Tuesday, 19 October 2021 00:00
How Does the Ankle-Brachial Index Test Work?
The Ankle-Brachial Index (ABI) test is a screening measure that a podiatrist can use to determine a patient’s risk of having peripheral artery disease (PAD). As many as 50% of people who have PAD are asymptomatic. This makes screenings very important for detection, diagnosis, and treatment. During an ABI test, the doctor uses a blood pressure cuff or ultrasound to take your blood pressure at the brachial artery in both upper arms and at the anterior and posterior tibial arteries in both lower legs. The doctor then takes the higher of the two brachial blood pressures and the highest of the anterior or posterior tibial artery blood pressures and compares the two numbers to form a ratio. This ratio correlates to one’s risk of having PAD. A ratio of 1.0-1.4 is considered within the normal range, while a ratio below 0.90 is considered abnormal. It is said that the lower the ratio, the more severe the PAD. For more information about vascular testing, please consult with a podiatrist.
Vascular testing plays an important part in diagnosing disease like peripheral artery disease. If you have symptoms of peripheral artery disease, or diabetes, 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 Vascular Testing?
Vascular testing checks for how well blood circulation is in the veins and arteries. This is most often done to determine and treat a patient for peripheral artery disease (PAD), stroke, and aneurysms. Podiatrists utilize vascular testing when a patient has symptoms of PAD or if they believe they might. If a patient has diabetes, a podiatrist may determine a vascular test to be prudent to check for poor blood circulation.
How Is it Conducted?
Most forms of vascular testing are non-invasive. Podiatrists will first conduct a visual inspection for any wounds, discoloration, and any abnormal signs prior to a vascular test.
The most common tests include:
- Ankle-Brachial Index (ABI) examination
- Doppler examination
- Pedal pulses
These tests are safe, painless, and easy to do. Once finished, the podiatrist can then provide a diagnosis and the best course for treatment.
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.
Published in Blog
Tagged under
Tuesday, 19 October 2021 00:00
Vascular Testing in Podiatry
In foot care, vascular testing may be required in the diagnosing and treatment of certain podiatric conditions. Vascular testing is particularly relevant for patients with high-risk diabetes, poor circulation, peripheral artery disease (PAD), and chronic venous insufficiency (CVI). Procedures typically involve the examination of blood vessels throughout the body for blockages or buildup.
Vascular testing is very important for the diagnosis of various conditions, including peripheral artery disease and chronic venous insufficiency, as these conditions can greatly affect one’s quality of life and cause pain in the lower limbs. Circulatory problems in the feet and ankles can reflect issues throughout the body, making testing of the blood vessels pertinent.
Testing methods vary between practitioners and can be specific to certain foot and ankle problems. Modern technology has brought about the ability to perform vascular testing using non-invasive methods, such as the cuff-based PADnet testing device. This device records the Ankle-Brachial Index (ABI)/Toe-Brachial Index (TBI) values and Pulse Volume Recording (PVR) waveforms. Contact your podiatrist to determine what vascular testing is available for your needs.
Published in Featured
Tagged under
Tuesday, 12 October 2021 00:00
What Can Be Done to Treat an Ankle Sprain?
Ankle sprains can occur when one or more ligaments in the ankle are overstretched or torn, usually due to a sudden, twisting injury of the ankle. Sprains can range from mild to severe, but in all cases, a full recovery is vital to prevent future ankle injuries. For all ankle sprains, it is important to protect the sprained ankle from further injury by resting it. Applying ice, compressing, and elevating the injured ankle can help reduce swelling and inflammation. Taking over-the-counter anti-inflammatory drugs can be useful for pain management. Gentle stretching and strengthening exercises can help during the recovery process as well. Moderate to severe sprains will usually require further treatments to ensure proper healing. These may include footwear modifications, wearing orthotics, going to physical therapy, wearing an ankle brace or support, and in particularly severe cases, undergoing surgery to repair a torn ligament. If you have sprained your ankle, it is suggested that you seek the care of a podiatrist.
Although ankle sprains are common, they aren’t always minor injuries. If you need your ankle injury looked at, 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.
How Does an Ankle Sprain Occur?
Ankle sprains are the result of a tear in the ligaments within the ankle. These injuries may happen when you make a rapid shifting movement while your foot is planted. A less common way to sprain your ankle is when your ankle rolls inward while your foot turns outward.
What Are the Symptoms?
- Pain at the sight of the tear
- Bruising/Swelling
- Ankle area is tender to touch
- In severe cases, may hear/feel something tear
- Skin discoloration
Preventing a Sprain
- Wearing appropriate shoes for the occasion
- Stretching before exercises and sports
- Knowing your limits
Treatment of a Sprain
In many cases, the RICE method (Rest, Ice, Compression, and Elevate) is used to treat ankle sprains. However, you should see a podiatrist to see which treatment option would work best with your injury. In severe cases, surgery may be required.
