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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!

Friday, 01 November 2024 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, 29 October 2024 00:00

Foot Pain While Cycling

Foot pain during cycling is a common issue that can arise from several factors, significantly impacting performance and comfort. One primary reason is wearing improper cycling shoes. Shoes that do not fit well can lead to pressure points and discomfort, making it essential to choose footwear that provides adequate support and a snug fit. Another critical factor is the location of the cleats. Misaligned cleats can cause improper foot positioning, resulting in pain and strain on the feet during pedaling. Ensuring that cleats are positioned correctly can promote a more natural pedal stroke and distribute pressure evenly across the foot. Additionally, consider adjusting the pedal tension and maintaining proper bike fit to enhance comfort. Having foot pain while cycling can cause temporary time off from pursuing this hobby. If this applies to you, it is suggested that you consult a podiatrist who can offer you effective relief and treatment solutions.

Sports related foot and ankle injuries require proper treatment before players can go back to their regular routines. For more information, 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.

Sports Related Foot and Ankle Injuries

Foot and ankle injuries are a common occurrence when it comes to athletes of any sport. While many athletes dismiss the initial aches and pains, the truth is that ignoring potential foot and ankle injuries can lead to serious problems. As athletes continue to place pressure and strain the area further, a mild injury can turn into something as serious as a rupture and may lead to a permanent disability. There are many factors that contribute to sports related foot and ankle injuries, which include failure to warm up properly, not providing support or wearing bad footwear. Common injuries and conditions athletes face, including:

  • Plantar Fasciitis
  • Plantar Fasciosis
  • Achilles Tendinitis
  • Achilles Tendon Rupture
  • Ankle Sprains

Sports related injuries are commonly treated using the RICE method. This includes rest, applying ice to the injured area, compression and elevating the ankle. More serious sprains and injuries may require surgery, which could include arthroscopic and reconstructive surgery. Rehabilitation and therapy may also be required in order to get any recovering athlete to become fully functional again. Any unusual aches and pains an athlete sustains must be evaluated by a licensed, reputable medical professional.

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 Sports Related Foot And Ankle Injuries
Tuesday, 29 October 2024 00:00

Sports Related Foot And Ankle Injuries

Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sports are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly, they can lead to permanent disability.

Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled medical professional.

Plantar fasciitis is a painful injury. It is inflammation of the plantar fascia, the thick band of tissue running from the heel to the base of the toes. If left untreated, it can lead to a degenerative disease called plantar fasciosis. There are several effective treatments for this ailment. Doctors often prescribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery, usually in that order. The most effective treatment for plantar fasciitis is orthotics, which offers foot support. Surgery is occasionally used as a last resort, but it comes with the risk of nerve damage and infection and often does not stop the pain.

The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount of stress placed on it. Non-surgical treatments include rest, ice or anti-inflammatory medication.  A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.

Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require reconstructive surgery followed by rehabilitation.

Tuesday, 22 October 2024 00:00

Painful Cracked Heels

Cracked heels, or heel fissures, occur when the skin on the heels becomes dry and thickened, leading to painful splits or cracks that can sometimes become infected. This condition often arises from a combination of factors, such as prolonged standing, wearing open-back shoes, and exposure to harsh weather conditions. Symptoms include visible cracks in the heel skin, which can become painful, especially when walking. The affected area may also appear dry, rough, sometimes inflamed, and ensuring proper foot hygiene can prevent infection. For persistent or severe cases of heel fissures, it is suggested that you schedule an appointment with a podiatrist for a comprehensive evaluation and treatment plan.

If the skin on your feet starts to crack, you may want to see a podiatrist to find treatment. If you have any concerns, 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.

Cracked Heels

It is important to moisturize your cracked heels in order to prevent pain, bleeding, and infection. The reason cracked heels form is because the skin on the foot is too dry to support the immense pressure placed on them. When the foot expands, the dry skin on the foot begins to split.

Ways to Help Heal Them

  • Invest in a good foot cream
  • Try Using Petroleum Jelly
  • Ease up on Soaps
  • Drink Plenty of Water

Ways to Prevent Cracked Heels

  • Moisturize After Showering
  • Skip a Shower
  • Keep Shower Water Lukewarm
  • Don’t Scrub Your Feet

If you are unsure how to proceed in treating cracked heels, seek guidance from a podiatrist. Your doctor will help you with any questions or information you may need. 

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 Solutions for Cracked Heels
Tuesday, 22 October 2024 00:00

Solutions for Cracked Heels

Cracked heels can make life very frustrating and embarrassing when displaying the bare feet. Aside from being unpleasing to the eye, they can also tear stockings and socks and wear out shoes at a faster rate. When severe, cracked heels may cause pain or infection.

Cracked heels are a problem for those who are athletic, those who may walk a lot, and those who have especially dry skin. Those who use medication that dry the skin, those who swim often, wearing certain types of shoes, and those who are diabetic may have trouble with cracked heels. Seniors whose skin produces less oil may also have trouble with cracked feet. There is no one way to develop cracked feet, and there is no cure.

