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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!

Tuesday, 08 October 2024 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.

Wednesday, 02 October 2024 00:00

Are Bunions Affecting Your Everyday Life?

Have you noticed a bony protrusion on the side of your big toe? If so, you may have developed the foot condition known as a bunion. Don't let bunions interfere with your daily activities.

Tuesday, 01 October 2024 00:00

Causes of a Black Toenail

A black toenail can be alarming, often caused by several underlying issues. Trauma is a common cause, typically from stubbing your toe or repeated pressure, such as from wearing ill-fitting shoes. This blunt force can cause blood to pool beneath the nail, creating a dark discoloration. Fungal or bacterial infections may also result in a blackened nail if they affect the nail bed. More seriously, melanoma, a type of skin cancer, can present as a dark streak or discoloration under the nail. It is important to monitor any changes in your toenail’s color or texture and seek medical advice if the condition persists or worsens. A podiatrist can help diagnose the cause accurately and provide appropriate treatment, ensuring that any serious issues are addressed promptly. If you have a black toenail, it is suggested that you schedule an appointment with a podiatrist.

If left untreated, toenail fungus may spread to other toenails, skin, or even fingernails. If you suspect you have toenail fungus it is important to seek treatment right away. For more information about treatment, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor can provide the care you need to keep you pain-free and on your feet.

Symptoms

  • Warped or oddly shaped nails
  • Yellowish nails
  • Loose/separated nail
  • Buildup of bits and pieces of nail fragments under the nail
  • Brittle, broken, thickened nail

Treatment

If self-care strategies and over-the-counter medications does not help your fungus, your podiatrist may give you a prescription drug instead. Even if you find relief from your toenail fungus symptoms, you may experience a repeat infection in the future.

Prevention

In order to prevent getting toenail fungus in the future, you should always make sure to wash your feet with soap and water. After washing, it is important to dry your feet thoroughly especially in between the toes. When trimming your toenails, be sure to trim straight across instead of in a rounded shape. It is crucial not to cover up discolored nails with nail polish because that will prevent your nail from being able to “breathe”.

In some cases, surgical procedure may be needed to remove the toenail fungus. Consult with your podiatrist about the best treatment options for your case of toenail fungus.  

If you have any questions, please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot care needs.

 

Read more about Toenail Fungus
Tuesday, 01 October 2024 00:00

Toenail Fungus

Toenail fungus is a frustrating problem that affects many people. It can be persistent and hard to get rid of. As many different types of fungi are present throughout the environment, it is very easy to contract toenail fungus.  

The feet are especially susceptible to toenail fungus because shoes and socks create the ideal dark and moist environment that fungal infections thrive in. While fungal infections of the nail plate are quite common, if left untreated they can spread beyond the toenail and into the skin and other parts of the body.

Signs of toenail fungus include a thickened nail that has become yellow or brown in color, a foul smell, and debris beneath the nail. The toe may become painful due to the pressure of a thicker nail or the buildup of debris.

Treatment for toenail fungus is most effective during the early stages of an infection. If there is an accumulation of debris beneath the nail plate, an ingrown nail or a more serious infection can occur. While each treatment varies between patients, your podiatrist may prescribe you oral medications, topical liquids and creams, or laser therapy. To determine the best treatment process for you, be sure to visit your podiatrist at the first signs of toenail fungus.

Tuesday, 24 September 2024 00:00

Types of Treatment for Ankle Sprains

Ankle sprains require proper treatment to ensure a full recovery and prevent future complications. After an ankle sprain, a podiatrist may recommend various treatment options to support healing and restore function. Moving the joint gently, within your pain tolerance, helps prevent stiffness and maintains normal movement. An ankle support, such as a brace, can provide stability while allowing some mobility as the ligament heals. For more severe sprains, certain prescribed exercises can help to improve joint movement, and muscle strength. In cases of severe sprains or instability, immobilization of the ankle with a brace or cast might be necessary, and surgery could be considered if damaged ligaments are significantly torn. If pain persists or the ankle remains unstable, further evaluation, including imaging, might be required. If you have sprained your ankle, it is suggested that you schedule an appointment with a podiatrist for an exam, diagnosis, and treatment options.

Although ankle sprains are common, they aren’t always minor injuries. If you need your ankle injury looked at, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor can provide the care you need to keep you pain-free and on your feet.

How Does an Ankle Sprain Occur?

Ankle sprains are the result of a tear in the ligaments within the ankle. These injuries may happen when you make a rapid shifting movement while your foot is planted. A less common way to sprain your ankle is when your ankle rolls inward while your foot turns outward.

What Are the Symptoms?

