April 2025

A bunion is a bony bump that forms at the base of the big toe as the top of toe to angles inward toward the other smaller toes. This deformity often results from inherited foot structure, wearing improper footwear, or medical conditions like arthritis. Over time, bunions can lead to pain, swelling, and difficulty walking. When conservative treatments fail to relieve symptoms, bunion surgery may be recommended to correct the alignment and relieve discomfort. Recovery from bunion surgery involves rest, elevation, and wearing a special shoe to protect the foot during healing. Swelling may last for several weeks, and, with proper care, most individuals can return to normal activities. If you have a bunion that is causing you pain, it is suggested that you confer with a podiatrist who can determine if this type of foot surgery is right for you.

Foot surgery is sometimes necessary to treat a foot ailment. To learn more, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor will assist you with all of your foot and ankle needs.

When Is Surgery Necessary?

Foot and ankle surgery is generally reserved for cases in which less invasive, conservative procedures have failed to alleviate the problem. Some of the cases in which surgery may be necessary include:

• Removing foot deformities like bunions and bone spurs
• Severe arthritis that has caused bone issues
• Cosmetic reconstruction

What Types of Surgery Are There?

The type of surgery you receive will depend on the nature of the problem you have. Some of the possible surgeries include:

• Bunionectomy for painful bunions
• Surgical fusion for realignment of bones
• Neuropathy decompression surgery to treat nerve damage

Benefits of Surgery

Although surgery is usually a last resort, it can provide more complete pain relief compared to non-surgical methods and may allow you to finally resume full activity.

Surgical techniques have also become increasingly sophisticated. Techniques like endoscopic surgery allow for smaller incisions and faster recovery times.

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.

Foot pain is a common complaint as people age, often resulting from years of wear and tear on the feet, toes, and ankles. Age-related foot issues include bunions, stress fractures, osteoarthritis, plantar fasciitis, and collapsed arches. These conditions can arise as the soft tissues lose elasticity, bones weaken, and joint cartilage wears down. Women are especially prone to developing foot problems due to factors such as hormonal changes and a higher likelihood of bone density loss later in life. In addition, high heels, often worn for many years, can increase pressure on the front of the foot and contribute to deformities and pain. A podiatrist can diagnose the source of your foot pain and recommend medical treatment, including custom orthotic devices, bracing, or injections to reduce inflammation and relieve pressure. In some cases, surgery may be necessary to correct deformities or repair damaged tissues. If you have foot problems related to aging, it is suggested that you schedule an appointment with a podiatrist for appropriate treatment.

If you need your feet checked, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor will attend to all of your foot and ankle needs and provide you with quality treatment.

Geriatrics and Podiatry
When people age, some common issues that may occur are bone density loss, dry skin, poor circulation, and rough brittle nails. These issues may also affect your foot health if the necessary steps are not taken to alleviate the problems.

It is important to take care of your feet because feet that are injured or diseased can affect your overall health. Having painful feet hinders your ability to do daily activities or may decrease your willingness to do the things that you need to do.

Visiting Your Geriatrician
As we age, health problems become more likely, so it is essential to visit your doctor for check-ups to ensure that you are doing the best you can to take care of your health. It is recommended to check your feet frequently for any possible cuts, bruises, swelling, corns or any other irregularities. 

Taking Care of Elderly Feet
Cracked or dry feet can be treated by applying moisturizer often. It is also important not to wear old socks because the older the sock is, the higher the possibility there will be that there is bacteria there. Wear fresh socks and make sure they fit properly.

Proper foot health means that you can have a more active lifestyle and you will not be bogged down by pain. Foot health also leads to good circulation, which is paramount for overall health.

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.

Flat feet in children occur when the arches do not develop properly, leading to the entire sole making contact with the ground. Causes vary and may include hereditary factors, muscle imbalances, or joint flexibility issues. Low muscle tone can prevent proper arch formation, while high muscle tone may cause stiffness and discomfort. Hypermobile joints allow excessive movement, making it difficult for the arch to maintain structure. Obesity places added pressure on the feet, contributing to flattening over time. Symptoms include foot pain, fatigue, difficulty walking long distances, and inward rolling of the ankles. Some children may also experience balance issues or discomfort when standing for extended periods. If your child has symptoms of flat feet, it is suggested that you contact a podiatrist who can offer treatment and relief management tips.

