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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!

December 2023

Tuesday, 26 December 2023 00:00

How to Care for Your Arthritic Foot

Arthritis is an inflammation of the joints and it can occur at any joint in the body, especially in the foot. It generally effects those who are older, however, it can occur at any age. Although there are many different forms of arthritis, there are three main types that occur in the foot. The three types are osteoarthritis, rheumatoid arthritis, and gout.

The primary cause of osteoarthritis is aging. As you age, cartilage degenerates around the joints which causes friction and pain. Obesity can cause osteoarthritis through mechanical stress. Injuries that damage joints can increase the probability as well. Finally, a family history of osteoarthritis can also increase chances of having it.

Rheumatoid arthritis occurs when the immune system attacks the joint linings and weakens them over a long time. While there is no known cause of rheumatoid arthritis, obesity and smoking can increase your chances of getting it. Women are also more likely to get it than men.

Gout is a form of arthritis that occurs when there is too much uric acid in your blood and painful crystals form in your joints. Men are more likely to have gout than women. People who are obese or drink alcohol often are also more likely to develop gout. Furthermore, having diabetes, heart disease, high blood pressure, high cholesterol, gastric bypass surgery or a family history of gout may increase your likelihood of developing the condition.

Symptoms of arthritis include pain, stiffness, swelling in the joints. These symptoms can make it harder and more painful to walk. Physical activity can increase pain and discomfort. Furthermore, joint pain can worsen throughout the day for osteoarthritis. Gout attacks generally last several days with the first few being the worst.

Diagnosis of gout includes either a joint fluid test or a blood test. X-ray imaging can detect osteoarthritis but not gout. On the other hand, there is no blood test for osteoarthritis. Rheumatoid arthritis is difficult to diagnosis. Doctors utilize family and personal medical history, a physical examination, and antibody blood tests to determine if you have rheumatoid arthritis.

Treatment varies for the different kinds of arthritis. Anti-inflammatory medication or steroids can help reduce pain from inflammation of the joints. Changing shoe types can help with some symptoms. Wider shoes can help with discomfort from gout and osteoarthritis. High heels should be avoided. Shoes with proper arch support and that take pressure off the ball of the foot can help with rheumatoid arthritis. Drinking lots of water can also help rid uric acid from the blood. Losing weight, improving your diet, and limiting alcohol and smoking can also help prevent or lessen the symptoms of arthritis.

If you are having trouble walking or pain in your feet, see a podiatrist to check if you have arthritis.

Arthritis in the feet is a condition that can bring a range of discomforts and unique sensations. It often manifests as pain and stiffness in the joints, making every step a potential challenge. Individuals with foot arthritis may experience a deep, aching pain that worsens with movement. This discomfort can be present in various areas of the foot, including the toes, the midfoot, or the ankle. One common sensation associated with foot arthritis is a feeling of stiffness or inflexibility. It can be particularly pronounced in the morning or after periods of inactivity. As arthritis progresses, swelling and warmth may accompany the pain, making the affected foot feel tender to the touch. In more advanced cases, individuals may notice a grinding or popping sensation in the affected joints, indicating the wear and tear of the cartilage. Understanding what arthritis in the feet feels like is essential for timely diagnosis and effective management. If you have any of the above symptoms which may indicate arthritis in the feet, it is suggested that you schedule an appointment with a podiatrist who can guide you toward relief methods.

Arthritis can be a difficult condition to live with. If you are seeking treatment, 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.

Arthritic Foot Care  

Arthritis is a joint disorder that involves the inflammation of different joints in your body, such as those in your feet. Arthritis is often caused by a degenerative joint disease and causes mild to severe pain in all affected areas. In addition to this, swelling and stiffness in the affected joints can also be a common symptom of arthritis.

In many cases, wearing ill-fitting shoes can worsen the effects and pain of arthritis. Wearing shoes that have a lower heel and extra room can help your feet feel more comfortable. In cases of rheumatoid arthritis, the arch in your foot may become problematic. Buying shoes with proper arch support that contour to your feet can help immensely.

Alleviating Arthritic Pain

  • Exercises that stretch the foot can prevent further pain and injury and increase mobility
  • Most of the pain can be alleviated with anti-inflammatory drugs, heat, and topical medications
  • Massages can help temporarily alleviate pain.

It is best to see your doctor for the treatment that is right for your needs and symptoms. Conditions vary, and a podiatrist can help you determine the right method of care for your feet.

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

Read more about How to Care for Your Arthritic Foot
Tuesday, 19 December 2023 00:00

Morton's Neuroma

A neuroma is a thickening of nerve tissue and can develop throughout the body.  In the foot, the most common neuroma is a Morton’s neuroma; this typically forms between the third and fourth toes.  The thickening of the nerve is typically caused by compression and irritation of the nerve; this thickening can in turn cause enlargement and, in some cases, nerve damage.

