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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, 23 November 2021 00:00

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a condition in which there is a compression of the posterior tibial nerve. The posterior tibial nerve runs along the inside of the ankle into the foot. Tarsal tunnel syndrome is named for the tarsal tunnel, which is a thin space along the inside of the ankle beside the ankle bones. This space contains various nerves, arteries, and tendons, and includes the posterior tibial nerve. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome the tibial nerve is compressed, causing tingling or burning, numbness, and pain.

Common causes of tarsal tunnel syndrome involve pressure or an injury. Injuries that produce inflammation and swelling in or around the tunnel may place pressure on the posterior tibial nerve. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or trauma to the tibial nerve, can result in tarsal tunnel syndrome. Diseases that damage nerves, such as diabetes or arthritis, may cause tarsal tunnel syndrome. Those with flat feet are at risk for developing the condition, as the extra pressure and strain placed on the foot may compress the posterior tibial nerve.

Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg. Symptoms are primarily felt on bottom of the foot and/or the inside of the ankle. Symptoms can appear suddenly and may occur due to overuse of the foot.

To diagnose tarsal tunnel syndrome, your podiatrist may examine the foot and tap the posterior tibial nerve to see if symptoms surface. He or she may also order an MRI to determine if a mass is present.

Treating tarsal tunnel syndrome will depend on the decision of your podiatrist. Multiple options are available, however, and can include rest, ice, immobilization, oral medications such as anti-inflammatory drugs (NSAIDS), physical therapy, injection therapy, orthotics, supportive shoes, braces, and surgery.

Tuesday, 16 November 2021 00:00

How to Tell if You’ve Broken a Foot Bone

The three main signs of a broken bone, or fracture, are pain, swelling, and deformity around the bone involved. At the time of injury, you may feel or hear a snapping or grinding in the foot. The area will likely be tender, swollen, and bruised. Putting weight or pressure on the injured area will cause pain. You may also be able to see where the bone is broken or displaced, particularly if it is an open fracture, where the bone pokes through the skin. Sometimes the signs of a foot fracture are not obvious. Stress fractures, which are tiny cracks that develop in a bone over time, are very common in the foot bones and often produce only mild symptoms. If you suspect that you have broken a foot bone, please seek the care of a podiatrist.

A broken foot requires immediate medical attention and treatment. If you need your feet checked, 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.

Broken Foot Causes, Symptoms, and Treatment

A broken foot is caused by one of the bones in the foot typically breaking when bended, crushed, or stretched beyond its natural capabilities. Usually the location of the fracture indicates how the break occurred, whether it was through an object, fall, or any other type of injury. 

Common Symptoms of Broken Feet:

  • Bruising
  • Pain
  • Redness
  • Swelling
  • Blue in color
  • Numbness
  • Cold
  • Misshapen
  • Cuts
  • Deformities

Those that suspect they have a broken foot shoot seek urgent medical attention where a medical professional could diagnose the severity.

Treatment for broken bones varies depending on the cause, severity and location. Some will require the use of splints, casts or crutches while others could even involve surgery to repair the broken bones. Personal care includes the use of ice and keeping the foot stabilized and elevated.

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 Causes, Symptoms, and Treatment for a Broken Foot

The human foot has 26 different bones, and the foot is divided into three parts: the hindfoot, the midfoot, and the forefoot. Each section of the foot is composed of a different amount of bones. For instance, the forefoot is made up of 19 bones. The midfoot is composed of five smaller bones called the navicular, cuboid, and three cuneiform bones. Lastly, the hindfoot is made up of only the talus and the calcaneus. The feet tend to be vulnerable to slipping and twisting; consequently, fractured bones within the foot are common. When a bone gets crushed, bent, twisted, or stretched it may become broken.

Many foot fractures occur through an accident or trauma. More specifically, common causes for broken feet are car accidents, falls, missteps, or overuse. If you have a broken ankle or foot, you may have one or more of the following symptoms: throbbing pain, swelling, bruising, tenderness, deformities, and difficulty walking.

There are some factors that may put you at a higher risk of developing a broken foot. People who participate in high-impact sports are more likely to develop foot fractures because of the stresses, direct blows, and twisting injuries involved in gameplay. Additionally, those who suddenly increase their activity level are more likely to suffer a stress fracture.

Unfortunately, there are different complications that may arise because of a foot fracture. For instance, arthritis may be caused by fractures that extend into the joints. Bone infections are also possible in open fractures due to the bone being exposed to bacteria. However, there are ways you can help prevent yourself from breaking your foot. One way to avoid fractures is to wear proper footwear. If you plan on going on a run, you should wear running shoes. You should also replace your shoes if you notice that they are becoming worn out. For runners, it is best to replace shoes every 300 to 400 miles.