  • Pain at the sight of the tear
  • Bruising/Swelling
  • Ankle area is tender to touch
  • In severe cases, may hear/feel something tear
  • Skin discoloration

Preventing a Sprain

  • Wearing appropriate shoes for the occasion
  • Stretching before exercises and sports
  • Knowing your limits

Treatment of a Sprain

In many cases, the RICE method (Rest, Ice, Compression, and Elevate) is used to treat ankle sprains. However, you should see a podiatrist to see which treatment option would work best with your injury. In severe cases, surgery may be required.

It is important to ask your doctor about rehab options after you receive treatment for your injury. Stretching, strength training, and balance exercises may help the ankle heal while also preventing further injury.

If you have any questions, please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Read more about Three Grades of Ankle Sprains
Tuesday, 24 September 2024 00:00

Three Grades of Ankle Sprains

An ankle sprain occurs when one or more ankle ligament gets overly stretched. Ligaments are strong bands of tissue that bind and support the bones and other structures that make up the ankle. In more severe ankle sprains, the ligament(s) tear—either partially or completely—and there may be an audible popping noise at the moment of injury.

Ankle sprains are quite common and can occur when the ankle rolls outwardly (eversion) or inwardly (inversion), causing the ligament(s) to stretch beyond normal limits, or even tear. Falls, twists, or blows to the ankle during sports or other activities can cause this injury, as well as wearing improper footwear, running on uneven surfaces, or having weak ankles.

Depending on the injury’s severity, an ankle sprain will be classified as Grade I, Grade II, or Grade III. Grade I sprains involve ligament(s) being overly stretched but not torn, with symptoms of mild pain, swelling, and ankle instability. There may also be some difficulty bearing weight. A Grade II sprain usually involves a partial tear of the ligament which brings more intensity in these symptoms, along with possible bruising. With a Grade III sprain, the ligament is completely torn, the symptoms are severe, and it may not be possible to put weight on the affected foot at all. 

To diagnose and grade an ankle sprain, a podiatrist will perform a physical examination, checking for tenderness and range of motion in the ankle. For more severe sprains, X-rays or other imaging studies may be necessary. 

It is vitally important to have an ankle sprain treated properly as improper healing often leads to future ankle sprains and possibly even chronic ankle stability. Treatment for an ankle sprain will vary, depending on its severity, and may include the RICE method (Rest/Ice/Compression/Elevation), physical therapy, bracing, medications, and possibly even surgery to repair a torn ligament. Rehabilitation is very important for the sprain to heal properly and to restore functionality.

Tuesday, 17 September 2024 00:00

Common Ankle Injuries

Ankle injuries are a frequent concern and can range from minor to severe. Osteoarthritis, a degenerative joint disease, causes pain and stiffness in the ankle, often due to wear and tear over time. Sprains occur when ligaments are stretched or torn, typically from sudden twists or falls, resulting in pain, swelling, and limited movement. Fractures or broken bones in the ankle can result from trauma or severe impact, leading to intense pain, swelling, and difficulty walking. Additionally, gout, a type of arthritis caused by uric acid buildup, can also affect the ankle, causing sudden, severe pain and swelling. If you have ankle pain or any of the above conditions, it is suggested that you consult a podiatrist who can offer you effective treatment solutions.

Ankle pain can have many different causes and the pain may potentially be 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 tendinitis
  • Achilles tendon rupture
  • Stress fractures
  • 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 Various Causes of Ankle Pain
Tuesday, 17 September 2024 00:00

Various Causes of Ankle Pain

Ankles are joints that connect bones in the feet with bones in the lower leg. They are comprised of bones, ligaments, muscles, tendons, blood vessels, and nerves. The ankle joint allows the foot to move side-to-side, as well as up-and-down.

Ankle pain can be caused by a variety of conditions, but is most commonly due to soft tissue injuries such as ankle sprains and strains. 

An ankle sprain occurs when one or more of the strong ligaments that support and stabilize the ankle become overly stretched or even torn if the ankle rolls, turns, or twists awkwardly. Depending on the grade of sprain (mild-moderate-severe), there will be varying degrees of pain, swelling, and restricted range of motion, along with tenderness, bruising, and ankle instability. There may even be an audible popping noise at the moment of injury.

Ankle strains can sometimes produce similar symptoms of pain, swelling, and loss of motion, however, they are due to overly stretched muscles and tendons—not ligaments. Ankle strains may also cause muscle cramps in the feet, calves and shins.

Ankle fractures are another common source of ankle pain and occur one or more of the three bones in the ankle become fractured (broken). These breaks can be stress fractures (due to repetitive stress) or traumatic fractures (due to an acute injury). Depending on where and how severe the fracture is, symptoms can include pain and swelling that can sometimes spread up to the knee, bruising or discoloration, and an inability to bear weight. A visible deformity or exposed bone may occur in severe fractures.

