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Dr. Horlebein will be joining Advanced Regional Ankle & Foot Care LLC as a full time physician in Altoona PA, as of June 1st 2023. Feel free to call our office with any scheduling inquires/questions!

January 2023

Tuesday, 31 January 2023 00:00

All About Cuboid Syndrome

Though cuboid syndrome predominately affects athletes, non-athletes can suffer from it too. Cuboid syndrome is also called cuboid subluxation or cuboid fault syndrome, and occurs when a joint or ligament near the cuboid bone of the foot becomes damaged, or when the bone itself is dislodged from its natural position. Pain may be persistent, or come and go, and it is usually marked by the outside of the foot. Cuboid syndrome, unless severe, can be difficult to diagnose. A doctor will likely ask questions about how long the pain has been present, and will apply pressure on the cuboid bone to determine the origin of pain.

There are a number of causes that can lead to the syndrome. Due to athletic activities, repeated stress placed on the foot can cause cuboid subluxation. Ballet dancers, runners, and other athletes often develop this condition. Basketball or tennis players may also develop this condition, as they place stress on their feet while moving side to side. Cuboid syndrome can often develop over time; however it can come out of a sudden injury as well. Over pronation, or other problems with feet, can exacerbate the condition if not corrected.

Among podiatrists, there is some disagreement about the treatment, as well as the definition of cuboid syndrome. Some see the injury as an injury to the ligaments located nearby the cuboid bone, while others believe it refers to the dislocation of the calcaneal-cuboid joint only. Treatment opinions differ as well. Although it can be treated by manipulation in order to reposition the bone, this must be done with extreme care in order to avoid injury. Some doctors, however, prefer treatment through the use of orthotic pads, designed to keep the bone in its place. Effectiveness of these treatments may vary, according to the severity of the injury.

When you experience side foot pain, it is important that you seek medical assistance. If a subluxed cuboid is caught and treated early, treatment is usually successful, and individuals may begin activities such as sports when the pain subsides. If left untreated, the pain will worsen, and the condition could cause permanent damage.

Tuesday, 31 January 2023 00:00

Examples of Developing Cuboid Syndrome

Cuboid syndrome is a condition affecting the health of the feet that develops when the cuboid bone is moved out of alignment in the foot. As a result, the lateral part of the foot may experience some discomfort or pain. There are many different examples of ways in which cuboid syndrome can develop. For example, athletes like basketball players may unintentionally move their cuboid bone out of alignment when rushing to the end of the court and using a lateral movement to suddenly slow down their motion. This lateral movement can sometimes cause the cuboid bone to shift out of place. Additionally, students who are rushing through the halls of their school might damage the alignment of their cuboid bone while pivoting their feet to suddenly change direction or speed. These are just some of many different examples of how individuals may develop cuboid syndrome. If you think you have this condition, please contact a podiatrist today for treatment. 


 

Cuboid syndrome, also known as cuboid subluxation, occurs when the joints and ligaments near the cuboid bone in the foot become torn. If you have cuboid syndrome, 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.

Cuboid syndrome is a common cause of lateral foot pain, which is pain on the outside of the foot. The condition may happen suddenly due to an ankle sprain, or it may develop slowly overtime from repetitive tension through the bone and surrounding structures.

Causes

The most common causes of cuboid syndrome include:

  • Injury – The most common cause of this ailment is an ankle sprain.
  • Repetitive Strain – Tension placed through the peroneus longus muscle from repetitive activities such as jumping and running may cause excessive traction on the bone causing it to sublux.
  • Altered Foot Biomechanics – Most people suffering from cuboid subluxation have flat feet.

Symptoms

A common symptom of cuboid syndrome is pain along the outside of the foot which can be felt in the ankle and toes. This pain may create walking difficulties and may cause those with the condition to walk with a limp.

Diagnosis

Diagnosis of cuboid syndrome is often difficult, and it is often misdiagnosed. X-rays, MRIs and CT scans often fail to properly show the cuboid subluxation. Although there isn’t a specific test used to diagnose cuboid syndrome, your podiatrist will usually check if pain is felt while pressing firmly on the cuboid bone of your foot.

Treatment

Just as the range of causes varies widely, so do treatments. Some more common treatments are ice therapy, rest, exercise, taping, and orthotics.

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.

