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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, 11 February 2019 00:00

Stretches That Can Help Sever’s Disease

Sever’s disease is a painful heel condition that only affects children. Swelling of the growth plate is what causes this disease, along with discomfort and pain. Children that are involved in sports are more likely to have this affiliation, because injuries to the growth plate are caused by weight-bearing activities. Stretching can help to prevent Sever’s disease, and it can also assist in the healing process. Movements that stretch the hamstring, calf muscles, and tendons on the back of the leg should be performed 2 to 3 times a day, with the stretch being held for around 20 seconds. Even if there is only pain in one heel, the stretches should be done with both legs. Exercises that strengthen the muscles surrounding the shin will also help alleviate some discomfort and help to prevent this condition from developing again. If you think your child may have Sever’s Disease, then it is highly recommended to consult with a podiatrist in order to receive more information and proper treatment.

Sever's disease often occurs in children and teens. If your child is experiencing foot or ankle pain, see John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor can treat your child’s foot and ankle needs.

Sever’s Disease

Sever’s disease is also known as calcaneal apophysitis, which is a medical condition that causes heel pain I none or both feet. The disease is known to affect children between the ages of 8 and 14.

Sever’s disease occurs when part of the child’s heel known as the growth plate (calcaneal epiphysis) is attached to the Achilles tendon. This area can suffer injury when the muscles and tendons of the growing foot do not keep pace with bone growth. Therefore, the constant pain which one experiences at the back of the heel will make the child unable to put any weight on the heel. The child is then forced to walk on their toes.

Symptoms

Acute pain – Pain associated with Sever’s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running.

Highly active – Children who are very active are among the most susceptible in experiencing Sever’s disease, because of the stress and tension placed on their 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 injuries.

Read more about Sever's Disease

There are many patients who are afflicted with rheumatoid arthritis who may experience discomfort in the big toe, in addition to painful ankles and joints. This may result in difficulty in walking, which may hinder completing daily activities. There are specific conditions that may develop if rheumatoid arthritis is present, and these include the formation of bunions, hammertoe, or plantar fasciitis. Additionally, it may be beneficial to wear shoes that fit properly which have adequate room for the toes to move about in. This may put less pressure on the joints in the toes, and a moderate level of relief may be attained. Research has indicated there may be measures that can be implemented to reduce a portion of the pain and discomfort that is associated with this condition, and these include maintaining a healthy body weight, avoiding standing for the majority of the day, and engaging in a massage or warm foot bath. If you have symptoms of rheumatoid arthritis, it is strongly advised to speak to a podiatrist who can properly guide you toward proper treatment.

Because RA affects more than just your joints, including the joints in your feet and ankles, it is important to seek early diagnosis from your podiatrist if you feel like the pain in your feet might be caused by RA. For more information, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor will assist you with all of your podiatric concerns.

What Is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is an autoimmune disorder in which the body’s own immune system attacks the membranes surrounding the joints. Inflammation of the lining and eventually the destruction of the joint’s cartilage and bone occur, causing severe pain and immobility.

Rheumatoid Arthritis of the Feet

Although RA usually attacks multiple bones and joints throughout the entire body, almost 90 percent of cases result in pain in the foot or ankle area.

Symptoms

  • Swelling and pain in the feet
  • Stiffness in the feet
  • Pain on the ball or sole of feet
  • Joint shift and deformation

Diagnosis

Quick diagnosis of RA in the feet is important so that the podiatrist can treat the area effectively. Your doctor will ask you about your medical history, occupation, and lifestyle to determine the origin of the condition. Rheumatoid Factor tests help to determine if someone is affected by the disease.

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 Rheumatoid Arthritis in the Feet
Monday, 04 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, 28 January 2019 00:00

Rheumatoid Arthritis in the Ankles

Rheumatoid arthritis usually affects small joints first, but it can move to larger joints, such as ankles. If this condition spreads to the ankles, then it can hinder one’s ability to walk, and cause extreme discomfort. Symptoms of rheumatoid arthritis usually come in flares that can last anywhere from a couple days to a couple weeks. These symptoms include inflammation and stiffness in the joints of the ankle. If this goes untreated, then this condition has the potential to permanently change the structure of the ankle joints. Rheumatoid arthritis also breaks down cartilage in the ankle that protects the bones from rubbing together, so this may create friction that will cause further weakness and instability. Oftentimes, people with rheumatoid arthritis in the ankles also experience symptoms in their feet. If you feel that you may have rheumatoid arthritis in either your feet or ankles, then it is strongly recommended that you consult with a podiatrist to receive treatment.

