September 2022
Sever's Disease
Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in children’s feet while they’re growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14.
Sever's disease occurs when the child’s growth plate, or the calcaneal epiphysis, an area attached to the Achilles tendon, is injured or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of the heel and the inability to put any weight on the heel. This forces the child to bear weight on their toes while walking. When a toe gait develops, the child must change the way they walk to avoid placing weight on the painful heel. If this is not properly addressed, this can lead to further developmental problems.
The most common symptom of Sever's disease is acute pain felt in the heel when a child engages in physical activity such as walking, jumping or running. Children who are active athletes are among the group most susceptible to experiencing Sever's disease. This is due to the extreme stress and tension placed on their growing feet. The rolling movement of the foot during walking or running and obesity are both additional conditions linked to causing Sever's disease.
The first step in treating Sever's disease is to rest the foot and leg and avoid physical activity. Over the counter pain-relieving and anti-inflammatory medications can be helpful for reducing the amount of heel pain. A child with Sever's disease should also wear shoes that properly support the heel and the arch of the foot. Consider purchasing orthotic shoe inserts which can help support the heel and foot while it is healing. Most patients with Sever's disease symptoms report an eventual elimination of heel pain after wearing orthotic insoles that support the affected heel.
Sever's disease may affect either one heel or both. It is important for a child experiencing heel pain to be examined by a foot doctor who can apply the squeeze test. The squeeze test compresses both sides of the heel in order to determine if there is intense pain. Discourage any child diagnosed with Sever's disease from going barefoot as this can intensify the problem. Apply ice packs to the affected painful heel two or three times a day for pain relief.
Exercises that help stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling has also proven to be very effective at treating Sever's disease. When foot curling, the foot is pointed away from the body, then curled toward the body to help stretch the muscles. The curling exercise should be done in sets of 10 or 20 repetitions and repeated several times throughout the day.
Treatment methods can continue for at least 2 weeks and as long as 2 months before the heel pain completely disappears. A child can continue doing daily stretching exercises for the legs and feet to prevent Sever’s disease from returning.
What Is Sever’s Disease?

Sever’s disease is a common overuse injury that affects the heels in growing children. This typically occurs in children ages seven to 14 when their bodies are undergoing rapid growth. Pain may develop due to inflammation where the Achilles tendon inserts into the growth plate located in the heel bone. Activities, like running and jumping can exacerbate the stress on the heel bone’s growth plate and cause pain. As might be expected, this affliction is most often seen in young athletes who participate in sports including soccer, gymnastics, football, and basketball. Such pain often goes away with rest and worsens the activities that caused it. It can be in one or both heels and a child might start limping or walking on their toes to avoid putting pressure on their heels. Resting the affected foot/feet is the best course of action. If the pain does not subside after a short period of time, take your child to a podiatrist who can properly diagnose the condition and treat it appropriately.
Sever's disease often occurs in children and teens. If your child is experiencing foot or ankle pain, see John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor can treat your child’s foot and ankle needs.
Sever’s Disease
Sever’s disease is also known as calcaneal apophysitis, which is a medical condition that causes heel pain I none or both feet. The disease is known to affect children between the ages of 8 and 14.
Sever’s disease occurs when part of the child’s heel known as the growth plate (calcaneal epiphysis) is attached to the Achilles tendon. This area can suffer injury when the muscles and tendons of the growing foot do not keep pace with bone growth. Therefore, the constant pain which one experiences at the back of the heel will make the child unable to put any weight on the heel. The child is then forced to walk on their toes.
Symptoms
Acute pain – Pain associated with Sever’s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running.
Highly active – Children who are very active are among the most susceptible in experiencing Sever’s disease, because of the stress and tension placed on their feet.
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 injuries.
What to Do to Keep Your Child’s Feet Healthy
Being a parent involves caring for your child in every way you can. You make sure they are eating the right food, being nice to others, and staying out of any trouble. However, it is also important that you are watchful of their health, more specifically their foot health. Maintaining good foot health in childhood is important in preventing later conditions in life from happening. As children continue to develop, their feet require different techniques of care. Here are some various ways in which you can help your child’s feet stay healthy.
A baby needs a lot of care and attention overall, but the importance of their feet should never be forgotten. Before a baby turns one, their feet change and develop greatly. It is important that during this time, a mother avoids putting tight socks on their child. She should also encourage movement of their feet so the baby can begin to feel more comfortable using them.
As a baby enters the toddler years of his or her life, they are begin to walk around. When your baby begins to take those first steps, it is crucial that they are wearing protective shoes on their feet. As a mother that is observant of your child’s feet, you may notice changes in them. This is completely normal as the feet are becoming susceptible to the activity of walking. It is normal for a toddler to be a bit unsteady or to “walk funny” at first.
