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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!

March 2020

Monday, 30 March 2020 00:00

All About Plantar Warts

Plantar warts are warts that are only found on the feet, hence the term “plantar”, which means “relating to the foot.” They are caused by the human papillomavirus, or HPV, and occur when this virus gets into open wounds on the feet. The warts themselves are hard bumps on the foot. They are easily recognizable, mostly found on the heels or ball of the foot. Plantar warts are non-malignant, but they can cause some pain, discomfort, and are often unsightly. Removing them is a common step toward treating them.

Plantar warts can cause some pain while standing, sometimes felt as tenderness on the sole of your foot. Unless the wart has grown into the foot behind a callus, you will be able to see the fleshy wart. A podiatrist should only be consulted if there is an excessive amount of pain. Plantar warts are not cancerous or dangerous, but they can affect your walking and continually reappear. Anyone who suffers from diabetes or a compromised immune system disease should seek out care immediately.

Podiatrists are easily able to diagnose plantar warts. They usually scrape off a tiny bit of the rough skin to make tiny blood clots visible and examine the inside of warts. However, a biopsy can be done if the doctor is not able to diagnose them from simply looking at them. Although plantar warts usually do not require an excessive amount of treatment, there are ways to go about removing them. A common method is to freeze them off using liquid nitrogen, removing them using an electrical tool, or burning them off via laser treatment. For a less invasive treatment option, topical creams can be used through a doctor’s prescription. This treatment method takes more time, however. Keep the wart covered for protection in between daily treatments.

The best way to avoid developing plantar warts is to avoid walking barefoot in public places. Avoid this especially if you have open sores or cuts on your feet. It is also important to avoid direct contact with warts in general, as they are highly contagious.

A wart that develops on the sole of the foot is commonly referred to as a plantar wart. Standing and walking may cause the wart to grow inward, which can produce severe pain and discomfort. It may happen from being exposed to the type of fungus that is known as human papillomavirus, which is also known as HPV. Mild relief may be found when a protective pad is worn over the wart, as this may help to provide adequate cushioning as daily activities are completed. For stubborn plantar warts that do not heal, it is suggested that you consult with a podiatrist who can perform the necessary medical procedures, which may include the use of prescription medicines.

Plantar warts can be very uncomfortable. If you need your feet checked, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will assist you with all of your foot and ankle needs.

About Plantar Warts

Plantar warts are the result of HPV, or human papillomavirus, getting into open wounds on the feet. They are mostly found on the heels or balls of the feet.

While plantar warts are generally harmless, those experiencing excessive pain or those suffering from diabetes or a compromised immune system require immediate medical care. Plantar warts are easily diagnosed, usually through scraping off a bit of rough skin or by getting a biopsy.

Symptoms

  • Lesions on the bottom of your feet, usually rough and grainy
  • Hard or thick callused spots
  • Wart seeds, which are small clotted blood vessels that look like little black spots
  • Pain, discomfort, or tenderness of your feet when walking or standing

Treatment

  • Freezing
  • Electric tool removal
  • Laser Treatment
  • Topical Creams (prescription only)
  • Over-the-counter medications

To help prevent developing plantar warts, avoid walking barefoot over abrasive surfaces that can cause cuts or wounds for HPV to get into. Avoiding direct contact with other warts, as well as not picking or rubbing existing warts, can help prevent the further spread of plantar warts. However, if you think you have developed plantar warts, speak to your podiatrist. He or she can diagnose the warts on your feet and recommend the appropriate treatment options.

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 All About Plantar Warts
Monday, 23 March 2020 00:00

Foot Pain

The feet, being the foundation of the body, carry all of the body’s weight and are therefore prone to experiencing pain and discomfort. If you are experiencing foot pain, it is important to determine where in the foot you are experiencing this pain to help discover the cause of it. While pain can be experienced virtually anywhere in the foot, the most common sites of foot pain are in the heel and ankle.   

Heel pain can be due to a multitude of conditions including plantar fasciitis, Achilles tendinitis, and heel spurs. Pain experienced in the ankle can be a sign of an ankle sprain, arthritis, gout, ankle instability, ankle fracture, or nerve compression. In more serious cases, pain in the foot can be a sign of improper alignment or an infection.

Foot pain can be accompanied by symptoms including redness, swelling, stiffness and warmth in the affected area. Whether the pain can be described as sharp or dull depends on the foot condition behind it. It is important to visit your local podiatrist if your foot pain and its accompanying symptoms persist and do not improve over time.

Depending on the location and condition of your foot pain, your podiatrist may prescribe certain treatments. These treatments can include but are not limited to prescription or over-the-counter drugs and medications, certain therapies, cortisone injections, or surgery.

If you are experiencing persistent foot pain, it is important to consult with your foot and ankle doctor to determine the cause and location. He or she will then prescribe the best treatment for you. While milder cases of foot pain may respond well to rest and at-home treatments, more serious cases may take some time to fully recover.

Monday, 23 March 2020 00:00

How Common Is Foot Pain?

