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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!

Tuesday, 25 January 2022 00:00

Heel Pain

Have you ever gotten up from a chair or out of bed in the morning, and upon taking that first step, feel like your heel has stepped on a tack? Many people experience a feeling of sharp pain which radiates into their arch from their heel and which does not allow them to put their heel on the floor. Sometimes they need to sit back down, stand only on their toes and use the wall for balance. If you can take a few steps, it seems to go away and lessen, allowing you to then resume your activity. Later, throughout your day and after a period of rest, it can happen again. If this sounds familiar you may be suffering from your first attack of heel pain.

Heel pain is a debilitating condition that affects day to day activities. Running and walking both causes stress on the heel because the heel is the part of the foot that hits the ground first. This means that the heel is taking on your entire weight. Diagnosis and treatments for heel pain can be easily found through your podiatrist.

Plantar Fasciitis

One of the main causes of heel pain is a condition known as plantar fasciitis. The plantar fascia is a band of tissue that extends along the bottom of the foot, from the toe to the bottom of the heel. A rip or tear in this ligament can cause inflammation of these tissues, resulting in heel pain. People who do not wear proper fitting shoes are often at risk of developing problems such as plantar fasciitis. Unnecessary stress from ill-fitting shoes, weight change, excessive running, and wearing non-supportive shoes on hard surfaces are all causes of plantar fasciitis.

Achilles Tendonitis

Achilles tendonitis is another cause of heel pain. Similar to plantar fasciitis, inflammation of the Achilles tendon will cause heel pain due to stress fractures and muscle tearing. A lack of flexibility of the ankle and heel is an indicator of Achilles tendonitis. If left untreated, this condition can lead to plantar fasciitis and cause even more pain on your heel.

Heel Spur

A third cause of heel pain is a heel spur. A heel spur occurs when the tissues of the plantar fascia undergo a great deal of stress, leading to a separation of the ligament from the heel bone entirely. This results in a pointed fragment of bone on the ball of the foot, known as a heel spur.

Tuesday, 18 January 2022 00:00

What Is an Achilles Tendon Rupture?

The Achilles tendon is a band of fibrous tissue that connects your calf muscles to your heel bone. Though this tendon is tough, it can tear or rupture during physical activity. A ruptured Achilles tendon can cause many symptoms, including a sharp, sudden pain at the back of the ankle, difficulty walking, weakness, and an inability to raise the injured foot. Some people are able to walk or continue playing sports with a ruptured Achilles tendon due to the surrounding muscles compensating. However, this can make the injury worse. A rupture can be treated conservatively or with surgery. Conservative treatment typically involves immobilizing the injured leg with a cast to allow it to heal. Surgery repairs the ruptured tendon. If you believe that you may have ruptured your Achilles tendon, it is strongly suggested that you seek the care of a podiatrist. 

Achilles tendon injuries need immediate attention to avoid future complications. If you have any concerns, 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 the Achilles Tendon?

The Achilles tendon is a tendon that connects the lower leg muscles and calf to the heel of the foot. It is the strongest tendon in the human body and is essential for making movement possible. Because this tendon is such an integral part of the body, any injuries to it can create immense difficulties and should immediately be presented to a doctor.

What Are the Symptoms of an Achilles Tendon Injury?

There are various types of injuries that can affect the Achilles tendon. The two most common injuries are Achilles tendinitis and ruptures of the tendon.

Achilles Tendinitis Symptoms

  • Inflammation
  • Dull to severe pain
  • Increased blood flow to the tendon
  • Thickening of the tendon

Rupture Symptoms

  • Extreme pain and swelling in the foot
  • Total immobility

Treatment and Prevention

Achilles tendon injuries are diagnosed by a thorough physical evaluation, which can include an MRI. Treatment involves rest, physical therapy, and in some cases, surgery. However, various preventative measures can be taken to avoid these injuries, such as:

  • Thorough stretching of the tendon before and after exercise
  • Strengthening exercises like calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses

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 What are Achilles Tendon Injuries
Tuesday, 18 January 2022 00:00

What are Achilles Tendon Injuries

The Achilles tendon is the strongest tendon in the human body. Its purpose is to connect the lower leg muscles and calf to the heel of the foot. This tendon is responsible for facilitating all types of movement, like walking and running. This tendon provides an enormous amount of mobility for the body. Any injuries inflicted to this tissue should be immediately brought up with a physician to prevent further damage. 