Treatment for foot fractures usually consists of rest, ice, elevation, and compression (RICE). If you plan on wrapping your foot, try not to wrap it too tightly because doing so may cut off blood supply in the foot. You should also avoid walking on the fractured foot.

If you suspect you have a broken foot, you should see your podiatrist right away. It is important that you have someone bring you to your doctor, since driving with a broken foot can be dangerous. You should especially seek urgent care if you are experiencing numbness, pain, or deformities in your foot.

Friday, 12 November 2021 00:00

Gout Pain Can Be Managed

Gout is a painful, inflammatory form of arthritis. Those affected will typically feel an intense stiffness in the joints of their feet, particularly in the big toe. Schedule a visit to learn about how gout can be managed and treated.

Tuesday, 09 November 2021 00:00

What Is an Ingrown Toenail?

When the toenail curls downwards and into the skin surrounding the nail, it is referred to as an ingrown toenail.  Common signs of an ingrown toenail include pain, redness, and swelling. Ingrown toenails can become infected if they are not treated. Ingrown toenails can form from a variety of reasons, such as shoes that are too tight, not properly trimming the toenails, excessively sweaty feet, or trauma to the toe. Patients who are struggling with an ingrown toenail may be able to find relief by soaking their feet in warm water for around 15 minutes a few times a day. However, ingrown toenails that persist should be looked at by a podiatrist in order to prevent an infection.   

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.

Read more about Ingrown Toenail Care
Tuesday, 09 November 2021 00:00

Ingrown Toenail Care

An ingrown toenail is a toenail that grows sideways into the nail bed, causing pain and swelling. Ingrown toenails can worsen and cause drainage, turning into a serious infection.

Several factors affect whether a person is at risk from an ingrown toenail. The many causes include being overweight, diabetes, participating in sports, having a fungal infection of the toe, and cutting your nails too short. Ingrown toenails also have a genetic predisposition, causing some people to be more prone to receive the condition than others. Other causes include improperly fitting shoes and shoes that keep the feet damp.

Ingrown toenails can be preventable with certain measures. For starters, allowing your toe nails to grow slightly longer in length will help prevent them from becoming ingrown. If you have already developed an ingrown toenail, soak the affected toe in warm water. This will alleviate the pain and help prevent an infection from forming. Antibiotic soap or Epsom salts may be added to further help the relieving process and avoid infection. Placing cotton beneath the affected area is also suggested, as this may help the toenail grow upwards and not into the nail bed. Swelling and redness can be reduced by resting with your feet elevated.

A podiatrist should be seen if the pain becomes so serious that it prevents you from doing your everyday activities. If a red streak running up your leg appears or if you suspect your infection has spread, contact a podiatrist immediately. Fast treatments can be undertaken to lessen your pain and have you walking comfortably.

An ingrown toenail can be easily treated with a Band-Aid. Simply wrap the affected toe with a Band-Aid to prevent infection and keep the nail from growing out at a painful angle.

In more serious cases, your podiatrist may decide to make a small incision to remove a portion of your toenail. To prevent the nail from growing back, medication will be placed directly into the nail bed. This procedure would be performed under local anesthesia and is a faster method to alleviate discomfort from an ingrown toenail. Post-procedure directions will have you stay off the affected foot for a day. Afterwards, normal activities can be resumed.  

Tuesday, 02 November 2021 00:00

Ankle Foot Orthotics for Athletes

Ankle foot orthotics are shoe inserts that offer support to control the placement and movement of the ankle, correct deformities, and compensate for weakness. These inserts are used to stabilize the foot and ankle and provide toe clearance during the swing phase of gate.

Athletes often suffer foot problems because their feet are not being supported within the shoe. Ankle and foot orthotics are custom made inserts that alleviate stress on the foot. However custom orthotics should be prescribed by a podiatrist who specializes in customized footwear and orthotics design. These inserts are used by athletes for different reasons. Runners use orthotics to absorb shock at heel contact and to set up the forefoot for push-off. Basketball players wear them to control their forefeet while jumping and running.

The two main types of orthotics are over-the-counter orthotics and custom-made orthotics. To be eligible for custom orthotics, an examination of the foot and ankle will need to be completed. Afterward, both the foot and ankle will need to be casted and fitted for the proper orthotic. When the fitting process is complete, adjustments can be made to make sure everything fits perfectly.