 

Read more about All About Cuboid Syndrome
Tuesday, 24 January 2023 00:00

Foot Orthotics

Orthotics are shoe inserts that are meant to correct an irregular walking gait or provide cushioning to the feet.  Orthotics come in a variety of different models and sizes, including over-the-counter and customizable variants. Customizable orthotics can be shaped and contoured to fit inside a specific shoe and are typically prescribed through a podiatrist who specializes in customized footwear and orthotics design and management.

Orthotics are beneficial because they can help prevent injuries from occurring and provide cushioning to keep pain levels down to a minimum. They also allow for the correct positioning of the feet. Orthotics can act as shock absorbers to help remove pressure from the foot and ankle. Therefore, orthotics can make bodily movements, such as walking and running, become more comfortable as well as help prevent the development of certain foot conditions.

Orthotics alleviate pain and make the foot more comfortable by slightly altering the angle at which the foot strikes the ground surface, therefore controlling the movement of the foot and ankle. Orthotics come in different variants and can be made of various materials. To determine what type of orthotic is most suited to your feet and your needs, it is best to consult your podiatrist. He or she will be able to recommend a type of orthotic that can help improve your foot function or prescribe a custom orthotic to best fit your feet.  

Tuesday, 24 January 2023 00:00

The Benefits of Wearing Orthotics

The feet are complex structures, and it may be easy for several bones, muscles, and tendons to move out of alignment. The feet are responsible for balancing the body, and certain foot conditions may cause foot pain, possibly affecting the entire body. Many patients look for relief and comfort, and may find it beneficial to wear custom-made orthotics. These are insoles that are specifically designed for an individual's feet and may provide stability, correct misalignments, and reduce existing foot pain. Additionally, the benefits of wearing orthotics can include preventing injuries, improving general well-being, and enhancing athletic performance. There are different types of orthotics that can be considered. If you have foot pain, please consult with a podiatrist who can determine if orthotics are right for you.

If you are having discomfort in your feet and would like to try orthotics, 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.

What Are Orthotics?

Orthotics are inserts you can place into your shoes to help with a variety of foot problems such as flat feet or foot pain. Orthotics provide relief and comfort for minor foot and heel pain but can’t correct serious biomechanical problems in your feet.

Over-the-Counter Inserts

Orthotics come in a wide variety of over-the-counter inserts that are used to treat foot pain, heel pain, and minor problems. For example, arch supports can be inserted into your shoes to help correct overarched or flat feet, while gel insoles are often used because they provide comfort and relief from foot and heel pain by alleviating pressure.

Prescription Orthotics

If over-the-counter inserts don’t work for you or if you have a more severe foot concern, it is possible to have your podiatrist prescribe custom orthotics. These high-quality inserts are designed to treat problems such as abnormal motion, plantar fasciitis, and severe forms of heel pain. They can even be used to help patients suffering from diabetes by treating foot ulcers and painful calluses and are usually molded to your feet individually, which allows them to provide full support and comfort.

If you are experiencing minor to severe foot or heel pain, it’s recommended to speak with your podiatrist about the possibilities of using orthotics. A podiatrist can determine which type of orthotic is right for you and allow you to take the first steps towards being pain-free.

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

Read more about Foot Orthotics
Tuesday, 17 January 2023 00:00

Elderly Foot Care

As you grow older, you will start to notice more problems with your feet due to wear and tear. This may also happen because the skin will start to become thin and lose elasticity. Some signs of aging feet are regular aches and pains, bunion development, and clawed toes.

Fortunately, there are ways you can improve comfort, relieve pain, and maintain mobility in your feet. One of the best ways to deal with aging feet is to exercise. If you keep active, your muscles will become toned which will then strengthen the arches in the foot and stimulate blood circulation.

It is important that you practice proper foot care to protect your aging feet. You should wash your feet in warm water on an everyday basis. Afterward, the feet need to be dried well and it is important to dry between the toes. Your toenails should be trimmed and kept under control; nails that are poorly cut may become ingrown. At the end of each day, performing an inspection of your feet will allow you to detect any ailments in their early stages.

As you grow older, it becomes more important that you wear comfortable shoes. Your shoes should be secure, and they should provide decent arch support. If you are looking to buy a new pair of shoes, it is best to look for a pair that are made from a breathable material. It is also helpful to have shoes that have a bit of extra room at the top of the shoe, especially if you suffer from swollen feet.

