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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!

July 2019

Monday, 29 July 2019 00:00

Treating Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a condition in which the tibial nerve, located in the tarsal tunnel in the foot, is compressed. The tibial nerve can become compressed from injury, such as an ankle sprain, flat feet, and lesions. Arthritis, diabetes, and varicose veins can also cause swelling and thus result in nerve compression.

Symptoms of tarsal tunnel syndrome include several different sensations in the sole of the foot, inside the ankle, and around the tibial nerve. These sensations include shooting pains, numbness or reduced sensation, pins and needles, burning, and tingling. Symptoms tend to worsen with greater activity to the area. In rare and severe occasions, this can change the muscles in the foot.

If you suspect you have tarsal tunnel syndrome, you should consult with your podiatrist. He or she will examine your medical history to see if you have a history of diabetes, arthritis, or flat feet. They will also check to see if you have suffered an injury to the area recently. An electrical test will be conducted to check if the nerve has been damaged. A simpler Tinel’s Test might also be used. This includes simply tapping the nerve to create a sensation. An MRI scan of the area may also be used.

Treatments vary greatly for tarsal tunnel syndrome. Treatments include both nonsurgical and surgical options depending upon the severity of the condition. Nonsurgical options include anti-inflammatory medication and steroid injections to the area. Orthotics, such as a splint or brace that immobilizes the foot, is another noninvasive option. For those with flat feet, custom shoes can be made to offer better foot support. Surgical options include a tunnel tarsal release, in which an incision is made behind the ankle down to the arch of the foot. This releases the ligament and relieves pressure off the nerve. Some doctors use a more minimally invasive surgery, where smaller incisions are made in the ankle and the ligament is stretched out.

If you are suffering from painful sensations in your foot, see a podiatrist who can determine if you are experiencing tarsal tunnel syndrome. Tarsal tunnel syndrome that is left unchecked can cause permanent nerve damage to the foot.

Monday, 29 July 2019 00:00

All About Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, also known as TTS, occurs when the posterior tibial nerve becomes compressed and damaged, in turn causing inflammation. This is usually caused by continual overuse of the foot and ankle such as prolonged walking, running, standing, or exercising. If left untreated, TTS can cause permanent nerve damage. Some common treatments are wearing specialized shoes and inserts, over-the-counter pain and anti-inflammatory medications, physical therapy and rest. Strengthening exercises should be done to help prevent problems. These exercises include heel-toe raises, pencil toe lifts and balance exercises. If not treated right away, TTS can lead to the risk of developing other conditions such as flat feet, fallen arches, rheumatoid arthritis, varicose veins and the susceptibility to becoming overweight. If you notice any symptoms of TTS, it is important that you see a podiatrist right away. 


 

Tarsal tunnel syndrome can be very uncomfortable to live with. If you are experiencing tarsal tunnel syndrome, 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.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, which can also be called tibial nerve dysfunction, is an uncommon condition of misfiring peripheral nerves in the foot. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome, the tibial nerve is damaged, causing problems with movement and feeling in the foot of the affected leg.

Common Cause of Tarsal Tunnel Syndrome

  • Involves pressure or an injury, direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or near the knee.
  • Diseases that damage nerves, including diabetes, may cause tarsal tunnel syndrome.
  • At times, tarsal tunnel syndrome can appear without an obvious cause in some cases.

The Effects of Tarsal Tunnel Syndrome

  • Different sensations, an afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg.
  • The foot muscles, toes and ankle become weaker, and curling your toes or flexing your foot can become difficult.
  • If condition worsens, infections and ulcers may develop on the foot that is experiencing the syndrome.

A physical exam of the leg can help identify the presence of tarsal tunnel syndrome. Medical tests, such as a nerve biopsy, are also used to diagnose the condition. Patients may receive physical therapy and prescriptive medication. In extreme cases, some may require 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 and ankle needs.

Read more about Treating Tarsal Tunnel Syndrome

The purpose of the body’s circulation system is to transport blood, oxygen, and nutrients throughout the body. A reduction of blood to a specific part of the body may cause one to experience symptoms of poor circulation. The most common causes of poor circulation in the feet are obesity, diabetes, and heart conditions such as peripheral artery disease (PAD). Common symptoms of poor circulation include tingling, numbness, throbbing, pain and muscle cramps.

