March 2022

When your ankle joint is damaged by arthritis, trauma, or a medical condition and it’s not responding to conservative treatment—and your quality of life is suffering—ankle replacement surgery may offer relief. This may be a viable treatment option, depending on your condition and overall health. Ankle replacement surgery (sometimes referred to as ankle arthroplasty) involves removing the damaged bone and cartilage of the ankle joint and replacing them with prosthetics made of metal or plastic that work together and operate like your natural ankle joint. Ankle replacement surgery can help increase stability and mobility in the joint as well as reduce pain. To learn more about ankle replacement surgery and determine if you might be a good candidate, it is a good idea to consult with a podiatrist for an exam and diagnosis.

In certain cases, in which the patient suffers from extreme pain or damage in a joint, joint replacement surgery may be deemed useful. If you have constant pain in a foot joint, consult with John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will assess your condition and provide you with quality foot and ankle treatment.

What Is Joint Replacement Surgery?

Over time, joints wear down; this can be exacerbated by diseases and conditions. Joint replacement surgery, also known as arthroplasty, is when a damaged joint is surgically removed and replaced with a prosthesis. Prostheses, which can be made of ceramic, plastic, or metal, act as joints in lieu of an actual joint. One of the most prevalent causes for joint replacement is arthritis.

Arthritis in the Foot

Arthritis can occur in any joint in the body, including in the feet. Common types of arthritis in the foot are osteoarthritis, rheumatoid arthritis, and gout. The big toe is usually where arthritis occurs in the foot; this is known as hallux rigidus.

Joint Replacement Surgery in the Foot

The most common form of joint replacement in the foot is a first metatarsophalangeal (MTP) joint placement. MTP joint replacement surgery is designed to treat hallux rigidus. Surgery is not intensive, and recovery occurs within one to two months after the procedure has been done. Overall, joint replacement surgery is a safe and effective way to treat pain in the joint of the foot.

If you have any questions, please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot care needs.

If you have noticed that your feet or toes turn white, and then change to blue or red and become painful, you may have a condition known as Raynaud’s phenomenon. It is usually caused by a change in temperature, but it can also be caused by stress.  It is common in young people, and it affects more women than men. If symptoms start over the age of 40, it may indicate other underlying conditions, such as rheumatoid arthritis, auto-immune disease, or poor blood circulation. You may also experience symptoms such as pain, pins and needles, swelling, and stiffness in the joints that can last as little as a few minutes or as long as a few hours. Common precautions that may be taken include keeping your feet warm during cold weather, as well as avoiding smoking and caffeinated beverages, which both decrease circulation. If Raynaud's symptoms worsen enough to interfere with your daily life, it is suggested that you make an appointment with a podiatrist for a full exam and options for other treatments.

Poor circulation is a serious condition and needs immediate medical attention. If you have any concerns with poor circulation in your feet contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor will treat your foot and ankle needs.

Poor Circulation in the Feet

Poor blood circulation in the feet and legs is can be caused by peripheral artery disease (PAD), which is the result of a buildup of plaque in the arteries.

Plaque buildup or atherosclerosis results from excess calcium and cholesterol in the bloodstream. This can restrict the amount of blood which can flow through the arteries. Poor blood circulation in the feet and legs are sometimes caused by inflammation in the blood vessels, known as vasculitis.

Causes

Lack of oxygen and oxygen from poor blood circulation restricts muscle growth and development. It can also cause:

• Muscle pain, stiffness, or weakness   
• Numbness or cramping in the legs 
• Skin discoloration
• Slower nail & hair growth
• Erectile dysfunction

Those who have diabetes or smoke are at greatest risk for poor circulation, as are those who are over 50. If you have poor circulation in the feet and legs it may be caused by PAD and is important to make changes to your lifestyle in order to reduce risk of getting a heart attack or stroke. Exercise and maintaining a healthy lifestyle will dramatically improve conditions.

As always, see a podiatrist as he or she will assist in finding a regimen that suits you. A podiatrist can also prescribe you any needed medication. 

If you have any questions please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Bunions are an acquired foot deformity where a misalignment in the bones of the big toe causes a protrusion to form on the outside of the foot at the toe’s joint. This forces the toe to angle toward the other toes rather than pointing straight ahead. Bunionettes, also known as tailor bunions, form on the outside of the pinky toe. Both bunions and bunionettes can cause pain, swelling, and soreness. Bunions that go untreated may lead to limited range of movement and will not get better on their own. Wearing proper footwear with lower heels, a rounded toe box and plenty of room for the toes can help you avoid getting a bunion or bunionette, although the shape of your feet, heredity, and certain medical conditions can also be contributing factors. If you have a bunion or bunionette, it's a good idea to seek the professional care of a podiatrist for treatment options.

If you are suffering from bunion pain, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor can provide the care you need to keep you pain-free and on your feet.

What Is a Bunion?