Foot pain is a common ailment among people worldwide. There are several foot conditions that may cause pain, ranging from mild to severe. One of these types of conditions is known as athlete’s foot. The symptoms that typically accompany athlete’s foot can consist of a burning or itching sensation between the toes or on the bottom of the feet. It is caused by a fungus that lives and thrives in warm and moist environments. These often include public pools and surrounding areas. A bump that protrudes from the side on the big toe may be indicative of a bunion. They can form as a result of wearing shoes that are too tight, or from genetic factors. Plantar fasciitis is another foot condition that is often considered to be uncomfortable. Severe pain is typically felt in the heel or arch areas for this condition. If you are experiencing any type of foot pain, it is strongly suggested that you seek the counsel of a podiatrist.

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, 16 March 2020 00:00

Effect of High Heels on the Feet

High heels are uncomfortable, but many women sacrifice comfort to be stylish. There are many problems that stem from wearing high heels, however these issues can be avoided by wearing proper shoes.

Heels are bad because they push your weight forward toward the fall of the foot. The higher the heel is, the more weight and pressure get shifted. This process causes the back to hyperextend backwards to counterbalance which may cause pain in the leg, hip, and back. Consequently, major posture problems may occur, and these issues may eventually become permanent.

Wearing high heels is one of the leading cause of ingrown toenails. Heels create a great deal of pressure on the big toenails which disrupts proper toenail growth. This may eventually lead to the big toenail growing into the skin.  Another common problem that stems from high heels is bunions. If bunions go untreated, they can cause serious scar tissue to form along with severe pain.

However, there are ways to minimize the harmful risks associated with wearing heels. You should try to massage and stretch your legs and feet after wearing heels for an extended time. Stretching helps prevent the Achilles tendons and calf muscles from becoming too tight. A good substitute for heels are platforms which provide a better surface area to evenly distribute the body’s weight.

If you are experiencing any painful foot conditions from wearing high heels, you should consult with your podiatrist right away.

Many women enjoy wearing high heels, as wearing this type of shoe can often make the feet and legs look slender. If you choose to wear high heels, it is important to look for heels that are slightly wider, as this may be helpful in preventing unwanted foot conditions from developing. Patients may find it beneficial to wear cushions over their toes which can help to prevent corns from forming. Additionally, existing friction may be reduced when a lubricant or powder is applied to your foot or put inside the shoe. If you would like additional information about how to choose high heels that are right for you, it’s suggested that you consult with a podiatrist. 

High heels have a history of causing foot and ankle problems. If you have any concerns about your feet or ankles, 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.

Effects of High Heels on the Feet

High heels are popular shoes among women because of their many styles and societal appeal.  Despite this, high heels can still cause many health problems if worn too frequently.

Which Parts of My Body Will Be Affected by High Heels?

  • Ankle Joints
  • Achilles Tendon – May shorten and stiffen with prolonged wear
  • Balls of the Feet
  • Knees – Heels cause the knees to bend constantly, creating stress on them
  • Back – They decrease the spine’s ability to absorb shock, which may lead to back pain.  The vertebrae of the lower back may compress.

What Kinds of Foot Problems Can Develop from Wearing High Heels?

  • Corns
  • Calluses
  • Hammertoe
  • Bunions
  • Morton’s Neuroma
  • Plantar Fasciitis

How Can I Still Wear High Heels and Maintain Foot Health?

If you want to wear high heeled shoes, make sure that you are not wearing them every day, as this will help prevent long term physical problems.  Try wearing thicker heels as opposed to stilettos to distribute weight more evenly across the feet.  Always make sure you are wearing the proper shoes for the right occasion, such as sneakers for exercising.  If you walk to work, try carrying your heels with you and changing into them once you arrive at work.  Adding inserts to your heels can help cushion your feet and absorb shock. Full foot inserts or metatarsal pads are available. 

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 Effect of High Heels on the Feet
Monday, 09 March 2020 00:00

Sesamoiditis

Sesamoiditis is a condition that affects the joint that is just behind the big toe in the area known as the ball of the foot. It is most common in younger people and people who have just begun an exercise program. Since the sesamoid bones are like a pulley controlling the big toe, they can rub against each other and cause a gradual onset of pain. Pain may also be caused by the inflammation of tendons surrounding the bones. If ignored, sesamoiditis can lead to other, more serious problems such as severe irritation and fractures of the bones.

The cause of sesamoiditis is sudden increase in activity. The ball of your foot acts as a springboard to help you lift off when you are jogging or running. Sudden increase in the use of these bones or the tendon that controls them can cause irritation. The tendon then begins to develop inflammation and the joint begins to swell. People with smaller, bonier feet or those with a high arch are typically more susceptible to this condition.

Sesamoiditis is fairly simple to diagnose since the symptoms have a gradual onset rather than a sudden impact. The symptoms begin with slight irritation around the joint shortly after the increase in activity. The discomfort eventually turns to pain with light swelling and possibly redness. Although redness or bruising are rare, this may be a symptom. After each session of exercising, the aggravated joint becomes more irritated and increases into a very intense throbbing.