Neuromas can be caused by anything that causes compression or irritation of the nerve.  A common cause is wearing shoes with tapered toe boxes or high heels that force the toes into the toe boxes.  Physical activities that involve repeated pressure to the foot, such as running or basketball, can also create neuromas.  Those with foot deformities, such as bunions, hammertoes, or flatfeet, are more likely to develop the condition.

Symptoms of Morton’s neuroma include tingling, burning, numbness, pain, and the feeling that either something is inside the ball of the foot or that something in one’s shoe or sock is bunched up.  Symptoms typically begin gradually and can even go away temporarily by removing one’s shoes or massaging the foot.  An increase in the intensity of symptoms correlates with the increasing growth of the neuroma.

Treatment for Morton’s neuroma can vary between patients and the severity of the condition.  For mild to moderate cases, padding, icing, orthotics, activity modifications, shoe modifications, medications, and injection therapy may be suggested or prescribed.  Patients who have not responded successfully to less invasive treatments may require surgery to properly treat their condition.  The severity of your condition will determine the procedure performed and the length of recovery afterwards.

Tuesday, 19 December 2023 00:00

What Causes Morton’s Neuroma?

Morton's neuroma is a painful condition that affects the ball of the foot, typically between the third and fourth toes. It is caused by the thickening or enlargement of the tissue around a nerve leading to the toes. Several factors contribute to the development of Morton's neuroma. Wearing tight, narrow, or high-heeled shoes can compress the toes and increase pressure on the nerve, leading to irritation and inflammation. Additionally, individuals with certain foot deformities, such as high arches or flat feet, are more prone to developing Morton's neuroma because these conditions can alter the distribution of weight and pressure on the nerves. Engaging in activities that involve repetitive stress on the forefoot, like running or activities that require tight footwear, can contribute to the development of this condition. A foot injury or trauma can lead to the formation of scar tissue around the nerve, which can then become irritated and inflamed. If you experience symptoms associated with Morton's neuroma, such as pain, numbness, or a burning sensation in the ball of your foot, it is suggested that you schedule an appointment with a podiatrist for a proper diagnosis and treatment.

Morton’s neuroma is a very uncomfortable condition to live with. If you think you have Morton’s neuroma, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor will attend to all of your foot care needs and answer any of your related questions.  

Morton’s Neuroma

Morton's neuroma is a painful foot condition that commonly affects the areas between the second and third or third and fourth toe, although other areas of the foot are also susceptible. Morton’s neuroma is caused by an inflamed nerve in the foot that is being squeezed and aggravated by surrounding bones.

What Increases the Chances of Having Morton’s Neuroma?

  • Ill-fitting high heels or shoes that add pressure to the toe or foot
  • Jogging, running or any sport that involves constant impact to the foot
  • Flat feet, bunions, and any other foot deformities

Morton’s neuroma is a very treatable condition. Orthotics and shoe inserts can often be used to alleviate the pain on the forefront of the feet. In more severe cases, corticosteroids can also be prescribed. In order to figure out the best treatment for your neuroma, it’s recommended to seek the care of a podiatrist who can diagnose your condition and provide different treatment options.

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 Morton's Neuroma
Tuesday, 12 December 2023 00:00

Hammertoe

Hammertoe is a foot deformity that occurs due to an imbalance in the tendons, muscles, or ligaments that are responsible for holding the toes in their normal position. This condition may be caused by poor footwear, foot structure, trauma, and disease. The most common solution for hammertoe is to relieve the pain by changing your footwear and wearing orthotics. In severe cases, surgery may be required.

The shoes that are most likely to cause hammertoe are high heeled shoes or shoes that are too tight in the toe box. Tight shoes will force your toes to crowd together in a curled position. This position will likely continue when you take your shoes off. Another cause is trauma. When you stub your toe, you are increasing the chance that you will develop hammertoe.

There are risk factors that may make you more likely to develop this condition. Women are more likely to have the condition compared to men, and it is also more likely to appear in those who are older in age.

Many different foot problems can be avoided by wearing shoes that have adjustability, adequate toe room, and low heels. Furthermore, if you want to buy new shoes, you should look to purchase them at the end of the day and make sure you know your correct size. The importance of buying shoes at the end of the day is that your feet swell as the day progresses. You should also ensure that you are wearing your correct size because your shoe size may change as you grow older.

To diagnose someone with hammertoe, your podiatrist will need to conduct a thorough examination of your foot. Your doctor may even order an x-ray to evaluate the bones and joints of your feet and toes.

If you have hammertoe, your podiatrist may recommend that you wear shoes that fit you better along with inserts to place inside them. Additionally, he or she may suggest special exercises for you to perform to stretch your toes. One helpful exercise it to pick up marbles with your feet or crumple a towel with your toes.

Prior to meeting with your podiatrist, it will be helpful to make a list of all the symptoms you are experiencing. You should also make a note of medications you are taking and important personal information about your medical history.