Bunions are painful bony bumps that usually develop on the inside of the foot at the joint of the big toe. As the deformity increases over time, it may become painful to walk and wear shoes. Women are more likely to exacerbate existing bunions since they often wear tight, narrow shoes that shift their toes together. Bunion pain can be relieved by wearing wider shoes with enough room for the toes.

Causes

• Genetics – some people inherit feet that are more prone to bunion development
• Inflammatory Conditions - rheumatoid arthritis and polio may cause bunion development

Symptoms

• Redness and inflammation
• Pain and tenderness
• Callus or corns on the bump
• Restricted motion in the big toe

In order to diagnose your bunion, your podiatrist may ask about your medical history, symptoms, and general health. Your doctor might also order an x-ray to take a closer look at your feet. Nonsurgical treatment options include orthotics, padding, icing, changes in footwear, and medication. If nonsurgical treatments don’t alleviate your bunion pain, surgery may be necessary.

If you have any questions, please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot care needs.

As we age, several factors combine to make the threat of a fall more prevalent. Balance problems, weaker muscles and poorer eyesight may all contribute to the likelihood of a fall. Most falls happen in the home, and can be caused by inadequate lighting, unsafe footwear, slippery floors, loose rugs and electrical cords, and uneven surfaces. Certain physical conditions, such as low blood pressure, incontinence, and diabetes also may increase the chances of a fall. Many of these issues can be controlled with a few simple lifestyle changes. However, if an elderly person falls more and more often, certain complications may ensue. Among them are hip and thigh fractures, head injuries, wrist fractures, and even a tendency to become more sedentary, which further weakens the muscles. If falling has become a problem for you, it’s a good idea to make an appointment with a podiatrist who can help you find ways to prevent injury and reduce any greater risk to your health.

Preventing falls among the elderly is very important. If you are older and have fallen or fear that you are prone to falling, consult with John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will assess your condition and provide you with quality advice and care.

Every 11 seconds, an elderly American is being treated in an emergency room for a fall related injury. Falls are the leading cause of head and hip injuries for those 65 and older. Due to decreases in strength, balance, senses, and lack of awareness, elderly persons are very susceptible to falling. Thankfully, there are a number of things older persons can do to prevent falls.

How to Prevent Falls

Some effective methods that older persons can do to prevent falls include:

• Enrolling in strength and balance exercise program to increase balance and strength
• Periodically having your sight and hearing checked
• Discuss any medications you have with a doctor to see if it increases the risk of falling
• Clearing the house of falling hazards and installing devices like grab bars and railings
• Utilizing a walker or cane
• Wearing shoes that provide good support and cushioning
• Talking to family members about falling and increasing awareness

Falling can be a traumatic and embarrassing experience for elderly persons; this can make them less willing to leave the house, and less willing to talk to someone about their fears of falling. Doing such things, however, will increase the likelihood of tripping or losing one’s balance. Knowing the causes of falling and how to prevent them is the best way to mitigate the risk of serious injury.  

If you have any questions, please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Runners understand the joy the sport brings, however, they are also aware of the possible pain that can come with the activity as well. About 70 percent of all runners injure themselves each year. They may run too fast, too far, or too soon after a previous injury. Luckily, a number of simple guidelines can keep runners on the move. If you are new to running, it’s wise to take it in phases that include walk-run activity. Try not to increase your activity more than 10 percent a week, and try to avoid running more than 45 miles per week, because after that distance, injury is more likely to occur. It’s important to listen to your feet and avoid running through pain. Give your feet and legs a chance to heal before renewing activity. Find running shoes that fit your feet well and cushion your heels, and get new ones after 500 miles. Finally, there are a number of stretching and strengthening exercises you can do to help avoid injuries. If you run consistently, it’s a good idea to plan regular visits with a podiatrist, who can examine your feet, identify any problems, and make custom orthotics as needed. 

Exercising your feet regularly with the proper foot wear is a great way to prevent injuries. If you have any concerns about your feet, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor will treat your foot and ankle needs.

How to Prevent Running Injuries

Many common running injuries are caused by overuse and overtraining. When the back of the kneecap starts wearing out and starts causing pain in your knee, this is commonly referred to as runner’s knee. Runner’s knee is a decrease in strength in your quadriceps and can occur if you’re not wearing properly fitted or supporting shoes. To prevent runner’s knee, focusing on hip strengthening is a good idea, as well as strengthening your quads to keep the kneecaps aligned.

What Are Some Causes of Running Injuries?
- One cause of a common running injury is called iliotibial band syndrome.
- Plantar fasciitis is also another common injury.
- Stress fractures can occur from overtraining, lack of calcium, or even your running style.

Best Ways to Prevent Running Injuries
- Wear footwear that fits properly and suits your running needs.
- Running shoes are the only protective gear that runners have to safeguard them from injury.
- Make a training schedule. Adding strengthening exercises as well as regular stretching can help keep you strong and limber and can lessen the possibility of injuries.
- Stretching keeps muscles limber; this will help you gain better flexibility.

If you have any questions please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.