December 2024

Diabetic foot disease, or DFD, is a serious complication of diabetes that significantly impacts quality of life. Its prevalence has increased due to predisposing factors such as prolonged high blood sugar levels, poor circulation, and impaired immune function. These factors heighten the risk of infections, slow wound healing, and contribute to conditions like diabetic neuropathy, which reduces sensation in the feet. This loss of feeling can lead to unnoticed injuries that develop into diabetic foot ulcers, a common precursor to lower limb amputations. Without proper care, these ulcers can become severely infected, making amputation necessary to prevent life-threatening complications. Podiatrists play a critical role in managing diabetic foot wounds, utilizing advanced treatments such as debridement, specialized dressings, and offloading devices to promote healing and prevent recurrence. If you have diabetes,it is suggested that you schedule regular podiatric appointments to reduce the risks associated with diabetic foot disease.

Wound care is an important part in dealing with diabetes. If you have diabetes and a foot wound or would like more information about wound care for diabetics, 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 Wound Care?

Wound care is the practice of taking proper care of a wound. This can range from the smallest to the largest of wounds. While everyone can benefit from proper wound care, it is much more important for diabetics. Diabetics often suffer from poor blood circulation which causes wounds to heal much slower than they would in a non-diabetic. 

What Is the Importance of Wound Care?

While it may not seem apparent with small ulcers on the foot, for diabetics, any size ulcer can become infected. Diabetics often also suffer from neuropathy, or nerve loss. This means they might not even feel when they have an ulcer on their foot. If the wound becomes severely infected, amputation may be necessary. Therefore, it is of the upmost importance to properly care for any and all foot wounds.

How to Care for Wounds

The best way to care for foot wounds is to prevent them. For diabetics, this means daily inspections of the feet for any signs of abnormalities or ulcers. It is also recommended to see a podiatrist several times a year for a foot inspection. If you do have an ulcer, run the wound under water to clear dirt from the wound; then apply antibiotic ointment to the wound and cover with a bandage. Bandages should be changed daily and keeping pressure off the wound is smart. It is advised to see a podiatrist, who can keep an eye on it.

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.

Bunions are bony bumps that form at the base of the big toe causing it to lean toward the other toes. They often look unsightly and can be painful, especially when wearing tight or narrow shoes. Bunions develop over time due to factors like genetics, foot structure, arthritis, or wearing ill-fitting footwear. While some people experience no pain, others may suffer from redness, swelling, and discomfort, particularly after prolonged walking or standing. Bunions are more common in women, likely due to shoe choices, and in those with a family history of the condition. Unfortunately, bunions do not go away on their own. They may worsen without intervention. Treatment includes wearing wider shoes, using orthotics, or padding the bunion to reduce friction. For severe cases, surgery may be necessary. If you have a painful bunion, it is suggested that you visit a podiatrist who can assess your bunions and recommend the best treatment plan.

If you are suffering from bunions, 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?

A bunion is formed of swollen tissue or an enlargement of boney growth, usually located at the base joint of the toe that connects to the foot. The swelling occurs due to the bones in the big toe shifting inward, which impacts the other toes of the foot. This causes the area around the base of the big toe to become inflamed and painful.

Why Do Bunions Form?

Genetics – Susceptibility to bunions are often hereditary

Stress on the feet – Poorly fitted and uncomfortable footwear that places stress on feet, such as heels, can worsen existing bunions

How Are Bunions Diagnosed?

Doctors often perform two tests – blood tests and x-rays – when trying to diagnose bunions, especially in the early stages of development. Blood tests help determine if the foot pain is being caused by something else, such as arthritis, while x-rays provide a clear picture of your bone structure to your doctor.

How Are Bunions Treated?

• Refrain from wearing heels or similar shoes that cause discomfort
• Select wider shoes that can provide more comfort and reduce pain
• Anti-inflammatory and pain management drugs
• Orthotics or foot inserts
• 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 care needs.