The most common injuries that can trouble the Achilles tendon are tendon ruptures and Achilles tendinitis. Achilles tendinitis is the milder of the two injuries. It can be recognized by the following symptoms: inflammation, dull-to-severe pain, increased blood flow to the tendon, thickening of the tendon, and slower movement time. Tendinitis can be treated via several methods and is often diagnosed by an MRI. 

An Achilles tendon rupture is trickier to heal, and is by far the most painful injury. It is caused by the tendon ripping or completely snapping. The results are immediate and absolutely devastating, and will render the patient immobile. If a rupture or tear occurs, operative and non-operative methods are available. Once the treatment begins, depending on the severity of the injury, recovery time for these types of issues can take up to a year. 

Simple preventative measures can be taken as a means to avoid both injuries. Prior to any movement, taking a few minutes to stretch out the tendon is a great way to stimulate the tissue. Calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses are all suggested ways to help strengthen the lower legs and promote Achilles tendon health. 

Many problems arise among athletes and people who overexert themselves while exercising. Problems can also happen among those who do not warm up properly before beginning an activity. Proper, comfortable shoes that fit correctly can also decrease tendon injuries. Some professionals also suggest that when exercising, you should make sure that the floor you are on is cushioned or has a mat. This will relieve pressure on the heels. A healthy diet will also increase tendon health. 

It is very important to seek out a podiatrist if you believe you have an injury in the Achilles region. Further damage could result in severe complications that would make being mobile difficult, if not impossible.

Tuesday, 11 January 2022 00:00

Ways to Reduce Foot Problems for Diabetics

Most people associate diabetes with blood sugar and insulin levels, but many diabetics are also at risk for severe foot problems. Over time diabetes may cause nerve damage and this is commonly referred to as diabetic neuropathy. This condition can cause numbness, tingling, and pain in the feet. Once this develops you might not notice a cut or sore on the foot which could lead to an infection. Diabetes can also reduce blood flow to the feet making it even more difficult for a cut or infection to heal. Without treatment an infection may lead to gangrene, and in severe cases amputation of a toe or foot could be necessary. If you have diabetes there are ways to keep your feet healthy: inspect your feet every day for cuts, sores, scrapes, or any other changes; wash and dry your feet thoroughly; trim toenails straight across and not too short; wear socks and shoes that fit correctly; and elevate your feet while you are sitting. If you have foot wounds that won't heal, notice an odor coming from your feet, or see changes to the color or shape of your feet, it is strongly suggested that you seek the care of a podiatrist as soon as possible.

Diabetic foot care is important in preventing foot ailments such as ulcers. If you are suffering from diabetes or have any other 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.

Diabetic Foot Care

Diabetes affects millions of people every year. The condition can damage blood vessels in many parts of the body, especially the feet. Because of this, taking care of your feet is essential if you have diabetes, and having a podiatrist help monitor your foot health is highly recommended.

The Importance of Caring for Your Feet

  • Routinely inspect your feet for bruises or sores.
  • Wear socks that fit your feet comfortably.
  • Wear comfortable shoes that provide adequate support.

Patients with diabetes should have their doctor monitor their blood levels, as blood sugar levels play such a huge role in diabetic care. Monitoring these levels on a regular basis is highly advised.

It is always best to inform your healthcare professional of any concerns you may have regarding your feet, especially for diabetic patients. Early treatment and routine foot examinations are keys to maintaining proper health, especially because severe complications can arise if proper treatment is not applied.

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 How to Care for Diabetic Foot
Tuesday, 11 January 2022 00:00

How to Care for Diabetic Foot

Millions of people are affected by diabetes each year. Diabetes damages blood vessels in all parts of the body, especially the feet. The legs and feet may develop slow blood flow, which causes neuropathy, or nerve damage. Once a diabetic patient develops neuropathy, it is important that the feet are well taken care of. Otherwise, the lower limbs may have to be amputated. This only happens in drastic cases, but it shows how seriously diabetic foot care should be taken.

It is very important to always wash and dry the feet thoroughly, especially in between the toes, if you’re a diabetic. Secondly, examining your feet and toes for redness or sores must be done, even if you do not feel pain.  You may also want to examine your feet from the bottom. Try to avoid wearing colored socks to prevent infections that may occur from the dye. Well-fitting socks are also highly recommended.

