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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!

February 2020

Monday, 24 February 2020 00:00

Sever's Disease

Sever’s disease, also known as calcaneal apophysitis is a common bone disorder that occurs during childhood. The disease is defined as an inflammation of the growth plate in the heel. When a child has a growth spurt, his heel bone grows faster than the muscles, tendons, and ligaments in his leg. This disease is a result of overuse. The people who are most likely to be affected by this disease are children who are in a growth spurt, especially boys who are from the ages of 5 to 13 years old. 60% of children with Sever’s disease have both heels involved.

Symptoms of this disease are heel pain that intensifies during running and jumping activities. The pain is typically localized to the posterior part of the heel. Symptoms may be severe, and they can easily interfere with daily activities. Children who play soccer, baseball, and basketball are more likely to develop Sever’s disease.

Your doctor will diagnose your child based on his or her symptoms, x-rays are generally not helpful in diagnosing this disease. Your doctor may examine both heels and ask your child questions about his or her activity level in sports. Your doctor may then use the squeeze test on your child’s heel to see if there is any pain. Nevertheless, some doctors might still use x-rays to rule out any other issues such as fractures, infections, and tumors.

Sever’s disease can be prevented by maintaining good flexibility while your child is growing. Another prevention method is to wear good-quality shoes that have firm support and a shock-absorbent sole. Sever’s disease can be treated by ceasing any activity that causes heel pain. You should apply ice to the injured heel for 20 minutes 3 times a day. Additionally, orthotics should be used for children who have high arches, flat feet, or bowed legs.

If you suspect your child has Sever’s disease, you should make an appointment with your podiatrist to have his or her foot examined. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen to relieve pain. In more severe cases, your child may need a cast to rest his or her heel. Fortunately, Sever’s disease does not cause long-term foot problems. After treatment, your child should start to feel better within two weeks to two months.

Monday, 24 February 2020 00:00

Who Does Sever’s Disease Affect?

The medical condition that is known as Sever’s disease can generally affect adolescents who participate in running and jumping activities. This ailment impacts the growth plate, and may occur as a result of the heel bone and surrounding muscles growing at different rates. There may be existing medical conditions that precede the onset of Sever’s disease. These can include flat feet, high arches, obesity, or having one leg that is shorter than the other. Some of the symptoms that are associated with this condition can consist of red skin around the affected area, swelling, and difficulty walking. Mild relief may be found when supportive shoes are worn, and gentle exercises are performed that may strengthen the foot. If you think your child may have Sever’s disease, it is strongly advised that you consult with a podiatrist for professional care and 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
Monday, 17 February 2020 00:00

Athlete's Foot

Athlete’s foot is an extremely contagious infection caused by a fungus that results in itching, burning, dry, and flaking feet. The fungus that causes athlete’s foot is known as tinea pedis and thrives in moist, dark areas such as shower floors, gyms, socks and shoes, commons areas, public changing areas, bathrooms, dormitory style houses, locker rooms, and public swimming pools. Athlete’s foot is difficult to treat as well because of the highly contagious and recurrent nature of the fungus.

Tinea is the same fungus that causes ringworm, and is spread by direct contact with an infected body part, contaminated clothing, or by touching other objects and body parts that have been exposed to the fungus. Because the feet are an ideal place for tinea to grow and spread, this is the most commonly affected area.  It is, however, known to grow in other places. The term athlete’s foot describes tinea that grows strictly on the feet.

The most commonly infected body parts are the hands, groin, and scalp, as well as the feet. Around 70% of the population suffer from tinea infections at some point in their lives, however not all of these cases are athlete’s foot. Just like any other ailment, some people are more likely to get it than others, such as people with a history of tinea infections or other skin infections, both recurring and non-recurring ones. The extent to which a person experiences regrowth and recurrent tinea infections varies from person to person.

Sometimes people will not even know that they are infected with tinea or that they have athlete’s foot because of a lack of symptoms. However, most experience mild to moderate flaking, itching, redness, and burning. However, some of the more severe symptoms include cracking and bleeding skin, intense itching and burning, pain while walking or standing, and even blistering.

Because of the recurring nature of the tinea fungus and the athlete’s foot it causes, the best way to treat this condition is with prevention. You can take some preventative measures such as wearing flip flops or sandals in locker rooms and public showers to reduce contact with the floor. It also helps to keep clean, dry feet while allowing them to breathe. Using powders to keep your feet dry is a good idea, as well as keeping your feet exposed to light and cool air, to prevent the growth of tinea. If you do happen to get athlete’s foot, opt for using topical medicated creams, ointments or sprays. These treatments help eliminate and prevent it from coming back.

Monday, 17 February 2020 00:00

Common Symptoms of Athlete’s Foot

A common fungal infection of the feet is known as athlete’s foot. It is caused by a fungus that thrives in warm and moist environments. These can consist of public swimming pools, locker rooms, and shower room floors. If you are to visit these types of places, it is suggested that appropriate shoes are worn, as this may help to prevent the fungus from entering your skin. There are also other factors that may make it easier for this condition to develop. These may include wearing socks that are wet for the majority of the day, or having a bandage on the skin for an extended period of time which may soften the skin. Common symptoms that are associated with athlete’s foot can include intense itchiness between the toes and on the bottom of the feet, and in more severe cases, blisters may develop. If you feel you have athlete’s foot, it is strongly suggested that you consult with a podiatrist who can guide you toward the proper treatment.

Athlete’s foot is an inconvenient condition that can be easily reduced with the proper treatment. If you have any concerns about your feet and ankles, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC.  Our doctor will treat your foot and ankle needs.