When your child grows out of their toddler years, it is important that you begin to show him or her how to care for their feet on their own. Practice with your child proper hygiene in order to prevent foot fungus or infection. Since children are constantly on the move, it is crucial to be cautious of any accidents or injuries that might occur. If an injury occurs, it is advised that you take your child to be examined by a doctor immediately. Since your child is still growing, particular injuries can shift the way in which a bone or other important part of the foot is developing.
Babies and kids are always changing and growing. Your job as a parent is to make sure they stay healthy and making sure they are properly maintained. This involves proper foot care and making sure the feet stay healthy. Following this guide, your child can live a long and happy life.
Measuring Your Child’s Feet

Taking good care of your child’s feet is essential in ensuring that they will grow up to have healthy, well-functioning feet. One critical element of maintaining the health of your child’s feet is measuring their feet properly before going shopping for shoes. There are several different ways in which you can take an accurate measure of your child’s feet, but you might consider performing a tracing. Simply have your child stand on a piece of paper with one end touching a wall. Your child should have their heel against the wall. Using a ruler, mark on the paper where your child’s longest toe ends. You can then perform this on the other foot. You might consider even adding one centimeter onto the final measurement so that your child’s shoe provides enough space in the toe box. If you want to learn more about children’s foot health, contact your podiatrist today.
Making sure that your children maintain good foot health is very important as they grow. If you have any questions, 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.
Keeping Children's Feet Healthy
Having healthy feet during childhood can help prevent medical problems later in life, namely in the back and legs. As children grow, their feet require different types of care. Here are some things to consider...
Although babies do not walk yet, it is still very important to take care of their feet.
Avoid putting tight shoes or socks on his or her feet.
Allow the baby to stretch and kick his or her feet to feel comfortable.
As a toddler, kids are now on the move and begin to develop differently. At this age, toddlers are getting a feel for walking, so don’t be alarmed if your toddler is unsteady or ‘walks funny’.
As your child gets older, it is important to teach them how to take care of their feet.
Show them proper hygiene to prevent infections such as fungus.
Be watchful for any pain or injury.
Have all injuries checked by a doctor as soon as possible.
Comfortable, protective shoes should always be worn, especially at play.
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.
Laser Treatment for Fungal Nails
A new treatment for fungal nails, or onychomycosis, which has grown in popularity in recent years, is laser treatment. Laser treatment involves the use of a laser that kills fungus in the toenail with heat. Laser therapy causes no side effects and does not affect nearby healthy tissue.
Toenail fungus afflicts almost 10 percent of the U.S. population and is more common among the elderly. The most common symptom of toenail fungus is the discoloration and thickening of the nail. The nail can also become brittle and a foul smell may be produced. In rare cases, pain might be present. While it is not a serious condition, it can lead to a perception of disgust amongst those it affects. There are several different fungi that cause fungal infections. These include dermatophyte, yeast, and mold. The most common of these is dermatophyte.
Diagnosis for fungal nails involves a podiatrist utilizing microscopy and fungal cultures. This will allow the doctor to determine whether it is a fungus or another condition, such as lichen planus, psoriasis, nail damage, and onychogryphosis.
Fungus in the nails can be hard to get rid of with over-the-counter drugs. This is due to the nail being hard and protective, with fungus able to slip between the nail bed and plate. Furthermore the slow growth of the nail increases the difficulty of fungus going away. Laser treatment seeks to get around this by directly penetrating through the nail and killing the fungus. The laser is used on each infected nail for a couple of minutes. Patients then typically return several weeks or months later for another laser treatment. During this time the podiatrist will routinely observe the foot and infection. It is also recommended to wear clean socks and shoes and allow the feet to dry and breathe to prevent toenail fungus.
Laser treatment is still a relatively new treatment and not all podiatrists have laser machines. Ask your podiatrist if they do laser treatment for toenail fungus and if it is right for you.
Laser Treatment May Help Toenail Fungus

Research has shown toenail fungus may be prevalent among the elderly population. There are several methods that can be implemented to treat toenail fungus, including laser treatment. This is a procedure that has been approved by the FDA and is said that it may be effective in killing the fungus as laser beams penetrate the nail bed. It is a painless procedure and many patients have had good results, but they could vary. Toenail fungus can be unsightly, and the symptoms generally consist of yellowed, thickened nails that often become brittle with the possibility of falling off. Patients who have toenail fungus are often embarrassed by their toenails and tend to hide their feet. If you have this condition and would like more information about the pros and cons of laser treatment, it is strongly advised that you schedule an appointment with a podiatrist who can answer any questions you may have.