Various forms of arthritis may also cause ankle pain. Rheumatoid arthritis (RA) causes the immune system to attack healthy joints, like the ankle joint, by mistake, causing stiffness and swelling in both ankles. Osteoarthritis occurs when cartilage covering the ends of bones wears down, causing the bones to rub against each other. This results in pain, stiffness, and reduced range of motion in the ankle. Gout is a form of arthritis where excess amounts of uric acid in the bloodstream crystallize and build up on joints, causing severe pain and swelling. Reactive arthritis causes joint pain and swelling in the ankle in response to an infection in another part of the body.

Other forms of ankle pain include bursitis (an inflammation of a cushioning bursa sac between tendons and bone), scleroderma (a thickening of connective tissues), chronic ankle instability (caused by improperly healed ankle sprains), Achilles tendon injuriesflat feet, or an infection in the ankle.

Tuesday, 10 September 2024 00:00

All About Cuboid Syndrome

Cuboid syndrome is a condition where the cuboid bone in the foot becomes partially dislocated, causing pain and discomfort. This small bone, located on the outer side of the foot, plays an important role in maintaining the foot's stability and facilitating movement. Causes of cuboid syndrome often include trauma, such as ankle sprains, or repetitive strain from activities like running and jumping. Poorly fitting shoes and biomechanical abnormalities can also contribute to its development. Symptoms typically involve pain on the outer side of the foot, swelling, and difficulty bearing weight. The pain may worsen with physical activity and improve with rest. Diagnosis is primarily based on physical examination and patient history, as X-rays may not always reveal the issue. Treatment involves realigning the cuboid bone through manipulation by a podiatrist, followed by rest, compression, and elevation. Targeted stretching exercises and orthotic inserts may be recommended to prevent recurrence. If you have persistent foot pain, it is suggested that you consult a podiatrist for further evaluation and treatment.

Cuboid syndrome, also known as cuboid subluxation, occurs when the joints and ligaments near the cuboid bone in the foot become torn. If you have cuboid syndrome, 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.

Cuboid syndrome is a common cause of lateral foot pain, which is pain on the outside of the foot. The condition may happen suddenly due to an ankle sprain, or it may develop slowly overtime from repetitive tension through the bone and surrounding structures.

Causes

The most common causes of cuboid syndrome include:

  • Injury – The most common cause of this ailment is an ankle sprain.
  • Repetitive Strain – Tension placed through the peroneus longus muscle from repetitive activities such as jumping and running may cause excessive traction on the bone causing it to sublux.
  • Altered Foot Biomechanics – Most people suffering from cuboid subluxation have flat feet.

Symptoms

A common symptom of cuboid syndrome is pain along the outside of the foot which can be felt in the ankle and toes. This pain may create walking difficulties and may cause those with the condition to walk with a limp.

Diagnosis

Diagnosis of cuboid syndrome is often difficult, and it is often misdiagnosed. X-rays, MRIs and CT scans often fail to properly show the cuboid subluxation. Although there isn’t a specific test used to diagnose cuboid syndrome, your podiatrist will usually check if pain is felt while pressing firmly on the cuboid bone of your foot.

Treatment

Just as the range of causes varies widely, so do treatments. Some more common treatments are ice therapy, rest, exercise, taping, and orthotics.

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 Cuboid Syndrome
Tuesday, 10 September 2024 00:00

Cuboid Syndrome

Cuboid syndrome mostly affects athletes, although it can affect non-athletes too. It is also known as cuboid subluxation or cuboid fault syndrome.  This condition occurs when joints and ligaments near the cuboid bone of the foot are damaged, or when the cuboid bone itself is dislodged from its natural position. It is usually marked by pain on the outer side of the foot, which may be persistent or may come and go. Cuboid syndrome can be difficult to diagnose unless it becomes severe and more noticeable. Your doctor will likely ask questions about when the pain began and how long it has been present, and will put pressure on the cuboid bone to determine if that area is the origin of the pain.

Causes of Cuboid Syndrome

  • Any repetitive stresses placed on the foot due to athletic activities are a common cause of cuboid syndrome.
  • Although it develops over time, it is possible that this syndrome can occur all of sudden due to a single event or injury.
  • Over-pronation can exacerbate the condition if not corrected.

Disagreements Amongst Podiatrists Regarding Cuboid Syndrome

  • Some refer to it as the dislocation of the calcaneal-cuboid joint only.
  • Other podiatrists see it as an injury of the ligaments located nearby, which also involves the cuboid bone.

It is very important that when you experience any kind of pain on the side of your foot, you should seek medical care right away. If a subluxed cuboid is caught early, your feet may respond well to the treatment, and you can get back into sports or other activities again as soon as the pain subsides.

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