It is important to ask your doctor about rehab options after you receive treatment for your injury. Stretching, strength training, and balance exercises may help the ankle heal while also preventing further 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.
Published in Blog
Tagged under
Tuesday, 12 October 2021 00:00
Ankle Sprains
Ankle sprains occur when ligaments that support the ankle stretch beyond their limits and tear. These types of injuries are very common and can occur in people of all ages. Sprains may range from mild to severe, depending on how much damage is done to the ligaments. If a sprain goes untreated, a more severe sprain may occur which can further damage the ankle. Repeated ankle sprains can lead to chronic ankle pain.
There are some risk factors that can increase your risk of suffering a sprained ankle. Those who participate in sports, walk on uneven surfaces, have a prior ankle injury, are in poor physical condition, or wear improper shoes are more likely to get a sprained ankle.
There are a few symptoms to look out for if you suspect you are suffering from a sprained ankle. Some common symptoms are swelling, bruising, tenderness, and instability of the ankle. In cases where the tearing of the ligaments is severe, there may be a “popping” sound when the strain occurs.
The RICE method is proven to be effective in treating ankle sprains. RICE stands for Rest, Ice, Compression, and Elevation. Rest is important for treatment, especially within the first 24 to 48 hours. You should also ice your sprained ankle for the first 48 hours for 20 minutes at a time. A small piece of cloth should be placed between the ice and the affected area. For the compression step, you should wear a brace that is snug, but not too tight that it cuts off circulation. When choosing a brace, be sure to choose one that is suitable for the type of ankle sprain you have. Lastly, you should elevate your foot above the heart as often as possible.
After you treat a sprain, you should go through rehabilitation to prevent the injury from occurring again. There are three phases to the rehab process. The first phase involves resting, protecting, and reducing the swelling of the injury. The second phase consists of restoring the ankle’s flexibility, range of motion, and strength. The third phase consists of slowly returning to activity and maintenance exercises.
If you suspect you have an ankle sprain, you shouldn’t hesitate to consult with your podiatrist. Your podiatrist will be able to give you a proper diagnosis and a suitable treatment option for your condition.
Published in Featured
Tagged under
Tuesday, 05 October 2021 00:00
Do I Need an X-Ray to Diagnose Hammertoes?
Hammertoe is a common foot deformity in which one or more of the four smaller toes bend downward at the middle joint, causing the affected toes to have a hammer-like shape. This condition can cause pain and discomfort that progressively worsens over time. The tops of the toes may develop corns or calluses as they rub against the inside of your shoes when walking. Diagnosing and treating hammertoe early is important, as the deformity can eventually become permanent. Your podiatrist will usually be able to diagnose hammertoe through physical examination alone. However, they may suggest an X-ray if they suspect that you could have arthritis or another condition that might be responsible for the hammertoe. In rarer cases, where the hammertoe is extremely painful, your doctor might also recommend that a fluid sample be taken from the joint to check for signs of infection or gout. If you have painful hammertoe, please seek the care of a podiatrist.
Hammertoes can be a painful condition to live with. For more information, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor will answer any of your foot- and ankle-related questions.
Hammertoe
Hammertoe is a foot deformity that occurs due to an imbalance in the muscles, tendons, or ligaments that normally hold the toe straight. It can be caused by the type of shoes you wear, your foot structure, trauma, and certain disease processes.
Symptoms
- Painful and/or difficult toe movement
- Swelling
- Joint stiffness
- Calluses/Corns
- Physical deformity
Risk Factors
- Age – The risk of hammertoe increases with age
- Sex – Women are more likely to have hammertoe compared to men
- Toe Length – You are more likely to develop hammertoe if your second toe is longer than your big toe
- Certain Diseases – Arthritis and diabetes may make you more likely to develop hammertoe
Treatment
If you have hammertoe, you should change into a more comfortable shoe that provides enough room for your toes. Exercises such as picking up marbles may strengthen and stretch your toe muscles. Nevertheless, it is important to seek assistance from a podiatrist in order to determine the severity of your hammertoe and see which treatment option will work best for you.
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.
Published in Blog
Tagged under
Tuesday, 05 October 2021 00:00
What Are Hammertoes?
Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics. This can be caused by the person’s specific gait or the manner in which they walk, or by shoes that do not comfortably fit the deformity. Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time. This can cause the muscles to shorten and toes to bend into the deformity of a hammertoe.
Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.
Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.
For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.
If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is essential. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed-toe shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted he or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.
Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses. Trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.
Published in Featured
Tagged under
Wednesday, 29 September 2021 00:00
Who Should I See To Treat Toenail Fungus?
