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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!

Monday, 13 May 2019 00:00

Plantar Fasciitis

The plantar fascia is a connective tissue in the heel that stretches across the bottom length of your foot. Plantar fasciitis occurs when the connective tissue becomes inflamed, causing heel pain and discomfort during physical activity. Although the condition is completely treatable, traditional methods can take up to a year to start becoming effective.

Plantar fasciitis is caused by a number of everyday activities, so understanding the condition is important for managing and treating it. One of the most common causes of plantar fasciitis is excessive running, especially with improper fitting or non-supportive shoes. Too much exercise can lead to the plantar fascia being overworked and overstretched, which can cause tears in the tissue. Along with improper fitting shoes, pronation, the rolling of the feet inward, is a common cause of plantar fasciitis. If not treated properly, the plantar fascia becomes overstretched and starts to tear, causing inflammation.

Despite the common causes of plantar fasciitis, there are many different treatment options. For less severe cases, conservative home remedies include taking anti-inflammatory drugs to alleviate pain, applying ice packs to the bottom of your foot and heel, slowly stretching and exercising your feet to re-strengthen the tissue, and using orthotic devices are all ways to help manage your plantar fasciitis.

For more severe cases, shockwave therapy has become a common solution for plantar fasciitis. Shockwave therapy can effectively break up the tissue on the bottom of your foot which facilitates healing and regeneration. This fights the chronic pain caused by plantar fasciitis. Even if this doesn’t work, surgery is always a final option. Surgery on the tissue itself can be done to permanently correct the issue and stop the inflammation and pain in your heels.

No matter what the case may be, consulting your podiatrist is the first and best step to recovery. Even the slightest amount of heel pain could be the first stage of plantar fasciitis. Untreated symptoms can lead to the tearing and overstretching of tissue. Because the tearing of tissue can be compounded if it remains ignored, it can evolve into a severe case. The solution is early detection and early treatment. Talk to your podiatrist about the possibilities of plantar fasciitis if you’re experiencing heel pain.

Tuesday, 28 May 2019 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.

Monday, 21 September 2020 00:00

Stretching Your Feet

Debilitating foot pain is a problem for many people. But just as stretching the torso can help alleviate back pain, stretching the feet can also help mend existing foot problems and prevent future ones.

The feet, as the body’s foundation, carry the body’s entire weight and can get easily strained from overexertion. Persistent sharp pain and cramping in the feet are often common concerns. Foot pain and foot problems can be due to any number of causes, and in many cases pain may be eased without medication or doctor visits. It is always a good idea, however, to first rule out any serious medical issues with a physician.

Stretching can help relax the feet and alleviate pain, but is especially important before heavy aerobic exercise. Stretching before such activities can help you avoid experiencing painful cramps or strained foot muscles. Stretches should be performed slowly and deliberately without forceful pulling. The stretch should be held for several seconds before relaxing.

A great way to stretch out and loosen up the foot muscles while sitting is to cross one leg over the other and pull the toes carefully back without overextending. Start by resting the left ankle on the right knee. With the left hand, gently flex the left foot by pulling back on the toes. Do not pull too hard; just hard enough to feel the stretch in the arch of the foot. Then point the toes of the left foot as far as you can. Rotate the motion of pointing with pulling back on the toes. This should relax and stretch the muscles on the bottom and the top of the foot. Doing this stretch ten to twenty times should bring relief. Repeat the whole process for the other foot by resting the right ankle on the left knee.

A stretch that focuses on the often injured Achilles tendon involves standing and facing a wall with your arms out and hands flat against the wall. Step back with one foot, keeping it flat against the floor. Move the other leg forward and lean toward the wall. You should feel a stretch through the back of your leg and your Achilles tendon, but do not push yourself too much. Stop when you feel a stretching sensation, and hold for 30 seconds. Ten repetitions may be done for each foot.

Stretching the feet is important for athletes or those performing aerobic exercise, but it can also help anyone with foot pain caused by poor footwear, plantar fasciitis, or long hours standing and walking. Individuals who tend to their feet by regularly stretching every day should be able to minimize foot pain and prevent new problems from arising.

People with diabetes may be at an increased risk of developing various joint problems, including osteoarthritis, rheumatoid arthritis and Charcot foot. Diabetes can cause a decrease in sensation in the lower limbs, make the ligaments of the feet more lax, and increase joint instability. These factors, coupled with small, repetitive, poorly-healing trauma to the joints, can lead to joint damage. Elevated blood sugar levels can also cause molecular and structural changes to the cartilage in the joints, exacerbating the problem. If you have diabetes and notice problems with the joints in your feet, it is recommended that you consult with a podiatrist.