The most common foot problems that elderly people will encounter are bunions, calluses, corns, hammertoes, heel pain, and foot problems related to diabetes. Some other issues include arch pain, tarsal tunnel syndrome, Achilles tendonitis, and Morton’s neuroma

An annual foot examination is a great way for you to ensure that you do not have any serious health problems with your feet. You should talk to a podiatrist about the available treatment options for whichever foot issue you are dealing with.

Tuesday, 17 January 2023 00:00

Foot Conditions May Develop in Older Adults

Foot conditions may increase as people grow older. This is often the result of reduced fat pads that act as shock absorbers, possibly leading to plantar fasciitis and heel spurs. Additional ailments that affect the feet that are prevalent among the elderly include toenail fungus, arthritis, and hammertoe. These may affect the foot structure and may cause the foot to look deformed. A sense of independence may be compromised, and the feet may develop a reduced range of motion. Many foot conditions in seniors can be remedied by choosing shoes that fit correctly and having routine podiatry visits. A podiatrist can correctly trim the toenails and detect uncomfortable conditions such as Morton’s neuroma, peripheral artery disease, and foot ulcers in diabetic patients. If you have questions about possible conditions that can happen to the feet as the aging process occurs, please confer with a podiatrist who can accurately address any concerns you may have.

Proper foot care is something many older adults forget to consider. If you have any concerns about your feet and ankles, 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.

The Elderly and Their Feet

As we age we start to notice many changes in our body, but the elder population may not notice them right away. Medical conditions may prevent the elderly to take notice of their foot health right away. Poor vision is a lead contributor to not taking action for the elderly.

Common Conditions 

  • Neuropathy – can reduce feeling in the feet and can hide many life-threatening medical conditions.
  • Reduced flexibility – prevents the ability of proper toenail trimming, and foot cleaning. If left untreated, it may lead to further medical issues.
  • Foot sores – amongst the older population can be serious before they are discovered. Some of the problematic conditions they may face are:
  • Gouging toenails affecting nearby toe
  • Shoes that don’t fit properly
  • Pressure sores
  • Loss of circulation in legs & feet
  • Edema & swelling of feet and ankles

Susceptible Infections

Diabetes and poor circulation can cause general loss of sensitivity over the years, turning a simple cut into a serious issue.

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.

Read more about Elderly Foot Care
Tuesday, 10 January 2023 00:00

How to Care for Your Child's Feet

It is never normal for a child to experience pain in his or her feet. Foot pain that lasts more than a few days and limits a child’s ability to walk should be examined by a podiatrist. Many adult foot ailments originate in childhood and may be present at birth. Common foot issues that are experienced by children are pediatric flat foot, Sever’s disease, ingrown toenails, and plantar warts.

A child’s foot grows rapidly during the first year, allowing it to reach almost half of their adult foot size. Consequently, foot specialists consider the first year to be the most crucial point in the foot development process. There are ways you can help ensure that your child’s foot develops properly. One way is to carefully look at your baby’s feet. If you notice any deformities, you should immediately seek professional care. You should also loosely cover your child’s foot, since tight coverings may prevent movement and inhibit normal development. Another tip is to change the baby’s positioning throughout the day. If your baby lies down in one spot for too long, it may put an excess amount of strain on the feet and legs.

It is best that you try not to force a child to start walking. Children will begin to walk when they are both physically and emotionally capable to do so. You should also avoid comparing your child’s walking progress with other children because the age range for independent walking may range. When your child’s feet begin to develop, you may need to change both their shoe and sock size every few months to allow room for their feet to grow.

Kids are sometimes prone to splinters, cuts, and severe injuries because they tend to walk around barefoot. This also makes them more susceptible to developing plantar warts which is a condition caused by a virus that invades the sole of the foot through breaks in the skin. These ailments can be avoided by making sure your child wears shoes in unsanitary environments. You should also wash any minor cuts or scrapes on your child’s feet. It is a myth that exposure to fresh air will heal injuries; fresh air will only expose your child’s cuts to germs.

As a parent, you should ensure that your child’s feet are developing properly and are being properly maintained. Consequently, it is important that you perform routine inspections on his or her feet to detect any injuries or deformities in their early stages. Early detection and treatment will help to ensure that your child does not develop any serious foot conditions.

