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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!

December 2019

Monday, 30 December 2019 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.

Damage that occurs to the joints and ligaments surrounding the cuboid bone may lead to a condition that is known as cuboid syndrome. Cuboid syndrome typically occurs when the nerve becomes compressed. This condition is often caused by participating in activities that involve running and jumping. The pain that typically accompanies this condition is felt on the outside of the foot, and can cause severe discomfort. Additional symptoms may include a tingling or burning sensation, and it may be difficult to walk. Relief may be found when larger shoes are worn, and it may also be beneficial to wear custom made orthotics that are designed to perfectly fit your feet. In severe cases, surgery may be a necessary treatment method. Once the ligament is cut, there may be adequate room for the affected nerve to expand. If you feel you have developed this ailment, it is advised that you seek the counsel of a podiatrist who can properly treat this condition.

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
Monday, 23 December 2019 00:00

Ingrown Toenails

Ingrown toenails (onychocryptosis) are a common foot ailment and it is very unpleasant to experience. The condition is caused by an increase in pressure from the ingrowth of the nail edge into the skin of the toe. Ingrown toenails commonly cause pain in those who experience them. In some cases, the skin surrounding the ingrown toenail may break which may lead bacteria to enter through and cause an infection. Common symptoms of this ailment include pain, redness, swelling, and warmth around the toe.

An imbalance between the size of the nail and the enlargement of the nail skin edge causes ingrown toenails. This condition is often caused by improperly trimming the toenails. If you are trying you cut your nails, you should always try to trim straight across instead of in a rounded shape. Ingrown toenails can also be an inherited condition and they may also be caused by improper shoe fitting.

Another common cause of the condition is wearing shoes that are either too small or too large. Other causes include poor foot hygiene, obesity, diabetes, arthritis, edema, and fungal infections. There are many risk factors that may make a person more likely to develop an ingrown toenail. Athletes who play “stop and start” sports such as tennis, soccer, and basketball are most likely to have ingrown toenails.

People who have diabetes, a compromised immune system, or poor circulation should immediately seek care from a podiatrist if they have an ingrown toenail. It is also recommended to seek professional assistance if at-home remedies are not successful within a week or if there is persistent pain.

Monday, 23 December 2019 00:00

How Does an Ingrown Toenail Heal?

An ingrown toenail is an uncomfortable condition that generally affects the big toe. It occurs as a result of the toenail growing into the outer edges of the skin. Typical symptoms that many patients notice with this ailment can include redness, swelling, pain, and discomfort. Moderate relief may be found if larger shoes are worn as the healing process takes place, in addition to soaking the affected toe in warm water. In severe cases, the nail may become infected, and surgery may be required for proper healing. If you have an ingrown toenail, it is strongly advised that you consult with a podiatrist as quickly as possible to obtain the best treatment for your condition.

Ingrown toenails may initially present themselves as a minor discomfort, but they may progress into an infection in the skin without proper treatment. For more information about ingrown toenails, 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.

Ingrown Toenails

Ingrown toenails are caused when the corner or side of a toenail grows into the soft flesh surrounding it. They often result in redness, swelling, pain, and in some cases, infection. This condition typically affects the big toe and may recur if it is not treated properly.

Causes

  • Improper toenail trimming
  • Genetics
  • Improper shoe fitting
  • Injury from pedicures or nail picking
  • Abnormal gait
  • Poor hygiene

You are more likely to develop an ingrown toenail if you are obese, have diabetes, arthritis, or have any fungal infection in your nails. Additionally, people who have foot or toe deformities are at a higher risk of developing an ingrown toenail.

Symptoms

Some symptoms of ingrown toenails are redness, swelling, and pain. In rare cases, there may be a yellowish drainage coming from the nail.

Treatment

Ignoring an ingrown toenail can have serious complications. Infections of the nail border can progress to a deeper soft-tissue infection, which can then turn into a bone infection. You should always speak with your podiatrist if you suspect you have an ingrown toenail, especially if you have diabetes or poor circulation.

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 Ingrown Toenails
Tuesday, 17 December 2019 00:00

Foot Pain

Our feet are arguably the most important parts of our bodies because they are responsible for getting us from place to place.  However, we often don’t think about our feet until they begin to hurt. If you have pain in your feet, you need to first determine where on the foot you are experiencing it to get to the root of the problem. The most common areas to feel pain on the foot are the heel and the ankle.

Heel pain is most commonly attributed to a condition called plantar fasciitis. Plantar fasciitis occurs when the plantar fascia, which is the band of tough tissue connecting the heel bone to the toes becomes inflamed. Plantar fasciitis pain is usually worse in the morning, and it tends to go away throughout the day. If you have plantar fasciitis, you should rest your foot and do heel and foot muscles stretches. Wearing shoes with proper arch support and a cushioned sole has also been proven to be beneficial.

Some common symptoms of foot pain are redness, swelling, and stiffness. Foot pain can be dull or sharp depending on its underlying cause. Toe pain can also occur, and it is usually caused by gout, bunions, hammertoes, ingrown toenails, sprains, fractures, and corns.

If you have severe pain in your feet, you should immediately seek assistance from your podiatrist for treatment. Depending on the cause of your pain, your podiatrist may give you a variety of treatment options.

Tuesday, 17 December 2019 00:00

Elderly People and Foot Pain

Patients who have foot pain may experience difficulty in walking in addition to maintaining proper balance. This can be a common condition among older patients, and may lead to an increased risk of falling. Research has indicated that varying types of foot pain affects one in four elderly people. Chronic foot pain can make walking difficult, and may be managed by being under the care of a podiatrist. The benefits of identifying the cause of foot pain followed by correctly treating it can possibly help to reinstate independence to elderly patients. Additionally, it may help seniors to realize that their foot conditions may be a treatable medical condition, and may possibly have little to do with aging. If you have any type of foot pain, it is strongly recommended that you consult with a podiatrist who can guide you toward correct treatment options.