When dealing with systemic disease of the feet, it is extremely important to check the affected areas routinely so that any additional problems are caught quickly.  If you have any concerns about your feet and ankles contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will assist you with all of your podiatric needs.

Systemic Diseases of the Feet

Systemic diseases affect the whole body, and symptoms usually are displayed in the feet. This condition can make a patient’s ability to walk unbearable.  Systemic diseases include gout, diabetes mellitus, neurological disorders, and arthritis.

Gout – is caused by an excess of uric acid in the body. Common symptoms include pain, inflammation, and redness at the metatarsal/phalangeal joint of the base big toe. Gout can be treated by NSAIDs to relieve pain and inflammation, and other drugs that lower the acid levels in the body.

Diabetes mellitus – is an increase in the level of blood sugar that the body cannot counteract with its own insulin. Failure to produce enough insulin is a factor in Diabetes.

Diabetes of the Feet

Diabetic Neuropathy – may lead to damaged nerves and affect the feet through numbness and loss of sensation.

Peripheral Vascular Disease – can restrict the blood flow to the feet, and often times lead to amputation of the feet. 

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 Systemic Diseases of the Foot
Tuesday, 02 March 2021 00:00

Systemic Diseases of the Foot

There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis, among others.

In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.

Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.

There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.

Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.

All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.

Wearing the right size shoe is very important in order to keep your feet healthy and free of foot problems. When looking for the right shoes, there should be about a half an inch between the big toe and the end of the shoe when checking the fit while sitting. This is because the foot will shift in the shoe while standing. Second, make sure to wear the same type of socks while shopping that you plan to wear with the shoes. It is also helpful to shop for shoes in the afternoon because the feet expand over the course of the day. If you find a pair of shoes that you really like but they are slightly too big, wearing insoles is a way to help them fit properly as well. If you have other questions about how to make sure your shoes have the best fit for you, please consult with a podiatrist.

It is important to find shoes that fit you properly in order to avoid a variety of different foot problems. For more information about treatment, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will treat your foot and ankle needs.

Proper Shoe Fitting

Shoes have many different functions. They cushion our body weight, protect our feet, and allow us to safely play sports. You should always make sure that the shoes you wear fit you properly in order to avoid injuries and deformities such as: bunions, corns, calluses, hammertoes, plantar fasciitis, stress fractures, and more. It is important to note that although a certain pair of shoes might be a great fit for someone else, that doesn’t mean they will be a great fit for you. This is why you should always try on shoes before buying them to make sure they are worth the investment. Typically, shoes need to be replaced ever six months to one year of regular use.

Tips for Proper Shoe Fitting

  • Select a shoe that is shaped like your foot
  • Don’t buy shoes that fit too tight, expecting them to stretch to fit
  • Make sure there is enough space (3/8” to ½”) for your longest toe at the end of each shoe when you are standing up
  • Walk in the shoes to make sure they fit and feel right
  • Don’t select shoes by the size marked inside the shoe, but by how the shoe fits your foot

The shoes you buy should always feel as good as they look. Shoes that fit properly will last longer, feel better, and improve your way of life each day.

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 Proper Shoe Fitting
Monday, 22 February 2021 00:00

Proper Shoe Fitting

When it comes to maintaining foot health, wearing properly-fitting shoes is important. While wearing the appropriate pair of shoes may seem like a trivial concern, the reality is that improperly fitted shoes cause an astounding amount of injuries to the feet. The overall structure and the biomechanics of our bodies are directly affected by our posture, gait, and feet. Because of this, pain and discomfort felt throughout the body are often related to a problem in the feet. And, most foot problems usually stem from improper footwear.

Shoes should not be purchased with the expectation that they will easily stretch and contort to the size and shape of your feet. When shopping for footwear, look for shoes that fit correctly and comfortably as soon as you put them on. Do not purchase shoes that are too large or that slip in the heel area when you walk. Do not choose shoes that are loose with the intention of wearing thicker socks to compensate for the space. The widest portion of the shoe, the ball of the foot, must be made sure to fit comfortably in the shoe. 

Keeping all of these suggestions in mind may be difficult when shopping and when trying to select from a wide array of different shoes. Nonetheless, your time and money will be wasted if you purchase a pair of shoes that are too uncomfortable for you to actually wear them. After finally selecting and purchasing a pair of shoes, try them on at home. To truly ensure whether or not your shoes fit comfortably with normal activity, walk around on a carpeted surface to determine how they feel on your feet.

The possibility of damaging your feet’s 33 joints, 26 bones, and 100+ ligaments is much higher than many people suspect. Finding an appropriate and properly-fitted pair of shoes is perhaps the single most important action you can take to maintain excellent foot health and help prevent injury. The fact that our feet continue to change with age is one that many people often forget. Even if our feet no longer change in size when we mature, our feet will still change in shape.