Peripheral artery disease is a common cause of poor circulation in the legs. Symptoms of PAD are cramping, pain or tiredness in the leg or hip muscles while walking or climbing stairs. This pain tends to go away with rest and starts back up when you begin to walk.  It is a condition that causes the blood vessels and arteries to become narrow. Although PAD is more common in adults over the age of 50, it may also occur in younger people.  A similar condition called atherosclerosis causes arteries to stiffen up due to a buildup of plaque in the arteries and blood vessels.

Blood clots are also a common cause of poor circulation in the feet. Clots may obstruct blood vessels and if they occur in the legs, they may eventually lead to pain and discoloration. This occurrence is commonly known as deep vein thrombosis (DVT) and it may travel to the lungs. Varicose veins are another condition that may lead to poor circulation, and it is caused by incompetence of the valves in the veins. Women who are overweight are prone to developing this condition. Lastly, diabetes, which is correlated with poor blood sugar metabolism may lead to chronic poor circulation. Those with diabetes often suffer from cramping in the legs, calves, thighs and buttocks.

If you are looking for ways to avoid poor circulation there are some tips you can follow. One tip is to avoid sitting for too long. If you plan to sit down for a long period of time, you should try standing up occasionally, to improve your circulation. Another great way to avoid poor circulation is to exercise. Exercise is an excellent way to pump the heart and increase blood flow. Those who suffer from poor circulation should also avoid smoking, reduce their salt intake, and try to lose weight.

If you are experiencing symptoms from poor circulation in your feet, you should consult with your podiatrist to determine the best method for treatment for you. He or she may prescribe medication in addition to recommending specific lifestyle changes to improve your circulation.

The purpose of the circulation system in the body is to carry oxygen and nutrients that are found in the blood throughout the body. The symptoms that are associated with poor circulation often include muscle cramps, a tingling sensation that is felt in the lower extremities, and the feet feeling numb. There are a variety of reasons why poor circulation may occur. These can include peripheral artery disease (PAD), blood clots, or medical ailments such as diabetes and Raynaud’s disease. It may be helpful to wear compression socks that can relieve any pain or swelling that may accompany poor circulation. Additionally, performing specific exercise programs may be an effective way to increase circulation. If you have any of these symptoms, it is suggested that you schedule a consultation with a podiatrist who can properly treat poor circulation. 

While poor circulation itself isn’t a condition; it is a symptom of another underlying health condition you may have. 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

Peripheral artery disease (PAD) can potentially lead to poor circulation in the lower extremities. PAD is a condition that causes the blood vessels and arteries to narrow. In a linked condition called atherosclerosis, the arteries stiffen up due to a buildup of plaque in the arteries and blood vessels. These two conditions can cause a decrease in the amount of blood that flows to your extremities, therefore resulting in pain.

Symptoms

Some of the most common symptoms of poor circulation are:

  • Numbness
  • Tingling
  • Throbbing or stinging pain in limbs
  • Pain
  • Muscle Cramps

Treatment for poor circulation often depends on the underlying condition that causes it. Methods for treatment may include insulin for diabetes, special exercise programs, surgery for varicose veins, or compression socks for swollen legs.

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 care needs.

Read more about Causes Symptoms and Treatment for Poor Circulation in the Feet
Monday, 15 July 2019 00:00

What to Know About a Broken Toe

Trauma to the foot, especially the toes, can occur in many ways. Banging them, stubbing them, or dropping something on them are a few different ways this trauma can occur. Given the fact that toes are positioned in front of the feet, they typically sustain the brunt of such trauma. When trauma occurs to a toe, the result can be a painful break or fracture. Another type of trauma that can break a toe is repeated activity that places stress on the toe for prolonged periods of time.

Broken toes can be categorized as either minor or severe fractures. Symptoms of minor toe fractures include throbbing pain, swelling, bruising on the skin and toenail, and the inability to move the toe with ease. Severe toe fractures require medical attention and are indicated when the broken toe appears crooked or disfigured, when there is tingling or numbness in the toe, or when there is an open, bleeding wound present on the toe.

Generally, a minor toe break will heal without long-term complications. However, it is important to discontinue activities that put pressure on the toe. It is best to stay off of the injured toe and immediately get a splint or cast to prevent any more additional movement of the toe bones. You can also immobilize your toe by placing a small cotton ball between the injured toe and the toe beside it. Then, tape the two toes together with medical tape. Swelling can be alleviated by placing an ice pack on the broken toe directly as well as elevating your feet above your head.

Severe toe fractures may be treated with a splint, cast, and in some cases, minor surgery, especially when the big toe has been broken. Due to its position and the pressure the big toe endures with daily activity, future complications can occur if it is not properly treated. Pain associated with minor toe fractures can be managed with over-the-counter pain medications. Prescription pain killers may be necessary for severe toe fractures.

