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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, 18 March 2019 00:00

How Do High Heels Affect the Feet?

Many women who enjoy wearing high heels may be unaware of the possible harm these types of shoes may do to the feet. When high heels are worn, the weight of the body may get shifted to the joint under the big toe. This may result in the formation of a bunion, which is characterized by a bony protrusion on the side of the big toe. Corns and calluses may form on the bottom of the foot and may result in metatarsalgia. This type of pain is typically felt in the ball of the foot. If you have pain in your heel and surrounding areas, it may lead to a condition that is referred to as plantar fasciitis. It may be similar to the pain and discomfort that is experienced with heel spurs, and both conditions may develop as a result of frequently wearing high heels. If you have any of these symptoms, please consult with a podiatrist who can guide you toward proper treatment.

High heels have a history of causing foot and ankle problems. If you have any concerns about your feet or ankles, 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.

Effects of High Heels on the Feet

High heels are popular shoes among women because of their many styles and societal appeal.  Despite this, high heels can still cause many health problems if worn too frequently.

Which Parts of My Body Will Be Affected by High Heels?

  • Ankle Joints
  • Achilles Tendon – May shorten and stiffen with prolonged wear
  • Balls of the Feet
  • Knees – Heels cause the knees to bend constantly, creating stress on them
  • Back – They decrease the spine’s ability to absorb shock, which may lead to back pain.  The vertebrae of the lower back may compress.

What Kinds of Foot Problems Can Develop from Wearing High Heels?

  • Corns
  • Calluses
  • Hammertoe
  • Bunions
  • Morton’s Neuroma
  • Plantar Fasciitis

How Can I Still Wear High Heels and Maintain Foot Health?

If you want to wear high heeled shoes, make sure that you are not wearing them every day, as this will help prevent long term physical problems.  Try wearing thicker heels as opposed to stilettos to distribute weight more evenly across the feet.  Always make sure you are wearing the proper shoes for the right occasion, such as sneakers for exercising.  If you walk to work, try carrying your heels with you and changing into them once you arrive at work.  Adding inserts to your heels can help cushion your feet and absorb shock. Full foot inserts or metatarsal pads are available. 

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 Effect of High Heels on the Feet
Monday, 18 March 2019 00:00

Effect of High Heels on the Feet

For hundreds of years, women have been wearing various kinds of high heels for aesthetic reasons. Women who wear high heels appear to be taller and have longer and thinner legs, and the wearer’s gait and posture changes. Though high heels have had an association with femininity and have kept them popular over the years, there are definite health problems caused by wearing them too frequently.

The motion of the ankle joints is limited when heels are worn. The ankle joint is very important to the body when it comes to walking. Because of their location, these joints have a great deal of weight put on them. Thus, it is very important to keep them as healthy as possible. The Achilles tendon is the main tendon in the ankle. Wearing high heels too often, studies have shown, can cause the calf muscle and Achilles tendon to shorten and stiffen. This can cause problems when shoes without heels are worn.

By putting a great deal of pressure on the ball of the foot and by forcing the toes into a small toe box, high heels can cause or may worsen many foot problems. These include corns, hammertoe, bunions, Morton’s neuroma and plantar fasciitis.

Not only does wearing high heels regularly have negative effects on the feet, the rest of the body can suffer as well. The knees, one of the most important joints in the entire body, can be affected by wearing high heels.  High heels can cause the knees to stay bent all the time. Also, it can cause them to bend slightly inward as well. Doctors believe that women can suffer from osteoarthritis later in life because of constantly walking like in high heels. By limiting the natural motion of the foot during walking, high heels also cause an increased in stress on the knees.

Similarly, high heels can cause the back to go out of alignment. If high heels are worn constantly, the spine’s ability to absorb shock can cause continued back pain. They can compress the vertebrae of the lower back, and can overuse the back muscles.

However, this is not to say that high heels can never be worn. If worn occasionally and not often, they will not cause serious problems. They should not be worn every day. It’s important to wear them modestly to avoid the long-term physical health problems of the feet, knees, ankles, and back mentioned above.

Monday, 11 March 2019 00:00

Have I Broken My Foot?

If you have fallen or twisted your ankle, you may have broken your foot. There are numerous bones, ligaments and tendons that are located in each foot, and one or more may easily fracture if falling occurs. There are several symptoms that may be associated with a broken foot. These may include pain and discomfort, swelling, bruising, or difficulty in walking. In severe fractures, the bones may become dislocated, and may protrude through the skin. It is important to obtain a proper diagnosis, which may be accomplished by having an X-ray performed. This is followed by beginning the correct treatment, which may consist of wearing a supportive boot or cast. This may help to immobilize the foot so the healing process can begin. If you feel you have broken your foot, it is recommended to consult with a podiatrist who can properly diagnosis and offer correct treatment options.