Your podiatrist can help you take care of not only your feet and ankles, but also your toenails. One very common condition that podiatrists treat are fungal toenail infections. These infections often start as athlete’s foot, a skin infection, before spreading to the toenails, although they can also occur on just the nails. Symptoms of toenail fungus include changes in the texture, color, and shape of the nail. The nail may become crumbly, brittle, or thickened and develop yellow, white, or brown spots. In more severe cases, the nail can change shape, separate from the nail bed, emit a foul odor, and make wearing shoes uncomfortable. If you have toenail fungus, and particularly if you have toenail fungus and diabetes, it is suggested that you see a podiatrist for treatment.
If left untreated, toenail fungus may spread to other toenails, skin, or even fingernails. If you suspect you have toenail fungus it is important to seek treatment right away. For more information about treatment, 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.
Symptoms
- Warped or oddly shaped nails
- Yellowish nails
- Loose/separated nail
- Buildup of bits and pieces of nail fragments under the nail
- Brittle, broken, thickened nail
Treatment
If self-care strategies and over-the-counter medications does not help your fungus, your podiatrist may give you a prescription drug instead. Even if you find relief from your toenail fungus symptoms, you may experience a repeat infection in the future.
Prevention
In order to prevent getting toenail fungus in the future, you should always make sure to wash your feet with soap and water. After washing, it is important to dry your feet thoroughly especially in between the toes. When trimming your toenails, be sure to trim straight across instead of in a rounded shape. It is crucial not to cover up discolored nails with nail polish because that will prevent your nail from being able to “breathe”.
In some cases, surgical procedure may be needed to remove the toenail fungus. Consult with your podiatrist about the best treatment options for your case of toenail fungus.
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.
Published in Blog
Tagged under
Wednesday, 29 September 2021 00:00
Treating Toenail Fungus
Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening. The fungal infection itself occurs beneath the surface of the nail. Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail. If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk.
The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms. Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails.
Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes. Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential. Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.
Fungal nail treatment may vary between patients and the severity of the condition. Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections. Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications. Debridement, or the removal of diseased nail matter and debris, may also be performed. In more severe cases, surgical treatment may be needed. In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed. In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.
Published in Featured
Tagged under
Tuesday, 14 September 2021 00:00
Proper Foot Care for Diabetic Feet
Diabetic patients are often aware of the link between foot problems and how their diabetes is managed. Complications can include a numbing sensation or tingling in the feet which may be the beginning of diabetic neuropathy. It may cause the inability to feel existing cuts, wounds, or bruises. If these ailments are left untreated, a diabetic ulcer may form, which may lead to amputation. Additionally, foot muscles may be affected in severely diabetic patients, which may change the alignment of the foot. Proper foot care management can begin with monitoring the glucose levels in the blood. A daily practice of good foot hygiene can consist of washing and drying the feet thoroughly, and special footwear may need to be worn. If you have diabetes, it is strongly suggested that you are under the care of a podiatrist who can help you to properly manage this condition, in addition to providing you with proper foot care advice.
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.
Published in Blog
Tagged under
Tuesday, 14 September 2021 00:00
Diabetic Foot Care
Diabetes affects millions of people every year. Blood vessels located all over the body are damaged due to diabetes—even the blood vessels of the feet. Neuropathy, or nerve damage, can result from slower blood flow in the legs and feet. In diabetic patients, neuropathy is very important to monitor, as diabetics are at risk for developing ulcers.
Always washing and thoroughly drying the feet are pertinent parts of diabetic foot care. There should be a focus on cleaning between the toes. Even if no pain is felt, the entire foot should be examined for redness and sores. Neuropathy can often mask the pain of sores and ulcers and can cause these conditions to be overlooked. Use a mirror to examine the underside of your feet if needed. It is recommended that diabetics wear well-fitting socks.
Patients with diabetes should have their doctor monitor their blood levels because blood sugar levels play a huge role in diabetic care. Monitoring these levels on a regular basis is highly advised. It is very important to keep your blood sugar levels in the normal range, which can be determined by your physician. There are medications that may be prescribed to help with any neuropathy experienced by the diabetic patient. It is also advisable to visit a podiatrist if one is experiencing any conditions involving the feet, such as ingrown toenails, which in more severe cases can cause infection.
Diabetic feet must be inspected daily. Diabetic foot care at home is possible if a patient is provided with instructions from their podiatrist. Patients can relieve dry heels with creams or ointments. Suspected wounds should warrant an immediate call to the podiatrist. Gangrene is a serious problem for diabetics and can lead to sepsis and amputation in its worst cases. Early treatment and daily inspection of diabetic feet are keys to staying healthy.
Published in Featured
Tagged under