Tuesday, 10 January 2023 00:00

Benefits of Children Walking Barefoot

Research has shown there may be a connection of walking barefoot and increased cognitive abilities. When children walk barefoot, they may become more aware of different textures that are walked on, which may contribute to understanding spatial awareness. There are numerous nerves in the feet, and when shoes are frequently eliminated, the opportunity to grow new neural connections may increase. The skin on the bottom of the feet will become tougher, and walking in environments with grass or sand may help to increase a sense of freedom. Toxic stress may be decreased, and walking in these types of environments may help to regulate the nervous system. Studies have shown that babies feet are preferred receptors, and emotions may possibly be regulated when children can walk barefoot while outside. If you would like more information about the benefits of having your child walk barefoot, please speak with a podiatrist who can address any concerns you may have.

The health of a child’s feet is vital to their overall well-being. If you have any questions regarding foot health, 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.

Tips for Keeping Children's Feet Healthy

  • Make sure their shoes fit properly
  • Look for any signs of in-toeing or out-toeing
  • Check to see if they have Clubfoot (condition that affects your child’s foot and ankle, twisting the heel and toes inward) which is one of the most common nonmajor birth defects.
  • Lightly cover your baby’s feet (Tight covers may keep your baby from moving their feet freely, and could prevent normal development)
  • Allow your toddler to go shoeless (Shoes can be restricting for a young child’s foot)
  • Cut toenails straight across to avoid ingrown toenails
  • Keep your child’s foot clean and dry
  • Cover cuts and scrapes. Wash any scratches with soap and water and cover them with a bandage until they’ve healed.

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.

Read more about How to Care for Your Child's Feet
Friday, 06 January 2023 00:00

Plantar Warts Can Be Treated!

Plantar warts are small growths that develop on parts of the feet that bear weight. They're typically found on the bottom of the foot. Don't live with plantar warts, and call us today!

Tuesday, 03 January 2023 00:00

Hyperhidrosis of the Feet

Hyperhidrosis of the feet, also termed plantar hyperhidrosis, is characterized by excessive sweating of the feet that can be onset by any cause, such as exercise, fever, or anxiety. Most people suffering from hyperhidrosis of the feet also experience hyperhidrosis of the hands, or palmar hyperhidrosis. Approximately 1-2% of Americans suffer from this disorder.

Sweating is a healthy process utilized by the body in order to cool itself and maintain a proper internal temperature, which is controlled by the sympathetic nervous system. In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than is actually needed.

Plantar hyperhidrosis is considered primary hyperhidrosis. Secondary hyperhidrosis refers to excessive sweating that occurs in an area other than the feet, hands, or armpits, and this indicates that is related to another medical condition, such as menopause, hyperthyroidism, or Parkinson's disease.

Symptoms of hyperhidrosis of the feet can include foot odor, athlete's foot, infections, and blisters. Because of the continual moisture, shoes and socks can rot which creates an additional foul odor and can ruin the material, requiring shoes and socks to be replaced frequently. In addition to the physical symptoms, emotional health is often affected as this disorder can be very embarrassing.

If left untreated, hyperhidrosis will usually persist throughout an individual's life. However, there are several treatment options available. A common first approach to treating hyperhidrosis of the feet is a topical ointment. Aluminum chloride, an ingredient found in antiperspirants, can be effective at treating hyperhidrosis if used in high concentration and applied to the foot daily. Some individuals can experience relief this way, while others encounter extreme irritation and are unable to use the product. Another procedure is the use of Botulinum Toxin A, commonly referred to as Botox. This is injected directly into the foot, and is effective at minimizing the sweat glands in the injected area. These injections must be repeated every 4 to 9 months.

If these treatments are ineffective, oral prescription medications may be taken in an effort to alleviate the symptoms. Again, some will experience relief while others do not. Going barefoot reportedly provides relief for most sufferers.

A final approach to combating hyperhidrosis of the feet is through surgery. Surgery has been less successful on patients with plantar hyperhidrosis than on those with palmar hyperhidrosis. It is only recommended when sweating is severe and other treatments have failed to work. This kind of surgery usually involves going into the central nervous system, and cutting nerves to stop the transmission of signals telling the foot to sweat.

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