Today, the market consists of numerous products that have a variety of ingredients to promote healing. Some of these are over-the-counter. Others are prescribed by a doctor, especially for those who have chronic dry feet and heels.

Some doctors recommend wearing socks at night for those with rough skin. This helps further healing, and helps creams stay on longer and better absorb into the skin.

One way to alleviate dryness that causes cracked heels is by using moisturizers both day and night. Another way is to make sure the skin is clean and dry at all times. Using a pumice stone to buff away dead skin before putting on moisturizer can also help. Cracked heels will not respond to the cream unless the outer layer of skin is first removed through exfoliation. After exfoliation, lotion or ointment will be absorbed by the skin more easily.

Foods that produce healing and balance can also help the skin from within. Everything that is put into the body can either help it or hurt it. Taking supplements of omega-3 fatty acids and zinc can also be very beneficial.

Nevertheless, not all products are guaranteed to help treat cracked feet. Seeing a professional is best if other treatments options were unsuccessful. A podiatrist should be able to give the best advice to help with this problem.

Tuesday, 15 October 2024 00:00

Causes of Achilles Tendinopathy

Achilles tendinopathy is a an injury that affects the Achilles tendon, which connects the calf muscles to the heel bone. This ailment typically arises from overuse or repetitive stress on the tendon, often seen in athletes who engage in activities like running or jumping. It can also develop from sudden increases in physical activity or improper footwear. Symptoms usually include pain and stiffness along the back of the heel, which may worsen with activity and improve with rest. The pain is often felt in the lower part of the calf or directly above the heel. Swelling and tenderness in the affected area are also common. If you have endured an Achilles tendon injury, it is suggested that you visit a podiatrist for a proper diagnosis to determine the type of injury and offer appropriate treatment solutions. 

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 The Causes, Types, and Treatments of Achilles Tendon Injuries

Tendons are fibrous tissues that connect muscles with bone. The Achilles tendon is the largest tendon in the body. It connects the calf muscles at the back of the leg with the heel, and facilitates movements such as jumping, running, and walking. 

Because the Achilles tendon is engaged so frequently and bears a great deal of pressure and stress throughout the day, it can become injured. Achilles tendon injuries cause the tissue to become irritated, inflamed, and swollen. Pain can come on gradually or be immediate, and will vary from mild to severe depending upon the injury. Where the pain occurs will vary as well, from just above the heel up through the back of the leg. There may also be stiffness in the tendon.

Achilles tendon injuries can often be caused by repetitive stress. They may also occur while running, playing tennis, gymnastics, football, basketball, dancing, soccer, baseball or other sports that require speeding up, slowing down, or pivoting quickly. Wearing high heels, falling from an elevation, stepping in a hole, having flat feet, bone spurs, tight leg muscles or tendons, wearing improper athletic shoes, exercising on uneven surfaces, or starting a new type of exercise can also cause Achilles tendon injuries.

The two most common Achilles tendon injuries are tendonitis and rupturesTendonitis causes painful inflammation and can occur in different parts of the tendon. Non-insertional Achilles tendonitis occurs when the fibers in middle of the tendon begin to break down, thicken, and swell. This condition typically affects younger, more active adults. Insertional Achilles tendonitis occurs where the tendon inserts into the heel bone. It is common for bone spurs to form with this type of injury. This condition can affect people of any age and level of activity.

Achilles tendon ruptures are a tear in the tendon. These breaks may be partial or complete. There may be an audible popping noise at the moment of injury and the pain will be sudden and severe.

An Achilles tendon injury can be diagnosed by your podiatrist after they examine you, check your range of motion, and possibly perform a calf squeeze test or review an X-ray or MRI. Depending on the type and severity of your injury, your podiatrist may treat your condition with rest/ice/compression/elevation (RICE), nonsteroidal anti-inflammatory medications, heel lifts, and stretching and strengthening exercises. If you have torn your Achilles tendon, treatment may include physical therapy, ultrasound, shockwave therapy, or possibly even surgery.


 

Monday, 20 May 2019 00:00

Preventing Running Injuries

Over half of all runners encounter at least one injury per year. The reason for this is because many runners do not train properly. Injuries are almost inevitable due to the physical stress that running causes. While our bodies are great at adapting to the stress, it can only handle it in small doses. Injuries occur when the stress is applied too quickly for the body to handle, causing something within it to break down. With each step you take, your leg is absorbing two or three times your body’s weight.

Some of the most popular running injuries are shin splints, plantar fasciitis, Achilles tendinitis, and stress fractures. Shin splints cause pain along the inside or outside of the shins, and this pain is usually felt at the beginning of a run. The condition itself is defined as an inflammation of the muscles or tendons located around the shinbone. To treat shin splints, it is advised that you ice the shin area and stretch the calf muscles. To prevent this injury, you should slowly increase the distance you plan on running, instead of jumping into a more strenuous routine.

