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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!

Patients who have pain between the toes may have a condition that is known as Morton’s neuroma. The discomfort can come from the nerves between the toes, and the pain may extend to the ball of the foot. The first symptom of Morton’s neuroma is often a tingling sensation, which will gradually worsen. In severe cases, the pain can become unbearable as pressure is exerted from shoes. Some patients describe the pain as being so unbearable they are anxious about putting the affected foot on the ground. This condition occurs as a result of compressed nerves between the toes, and the surrounding tissue may become thick. People who are most likely to be affected by Morton’s neuroma include women who frequently wear high heels, runners, or anyone with a high arch. In mild cases, treatment can consist of changing the type of shoes worn, and it may help to use orthotics. In severe cases, surgery may be necessary. After the surgery, many times a protective shoe is worn as the healing process takes place. If you have pain in this part of your foot, it is suggested to consult with a podiatrist who can perform a proper diagnosis and suggest the correct treatment for you.

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, 24 May 2022 00:00

Morton's Neuroma

Morton's Neuroma, also called Intermetatarsal Neuroma or Plantar Neuroma, is a condition that affects the nerves of the feet, usually the area between the third and fourth toe. Neuroma refers to a benign growth that can occur in different parts of the body. Morton's Neuroma strictly affects the feet. This condition causes the tissue around the nerves that lead to the toes becoming thick, causing pain in the ball of the foot.

This condition can be caused by injury, pressure or irritation. Normally no lump will be felt, but instead burning pain in the ball of the foot will be experienced. Numbness and tingling may also occur. With the onset of this condition, a person may feel pain when tight or narrow shoes are worn. As the condition worsens, the pain may persist for days, or even weeks.

Persistent foot pain should always be a concern. The foot should be examined by a podiatrist if pain persists longer than a few days with no relief from changing shoes. The earlier the foot is examined and treated, the less chance there will be for surgical treatment.

There are some factors that can play a role in the development of Morton's Neuroma. These include wearing ill-fitting shoes that cause pressure to the toes, such as high heels. Also, high impact exercise may contribute to the cause of this condition. Morton’s Neuroma may also develop if the foot sustains an injury. Another cause includes walking abnormally due to bunions or flat feet. This causes excessive pressure and irritates the tissue. At times, people are affected for no determinable reason.

Podiatrists can alleviate the effects of this condition using a treatment plan to help decrease the pain and heal the foot tissue. Depending upon the severity of the Morton's Neuroma, the treatment plan can vary. For cases that are mild to moderate, treatments may include applying padding to the arch to relieve pressure from the nerve and reduce compression while walking. Ice packs can also help reduce swelling. The podiatrist may also create a custom orthotic device to support the foot and reduce compression and pressure on the affected nerve. The doctor will probably advise against partaking in activities that cause constant pressure on the affected area. They may provide wider shoes to ease the pressure from the toes. If these treatments do not relieve the symptoms of this condition, the doctor may use injection therapy.

Surgical treatment may be recommended by the podiatrist if all other treatments fail to provide relief. Normally, the podiatric surgeon will decide on either a surgical procedure that involves removal of the affected nerve or will choose surgery to release the nerve. After examination, the surgeon will decide on the best approach to treat the problem.

Recovery varies according to the type of surgical procedure. The patient will also be instructed on the best shoe wear to prevent the return of this condition, along with changes to workout routines, if this was a cause. Preventative measures are important in ensuring the condition does not return.

Tuesday, 17 May 2022 00:00

Every Day Foot Care

Our feet are important in our everyday lives. The problem is that we tend to neglect them. When this becomes a habit, it can cause significant trouble. Ignoring foot problems can mean pain, limited mobility, and expensive doctor's visits. On the other hand, if feet are cared for and looked after regularly, they will perform without pain or complication.

Routine hygiene is the most basic way to care for the feet. Wash and dry them thoroughly daily. Remember to get between the toes and keep the toenails trimmed and short. If the feet feel dry or there are signs of dryness or cracking, use a moisturizer designed for the feet.

When using moisturizer on the feet, try to avoid applying between the toes. If cream or lotion sits too long, they can cause fungal and bacterial growth. When moisturizer is used between the toes, it can also cause the skin to soften too much.

Shoes are also an important aspect of foot care. When one is picking out shoes, make sure they are the correct size. Shoes need to be snug, but not too tight. On the other hand, if shoes are too loose they can cause foot problems as well. It is highly recommended that shopping for new shoes be done later in the day. The reason for this is that the feet will have settled and swelled to their full size by then. To keep your feet at their most healthy, avoid wearing high heels or flip flops too often. Instead, choose shoes that are good for your feet. Good shoes pad the soles of your feet and support the arches and ankles.

