’Donoghue Award for Sports Injury Research. He will be starting at an Assistant Professor in the Department of Orthopedics and Rehabilitation at the University of Florida in July 2013.

A new study shows that college athletes who sustain concussions are more likely to have a lower extremity injury in the same season after they return from the concussion.

Dr. Daniel Herman, a fellow in primary care sports medicine at the University of Florida, presented this research at the American Medical Society for Sports Medicine conference in San Diego, California. Athletes with concussions were 3.79 times more likely to get a muscle or ligament injury than their non-concussed teammates. The severity of the injuries was not statistically different between the two groups. This research takes the popular topic of concussions in a direction that many people have not thought about.

“These results may have clinical implications ranging from pre-season injury risk stratification to post-concussion rehabilitation practices to return to play considerations following concussion, said Dr. Herman. My colleagues and I are working to develop additional studies investigating the impact of neurocognitive performance on musculoskeletal injuries.”

Dr. Daniel Herman, a fellow in primary care sports medicine at the University of Florida, received his MD and PhD (Biomedical Engineering) at the University of North Carolina, and completed his residency in Physical Medicine and Rehabilitation at the University of Virginia. His research focuses on neuromuscular and neurocognitive risk factors for musculoskeletal injury, and he is a prior recipient of the American Orthopedic Society for Sports Medicine’s O’Donoghue Award for Sports Injury Research. He will be starting at an Assistant Professor in the Department of Orthopedics and Rehabilitation at the University of Florida in July 2013.

Fat Injections Provide Long-Term Solution for Foot Pain

Press release:

11/28/2018
PITTSBURGH – Fat grafting to the foot can provide long-lasting improvements in foot pain and function for patients suffering from pedal fat pad atrophy, or the disintegration of fat in the ball of the foot. Results of a clinical trial led by experts at the University of Pittsburgh Department of Plastic Surgery are available online and published today in the December issue of the journal Plastic and Reconstructive Surgery.

Jeff and Beth Gusenoff feature“Forefoot fat pad atrophy is common because the fat pads in the foot are used constantly for shock absorption when walking,” said lead author Jeffrey Gusenoff, M.D., professor of plastic surgery at Pitt. “We typically see this condition in patients with specific foot structures, a history of long-term aggressive activity, and those who have experienced surgery, foot trauma or multiple forefoot steroid injections.”

Gusenoff led a multidisciplinary team that included podiatry and plastic surgery clinicians as they examined 31 patients divided into two groups over a span of two years. The overall purpose of this outcomes study was to “assess whether fat grafting to the forefoot in patients with fat pad atrophy will reduce foot pressure during gait, increase the soft tissue thickness of the foot pad and ultimately reduce pain.”

All patients participating in the trial received the minimally invasive pedal fat grafting surgery, with the first group undergoing the procedure immediately with two years of follow-up and the second group managing the condition conservatively for one year and then undergoing the procedure with one year of follow-up.

Study results show that fat grafting is a safe, minimally invasive approach to treat pedal fat pad atrophy and that undergoing the procedure sooner prevents worsening symptoms that would occur as a result of conservative management. Fat grafting currently is the only minimally invasive treatment method that has proven to be effective for this condition.

“We are happy that we can finally bring relief to people who have been living with pain and a decreased quality of life,” said Gusenoff. “The positive responses we’ve heard from our patients have made all of our research worthwhile.”

Additional authors on the study were Beth Gusenoff, D.P.M., and Danielle Minteer, Ph.D., both of Pitt. This work was funded by 2013 and 2014 Plastic Surgery Foundation Pilot Research Grants, and the treatment is available at UPMC.

Going Barefoot: Strong ‘Foot Core’ Could Prevent Plantar Fasciitis, Shin Splints, and Other Common Injuries

Press release:

As your cold-weather footwear makes the seasonal migration from the back of your closet to replace summer’s flip flops and bare feet, don’t underestimate the benefits of padding around naked from the ankles down.

Barefoot activities can greatly improve balance and posture and prevent common injuries like shin splints, plantar fasciitis, stress fractures, bursitis, and tendonitis in the Achilles tendon, according to Patrick McKeon, a professor in Ithaca College’s School of Health Sciences and Human Performance.

The small, often overlooked muscles in the feet that play a vital but underappreciated role in movement and stability. Their role is similar to that of the core muscles in the abdomen.

“If you say ‘core stability,’ everyone sucks in their bellybutton,” he said. Part of the reason why is about appearance, but it’s also because a strong core is associated with good fitness. The comparison between feet and abs is intentional on McKeon’s part; he wants people to take the health of their “foot core” just as seriously.

The foot core feedback loop

McKeon describes a feedback cycle between the larger “extrinsic” muscles of the foot and leg, the smaller “intrinsic” muscles of the foot, and the neural connections that send information from those muscle sets to the brain.

“Those interactions become a very powerful tool for us,” he said. When that feedback loop is broken, though, it can lead to the overuse injuries that plague many an athlete and weekend warrior alike.

Shoes are the chief culprit of that breakdown, according to McKeon. “When you put a big sole underneath, you put a big dampening effect on that information. There’s a missing link that connects the body with the environment,” he said.

Muscles serve as the primary absorbers of force for the body. Without the nuanced information provided by the small muscles of the foot, the larger muscles over-compensate and over-exert past the point of exhaustion and the natural ability to repair. When the extrinsic muscles are no longer able to absorb the forces of activity, those forces are instead transferred to the bones, tendons, and ligaments, which leads to overuse injuries.

It’s not that McKeon is opposed to footwear. “Some shoes are very good, from the standpoint of providing support. But the consequence of that support, about losing information from the foot, is what we see the effects of [in overuse injuries].”

Strengthening the foot core

The simplest way to reintroduce the feedback provided by the small muscles of the foot is to shed footwear when possible. McKeon says activities like Pilates, yoga, martial arts, some types of dance, etc. are especially beneficial.

“Anything that has to deal with changing postures and using the forces that derive from the interaction with the body and the ground [is great for developing foot core strength],” he said.

McKeon also described the short-foot exercise, which targets the small muscles by squeezing the ball of the foot back toward the heel. It’s a subtle motion, and the toes shouldn’t curl when performing it. The exercise can be done anywhere while seated or standing, though he recommends first working with an athletic trainer or physical therapist to get familiar with the movement.

He notes the exercise seems to have especially positive results for patients suffering from ankle sprain, shin splints, and plantar fasciitis. It’s even been shown to improve the strain suffered by individuals with flat feet.

The payoff could be more than just physical, as there could be financial savings. With strong feet, McKeon suggests that – depending on the activity – consumers may not need to invest hundreds of dollars in slick, well-marketed athletic sneakers (though he doesn’t recommend going for the cheapest of cheap sneakers, either). People with a strong foot core can actively rely on the foot to provide proper support, rather than passively relying on the shoes alone.

“You might be able to get a $50 pair of basketball shoes that don’t have the typical support that you’d expect. Because you have strong feet, you’re just using the shoes to protect the feet and grip the ground,” he said.

The easiest way to get started on strengthening the small muscles of the foot, though, is to kick off your shoes in indoor environments.

“The more people can go barefoot, such as at home or the office, is a really good thing,” McKeon said.