A diabetic’s physician should always monitor their blood levels to test how well blood sugars are being maintained. In addition to giving advice about everyday eating habits and foot care, a physician may prescribe medicine to help with the diabetic patient’s neuropathy. It is also advised to see a podiatrist if experiencing any feet conditions. Toenails may also need to be taken care of by a podiatrist. This prevents patients from cutting too deeply around their cuticles, which can lead to infection.

A person can take care of their feet at home by following the instructions of their physician. Using creams on one’s feet is also an effective way to heal dryness. Proceed with caution when using tools to remove calluses, as severe diabetics may not be able to feel pain on their feet. If any complications arise do not hesitate to contact a podiatrist.

On a daily basis, diabetic feet must be checked. If you are ever concerned about something, contact your health care professional. You never want to wait until a wound becomes too severe to treat. If left untreated, gangrene may develop. Gangrene is a serious infection that can lead to sepsis or amputation. It is also important for diabetics to be on the lookout for ulcers. Ulcers are sores that develop from tissue loss on the skin. They can be quite painful and require intensive treatment. Early treatment and everyday inspection are imperative to staying healthy.

Tuesday, 11 January 2022 00:00

Plantar Warts Can Be Treated!

Plantar warts are small growths that develop on parts of the feet that bear weight. They're typically found on the bottom of the foot. Don't live with plantar warts, and call us today!

Wednesday, 05 January 2022 00:00

Dealing With Side-Of-Foot Pain

Pain to the side of the foot is generally caused by an injury, standing for long periods of time, or overuse from repetitive physical activity. Common causes of such pain are sprains from tripping or rolling over the ankle; overuse of the feet, ankles or legs, especially in sports or other vigorous movement; stress fractures as a result of running and jumping; and collapsed arches that can put undue pressure on the rest of the foot and the ankle. At the first sign of such pain, you can ease it by stopping the activity, putting ice on the site of the pain, wrapping your foot with an elastic bandage or brace, and keeping it elevated as much as possible. In cases where the pain is ongoing and more severe, it would be wise to consult with a podiatrist who can examine the site of the pain to determine the proper treatment options for you. 

Foot Pain

Foot pain can be extremely painful and debilitating. If you have a foot pain, 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.

Causes

Foot pain is a very broad condition that could be caused by one or more ailments. The most common include:

  • Bunions
  • Hammertoes
  • Plantar Fasciitis
  • Bone Spurs
  • Corns
  • Tarsal Tunnel Syndrome
  • Ingrown Toenails
  • Arthritis (such as Gout, Rheumatoid, and Osteoarthritis)
  • Flat Feet
  • Injury (from stress fractures, broken toe, foot, ankle, Achilles tendon ruptures, and sprains)
  • And more

Diagnosis

To figure out the cause of foot pain, podiatrists utilize several different methods. This can range from simple visual inspections and sensation tests to X-rays and MRI scans. Prior medical history, family medical history, and any recent physical traumatic events will all be taken into consideration for a proper diagnosis.

Treatment

Treatment depends upon the cause of the foot pain. Whether it is resting, staying off the foot, or having surgery; podiatrists have a number of treatment options available for foot pain.

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 Foot Pain
Wednesday, 05 January 2022 00:00

Foot Pain

The feet, being the foundation of the body, carry all of the body’s weight and are therefore prone to experiencing pain and discomfort. If you are experiencing foot pain, it is important to determine where in the foot you are experiencing this pain to help discover the cause of it. While pain can be experienced virtually anywhere in the foot, the most common sites of foot pain are in the heel and ankle.   

Heel pain can be due to a multitude of conditions including plantar fasciitis, Achilles tendinitis, and heel spurs. Pain experienced in the ankle can be a sign of an ankle sprain, arthritis, gout, ankle instability, ankle fracture, or nerve compression. In more serious cases, pain in the foot can be a sign of improper alignment or an infection.

Foot pain can be accompanied by symptoms including redness, swelling, stiffness and warmth in the affected area. Whether the pain can be described as sharp or dull depends on the foot condition behind it. It is important to visit your local podiatrist if your foot pain and its accompanying symptoms persist and do not improve over time.

Depending on the location and condition of your foot pain, your podiatrist may prescribe certain treatments. These treatments can include but are not limited to prescription or over-the-counter drugs and medications, certain therapies, cortisone injections, or surgery.