Socks should also be worn daily with closed-toe shoes. They may feel hot during the summer months, but they absorb sweat and moisture off the feet. Without socks, the build-up of sweat in a closed-toe shoe can cause fungal problems and athlete's foot.

The best thing to remember in every day foot care is that shoes do make a difference. If you spend a lot of time on your feet, make sure that your shoes show no signs of wear. Shoes should offer ample support for the arches and the overall foot. Additionally, try to make foot cleaning and maintenance a daily habit. If you keep these things in mind, your feet will stay healthy and safe.

Wednesday, 11 May 2022 00:00

It's Time for Beautiful Feet

You don't need an excuse to have beautiful nails. Step outside without worrying about the appearance of your feet.

Tuesday, 10 May 2022 00:00

Athlete’s Foot

Athlete’s foot, or tinea pedis, is a skin disease caused by a fungal infection.  The infection typically occurs between the toes, and the feet are most subject to this disease because shoes best create the warm, dark, and moist environment in which fungus thrives.  Other areas that create a similar environment, such as swimming pools, public showers, and locker rooms; can also promote fungi growth. 

Symptoms of athlete’s foot include dry skin, itching, scaling, inflammation, and blistering.  Sometimes, blisters can evolve into the cracks or breaks in the skin.  The exposed tissue can then create pain, swelling, and discharge.  The spread of infection can cause itching and burning as well.

While athlete’s foot commonly occurs between the toes, it may also spread to the toenails or soles of the feet.  Other parts of the body, such as the groin or underarms, can also become infected if they are touched after the original area of infection is scratched.  Aside from physical contact, athlete’s foot can also spread through the contamination of footwear, clothing or bedsheets.

Proper foot hygiene is essential in preventing athlete’s foot.  You can prevent the fungus from spreading by frequently washing your feet using soap and water, thoroughly drying the feet between the toes, changing shoes and socks every day to reduce moisture, and ensuring that bathroom and shower floors are disinfected.  Other tips include using shower shoes, avoiding walking barefoot in public environments, wearing light and airy shoes, and wearing socks that keep the feet dry.

While treatment for athlete’s foot can involve topical or oral antifungal drugs, mild cases of the infection can be treated by dusting foot powder in shoes and socks.  Any treatment used can be supplemented by frequently bathing the feet and drying the toes.  If proper foot hygiene and self-care do not ease your case of athlete’s foot, contact your podiatrist.  He will determine if the underlying cause of your condition is truly a fungus.  If that is the case, a comprehensive treatment plan may be suggested with the inclusion of prescription antifungal medications.

Tuesday, 03 May 2022 00:00

Foot Pain

Our feet are arguably the most important parts of our bodies because they are responsible for getting us from place to place.  However, we often don’t think about our feet until they begin to hurt. If you have pain in your feet, you need to first determine where on the foot you are experiencing it to get to the root of the problem. The most common areas to feel pain on the foot are the heel and the ankle.

Heel pain is most commonly attributed to a condition called plantar fasciitis. Plantar fasciitis occurs when the plantar fascia, which is the band of tough tissue connecting the heel bone to the toes becomes inflamed. Plantar fasciitis pain is usually worse in the morning, and it tends to go away throughout the day. If you have plantar fasciitis, you should rest your foot and do heel and foot muscles stretches. Wearing shoes with proper arch support and a cushioned sole has also been proven to be beneficial.

Some common symptoms of foot pain are redness, swelling, and stiffness. Foot pain can be dull or sharp depending on its underlying cause. Toe pain can also occur, and it is usually caused by gout, bunions, hammertoes, ingrown toenails, sprains, fractures, and corns.

If you have severe pain in your feet, you should immediately seek assistance from your podiatrist for treatment. Depending on the cause of your pain, your podiatrist may give you a variety of treatment options.

Tuesday, 26 April 2022 00:00

Methods That Can Help to Prevent Falling

Falling is common among people who are sixty-five years and older. This can happen as a result of poor vision and balance, in addition to safety hazards that may be present in the household. It is beneficial for seniors to undergo routine physical examinations, and this can be helpful in updating existing medication. Additionally, balance and strength may be increased when a gentle exercise routine is frequently practiced. It is beneficial to implement falls prevention techniques which can consist of installing handrails in the bath and toilet area and removing any worn rugs. It is important for lighting to be improved, and existing clutter removed. The feet can be affected when falling occurs and can cause lifestyle changes. If you would like more information about how falling can affect the feet, please consult with a podiatrist.

