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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.

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.

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, 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, 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.

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