Ankle pain can be caused by a number of problems and may be potentially serious. If you have ankle pain, 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.

Ankle pain is any condition that causes pain in the ankle. Due to the fact that the ankle consists of tendons, muscles, bones, and ligaments, ankle pain can come from a number of different conditions.

Causes

The most common causes of ankle pain include:

  • Types of arthritis (rheumatoid, osteoarthritis, and gout)
  • Ankle sprains
  • Broken ankles
  • Achilles tendonitis
  • Achilles tendon rupture
  • Stress fractures
  • Bursitis
  • Tarsal tunnel syndrome
  • Plantar fasciitis

Symptoms

Symptoms of ankle injury vary based upon the condition. Pain may include general pain and discomfort, swelling, aching, redness, bruising, burning or stabbing sensations, and/or loss of sensation.

Diagnosis

Due to the wide variety of potential causes of ankle pain, podiatrists will utilize a number of different methods to properly diagnose ankle pain. This can include asking for personal and family medical histories and of any recent injuries. Further diagnosis may include sensation tests, a physical examination, and potentially x-rays or other imaging tests.

Treatment

Just as the range of causes varies widely, so do treatments. Some more common treatments are rest, ice packs, keeping pressure off the foot, orthotics and braces, medication for inflammation and pain, and surgery.

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 Ankle Pain

Being a parent involves caring for your child in every way you can. You make sure they are eating the right food, being nice to others, and staying out of any trouble. However, it is also important that you are watchful of their health, more specifically their foot health. Maintaining good foot health in childhood is important in preventing later conditions in life from happening. As children continue to develop, their feet require different techniques of care. Here are some various ways in which you can help your child’s feet stay healthy.

A baby needs a lot of care and attention overall, but the importance of their feet should never be forgotten. Before a baby turns one, their feet change and develop greatly. It is important that during this time, a mother avoids putting tight socks on their child. She should also encourage movement of their feet so the baby can begin to feel more comfortable using them.

As a baby enters the toddler years of his or her life, they are begin to walk around. When your baby begins to take those first steps, it is crucial that they are wearing protective shoes on their feet. As a mother that is observant of your child’s feet, you may notice changes in them. This is completely normal as the feet are becoming susceptible to the activity of walking. It is normal for a toddler to be a bit unsteady or to “walk funny” at first.

When your child grows out of their toddler years, it is important that you begin to show him or her how to care for their feet on their own. Practice with your child proper hygiene in order to prevent foot fungus or infection. Since children are constantly on the move, it is crucial to be cautious of any accidents or injuries that might occur. If an injury occurs, it is advised that you take your child to be examined by a doctor immediately. Since your child is still growing, particular injuries can shift the way in which a bone or other important part of the foot is developing.

Babies and kids are always changing and growing. Your job as a parent is to make sure they stay healthy and making sure they are properly maintained. This involves proper foot care and making sure the feet stay healthy. Following this guide, your child can live a long and happy life.

Wednesday, 26 December 2018 00:00

What are Achilles Tendon Injuries

The Achilles tendon is the strongest tendon in the human body. Its purpose is to connect the lower leg muscles and calf to the heel of the foot. This tendon is responsible for facilitating all types of movement, like walking and running. This tendon provides an enormous amount of mobility for the body. Any injuries inflicted to this tissue should be immediately brought up with a physician to prevent further damage. 

The most common injuries that can trouble the Achilles tendon are tendon ruptures and Achilles tendinitis. Achilles tendinitis is the milder of the two injuries. It can be recognized by the following symptoms: inflammation, dull-to-severe pain, increased blood flow to the tendon, thickening of the tendon, and slower movement time. Tendinitis can be treated via several methods and is often diagnosed by an MRI. 

An Achilles tendon rupture is trickier to heal, and is by far the most painful injury. It is caused by the tendon ripping or completely snapping. The results are immediate and absolutely devastating, and will render the patient immobile. If a rupture or tear occurs, operative and non-operative methods are available. Once the treatment begins, depending on the severity of the injury, recovery time for these types of issues can take up to a year. 