Treatment for sesamoiditis can vary depending on the severity of the situation. However, treatment is almost always approached in a noninvasive way. For a case that is just beginning the doctor may recommend a very strict rest period that will limit the activity allowed on the joint. If you must be active, a recommendation for as modified shoe or insole, along with bandaging and immobilizing the big toe will be made to ensure that pressure is not placed on the joint. For severe cases, it is typically recommended that the joint and the big toe be completely immobilized to allow adequate time to heal. Ice and an over the counter anti-inflammatory may can help with the pain and discomfort while you are at rest.

When you return to your regular exercise activities, it is recommended that you use an insole that will allow even distribution of impact to your entire foot, rather than just the balls of your foot. This will prevent further aggravation of the injury.

 

Monday, 09 March 2020 00:00

The Function of the Sesamoid Bones

The sesamoid bones are located under the ball of the foot. They help to enable the big toe to press down, and pain and discomfort may develop if they should become inflamed. This may happen as a result of participating in running and jumping activities, or from wearing shoes that do not fit correctly. Common symptoms that can be associated with this ailment may include pain on the bottom of the foot, and it may be difficult to stand on your tiptoes. Patients who have this condition may find moderate relief when the affected foot is elevated, and it may help to use an insole that can support the arch. If you feel you may have sesamoiditis, it is strongly advised that you consult with a podiatrist who can properly diagnose and treat this condition. 

Sesamoiditis is an unpleasant foot condition characterized by pain in the balls of the feet. If you think you’re struggling with sesamoiditis, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor will treat your condition thoroughly and effectively.

Sesamoiditis

Sesamoiditis is a condition of the foot that affects the ball of the foot. It is more common in younger people than it is in older people. It can also occur with people who have begun a new exercise program, since their bodies are adjusting to the new physical regimen. Pain may also be caused by the inflammation of tendons surrounding the bones. It is important to seek treatment in its early stages because if you ignore the pain, this condition can lead to more serious problems such as severe irritation and bone fractures.

Causes of Sesamoiditis

  • Sudden increase in activity
  • Increase in physically strenuous movement without a proper warm up or build up
  • Foot structure: those who have smaller, bonier feet or those with a high arch may be more susceptible

Treatment for sesamoiditis is non-invasive and simple. Doctors may recommend a strict rest period where the patient forgoes most physical activity. This will help give the patient time to heal their feet through limited activity. For serious cases, it is best to speak with your doctor to determine a treatment option that will help your specific needs.

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 Sesamoiditis
Wednesday, 04 March 2020 00:00

Are You Suffering From Ingrown Toenails?

If left untreated, an ingrown toenail can lead to more serious concerns, such as an infection. Knowing proper nail care can help in the prevention of an ingrown toenail. Give us a call, and get treated!

Monday, 02 March 2020 00:00

Everything You Need to Know About Gout

Gout, typically found in diabetic patients, is an unusually painful form of arthritis caused by elevated levels of uric acid in the bloodstream. The condition typically strikes the big joint on the big toe. It has also been known to strike the knees, elbows, fingers, ankles and wrists—generally anywhere that has a functioning, moving joint.

The high level of uric acid in a person’s bloodstream creates the condition known as hyperuricema—the main cause of gout. Genetic predisposition occurs in nine out of ten sufferers. The children of parents who suffer gout will have a two in ten chance of developing the condition as well. 

This form of arthritis, being particularly painful, is the leftover uric acid crystallizing in the blood stream. The crystallized uric acid then travels to the space between joints where they rub, causing friction when the patient moves. Symptoms include: pain, redness, swelling, and inflammation. Additional side effects may include fatigue and fever, although reports of these effects are very rare. Some patients have reported that pain may intensify when the temperature drops, such as when you sleep.

Most cases of gout are easily diagnosed by a podiatrist’s assessment of the various symptoms. Defined tests can also be performed. A blood test to detect elevated levels of uric acid is often used as well as an x-ray to diagnose visible and chronic gout.

Treatment for gout simply means eliminating symptoms. Non-steroid anti-inflammatory drugs or NSAIDs (Colchicine and other corticosteroid drugs, etc.) will quell the redness, the swelling, and the inflammation. However, managing your diet, lifestyle changes, and using preventative drugs are all helpful toward fully combating the most severe cases.

 Those that lead an inactive lifestyle are at a higher risk for gout. Any amount of exercise decreases the probability of repeat encounters with the condition. Reducing your consumption of red meat, sea food, and fructose-sweetened drinks also reduces the likelihood of chronic gout as well.

Ingesting Vitamin C, coffee, and particular dairy products can help with maintaining a healthy lifestyle. There are new drugs out on the market that inhibit the body’s production of uric acid-producing enzymes. However, reducing or eliminating your overall levels of uric acid is the best remedy to ensuring you lead a gout-free life.

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