Tuesday, 12 December 2023 00:00

Treatment of Hammertoe

Choosing how to treat a hammertoe, which is a foot deformity, depends on whether the toe can still move and is flexible, or is stiff and fixed. The severity of the deformity also plays a role in deciding whether to opt for surgery. Surgery is considered when there is disabling pain that does not improve with non-surgical options, like taping for a flexible hammertoe, or wearing special shoes for a fixed hammertoe. For flexible hammertoes, soft-tissue procedures are used, while rigid ones might need surgery involving the bones. Different surgical techniques are employed based on whether the deformity is flexible, fixed, or involves a rotated toe. In some cases, shortening the metatarsal bone, which is part of the middle foot, is necessary. If you have a hammertoe that is causing pain and discomfort, it is strongly suggested that you schedule an appointment with a podiatrist for an examination and discussion of treatment options that may benefit you.

Hammertoe

Hammertoes can be a painful condition to live with. For more information, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will answer any of your foot- and ankle-related questions.

Hammertoe is a foot deformity that affects the joints of the second, third, fourth, or fifth toes of your feet. It is a painful foot condition in which these toes curl and arch up, which can often lead to pain when wearing footwear.

Symptoms

  • Pain in the affected toes
  • Development of corns or calluses due to friction
  • Inflammation
  • Redness
  • Contracture of the toes

Causes

Genetics – People who are genetically predisposed to hammertoe are often more susceptible

Arthritis – Because arthritis affects the joints in your toes, further deformities stemming from arthritis can occur

Trauma – Direct trauma to the toes could potentially lead to hammertoe

Ill-fitting shoes – Undue pressure on the front of the toes from ill-fitting shoes can potentially lead to the development of hammertoe

Treatment

Orthotics – Custom made inserts can be used to help relieve pressure placed on the toes and therefore relieve some of the pain associated with it

Medications – Oral medications such as anti-inflammatories or NSAIDs could be used to treat the pain and inflammation hammertoes causes. Injections of corticosteroids are also sometimes used

Surgery – In more severe cases where the hammertoes have become more rigid, foot surgery is a potential option

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 Hammertoe
Tuesday, 05 December 2023 00:00

Sports Related Foot And Ankle Injuries

Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sports are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly, they can lead to permanent disability.

Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled medical professional.

Plantar fasciitis is a painful injury. It is inflammation of the plantar fascia, the thick band of tissue running from the heel to the base of the toes. If left untreated, it can lead to a degenerative disease called plantar fasciosis. There are several effective treatments for this ailment. Doctors often prescribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery, usually in that order. The most effective treatment for plantar fasciitis is orthotics, which offers foot support. Surgery is occasionally used as a last resort, but it comes with the risk of nerve damage and infection and often does not stop the pain.

The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount of stress placed on it. Non-surgical treatments include rest, ice or anti-inflammatory medication.  A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.

Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require reconstructive surgery followed by rehabilitation.

Tuesday, 05 December 2023 00:00

Effects of High Impact Sports on the Feet

Engaging in high-impact sports can be exhilarating, but it is also essential to recognize their potential consequences on the feet. The repetitive stress and force associated with activities such as running, basketball, or soccer can lead to various foot-related issues. The constant pounding on hard surfaces can contribute to stress fractures, impacting the bones in the feet. Additionally, the intense footwork involved in high-impact sports may lead to conditions like plantar fasciitis, where the connective tissue along the bottom of the foot becomes inflamed. Ankle sprains are another common occurrence, as sudden stops or changes in direction can sprain the ligaments. The pressure exerted during high impact activities can also contribute to the development of bunions, calluses, and neuromas. Wearing proper footwear, regular stretching, and attentive foot care are vital for athletes participating in high-impact sports, allowing them to enjoy the thrill of these activities while minimizing the risk of enduring long-lasting foot repercussions. If you are interested in learning more about how high-impact activities can affect the feet, it is suggested that you consult a podiatrist who can offer you additional information on foot protection.

Sports related foot and ankle injuries require proper treatment before players can go back to their regular routines. For more information, 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.

Sports Related Foot and Ankle Injuries

Foot and ankle injuries are a common occurrence when it comes to athletes of any sport. While many athletes dismiss the initial aches and pains, the truth is that ignoring potential foot and ankle injuries can lead to serious problems. As athletes continue to place pressure and strain the area further, a mild injury can turn into something as serious as a rupture and may lead to a permanent disability. There are many factors that contribute to sports related foot and ankle injuries, which include failure to warm up properly, not providing support or wearing bad footwear. Common injuries and conditions athletes face, including:

  • Plantar Fasciitis
  • Plantar Fasciosis
  • Achilles Tendinitis
  • Achilles Tendon Rupture
  • Ankle Sprains

Sports related injuries are commonly treated using the RICE method. This includes rest, applying ice to the injured area, compression and elevating the ankle. More serious sprains and injuries may require surgery, which could include arthroscopic and reconstructive surgery. Rehabilitation and therapy may also be required in order to get any recovering athlete to become fully functional again. Any unusual aches and pains an athlete sustains must be evaluated by a licensed, reputable medical professional.

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 Sports Related Foot And Ankle Injuries

If you are suffering from tenderness, pain, or stiffness in the joints of your feet or ankles, call us to schedule an appointment.

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