Wearing worn-out running shoes can lead to foot, toe, and ankle problems as a result of inadequate support and cushioning. Over time, the foam and tread in running shoes degrades, reducing their ability to absorb shock and stabilize the foot. This can increase pressure on the arches, contribute to overpronation or underpronation, and lead to conditions like arch pain or Achilles tendon discomfort. Signs of wear include new foot pain, flattened midsoles, or uneven tread patterns. For runners with flat feet or for those who overpronate, worn out shoes can aggravate these structural issues, increasing the risk of foot and other injuries. Experts suggest that active runners replace their shoes every 300 to 500 miles, or approximately every six months. A podiatrist can assess a runner’s foot alignment, gait, and running habits to help them choose appropriate footwear and reduce injury risks. If you are experiencing foot pain after running, it is suggested that you schedule an appointment with a podiatrist for an exam, diagnosis, and treatment options.

All runners should take extra precaution when trying to avoid injury. 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

There are a lot of mistakes a runner can make prior to a workout that can induce injury. A lot of athletes tend to overstretch before running, instead of saving those workouts for a post-run routine. Deep lunges and hand-to-toe hamstring pulls should be performed after a workout instead of during a warmup. Another common mistake is jumping into an intense routine before your body is physically prepared for it. You should try to ease your way into long-distance running instead of forcing yourself to rush into it.

More Tips for Preventing Injury

• Incorporate Strength Training into Workouts - This will help improve the body’s overall athleticism
• Improve and Maintain Your Flexibility – Stretching everyday will help improve overall performance
• “Warm Up” Before Running and “Cool Down” Afterward – A warm up of 5-10 minutes helps get rid of lactic acid in the muscles and prevents delayed muscle soreness
• Cross-Training is Crucial
• Wear Proper Running Shoes
• Have a Formal Gait Analysis – Poor biomechanics can easily cause 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.

Juvenile idiopathic arthritis, or JIA, is an autoimmune disease that causes chronic inflammation in children’s joints, including the feet. This condition can lead to joint pain, stiffness, and swelling, particularly in the ankles and feet, making movement challenging and uncomfortable. For kids with JIA, customized preformed orthotics can provide essential support. These orthotics start with a pre-made structure, which is then tailored to the child’s specific foot shape and needs, offering personalized comfort and stability. By adjusting the orthotic’s arch support, heel cushioning, and alignment, these inserts help reduce pressure on inflamed joints and improve gait, which is often affected in JIA. Customized preformed orthotics can relieve pain, reduce joint stress, and enhance mobility, making daily activities more manageable. If your child has JIA, it is suggested that you schedule an appointment with a podiatrist to discuss if orthotics can help manage pain in their feet and ankles.

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.

Plantar fasciitis causes pain and inflammation in the plantar fascia, a thick band of tissue that runs along the bottom of the foot, connecting the heel to the toes. This condition results in sharp heel pain, especially in the morning or after long periods of standing or walking.. The pain may improve with activity but can return after rest. The main cause of plantar fasciitis is repetitive stress or strain on the plantar fascia, often due to excessive pressure from activities or improper footwear. Other risk factors include obesity, tight calf muscles, and flat feet. If you have heel pain, it is suggested that you consult a podiatrist who can accurately diagnose and treat plantar fasciitis.

Plantar fasciitis can be very painful and inconvenient. If you are experiencing heel pain or symptoms of plantar fasciitis, 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 Is Plantar Fasciitis?

Plantar fasciitis is the inflammation of the thick band of tissue that runs along the bottom of your foot, known as the plantar fascia, and causes mild to severe heel pain.

What Causes Plantar Fasciitis?

• Excessive running
• Non-supportive shoes
• Overpronation
• Repeated stretching and tearing of the plantar fascia

How Can It Be Treated?

• Conservative measures – anti-inflammatories, ice packs, stretching exercises, physical therapy, orthotic devices
• Shockwave therapy – sound waves are sent to the affected area to facilitate healing and are usually used for chronic cases of plantar fasciitis
• Surgery – usually only used as a last resort when all else fails. The plantar fascia can be surgically detached from the heel

While very treatable, plantar fasciitis is definitely not something that should be ignored. Especially in severe cases, speaking to your doctor right away is highly recommended to avoid complications and severe heel pain. Your podiatrist can work with you to provide the appropriate treatment options tailored to your condition.

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.