The healing time for a broken toe is approximately four to six weeks. In severe cases where the toe becomes infected or requires surgery, healing time can take up to eight weeks or more. While complications associated with a broken toe are immediately apparent, it is important to note that there are rare cases when additional complications, such as osteoarthritis, can develop over time. You should immediately speak with your podiatrist if you think you have broken your toe due to trauma. They will be able to diagnose the injury and recommend the appropriate treatment options. 

Monday, 15 July 2019 00:00

Different Types of Toe Fractures

The toes play a significant role in maintaining balance in the body while standing, in addition to pursuing walking and running activities. The bones are small, and can easily break if something heavy is dropped on one of them, or if it bangs against a piece of furniture. There are noticeable symptoms of a broken toe. These often consist of immediate pain, discomfort, redness, and the affected area may appear to be bruised and swollen. Research has shown there are several different types of breaks. A traumatic fracture consists of a sudden break, and this can occur from falling, or severely stubbing the toe. Additionally, if extended periods of time are spent in running activities, the toes may endure stress fractures. This can be a result of a gradual weakening of the bones in the toes.  A fracture is considered to be severe if a bone is protruding from the skin, and an infection may occur from the open wound. If you have broken your toe, it is suggested to seek the counsel of a podiatrist who can properly diagnose and treat this condition.

A broken toe can be very painful and lead to complications if not properly fixed. If you have any concerns about your feet, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will treat your foot and ankle needs.

What to Know About a Broken Toe

Although most people try to avoid foot trauma such as banging, stubbing, or dropping heavy objects on their feet, the unfortunate fact is that it is a common occurrence. Given the fact that toes are positioned in front of the feet, they typically sustain the brunt of such trauma. When trauma occurs to a toe, the result can be a painful break (fracture).

Symptoms of a Broken Toe

  • Throbbing pain
  • Swelling
  • Bruising on the skin and toenail
  • The inability to move the toe
  • Toe appears crooked or disfigured
  • Tingling or numbness in the toe

Generally, it is best to stay off of the injured toe with the affected foot elevated.

Severe toe fractures may be treated with a splint, cast, and in some cases, minor surgery. Due to its position and the pressure it endures with daily activity, future complications can occur if the big toe is not properly treated.

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 What to Know About a Broken Toe
Monday, 08 July 2019 00:00

Flat Feet

Flatfoot is a condition that occurs when the arches on the foot are flattened, which allows the soles of the feet to touch the floor. Flatfoot is a common condition and it is usually painless.

Throughout childhood, most people begin to develop arches in their feet, however, some do not. Those who do not develop arches are left with flatfoot. The pain associated with flat feet is usually at its worse when engaging in activity. Another symptom that may occur with those who have this condition is swelling along the inside of the ankle.

It is also possible to have flexible flatfoot. Flexible flatfoot occurs when the arch is visible while sitting or standing on the tiptoes, but it disappears when standing. People who have flexible flatfoot are often children and most outgrow it without any problems.

There are some risk factors that may make you more likely to develop flatfoot. Those who have diabetes and rheumatoid arthritis have an increased risk of flatfoot development. Other factors include aging and obesity.

Diagnosis for flat feet is usually done by a series of tests by your podiatrist. Your podiatrist will typically try an x-ray, CT scan, ultrasound, or MRI on the feet. Treatment is usually not necessary for flat foot unless it causes pain. However, therapy is often used for those who experience pain in their flat feet. Some other suggested treatment options are arch supports, stretching exercises, and supportive shoes. 

Monday, 08 July 2019 00:00

Flat Feet May Cause Foot Pain

The medical condition that is known as flat feet can also be referred to as fallen arches. Patients who have this condition have little or no arch in their foot, and this can cause discomfort while engaging in daily activities. This can be a result of strained muscles and ligaments, and most likely will affect the inside of the ankle. There are several reasons why flat feet may develop. These can include genetic factors, medical conditions such as rheumatoid arthritis, or if an injury has occurred to the foot or ankle. Pregnant women may develop flat feet, which is often the result of additional weight that is gained during this time. If you have flat feet and are experiencing chronic foot pain, it is advised that you consult with a podiatrist who can provide you with proper treatment options.

Flatfoot is a condition many people suffer from. If you have flat feet, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will treat your foot and ankle needs.

What Are Flat Feet?

Flatfoot is a condition in which the arch of the foot is depressed and the sole of the foot is almost completely in contact with the ground. About 20-30% of the population generally has flat feet because their arches never formed during growth.