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

One out of ten broken bones is reported to be in the feet. When an object crushes, bends, or stretches the bone beyond acceptable ranges, bones break. A break in the foot is either a fracture or a straight break.

The location of any break can tell you how the break happened. Toes, for instance, break typically as a result of something being kicked hard and with great force. Heel breaks almost always are a result of an improper landing from a tall height. Twists or sprains are the other two frequent occurrences. As with all usual breaks, they result from unexpected accident or sudden injury. As with stress fractures, breaks form as a process over time from repeated stress on already present cracks. Runners, dancers, and gymnasts are the usual athletes who receive this type of break. Stress fractures result from incredible pressure on the feet. It is no surprise these athletes bear the majority of reported fractures.

Pain, swelling, bruising, and redness are all indicative of the typical symptoms from a broken foot. Severe pain—to the point of not being able to walk—usually depends on the location of the break in the foot. Toes are on the lower scale of pain threshold, but heels are high, as are a few other particular bones. As the severity of the broken foot increases, symptoms like blueness, numbness, misshaping of the foot, cuts, or deformities will become apparent. These symptoms indicate the need to see a medical professional with access to an x-ray facility.

Prior to seeing a specialist, precautions should be taken to reduce pain and swelling. Elevate and stabilize the foot, and refrain from moving it. Immobilization of the foot is the next priority, so creating a homemade splint is acceptable. Keep in mind that while creating a splint, any increase of pain or cutting off blood circulation means that the splint should be removed immediately. Use ice to decrease swelling and relieve pain symptoms.

When dealing with a medical center, the patient should note that the treatment can vary. The treatment will depend on the severity of the fracture and the cause of the break. Crutches, splits, or casts are common treatments while surgery has been known to be used in more severe cases in order to repair the break in the bones. 

Monday, 11 February 2019 00:00

Sever's Disease

Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in children’s feet while they’re growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14.

Sever's disease occurs when the child’s growth plate, or the calcaneal epiphysis, an area attached to the Achilles tendon, is injured or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of the heel and the inability to put any weight on the heel. This forces the child to bear weight on their toes while walking. When a toe gait develops, the child must change the way they walk to avoid placing weight on the painful heel. If this is not properly addressed, this can lead to further developmental problems.

The most common symptom of Sever's disease is acute pain felt in the heel when a child engages in physical activity such as walking, jumping or running. Children who are active athletes are among the group most susceptible to experiencing Sever's disease. This is due to the extreme stress and tension placed on their growing feet. The rolling movement of the foot during walking or running and obesity are both additional conditions linked to causing Sever's disease.

The first step in treating Sever's disease is to rest the foot and leg and avoid physical activity. Over the counter pain-relieving and anti-inflammatory medications can be helpful for reducing the amount of heel pain. A child with Sever's disease should also wear shoes that properly support the heel and the arch of the foot. Consider purchasing orthotic shoe inserts which can help support the heel and foot while it is healing. Most patients with Sever's disease symptoms report an eventual elimination of heel pain after wearing orthotic insoles that support the affected heel.

Sever's disease may affect either one heel or both. It is important for a child experiencing heel pain to be examined by a foot doctor who can apply the squeeze test. The squeeze test compresses both sides of the heel in order to determine if there is intense pain. Discourage any child diagnosed with Sever's disease from going barefoot as this can intensify the problem. Apply ice packs to the affected painful heel two or three times a day for pain relief.

Exercises that help stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling has also proven to be very effective at treating Sever's disease. When foot curling, the foot is pointed away from the body, then curled toward the body to help stretch the muscles. The curling exercise should be done in sets of 10 or 20 repetitions and repeated several times throughout the day.

Treatment methods can continue for at least 2 weeks and as long as 2 months before the heel pain completely disappears. A child can continue doing daily stretching exercises for the legs and feet to prevent Sever’s disease from returning.

Monday, 04 March 2019 00:00

Flat Feet

Flatfoot is a foot condition in which the arch of the foot has either partially or totally dropped or has never developed. While it is common in babies and small children, it can become a problem for them in adulthood if the arch never forms. For adults, the development of flat feet can be brought upon by injury, as a result of pregnancy due to increased elasticity, or obesity. Those who have health concerns such as rheumatoid arthritis or diabetes may also be at greater risk for developing the condition.

If you suspect that you have flat feet, it is best to consult your podiatrist. Your foot doctor will examine the suspected foot and observe how it looks while you sit and stand. He or she may take an X-ray to determine how serious the condition is. Some common signs of flatfoot include toe drift, in which the toes and front part of the foot point outward, a short Achilles tendon, and a heel that tilts outwardly while the ankle tilts inward.