Foot Pain

Foot pain can be extremely painful and debilitating. If you have a foot 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.

Causes

Foot pain is a very broad condition that could be caused by one or more ailments. The most common include:

  • Bunions
  • Hammertoes
  • Plantar Fasciitis
  • Bone Spurs
  • Corns
  • Tarsal Tunnel Syndrome
  • Ingrown Toenails
  • Arthritis (such as Gout, Rheumatoid, and Osteoarthritis)
  • Flat Feet
  • Injury (from stress fractures, broken toe, foot, ankle, Achilles tendon ruptures, and sprains)
  • And more

Diagnosis

To figure out the cause of foot pain, podiatrists utilize several different methods. This can range from simple visual inspections and sensation tests to X-rays and MRI scans. Prior medical history, family medical history, and any recent physical traumatic events will all be taken into consideration for a proper diagnosis.

Treatment

Treatment depends upon the cause of the foot pain. Whether it is resting, staying off the foot, or having surgery; podiatrists have a number of treatment options available for foot pain.

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 Foot Pain
Monday, 09 December 2019 00:00

Hyperhidrosis of the Feet

Hyperhidrosis of the feet, also termed plantar hyperhidrosis, is characterized by excessive sweating of the feet that can be onset by any cause, such as exercise, fever, or anxiety. Most people suffering from hyperhidrosis of the feet also experience hyperhidrosis of the hands, or palmar hyperhidrosis. Approximately 1-2% of Americans suffer from this disorder.

Sweating is a healthy process utilized by the body in order to cool itself and maintain a proper internal temperature, which is controlled by the sympathetic nervous system. In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than is actually needed.

Plantar hyperhidrosis is considered primary hyperhidrosis. Secondary hyperhidrosis refers to excessive sweating that occurs in an area other than the feet, hands, or armpits, and this indicates that is related to another medical condition, such as menopause, hyperthyroidism, or Parkinson's disease.

Symptoms of hyperhidrosis of the feet can include foot odor, athlete's foot, infections, and blisters. Because of the continual moisture, shoes and socks can rot which creates an additional foul odor and can ruin the material, requiring shoes and socks to be replaced frequently. In addition to the physical symptoms, emotional health is often affected as this disorder can be very embarrassing.

If left untreated, hyperhidrosis will usually persist throughout an individual's life. However, there are several treatment options available. A common first approach to treating hyperhidrosis of the feet is a topical ointment. Aluminum chloride, an ingredient found in antiperspirants, can be effective at treating hyperhidrosis if used in high concentration and applied to the foot daily. Some individuals can experience relief this way, while others encounter extreme irritation and are unable to use the product. Another procedure is the use of Botulinum Toxin A, commonly referred to as Botox. This is injected directly into the foot, and is effective at minimizing the sweat glands in the injected area. These injections must be repeated every 4 to 9 months.

If these treatments are ineffective, oral prescription medications may be taken in an effort to alleviate the symptoms. Again, some will experience relief while others do not. Going barefoot reportedly provides relief for most sufferers.

A final approach to combating hyperhidrosis of the feet is through surgery. Surgery has been less successful on patients with plantar hyperhidrosis than on those with palmar hyperhidrosis. It is only recommended when sweating is severe and other treatments have failed to work. This kind of surgery usually involves going into the central nervous system, and cutting nerves to stop the transmission of signals telling the foot to sweat.

Monday, 09 December 2019 00:00

What Can Cause Feet to Constantly Sweat?

If your feet sweat profusely, you may have a condition that is referred to as plantar hyperhidrosis. It is considered to be a rare medical ailment that typically affects approximately three percent of the population. Many patients who have this condition are aware of how their quality of life is affected. Common side effects of feet that sweat excessively can consist of soggy shoes and socks, and the feet may feel cold the majority of the time. Research has indicated this condition is generally caused by hyperactive sweat glands. The circumstances that may trigger sweating can include increased temperatures or stressful situations. If you are suffering from plantar hyperhidrosis, it is strongly advised that you consult with a podiatrist who can properly diagnosis and treat this condition.

If you are suffering from hyperhidrosis contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor can provide the care you need to attend to all of your foot and ankle needs.

Hyperhidrosis of the Feet

Hyperhidrosis is a rare disorder that can cause people to have excessive sweating of their feet. This can usually occur all on its own without rigorous activity involved. People who suffer from hyperhidrosis may also experience sweaty palms.

Although it is said that sweating is a healthy process meant to cool down the body temperature and to maintain a proper internal temperature, hyperhidrosis may prove to be a huge hindrance on a person’s everyday life.

Plantar hyperhidrosis is considered to be the main form of hyperhidrosis. Secondary hyperhidrosis can refer to sweating that occurs in areas other than the feet or hands and armpits. Often this may be a sign of it being related to another medical condition such as menopause, hyperthyroidism and even Parkinson’s disease.

In order to alleviate this condition, it is important to see your doctor so that they may prescribe the necessary medications so that you can begin to live a normal life again. If this is left untreated, it is said that it will persist throughout an individual’s life.

A last resort approach would be surgery, but it is best to speak with your doctor to find out what may be the best treatment for you.

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 Hyperhidrosis of the Feet
Thursday, 05 December 2019 00:00

Before you start dancing...

 

Monday, 02 December 2019 00:00

Stretching Your Feet

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

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

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

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

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

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

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