Over the counter orthotics tend to be more popular than custom fit ones. Athletes who have less severe aches and pains in the foot, ankle or lower back area can use the over-the-counter version of orthotics. Unfortunately, over-the-counter orthotics tend to not work in treating severe injuries or ailments. Whenever you suspect you may need an ankle foot orthotic, you should consult with your podiatrist to determine which type of orthotic is right for you.

If you like walking or hiking, stretching the bottoms of your feet and ankles can be very beneficial. Stretching helps by relieving foot pain and improving flexibility, which reduces your risk of foot and ankle injuries. One simple stretch that you can perform is a foot stepover. To do this stretch, place a rolled up towel on the floor. Stand up straight and place the front half of one foot onto the towel. Be sure to keep the heel of the foot on the floor. Take a small step forward with the other foot. You should feel a stretch in the foot that is standing on the towel. Repeat ten times, holding the stretch for two to five seconds each time, and then repeat on the opposite foot. For more information about stretching the feet, please consult with a podiatrist. 

Stretching the feet is a great way to prevent injuries. If you have any concerns with 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.

Stretching the Feet

Stretching the muscles in the foot is an important part in any physical activity. Feet that are tight can lead to less flexibility and make you more prone to injury. One of the most common forms of foot pain, plantar fasciitis, can be stretched out to help ease the pain. Stretching can not only ease pain from plantar fasciitis but also prevent it as well. However, it is important to see a podiatrist first if stretching is right for you. Podiatrists can also recommend other ways to stretch your feet. Once you know whether stretching is right for you, here are some excellent stretches you can do.

  • Using a foam roller or any cylindrical object (a water bottle or soda can will do), roll the object under your foot back and forth. You should also exert pressure on the object. Be sure to do this to both feet for a minute. Do this exercise three times each.
  • Similar to the previous one, take a ball, such as a tennis ball, and roll it under your foot while seated and exert pressure on it.
  • Grab a resistance band or towel and take a seat. If you are using a towel, fold it length wise. Next put either one between the ball of your foot and heel and pull with both hands on each side towards you. Hold this for 15 seconds and then switch feet. Do this three times for each foot.
  • Finally hold your big toe while crossing one leg over the other. Pull the toe towards you and hold for 15 seconds. Once again do this three times per foot.

It is best to go easy when first stretching your foot and work your way up. If your foot starts hurting, stop exercising and ice and rest the foot. It is advised to then see a podiatrist for help.

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 How to Stretch Your Feet
Tuesday, 26 October 2021 00:00

How to Stretch Your Feet

Your feet endure a great amount of stress each day from constantly allowing us to move around. It is important to stretch your feet to help prevent them from becoming injured. Your toes may easily deform into unhealthful positions if they are not stretched.

One of the most common reasons for toe deformities are the shoes you may be wearing. Shoes that are too tight may fold and shift the toes out of place. Heeled shoes may also push your toes upward. Forcing your toes into an unnatural position which may cause the muscles to tighten and prevent them from reverting to normal length. Another common reason is improper use of foot muscles. Many people fail to use the muscles in their feet or toes when they walk. Lastly, the positioning of your feet while walking may also cause toe deformities. If you walk with your feet facing outward, your “push-off” phase is on the side of your big toe instead of the bottom of your foot. This may cause the big toe to eventually tighten into a new shifted position.

There are many reasons why stretching your toes may be helpful. One reason is that healthy spacing may aid in avoiding calluses and other injuries that are caused by rubbing.  Stretching will also prevent you from developing toes that curl, hammertoes, or bunions.

A great way to stretch your toes is to place them in your hands and bend them all downward; this will help you stretch the top of your foot. Next, you should repeat this process but instead bend them upward enough to feel a nice stretch in the bottom of your foot. You should then try to pull each toe apart from the next and pull any toes that are bent upward until they are back downward.

If you are looking to practice stretching your entire foot, you can try a towel stretch. This is done by sitting on the floor with your legs in front of you. Take a towel and wrap it around your toes. Afterward, pull the towel toward you with your toes and hold this position for 15 to 30 seconds before releasing. Practice this stretch for three sets. Another stretch your feet are towel lifts. This is done by sitting in a chair and trying to pick a towel up from the ground with your toes. Try lifting the towel with your little toes for five sets before switching feet.

If you are an athlete, or exercise often, it is especially important for you to practice stretching your feet. Those who suffer from foot pain caused by poor footwear, plantar fasciitis, or long hours of standing at work may also benefit from foot exercises.

Wednesday, 13 October 2021 00:00

Are Bunions Affecting Your Everyday Life?

Have you noticed a bony protrusion on the side of your big toe? If so, you may have developed the foot condition known as a bunion. Don't let bunions interfere with your daily activities.

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