Preventing falls among the elderly is very important. If you are older and have fallen or fear that you are prone to falling, consult with John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will assess your condition and provide you with quality advice and care.

Every 11 seconds, an elderly American is being treated in an emergency room for a fall related injury. Falls are the leading cause of head and hip injuries for those 65 and older. Due to decreases in strength, balance, senses, and lack of awareness, elderly persons are very susceptible to falling. Thankfully, there are a number of things older persons can do to prevent falls.

How to Prevent Falls

Some effective methods that older persons can do to prevent falls include:

  • Enrolling in strength and balance exercise program to increase balance and strength
  • Periodically having your sight and hearing checked
  • Discuss any medications you have with a doctor to see if it increases the risk of falling
  • Clearing the house of falling hazards and installing devices like grab bars and railings
  • Utilizing a walker or cane
  • Wearing shoes that provide good support and cushioning
  • Talking to family members about falling and increasing awareness

Falling can be a traumatic and embarrassing experience for elderly persons; this can make them less willing to leave the house, and less willing to talk to someone about their fears of falling. Doing such things, however, will increase the likelihood of tripping or losing one’s balance. Knowing the causes of falling and how to prevent them is the best way to mitigate the risk of serious 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.

Read more about Falls Prevention
Tuesday, 26 April 2022 00:00

Falls Prevention

Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds. In light of these striking statistics, one can see the importance of taking steps to prevent falls.

Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.

Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.  

Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.

Walking and running are two completely different activities that impact different parts of the feet. Research has shown it is beneficial to wear shoes that can complement different running and walking styles. One of the differences between the two types of shoes has to do with the type of sole. Running shoes have stiffer and sturdier soles than walking shoes. This is helpful in providing the necessary stability while running. Proper walking shoes have a flexible sole, and the heels tend to be heavier than those of running shoes. Additionally, the shoes are made of different materials. Running shoes are made of breathable fabrics, which can help when feet become sweaty. A portion of the shoe that is referred to as the counter can help provide a secure fit. In walking shoes, the heel is tilted, and the toe area is stiff. Please confer with a podiatrist who can provide you with more information about the differences between walking and running shoes.

For more information about walking shoes versus running shoes, consult with John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor can measure your feet to determine what your needs are and help you find an appropriate pair of footwear.

Foot Health: The Differences between Walking & Running Shoes

There are great ways to stay in shape: running and walking are two great exercises to a healthy lifestyle. It is important to know that running shoes and walking shoes are not interchangeable. There is a key difference on how the feet hit the ground when someone is running or walking. This is why one should be aware that a shoe is designed differently for each activity.

You may be asking yourself what the real differences are between walking and running shoes and the answers may shock you.

Differences

Walking doesn’t involve as much stress or impact on the feet as running does. However, this doesn’t mean that you should be any less prepared. When you’re walking, you land on your heels and have your foot roll forward. This rolling motion requires additional support to the feet.

Flexibility – Walking shoes are designed to have soft, flexible soles. This allows the walker to push off easily with each step.

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 Differences between Walking and Running Shoes

Both running and walking are great exercises, but should a person wear the same shoes for both activities? The answer is no, because there is a difference between the way a person’s feet hit the ground when they are walking and when they are running. Therefore, the shoes for each activity are designed differently. Before you begin any exercise program it is always recommended that you speak with your doctor or podiatrist.

Walking is a low impact exercise that is often recommended by doctors to their patients. While walking is a simple activity, it still requires some degree of preparation. If you think about walking and how your feet strike the ground as you move, you will notice that your heel hits the ground first before your foot continues to roll forward and your next step begins. Because of this rolling motion, walking shoes are designed to be more flexible than running shoes. This flexibility helps the walker push off with each step taken.

Because the heel hits the ground first when you walk, walking shoes are designed to absorb most of the shock. Walking shoes should therefore have a beveled or angled heel. The angle of the heel helps absorb the shock and reduces pressure from the ankles. This is especially important for speed walkers, as their feet will hit the ground twice as often as the normal walker.

When people decide to run as a hobby or for their health, they must first realize that running is a high impact exercise. If not done with the proper equipment, running may cause damage to the feet and legs. Running shoes are designed to be more lightweight and to have thicker soles. The thicker soles act as shock absorbers for the rest of the body. Walking shoes often do not have the proper arch support that running shoes do.

A proper fitting shoe can make or break a runner or a walker. If the shoes are too big, their feet will slide back and forth inside the shoe and cause blisters. Whether you will be running or walking, the right equipment can make all of the difference in the world.

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