November 2023

If you are over the age of 50, you are likely familiar with foot pain. Studies indicate that 20 percent of older adults regularly experience foot pain, often attributed to factors like excess weight or poorly fitting footwear. However, foot pain also can be a sign of more significant health concerns that affect balance and foot function, and increase the risk of falls. Persistent foot pain may signal underlying health issues, such as stress fractures, plantar fasciitis, neuropathy, and gout. Stress fractures, common in older adults due to thinning bone tissue, may require rest, special shoe inserts, or braces. Plantar fasciitis, involving inflammation of the ligament connecting the heel to the front of the foot, should be examined if it persists. Neuropathy, common in individuals with diabetes, causes tingling, burning, and foot numbness. Prompt investigation is essential, as neuropathy can stem from various causes, including alcohol overuse or infections like Lyme disease and cancer. Gout, a form of inflammatory arthritis, is often misdiagnosed and overlooked. It typically begins in the big toe, causing severe pain, especially at night. Diagnosis involves blood work to check uric acid levels, fluid sample analysis for urate crystals, and ultrasound. If you are feeling foot pain on a continued basis, it is suggested that you schedule an appointment with a podiatrist for a complete examination and proper diagnosis. Treatment options will follow. 

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.

The human foot is a marvel of engineering, with a complex network of 26 bones working seamlessly in unison to support our body weight and enable a wide range of movements. These bones can be categorized into three main groups, known as the tarsal bones in the ankle, metatarsals in the arch, and phalanges in the toes. Tarsal bones provide the foot's stability and shock-absorbing capacity. They bear the weight and help transmit the forces generated during activities. Metatarsals form the foot's longitudinal arch, creating a flexible structure that acts as a lever during walking, running, and jumping. The phalanges, or toes, contribute to balance and provide dexterity. The biomechanics of the feet rely on an extensive network of muscles, tendons, and ligaments. Together, they allow for precise and controlled movements. When all components function harmoniously, the foot operates efficiently, ensuring that we can walk, run, and stand with stability and grace. Understanding this collaboration among foot bones highlights the importance of proper foot care and maintenance for a lifetime of healthy and pain-free mobility. If you would like additional information about the intricacies of the feet, it is suggested that you consult a podiatrist who can provide you with the information you are seeking.

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.

Biomechanics in Podiatry

Podiatric biomechanics is a particular sector of specialty podiatry with licensed practitioners who are trained to diagnose and treat conditions affecting the foot, ankle and lower leg. Biomechanics deals with the forces that act against the body, causing an interference with the biological structures. It focuses on the movement of the ankle, the foot and the forces that interact with them.

A History of Biomechanics

• Biomechanics dates back to the BC era in Egypt where evidence of professional foot care has been recorded.
• In 1974, biomechanics gained a higher profile from the studies of Merton Root, who claimed that by changing or controlling the forces between the ankle and the foot, corrections or conditions could be implemented to gain strength and coordination in the area.

Modern technological improvements are based on past theories and therapeutic processes that provide a better understanding of podiatric concepts for biomechanics. Computers can provide accurate information about the forces and patterns of the feet and lower legs.

Understanding biomechanics of the feet can help improve and eliminate pain, stopping further stress to 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 and ankle needs.

Tarsal tunnel syndrome, abbreviated TTS, is a relatively rare but painful condition involving the compression of the tibial nerve as it passes through the tarsal tunnel, a narrow passageway on the inside of the ankle. The tarsal tunnel is enclosed by bone and ligaments, and when pressure is exerted on the tibial nerve within this space, it can lead to TTS. The exact causes of tarsal tunnel syndrome can vary, but common factors include injury or trauma to the ankle, such as sprains or fractures, which may lead to swelling and compression of the nerve. Overpronation, where the foot rolls excessively inward, can also place additional stress on the tibial nerve. Other factors contributing to TTS may include systemic conditions like diabetes, which can result in nerve inflammation and entrapment. Recognizing the potential causes of tarsal tunnel syndrome is essential in seeking appropriate medical care and taking preventive measures to alleviate this painful condition. If you have foot pain, it is suggested that you contact a podiatrist who can accurately diagnose and treat tarsal tunnel syndrome.

Tarsal tunnel syndrome can be very uncomfortable to live with. If you are experiencing tarsal tunnel syndrome, 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.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, which can also be called tibial nerve dysfunction, is an uncommon condition of misfiring peripheral nerves in the foot. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome, the tibial nerve is damaged, causing problems with movement and feeling in the foot of the affected leg.

Common Cause of Tarsal Tunnel Syndrome

• Involves pressure or an injury, direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or near the knee.
• Diseases that damage nerves, including diabetes, may cause tarsal tunnel syndrome.
• At times, tarsal tunnel syndrome can appear without an obvious cause in some cases.

The Effects of Tarsal Tunnel Syndrome

• Different sensations, an afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg.
• The foot muscles, toes and ankle become weaker, and curling your toes or flexing your foot can become difficult.
• If condition worsens, infections and ulcers may develop on the foot that is experiencing the syndrome.

A physical exam of the leg can help identify the presence of tarsal tunnel syndrome. Medical tests, such as a nerve biopsy, are also used to diagnose the condition. Patients may receive physical therapy and prescriptive medication. In extreme cases, some may require surgery.

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.

Rheumatoid arthritis, abbreviated RA, is a systemic autoimmune disorder that can have a significant impact on various parts of the body, including the feet. While it is known for joint pain and inflammation, RA's effects on the feet are particularly noteworthy. This condition can lead to deformities in the feet, such as bunions and hammertoes, causing pain and difficulty walking. RA can also cause joint swelling and tenderness in the ankles and the joints that connect the foot to the toes, known as metatarsophalangeal joints. Over time, untreated RA can result in joint erosion and severe damage to the feet, severely limiting mobility. Another critical aspect is the role of early diagnosis and treatment. Addressing RA promptly can help manage symptoms and slow the progression of the disease in the feet. Regular visits to a podiatrist are essential for those living with RA to ensure proper foot care. Understanding the facts about rheumatoid arthritis in the feet is vital for those who may be affected, as it can lead to more effective management and an improved quality of life. If you have rheumatoid arthritis that is affecting your feet, it is strongly suggested that you are under the care of a podiatrist who can offer you appropriate management tips.

Because RA affects more than just your joints, including the joints in your feet and ankles, it is important to seek early diagnosis from your podiatrist if you feel like the pain in your feet might be caused by RA. For more information, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor will assist you with all of your podiatric concerns.

What Is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is an autoimmune disorder in which the body’s own immune system attacks the membranes surrounding the joints. Inflammation of the lining and eventually the destruction of the joint’s cartilage and bone occur, causing severe pain and immobility.

Rheumatoid Arthritis of the Feet

Although RA usually attacks multiple bones and joints throughout the entire body, almost 90 percent of cases result in pain in the foot or ankle area.

Symptoms

• Swelling and pain in the feet
• Stiffness in the feet
• Pain on the ball or sole of feet
• Joint shift and deformation

Diagnosis

Quick diagnosis of RA in the feet is important so that the podiatrist can treat the area effectively. Your doctor will ask you about your medical history, occupation, and lifestyle to determine the origin of the condition. Rheumatoid Factor tests help to determine if someone is affected by the disease.

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.