Flatfoot is a condition many people suffer from. If you have flat feet, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will treat your foot and ankle needs.

What Are Flat Feet?

Flatfoot is a condition in which the arch of the foot is depressed and the sole of the foot is almost completely in contact with the ground. About 20-30% of the population generally has flat feet because their arches never formed during growth.

Conditions & Problems:

Having flat feet makes it difficult to run or walk because of the stress placed on the ankles.

Alignment – The general alignment of your legs can be disrupted, because the ankles move inward which can cause major discomfort.

Knees – If you have complications with your knees, flat feet can be a contributor to arthritis in that area.  

Symptoms

• Pain around the heel or arch area
• Trouble standing on the tip toe
• Swelling around the inside of the ankle
• Flat look to one or both feet
• Having your shoes feel uneven when worn

Treatment

If you are experiencing pain and stress on the foot you may weaken the posterior tibial tendon, which runs around the inside of the ankle. 

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.

Debridement is the process of removing dead or infected tissue from foot wounds or ulcers to help the body restart the healing process. When unhealthy tissue is present, it can delay healing and increase the risk of infection. By clearing out this tissue, debridement encourages the growth of healthy skin, reduces the chance of complications, and may minimize long-term scarring. There are several types of debridement, including enzymatic, autolytic, mechanical, and sharp methods. The method chosen often depends on the severity and condition of the wound, as well as a patient’s overall health. In some cases, surgery may be required, particularly for deep or severely infected wounds that do not respond to conservative options. A podiatrist can evaluate the wound and determine the most effective way to promote healing. Podiatrists are trained to manage foot, toe, and ankle wounds safely and effectively, and they provide continued monitoring throughout recovery to help prevent further issues. If you have foot wounds or ulcers that are not healing properly, it is suggested that you schedule an appointment with a podiatrist for an exam and ongoing wound care.

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.

Ingrown toenails occur when the edges or corners of a toenail grow into the surrounding skin, causing pain, swelling, and sometimes infection. This condition commonly affects the big toe and can result from improper nail trimming, tight shoes, or injury. Symptoms of ingrown toenails include redness, tenderness, swelling, and sometimes a discharge of pus if an infection develops. The pain can range from mild to severe, making it difficult to wear shoes or walk comfortably. A podiatrist can help treat ingrown toenails by removing the affected portion of the nail or, in more severe cases, performing a minor surgical procedure to prevent it from recurring. They can also provide advice on proper nail care and footwear to prevent future issues. If you are dealing with ingrown toenails, it is suggested that you make an appointment with a podiatrist.

Ingrown toenails may initially present themselves as a minor discomfort, but they may progress into an infection in the skin without proper treatment. For more information about ingrown toenails, 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.

Ingrown Toenails

Ingrown toenails are caused when the corner or side of a toenail grows into the soft flesh surrounding it. They often result in redness, swelling, pain, and in some cases, infection. This condition typically affects the big toe and may recur if it is not treated properly.

Causes

• Improper toenail trimming
• Genetics
• Improper shoe fitting
• Injury from pedicures or nail picking
• Abnormal gait
• Poor hygiene

You are more likely to develop an ingrown toenail if you are obese, have diabetes, arthritis, or have any fungal infection in your nails. Additionally, people who have foot or toe deformities are at a higher risk of developing an ingrown toenail.

Symptoms

Some symptoms of ingrown toenails are redness, swelling, and pain. In rare cases, there may be a yellowish drainage coming from the nail.

Treatment

Ignoring an ingrown toenail can have serious complications. Infections of the nail border can progress to a deeper soft-tissue infection, which can then turn into a bone infection. You should always speak with your podiatrist if you suspect you have an ingrown toenail, especially if you have diabetes or poor circulation.

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.