Conditions & Problems:

Having flat feet makes it difficult to run or walk because of the stress placed on the ankles.

Alignment – The general alignment of your legs can be disrupted, because the ankles move inward which can cause major discomfort.

Knees – If you have complications with your knees, flat feet can be a contributor to arthritis in that area.  

Symptoms

  • Pain around the heel or arch area
  • Trouble standing on the tip toe
  • Swelling around the inside of the ankle
  • Flat look to one or both feet
  • Having your shoes feel uneven when worn

Treatment

If you are experiencing pain and stress on the foot you may weaken the posterior tibial tendon, which runs around the inside of the ankle. 

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 Flat Feet
Monday, 01 July 2019 00:00

Flip Flops and Feet

Flip flops are often a popular choice of footwear for many people. Flip flops allow your feet to breathe and give your toes the freedom of movement. They are easy to slip on and can be worn with virtually any style of clothing. Flip flops, however, despite their many benefits, can be detrimental for your foot health.

Despite their comfortableness, frequently wearing flip flops can create problems in the lower body over time. Issues mainly stem from the fact that people walk differently in flip flops compared to other footwear, such as sneakers. This is due to a change in one’s natural gait, which therefore creates stress in different parts of the body while hindering the body’s natural posture. Problems can also arise in the arches and balls of the feet. Flip flops provide little to no support to these areas.

Aside from long-term problems, flip-fops can also create short-term issues as well, such as ankle sprains and blisters. Weak materials that are flexible and bendable are generally used to manufacture flip flops. These materials make its wearers prone to both tripping and injuring their ankles. Flip flops can create blisters as the material rubs against the foot. People are much more at risk for infection while wearing flip flops due to their openness. This also makes it easier to scrape and cut the foot since there is a lack of protection. If these cuts are left untreated and uncovered, the risk then becomes greater.

To prevent the aforementioned occurrences, purchase a pair of flip flops that offer significant protection. The soles of the flip flops should not be floppy, but sturdy and firm, and should not significantly bend or wiggle when lifted from the floor. Flip flops made of high-quality materials will not be affected by this problem. While higher quality flip flops may be more expensive, they will last longer and provide better protection compared to a cheaper pair. Brand name flip flops sold from a quality manufacturer are a dependable option.

There is no problem in wearing your favorite pair of flip flops so as long as you do not wear them daily or for extended periods of time. Flip flops should be replaced every 3-4 months to ensure that they provide your feet with the best protection.

Monday, 01 July 2019 00:00

Why are Flip-Flops Bad for Your Feet?

Many people enjoy the ease of wearing flip-flops. They are a simple shoe, easy to wear, and designed in a variety of colors. Despite their popularity, there are foot conditions that can develop from wearing this type of shoe. Ligaments and tendons may slowly pull out of alignment, and a bunion can form. Additionally, if there is little or no arch support, this may trigger the onset of heel pain, which could be indicative of plantar fasciitis or heel spurs. Many flip-flops are constructed of a porous material, and this can be the perfect area for fungus to grow. This can lead to athlete’s foot and toenail fungus. If flip-flops are frequently worn, hammertoe can develop as a result of the toes grasping the shoe to stay on the foot. If you would like additional information about the consequences of wearing flip flops, please consult with a podiatrist.

Flip-flops are not always the best choice of footwear. If you have any concerns about your feet or ankles, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will assist you with all of your foot and ankle needs.

Flip-Flops and Feet

When the weather starts warming up, people enjoy wearing flip-flops.  Flip-flops are comfortable, stylish, and easy to slip on and off; they're perfect for any summer beach goer.  However, these shoes can cause harm to the feet.

How Can Flip-Flops Affect Me Long-Term?

  • Ankle problems
  • Hip problems
  • Lower back problems
  • Pain in the balls of the feet
  • Problems with foot arches
  • Changes in the way you walk

Are There Injuries Associated with Flip-Flops?

Yes.  Since flip-flops are relatively weak and do not provide the same amount of support as sneakers, people who wear flip-flops regularly are more susceptible to injuries. On top of that, the open nature of the shoe makes your feet more prone to other problems, such as cuts and even infections.  Common injuries and ailments include:

  • Sprained ankles
  • Blisters
  • Infections
  • Cuts and Scrapes

I like Wearing Flip-Flops. Are There Safe Alternatives?

When buying flip-flops, try to find ones that have sturdy soles and that are made of high-quality materials that will support for your feet.  These flip-flops will cost more but will also last longer as a result.

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 Flip Flops and Feet
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