Athlete’s Foot: The Sole Story

Athlete's foot, also known as tinea pedis, can be an extremely contagious foot infection. It is commonly contracted in public changing areas and bathrooms, dormitory style living quarters, around locker rooms and public swimming pools, or anywhere your feet often come into contact with other people.

Solutions to Combat Athlete’s Foot

  • Hydrate your feet by using lotion
  • Exfoliate
  • Buff off nails
  • Use of anti-fungal products
  • Examine your feet and visit your doctor if any suspicious blisters or cuts develop

Athlete’s foot can cause many irritating symptoms such as dry and flaking skin, itching, and redness. Some more severe symptoms can include bleeding and cracked skin, intense itching and burning, and even pain when walking. In the worst cases, Athlete’s foot can cause blistering as well. Speak to your podiatrist for a better understanding of the different causes of Athlete’s foot, as well as help in determining which treatment options are best 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 Athlete's Foot
Monday, 10 February 2020 00:00

Wound Care

Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.

Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound.  To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.

To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.

Monday, 10 February 2020 00:00

Promptly Treating Wounds on the Feet

Many diabetic patients are aware of the importance of promptly treating existing foot wounds. There may be serious complications if foot wounds are not treated, which may cause pain and discomfort. Some of the wounds on the feet that can be dangerous to the health of a diabetic patient can include cuts, blisters, or severely dry skin that may result in cracked heels. There are noticeable signs an infection may have developed. These can consist of extreme pain, swelling, and pus may appear surrounding the affected area. Additionally, some patients may experience a high temperature, swollen glands, or a general feeling of being unwell. If you have wounds on your feet, it is strongly advised that you are under the care of a podiatrist who can treat existing wounds.

Wound care is an important part in dealing with diabetes. If you have diabetes and a foot wound or would like more information about wound care for diabetics, 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.

What Is Wound Care?

Wound care is the practice of taking proper care of a wound. This can range from the smallest to the largest of wounds. While everyone can benefit from proper wound care, it is much more important for diabetics. Diabetics often suffer from poor blood circulation which causes wounds to heal much slower than they would in a non-diabetic. 

What Is the Importance of Wound Care?

While it may not seem apparent with small ulcers on the foot, for diabetics, any size ulcer can become infected. Diabetics often also suffer from neuropathy, or nerve loss. This means they might not even feel when they have an ulcer on their foot. If the wound becomes severely infected, amputation may be necessary. Therefore, it is of the upmost importance to properly care for any and all foot wounds.

How to Care for Wounds

The best way to care for foot wounds is to prevent them. For diabetics, this means daily inspections of the feet for any signs of abnormalities or ulcers. It is also recommended to see a podiatrist several times a year for a foot inspection. If you do have an ulcer, run the wound under water to clear dirt from the wound; then apply antibiotic ointment to the wound and cover with a bandage. Bandages should be changed daily and keeping pressure off the wound is smart. It is advised to see a podiatrist, who can keep an eye on it.

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 Wound Care
Monday, 03 February 2020 00:00

Ingrown Toenails

An ingrown toenail is a nail that has curved downward and grown into the skin.  This typically occurs at either the nail borders or the sides of the nail.  As a result, pain, redness, swelling, and warmth may occur in the toe.  If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.

Ingrown toenails have multiple reasons for developing.  In many instances, the condition is a result of genetics and is inherited.  The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over.  An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running.  Wearing shoes that are too tight or too short can also cause ingrown toenails.

Treatment for an ingrown toenail varies between patients and the severity of the condition.  In most cases, it is best to see your podiatrist for thorough and proper treatment.  After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present.  Surgical removal of either a portion of the nail or the entire nail may also be considered.  In some cases, complete removal or destruction of the nail root may be required.  Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.

Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes.  When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short.  Shoes should not be too short or tight in the toe box.

Monday, 03 February 2020 00:00

Avoid Developing an Ingrown Toenail

As many patients know, having an ingrown toenail can be extremely painful, and can often make completing everyday activities more difficult. To help prevent developing this uncomfortable condition, it’s important that certain precautions are taken while cutting your toenails. The first step for proper trimming starts with your technique. Nails should be trimmed straight across, avoiding making them rounded. They should also be trimmed just enough that the corners loosely sit on the skin, and not too short where they begin to dig into the skin. You also want to make sure that the clippers you’re using to trim your nails are specifically designed for the purpose of trimming toenails. Some signs that may indicate you’ve developed an ingrown toenail can include redness surrounding the skin of the affected toe, swelling, pain, and in more severe cases, you may notice pus around the nail. In order to safely treat an ingrown toenail, we recommend you consult with a podiatrist for professional care and attention.

Ingrown toenails can become painful if they are not treated properly. 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 occur when a toenail grows sideways into the bed of the nail, causing pain, swelling, and possibly infection.

Causes

  • Bacterial infections
  • Improper nail cutting such as cutting it too short or not straight across
  • Trauma to the toe, such as stubbing, which causes the nail to grow back irregularly
  • Ill-fitting shoes that bunch the toes too close together
  • Genetic predisposition

Prevention

Because ingrown toenails are not something found outside of shoe-wearing cultures, going barefoot as often as possible will decrease the likeliness of developing ingrown toenails. Wearing proper fitting shoes and using proper cutting techniques will also help decrease your risk of developing ingrown toenails.

Treatment

Ingrown toenails are a very treatable foot condition. In minor cases, soaking the affected area in salt or antibacterial soaps will not only help with the ingrown nail itself, but also help prevent any infections from occurring. In more severe cases, surgery is an option. In either case, speaking to your podiatrist about this condition will help you get a better understanding of specific treatment options that are right 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 Ingrown Toenails

Suffering from this type of pain? You may have the foot condition known as Morton's neuroma. Morton's neuroma may develop as a result of ill-fitting footwear and existing foot deformities. We can help.

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