Simple preventative measures can be taken as a means to avoid both injuries. Prior to any movement, taking a few minutes to stretch out the tendon is a great way to stimulate the tissue. Calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses are all suggested ways to help strengthen the lower legs and promote Achilles tendon health. 

Many problems arise among athletes and people who overexert themselves while exercising. Problems can also happen among those who do not warm up properly before beginning an activity. Proper, comfortable shoes that fit correctly can also decrease tendon injuries. Some professionals also suggest that when exercising, you should make sure that the floor you are on is cushioned or has a mat. This will relieve pressure on the heels. A healthy diet will also increase tendon health. 

It is very important to seek out a podiatrist if you believe you have an injury in the Achilles region. Further damage could result in severe complications that would make being mobile difficult, if not impossible.

Monday, 15 October 2018 00:00

Intense Pain May Accompany Gout

An excess of uric acid levels in the blood may lead to a painful condition known as gout. When the body has difficulty in processing this buildup, crystals will typically form in the joint of the big toe. It is often considered to be a form of arthritis, and may cause considerable pain and discomfort. This ailment may develop as a result of ingesting foods that are rich in purines, which may often include red wine, seafood or chocolate. Research has shown there may be several predispositions for gout to occur. People who have high blood pressure or who have abnormal kidney functions may be at a greater risk to develop this ailment. Patients who are afflicted with gout are aware of the intense pain, swelling and redness that accompanies this predicament. If you have developed gout it's suggested to consult with a podiatrist who can provide valuable information about the treatment of this debilitating condition.

Gout is a foot condition that requires certain treatment and care. If you are seeking treatment, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will treat your foot and ankle needs.

What Is Gout?

Gout is a type of arthritis caused by a buildup of uric acid in the bloodstream. It often develops in the foot, especially the big toe area, although it can manifest in other parts of the body as well. Gout can make walking and standing very painful and is especially common in diabetics and the obese.

People typically get gout because of a poor diet. Genetic predisposition is also a factor. The children of parents who have had gout frequently have a chance of developing it themselves.

Gout can easily be identified by redness and inflammation of the big toe and the surrounding areas of the foot. Other symptoms include extreme fatigue, joint pain, and running high fevers. Sometimes corticosteroid drugs can be prescribed to treat gout, but the best way to combat this disease is to get more exercise and eat a better diet.

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 Everything You Need to Know About Gout
Monday, 15 October 2018 00:00

The Importance of Biomechanics in Podiatry

Biomechanics and its related study deal with the forces that act against the body and affect things like our movement. In podiatry, biomechanics are studied to determine the movement of the ankle, toes, and the foot, as well as the forces that impact them. Podiatrists who train in this specialty are able to effectively diagnose and treat conditions that affect people’s everyday movement.

Regardless of your lifestyle, age, or any other factors, many people experience foot problems throughout their lives. Twists and turns, improper balance, and added weight are just a few of the things that can add stress to the feet. These issues can also limit our bodies’ mobility that we often take for granted. Pain in the feet and ankles can also trickle up towards the lower legs, knees, hip, and even back area. This affects the way you move around on a daily basis.

Biomechanics and its related study deal with forces that act against the body and affect things like our movement. In podiatry, biomechanics are studied to determine the movement of the ankle, toes, and the foot, as well as the forces that impact them. Podiatrists who train in this specialty are able to effectively diagnose and treat conditions that affect people’s everyday movement.

Regardless of your lifestyle, age, or any other factors, many people experience foot problems throughout their lives. Twists and turns, improper balance, and added weight are just a few of the things that can add stress to the feet. These issues can also limit our bodies’ mobility that we often take for granted. Pain in the feet and ankles can also trickle up towards the lower legs, knees, hip, and even back area. This affects the way you move around on a daily basis.

The history of studying biomechanics dates back to ancient Egypt at around 3000 B.C., where evidence of professional foot care has been recorded. Throughout the centuries, advances in technology, science, and an understanding of the human body led to more accurate diagnosis of conditions such as corns for example. In 1974, biomechanics garnered a large audience when Merton Root founded Root Lab to make custom orthotics. He proposed that corrections of certain conditions could be implemented to gain strength and coordination in the area. Due to his research, we still use his basic principle of foot orthotics to this day.

As technology has improved, so have the therapeutic processes that allow us to correct deficiencies in our natural biomechanics. Computers can now provide accurate readings of the forces, movements, and patterns of the foot and lower leg. Critical treatment options can be provided to patients now who suffer from problems that cause their biomechanics to not function naturally. The best results are now possible thanks to 3D modeling and computing technologies that can take readings and also map out what treatment will do to the affected areas.