Achilles tendinitis is another common injury and it feels like pain along the back of the leg, toward the heel. This condition is defined as an inflammation of the Achilles which is the largest tendon in the body. The Achilles is responsible for connecting your calf muscles to the heel bone and it is caused by tight calf muscles. If you want to treat this injury, you should take a break from running to cross train with a low-impact activity.

There are a lot of common mistakes runners make that are causing them to experience injury. One mistake is stretching too much prior to warming up. If you plan to go on a run, you should warm up with a gentle 3-5-minute walk followed by a 5-minute run-walk.  Another common mistake is jumping into a routine too quickly. Consequently, you should incorporate cross-training into your routine. If you are looking to get active, you should slowly weave running into an activity you are currently participating in. For example, you can try bike riding for 40 minutes followed by a 10-minute run.

Another way to prevent running injuries is to choose shoes that are appropriate for running. There are certain things you should look for when buying a new pair of running shoes. An important factor in these sneakers is flexibility. Running shoes should be capable of bending and flexing at the forefoot. However, you should not be able to bend the entire shoe in half with ease because this is a sign that the shoe does not have enough structure. Additionally, you should look for the fit of the running shoes you want to purchase. It is best to visit a specialty running shoe store to have your feet properly sized. Choosing shoes that fit properly can prevent many foot ailments.

If you are suffering from any pain from running injuries, you should make an appointment with your podiatrist to discover the underlying cause of your pain. He or she will be able to help treat your condition in the best way possible.

Monday, 14 September 2020 00:00

Achilles Tendon Injuries

The Achilles tendon is the largest tendon in the body; it is a tough band of fibrous tissue that stretches from the bones of the heel to the calf muscles. This tendon is what allows us to stand on our toes while running, walking, or jumping, it is common for this tendon to become injured. In severe cases, the Achilles tendon may become partially torn or completely ruptured. However, this tendon is susceptible to injury because of its limited blood supply and the high level of tension it endures.

The people who are more likely to suffer from Achilles tendon injuries are athletes who partake in activities that require them to speed up, slow down, or pivot. Consequently, athletes who engage in running, gymnastics, dance, football, baseball, basketball, or tennis are more likely to suffer from Achilles tendon injuries. Additionally, there are other factors that may make you more prone to this injury. People who wear high heels, have flat feet, tight leg muscles or tendons, or take medicines called glucocorticoids are more likely to have Achilles tendon injuries.

A common symptom of an Achilles tendon injury is pain above the heel that is felt when you stand on your toes. However, if the tendon is ruptured, the pain will be severe, and the area may become swollen and stiff. Other symptoms may be reduced strength in the lower ankle or leg area, and reduced range of motion in the ankle. When the Achilles tendon tears, there is usually a popping sound that occurs along with it. People who have acute tears or ruptures may find walking and standing to be difficult.

If you suspect you have injured your Achilles tendon, you should see your podiatrist to have a physical examination. Your podiatrist will likely conduct a series of tests to diagnose your injury including a “calf-squeeze” test. Calf squeeze tests are performed by first squeezing the calf muscle on the healthy leg. This will pull on the tendon and consequently cause the foot to move. Afterward, the same test will be performed on the injured leg. If the tendon is torn, the foot won’t move because the calf muscle won’t be connected to the foot.

Tuesday, 08 October 2024 00:00

How Foot Biomechanics Impact Foot Health

The foot and ankle consist of 26 bones, 33 joints, and over 100 muscles, tendons, and ligaments, forming a complex structure that provides support, balance, and mobility. Key joints include the ankle joint where the tibia, fibula, and talus meet, the subtalar joint allowing side-to-side motion, and the midfoot joints, which contribute to arch flexibility. Biomechanics of the foot and ankle are critical, as they impact walking, running, and overall posture. Improper alignment or function in these joints can lead to issues like plantar fasciitis, tendonitis, or osteoarthritis, affecting movement and increasing stress on the knees, hips, and lower back. Proper foot care, wearing supportive footwear, and orthotics can help maintain good biomechanics, reduce pain, and prevent injuries. It is suggested that you include regular check-ups with a podiatrist in your health care routine to catch potential problems early, ensuring long-term foot health.

If you have any 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.

Biomechanics in Podiatry

Podiatric biomechanics is a particular sector of specialty podiatry with licensed practitioners who are trained to diagnose and treat conditions affecting the foot, ankle and lower leg. Biomechanics deals with the forces that act against the body, causing an interference with the biological structures. It focuses on the movement of the ankle, the foot and the forces that interact with them.

A History of Biomechanics

  • Biomechanics dates back to the BC era in Egypt where evidence of professional foot care has been recorded.
  • In 1974, biomechanics gained a higher profile from the studies of Merton Root, who claimed that by changing or controlling the forces between the ankle and the foot, corrections or conditions could be implemented to gain strength and coordination in the area.

Modern technological improvements are based on past theories and therapeutic processes that provide a better understanding of podiatric concepts for biomechanics. Computers can provide accurate information about the forces and patterns of the feet and lower legs.

Understanding biomechanics of the feet can help improve and eliminate pain, stopping further stress to the foot.

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 The Importance of Biomechanics in Podiatry
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