Laser treatment can be an effective way to get rid of toenail fungus. If you have any questions about laser treatment, consult with John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will assess your condition and provide you with quality treatment for fungal nails.
What Are Toenail Fungal Infections?
Onychomycosis, or fungal infection of the nail, is a relatively common and non-serious condition. Around 10 percent of U.S. citizens are afflicted with fungal nails. Common forms of fungus that infect the nail include dermatophytes, yeasts, and molds.
Symptoms of Toenail Fungal Infections Include:
- Nail thickening
- Brittleness of the nail
- Discoloration of the nail
Diagnosis for Fungal Nails
Fungal infections are diagnosed by fungal culture and microscopy. This will rule out any other conditions such as nail trauma, psoriasis, lichen planus, and onychogryphosis.
What Is Laser Treatment?
Laser treatment is a non-invasive, safe, quick, and painless procedure that uses the heat from a laser to kill fungus in the nail. Each infected nail is targeted with a laser for several minutes. The treatment is usually utilized several different times over a select period. During this time, a podiatrist will keep an eye on the infection.
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.
Are You Suffering From Ingrown Toenails?
Exercise for Your Feet
Whether your feet are over-worked or under-worked, chances are they could benefit from some special attention. Even those who exercise regularly probably do not spend any time strengthening their feet. This can be just as rewarding as strengthening the rest of the body, since the health of your feet affects the health of the rest of the body as well, especially the ankles, legs, and spine.
For those who might not have any idea on how a foot-specific exercise might be conducted, there are several workouts that are fairly easy to perform in the comfort of ones’ home. One of the easiest is the toe rise, also known as the tip-toe. This exercise involves standing on the tip-toes for a count of 15 then resting the feet on the ground. This process should be repeated a minimum of three times a day in order to strengthen the feet.
Toe pick-ups strengthen the feet by working them in a very different way. In this exercise, small items are picked up using the toes in order to strengthen the muscles on the upper part of the feet. Once again three sets should be performed, with the item in question being held for 15 seconds then dropped. Items that may be picked up using the feet include marbles and even stationery, which works wonders for the toes and the surrounding muscles.
Yet another simple workout is the ankle pump. This can be done either upwards or downwards, but for the workout to be most effective both can be incorporated into the routine. As the term suggests, this involves lifting the foot off the floor and flexing the toes either towards the shin or towards the ground. This movement puts the feet and ankles through a large range of motion which works the muscles.
Last but not least, feet should be stretched so that the muscles can relax and recuperate. This can be done by placing both feet off of the floor and bracing oneself against the wall at a 45 degree angle. This ensures that the feet and ankles are adequately stretched once the workout is complete.
In short, giving the feet a good workout every now and then is important in order to avoid problems such as plantar fasciitis. It’s also important to warm-up or cool-down after running or vigorous walking. Foot exercises may be followed by a good foot massage. This encourages circulation in the feet as well as muscle relaxation.
Stretching the Feet Before a Workout

Before an individual begins their exercise routine, they may briefly stretch their neck, arms, and legs. It is undoubtedly important to ensure that these body parts are loose and limber. However, stretching out the feet before an exercise routine is just as important. This is because foot pain, injuries, and afflictions developed from not stretching can make it difficult to continue working out the next day. If an individual properly stretches or warms up their feet before a workout, other parts of the body may benefit. For example, depending on the stretch, the calves, hamstrings, and shins might benefit from foot stretches. Before a workout, you might consider performing the tiptoe walk. This stretch can be performed by standing on your tiptoes and walking on an exercise mat for about thirty seconds or so. Some individuals who perform this pre-workout stretch might notice increased ankle stability. When stretching, it is always important to listen to your body and never push or strain your body. If you are someone who works out frequently and has always neglected stretching the feet, contact a podiatrist. They will be able to help you with more information about stretching your feet.
Exercising your feet regularly with the proper foot wear is a great way to prevent injuries and build strength. If you have any concerns about your feet, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor can provide the care you need to keep you pain-free and on your feet.
Exercise for Your Feet
Exercise for your feet can help you gain strength, mobility and flexibility in your feet. They say that strengthening your feet can be just as rewarding as strengthening another part of the body. Your feet are very important, and we often forget about them in our daily tasks. But it is because of our feet that are we able to get going and do what we need to. For those of us fortunate enough to not have any foot problems, it is an important gesture to take care of them to ensure good health in the long run.
Some foot health exercises can include ankle pumps, tip-toeing, toe rises, lifting off the floor doing reps and sets, and flexing the toes. It is best to speak with Our doctor to determine an appropriate regimen for your needs. Everyone’s needs and bodies are different, and the activities required to maintain strength in the feet vary from individual to individual.
Once you get into a routine of doing regular exercise, you may notice a difference in your feet and how strong they may become.
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.