If you already have pre-existing foot problems, there is a greater possibility that wearing improperly-fitted shoes will worsen those problems. The good news, however, is that appropriate footwear is not difficult to find. While shopping for shoes, remember that improper footwear can detrimentally affect the feet, the entire body and its biomechanical structure as well. The shoes you wear can greatly impact your legs, back, and entire body, as your posture and gait are related to your feet. Finding and selecting the best properly-fitted shoes is necessary in achieving optimal health.

Monday, 15 February 2021 00:00

Two Categories of Flat Feet

Patients who are missing an arch in their foot have the condition that is known as flat feet. Flat feet fall into two categories. Flexible flat feet have an arch that disappears when the foot bears weight and reappears while sitting or standing on tiptoes. Rigid flat feet do not have an arch regardless of whether you stand or sit. Children that have flat feet may benefit from wearing soft insoles, and this may provide additional comfort. If your child has flat feet that are causing them discomfort, it is suggested that you confer with a podiatrist who can offer treatment options.

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.

Read more about What is Flexible Flat Foot?
Monday, 15 February 2021 00:00

What is Flexible Flat Foot?

Flatfoot is classified as having the entire sole of the foot in contact or near contact to the ground while standing. The disorder is also known as fallen arches, because those affected have no arch in their feet. Flexible flatfoot and rigid flatfoot are the two types of flatfoot.

A person has flexible flatfoot if when sitting or standing on their toes, they have an arch that disappears when they stand with the entire foot on the ground. Flexible flatfoot may also be called “pediatric flatfoot” because the condition first appears in childhood. It is common among infants because the arch does not develop until the age of 5 or 6 years. Rigid flatfoot is not as common in children as it is with adults. This type of flatfoot is developed due to the weakening of tibialis posterior muscle tendon, a major supporting structure of the foot arch. Development of this deformity is progressive and shows early signs of pain and swelling that begins at the inside arch of the foot and moves to the outside of the foot below the ankle. More severe cases can possibly lead to arthritis of the foot and ankle joints.

Although most cases of flatfoot involve people born with the condition, some less common causes are obesity, diabetes, pregnancy, and osteoporosis. In some cases, flatfoot may come with no symptoms at all and does not require any type of treatment. With other cases though, symptoms may include pain in the shin, knee, hips and lower back. If a person with flatfeet experiences such symptoms, a health care provider may suggest using orthotic devices or arch supports, which may reduce the pain. Wearing supportive shoes can also prove more comfortable with flatfeet and staying away from shoes with little support such as sandals. Other methods to relieve pain also include stretching the Achilles tendon properly and using proper form when doing any physical activity. In addition, losing weight can reduce the stress on your feet and reduce the pain.

Monday, 08 February 2021 00:00

What Are Orthotics?

Orthotics are inserts that are worn inside of the shoes to correct issues with foot deformities, foot alignment, or to relieve pressure from various foot conditions. Orthotics can help relieve foot pain, knee pain, and lower back pain as well. There are 3 common types of orthotics including: soft, rigid, and semi-rigid. Soft orthotics are designed to cushion the foot when planted on the ground. Semi-rigid orthotics are designed to provide a middle ground between stability and cushioning and are often used for patients with flat feet. Rigid orthotics are designed to control movement in the foot that causes pain.  If you believe that orthotics may be right for you, please consult with a podiatrist for professional advice. A podiatrist will custom make your orthotics to maximize your experience.

If you are having discomfort in your feet and would like to try orthotics, 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.

What Are Orthotics?

Orthotics are inserts you can place into your shoes to help with a variety of foot problems such as flat feet or foot pain. Orthotics provide relief and comfort for minor foot and heel pain but can’t correct serious biomechanical problems in your feet.

Over-the-Counter Inserts

Orthotics come in a wide variety of over-the-counter inserts that are used to treat foot pain, heel pain, and minor problems. For example, arch supports can be inserted into your shoes to help correct overarched or flat feet, while gel insoles are often used because they provide comfort and relief from foot and heel pain by alleviating pressure.

Prescription Orthotics

If over-the-counter inserts don’t work for you or if you have a more severe foot concern, it is possible to have your podiatrist prescribe custom orthotics. These high-quality inserts are designed to treat problems such as abnormal motion, plantar fasciitis, and severe forms of heel pain. They can even be used to help patients suffering from diabetes by treating foot ulcers and painful calluses and are usually molded to your feet individually, which allows them to provide full support and comfort.

If you are experiencing minor to severe foot or heel pain, it’s recommended to speak with your podiatrist about the possibilities of using orthotics. A podiatrist can determine which type of orthotic is right for you and allow you to take the first steps towards being pain-free.

If you have any questions please 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 Foot Orthotics
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