These advanced corrective methods were able to come to light thanks to an increase in both the technologies surrounding biomechanics and also the knowledge of how they work naturally. For example, shoe orthotics are able to treat walking inabilities by realigning the posture deviations in patients caused by hip or back problems. Understanding foot biomechanics can help improve movement and eliminate pain, stopping further stress to the foot. Speak with your podiatrist if you have any of these problems.

Monday, 08 October 2018 00:00

Are Plantar Warts Painful?

The majority of warts can be unsightly and painful, and a plantar wart is no exception. This type of wart develops on the heel of the foot and will grow inward as a result of the pressure the feet endures on a daily basis. It is known to be caused by the human papillomavirus, which is also referred to as HPV, and may be more prevalent in children and people who have compromised immune systems. This contagious virus can be transmitted by direct contact with a person who may carry the germ or from an object that may have been contaminated. Some of the symptoms that might be associated with plantar warts may include a small area that may be rough in texture on the heel of the foot. Additionally, there may be tiny black dots in the center of the wart, and you may experience pain while walking or standing. If you are afflicted with plantar warts, it’s suggested to speak with a podiatrist who can offer correct treatment options that may include removal of the wart.

Plantar warts can be very uncomfortable. If you need your feet checked, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will assist you with all of your foot and ankle needs.

About Plantar Warts

Plantar warts are the result of HPV, or human papillomavirus, getting into open wounds on the feet. They are mostly found on the heels or balls of the feet.

While plantar warts are generally harmless, those experiencing excessive pain or those suffering from diabetes or a compromised immune system require immediate medical care. Plantar warts are easily diagnosed, usually through scraping off a bit of rough skin or by getting a biopsy.

Symptoms

  • Lesions on the bottom of your feet, usually rough and grainy
  • Hard or thick callused spots
  • Wart seeds, which are small clotted blood vessels that look like little black spots
  • Pain, discomfort, or tenderness of your feet when walking or standing

Treatment

  • Freezing
  • Electric tool removal
  • Laser Treatment
  • Topical Creams (prescription only)
  • Over-the-counter medications

To help prevent developing plantar warts, avoid walking barefoot over abrasive surfaces that can cause cuts or wounds for HPV to get into. Avoiding direct contact with other warts, as well as not picking or rubbing existing warts, can help prevent the further spread of plantar warts. However, if you think you have developed plantar warts, speak to your podiatrist. He or she can diagnose the warts on your feet and recommend the appropriate treatment options.

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 All About Plantar Warts
Monday, 08 October 2018 00:00

All About Plantar Warts

Plantar warts are warts that are only found on the feet, hence the term “plantar”, which means “relating to the foot.” They are caused by the human papillomavirus, or HPV, and occur when this virus gets into open wounds on the feet. The warts themselves are hard bumps on the foot. They are easily recognizable, mostly found on the heels or ball of the foot. Plantar warts are non-malignant, but they can cause some pain, discomfort, and are often unsightly. Removing them is a common step toward treating them.

Plantar warts can cause some pain while standing, sometimes felt as tenderness on the sole of your foot. Unless the wart has grown into the foot behind a callus, you will be able to see the fleshy wart. A podiatrist should only be consulted if there is an excessive amount of pain. Plantar warts are not cancerous or dangerous, but they can affect your walking and continually reappear. Anyone who suffers from diabetes or a compromised immune system disease should seek out care immediately.

Podiatrists are easily able to diagnose plantar warts. They usually scrape off a tiny bit of the rough skin to make tiny blood clots visible and examine the inside of warts. However, a biopsy can be done if the doctor is not able to diagnose them from simply looking at them. Although plantar warts usually do not require an excessive amount of treatment, there are ways to go about removing them. A common method is to freeze them off using liquid nitrogen, removing them using an electrical tool, or burning them off via laser treatment. For a less invasive treatment option, topical creams can be used through a doctor’s prescription. This treatment method takes more time, however. Keep the wart covered for protection in between daily treatments.

The best way to avoid developing plantar warts is to avoid walking barefoot in public places. Avoid this especially if you have open sores or cuts on your feet. It is also important to avoid direct contact with warts in general, as they are highly contagious.

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