If you are experiencing persistent foot pain, it is important to consult with your foot and ankle doctor to determine the cause and location. He or she will then prescribe the best treatment for you. While milder cases of foot pain may respond well to rest and at-home treatments, more serious cases may take some time to fully recover.

Tuesday, 28 December 2021 00:00

Tingling, Numb Feet

Peripheral neuropathy is a form of nerve damage that can cause a loss of sensation in the feet. This condition often co-occurs with diabetes. Symptoms of peripheral neuropathy include tingling or a pins and needles sensation in the feet, burning pain or increased sensitivity in the lower legs, numbness, or weakness. Peripheral neuropathy can lead to serious complications, such as reduced mobility, deformity, and foot ulcers. A podiatrist can examine your feet and determine if you may have peripheral neuropathy. Treatment focuses on managing symptoms and reducing pain. For more information about peripheral neuropathy, please consult with a podiatrist.

Neuropathy

Neuropathy can be a potentially serious condition, especially if it is left undiagnosed. If you have any concerns that you may be experiencing nerve loss in your feet, 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 for neuropathy.

What Is Neuropathy?

Neuropathy is a condition that leads to damage to the nerves in the body. Peripheral neuropathy, or neuropathy that affects your peripheral nervous system, usually occurs in the feet. Neuropathy can be triggered by a number of different causes. Such causes include diabetes, infections, cancers, disorders, and toxic substances.

Symptoms of Neuropathy Include:

  • Numbness
  • Sensation loss
  • Prickling and tingling sensations
  • Throbbing, freezing, burning pains
  • Muscle weakness

Those with diabetes are at serious risk due to being unable to feel an ulcer on their feet. Diabetics usually also suffer from poor blood circulation. This can lead to the wound not healing, infections occurring, and the limb may have to be amputated.

Treatment

To treat neuropathy in the foot, podiatrists will first diagnose the cause of the neuropathy. Figuring out the underlying cause of the neuropathy will allow the podiatrist to prescribe the best treatment, whether it be caused by diabetes, toxic substance exposure, infection, etc. If the nerve has not died, then it’s possible that sensation may be able to return to the foot.

Pain medication may be issued for pain. Electrical nerve stimulation can be used to stimulate nerves. If the neuropathy is caused from pressure on the nerves, then surgery may be necessary.

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 Neuropathy
Tuesday, 28 December 2021 00:00

Neuropathy

Neuropathy is the weakness, numbness, and pain in the hands and feet due to damage to the peripheral nerves. The peripheral nerves are responsible for sending information from the brain and spinal cord to the rest of your body. Causes of Neuropathy include: traumatic injuries, infections, metabolic problems, exposure to toxins, and diabetes.

Diabetes is the most common cause, with more than half of the diabetic population developing some type of neuropathy. There are several types of neuropathy and they vary based on the damage of the nerves. Mononeuropathy is classified as only one nerve being damaged. When multiple nerves are affected, it is referred as polyneuropathy. One of the types of polyneuropathy is distal symmetric polyneuropathy. It is the most common for people with diabetes and starts when the nerves furthest away from the central nervous begin to malfunction. The symptoms begin with pain and numbness in the feet and then they travel up to the legs. A rarer form of polyneuropathy is acute symmetrical peripheral neuropathy, which is a severe type that affects nerves throughout the body and is highly associated with Guillain-Barre syndrome, an autoimmune disorder that attacks the peripheral nervous system and can be fatal. Although there are many types of neuropathy, most of them share the same symptoms such as pain, extreme sensitivity to touch, lack of coordination, muscle weakness, dizziness, and digestive problems. Since neuropathy affects the nerves, those affected should be careful of burns, infection and falling, as depleted sensations disguise such ailments.

The best way to prevent neuropathy is to manage any medical conditions such as diabetes, alcoholism, or rheumatoid arthritis. Creating and managing a healthy lifestyle can also go a long way. Having a healthy diet full of fruits, vegetables, whole grains and lean protein can keep the nerves healthy. These types of food have the nutrients to prevent neuropathy. Regularly exercising can help as well, but it is best to consult with a doctor about the right amount. In addition to diet and exercise, avoiding risk factors will also prevent neuropathy. This includes repetitive motions, cramped positions, exposure to toxic chemicals, smoking and overindulging on alcohol.

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