Once flatfoot has been diagnosed, your podiatrist may suggest one of several treatment options. Flat feet can be rigid, in which the feet appear to have no arch even when the person is not standing; or flexible, in which the person appears to have an arch while not standing, but once standing the arch disappears. Those with flexible flatfoot may be told to reduce any activities that cause pain and to avoid extended periods of walking or standing. Another suggestion may be weight loss, as excessive weight may be placing pressure on the arches

In few cases, if the condition is severe and all other methods have been exhausted surgery may be required. This is normally avoided, however, due to a lengthy recovery time and high cost.

Monday, 25 February 2019 00:00

Reasons for Cracked Heels to Develop

Many people experience cracked heels, and if it begins in childhood, genetic reasons may be the cause. If it starts as an adult, the reasons may be environmental or hormonal. Additionally, medical conditions, which may include eczema and psoriasis, may play a significant role in developing cracked heels. It typically appears as a thickening of the skin on the heel, and deep cracks, or fissures may form if left untreated. Patients who wear open-back sandals or who stand for extended periods of time during the day may find they have cracked heels. Mild relief may be found when washing and drying the feet thoroughly, followed by utilizing a good moisturizer. If you have cracked heels that are painful, it is suggested to speak to a podiatrist who can properly treat this condition.

Cracked heels are unsightly and can cause further damage to your shoes and feet. 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

Cracked heels appear unappealing and can make it harder for you walk around in sandals. Aside from looking unpleasant, cracked heels can also tear stockings, socks, and wear out your shoes. There are several methods to help restore a cracked heel and prevent further damage.

How Do You Get Them?

Dry skin is the number one culprit in creating cracked heels. Many athletes, walkers, joggers, and even swimmers suffer from cracked heels. Age and skin oil production play a role to getting cracked heels as well.

Promote Healing

Over the counter medicines can help, especially for those that need instant relief or who suffer from chronic dry feet.

Wear Socks – Wearing socks with medicated creams helps lock in moisture.

Moisturizers – Applying both day and night will help alleviate dryness which causes cracking.

Pumice Stones – These exfoliate and remove dead skin, which allows for smoother moisturizer application and better absorption into the skin. 

Change in Diet

Eating healthy with a well-balanced diet will give the skin a fresh and radiant look. Your body responds to the kinds of food you ingest. Omega-3 fatty acids and zinc supplements can also revitalize skin tissue.

Most importantly, seek professional help if unsure how to proceed in treating cracked heels. A podiatrist will help you with any questions or information needed. 

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
Monday, 25 February 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.

Monday, 18 February 2019 00:00

Causes of Poor Circulation

The medical condition that is referred to as poor circulation can be an indication of  health issues that may exist in the body. It may be caused by poor dietary habits or sitting for extended periods of time. Additional causes may consist of diabetes, peripheral artery disease (PAD), or blood clots in the legs. Many patients experience symptoms that are indicative of poor circulation, and these may include a lack of energy, feet that are cold the majority of the time, or a tingling or numbing sensation in the hands and feet. Other symptoms may consist of having a poor memory, a weakened immune system, or a loss of appetite. Research has indicated that maintaining a healthy diet and engaging in an exercise regime may be helpful in treating poor circulation. It’s important to drink plenty of fresh water daily, in addition to avoiding alcohol. If poor circulation is affecting your feet, it is suggested to speak to a podiatrist who can properly diagnose and treat this condition.

Poor circulation is a serious condition and needs immediate medical attention. If you have any concerns with poor circulation in your feet contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor will treat your foot and ankle needs.

Poor Circulation in the Feet

Poor blood circulation in the feet and legs is can be caused by peripheral artery disease (PAD), which is the result of a buildup of plaque in the arteries.

Plaque buildup or atherosclerosis results from excess calcium and cholesterol in the bloodstream. This can restrict the amount of blood which can flow through the arteries. Poor blood circulation in the feet and legs are sometimes caused by inflammation in the blood vessels, known as vasculitis.

Causes

Lack of oxygen and oxygen from poor blood circulation restricts muscle growth and development. It can also cause:

  • Muscle pain, stiffness, or weakness   
  • Numbness or cramping in the legs 
  • Skin discoloration
  • Slower nail & hair growth
  • Erectile dysfunction

Those who have diabetes or smoke are at greatest risk for poor circulation, as are those who are over 50. If you have poor circulation in the feet and legs it may be caused by PAD and is important to make changes to your lifestyle in order to reduce risk of getting a heart attack or stroke. Exercise and maintaining a healthy lifestyle will dramatically improve conditions.

As always, see a podiatrist as he or she will assist in finding a regimen that suits you. A podiatrist can also prescribe you any needed medication. 

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 of Poor Blood Circulation in the Feet

Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a buildup of plaque in the arteries. Plaque buildup, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream. This restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives. This leads to degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as the damaging or inflammation of blood vessels, known as vasculitis.

The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.

Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions such as a heart attack, stroke, etc. Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age, over 50, can also increase risk.

If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely. This will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet. Saturated fats come from fatty meats, fried foods, whole milk, etc., can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.

Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others.

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