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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!

April 2021

Monday, 26 April 2021 00:00

What is Morton's Neuroma?

Morton’s neuroma, (also referred to as Morton’s metatarsalgia, Morton’s neuralgia, plantar neuroma or intermetatarsal neuroma) is a condition that is caused when the tissue around one of the nerves between your toes begins to thicken. This thickening can result in pain in the ball of the foot. Fortunately, the condition itself is not cancerous.

Morton’s neuroma affects women more often than men with a ratio of 4:1. It tends to target women between the age of 50 and 60, but it can occur in people of all ages. There are some risk factors that may put you at a slightly higher risk of developing the condition. People who often wear narrow or high-heeled shoes are often found to be linked to Morton’s neuroma. Additionally, activities such as running or jogging can put an enormous amount of pressure on the ligament and cause the nerve to thicken.

There usually aren’t any outward symptoms of this condition. A person who has Morton’s neuroma may feel as if they are standing on a pebble in their shoe. They may also feel a tingling or numbness in the toes as well as a burning pain in the ball of their foot that may radiate to their toes.

In order to properly diagnose you, the doctor will press on your foot to feel for a mass or tender spot. He may also do a series of tests such as x-rays, an ultrasound, or an MRI. X-rays are usually done to rule out any other causes for your foot pain such as a stress fracture. Ultrasounds are used to reveal soft tissue abnormalities that may exist, such as neuromas. Your podiatrist may want to use an MRI in order to visualize your soft tissues.

There are three main options for treatment of Morton’s neuroma: Injections, decompression surgery, and removal of the nerve. Injections of steroids into the painful area have been proven to help those with Morton’s neuroma. Decompression surgery has been shown to relieve pressure on the affected nerve by cutting nearby structures such as the ligaments in the foot. Another treatment option would be to surgically remove the growth to provide pain relief.

If you suspect that you have Morton’s neuroma you should make an appointment with your podiatrist right away. You shouldn’t ignore any foot pain that lasts longer than a few days, especially if the pain does not improve.

If you feel like you’re walking with a pebble in your shoe, only to find out there’s nothing there, then you may be afflicted with Morton’s neuroma. Morton’s neuroma is a condition in which the tissue around one of the nerves that leads to your toes becomes thickened. This causes pain in the ball of the foot and burning, tingling, or numbness in the toes may be felt as well. There may also be a unique sensation that you are stepping on a pebble when walking. Morton’s neuroma occurs due to irritation, pressure, or an injury on the affected nerve. People who wear high heels, participate in high impact sports, and those who have certain foot deformities, like bunions or hammertoes, may be more prone to develop this condition. If you are experiencing any symptoms of Morton’s neuroma, please seek the care of a podiatrist. 

Morton’s neuroma is a very uncomfortable condition to live with. If you think you have Morton’s neuroma, contact John Horlebein, DPM of Northern Cascades Foot & Ankle, LLC. Our doctor will attend to all of your foot care needs and answer any of your related questions.  

Morton’s Neuroma

Morton's neuroma is a painful foot condition that commonly affects the areas between the second and third or third and fourth toe, although other areas of the foot are also susceptible. Morton’s neuroma is caused by an inflamed nerve in the foot that is being squeezed and aggravated by surrounding bones.

What Increases the Chances of Having Morton’s Neuroma?

  • Ill-fitting high heels or shoes that add pressure to the toe or foot
  • Jogging, running or any sport that involves constant impact to the foot
  • Flat feet, bunions, and any other foot deformities

Morton’s neuroma is a very treatable condition. Orthotics and shoe inserts can often be used to alleviate the pain on the forefront of the feet. In more severe cases, corticosteroids can also be prescribed. In order to figure out the best treatment for your neuroma, it’s recommended to seek the care of a podiatrist who can diagnose your condition and provide different 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 care needs.

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Monday, 19 April 2021 00:00

Sports Related Foot And Ankle Injuries

Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sports are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly, they can lead to permanent disability.

Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled medical professional.

Plantar fasciitis is a painful injury. It is inflammation of the plantar fascia, the thick band of tissue running from the heel to the base of the toes. If left untreated, it can lead to a degenerative disease called plantar fasciosis. There are several effective treatments for this ailment. Doctors often prescribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery, usually in that order. The most effective treatment for plantar fasciitis is orthotics, which offers foot support. Surgery is occasionally used as a last resort, but it comes with the risk of nerve damage and infection and often does not stop the pain.

The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount of stress placed on it. Non-surgical treatments include rest, ice or anti-inflammatory medication.  A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.

Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require reconstructive surgery followed by rehabilitation.

Runners’ feet can take a beating striking the ground roughly 800 times for every mile they run. Even the best running shoe may not offer the support and cushioning necessary to avoid pain or overuse injuries to the arches and heels such as plantar fasciitis, Achilles tendonitis, sesamoiditis, stress fractures, metatarsalgia, and more. The lack of proper foundational support leading to these conditions can also negatively affect knees, hips, and the lower back. Custom orthotics may prevent and also treat overuse injuries and can even correct imbalances in a runner’s stride which can lead to foot pain and other issues. If you are a runner, consider contacting a podiatrist who can examine your feet, create custom orthotics to support your individual foot structure and address your specific foot condition.

Sports related foot and ankle injuries require proper treatment before players can go back to their regular routines. For more information, 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.

Sports Related Foot and Ankle Injuries

Foot and ankle injuries are a common occurrence when it comes to athletes of any sport. While many athletes dismiss the initial aches and pains, the truth is that ignoring potential foot and ankle injuries can lead to serious problems. As athletes continue to place pressure and strain the area further, a mild injury can turn into something as serious as a rupture and may lead to a permanent disability. There are many factors that contribute to sports related foot and ankle injuries, which include failure to warm up properly, not providing support or wearing bad footwear. Common injuries and conditions athletes face, including:

  • Plantar Fasciitis
  • Plantar Fasciosis
  • Achilles Tendinitis
  • Achilles Tendon Rupture
  • Ankle Sprains

Sports related injuries are commonly treated using the RICE method. This includes rest, applying ice to the injured area, compression and elevating the ankle. More serious sprains and injuries may require surgery, which could include arthroscopic and reconstructive surgery. Rehabilitation and therapy may also be required in order to get any recovering athlete to become fully functional again. Any unusual aches and pains an athlete sustains must be evaluated by a licensed, reputable medical professional.

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.

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Friday, 16 April 2021 00:00

Heel Pain Can Be Treated!

Do you suffer from heel pain when you get up in the morning? If so, you should seek the professional help of your podiatrist and have a proper diagnosis performed. Heel pain can be caused by several different foot-related conditions.

Monday, 12 April 2021 00:00

Shockwave Therapy

Extracorporeal Shockwave Therapy (ESWT) is an alternative treatment method that is used for bone and soft tissue disorders in the foot and ankle. EWST is a noninvasive option for pain relief and it was originally created to help dissolve kidney stones. This therapy works by focusing impulses to target the area in pain. This method has been proven to show a reduction in the amount of nerve fibers that transmit painful impulses, which leads to a reduction in pain. Shockwave therapy can also expedite the tissue which would, in turn, increase the amount of new blood vessels that are formed.

Conditions that can be treated with shockwave therapy include Achilles pain and heel pain. People with plantar fasciitis may opt for this therapy and the results are usually great after 18 months. Additionally, this method can also be used to treat fractures that have failed to heal correctly. Anesthesia is not required to perform this treatment. It usually is not painful, but it can be uncomfortable.

The duration of treatment sessions usually lasts 5-15 minutes each. This procedure is safe since there is no risk of infection from wound complications, if you are looking to try shockwave therapy to heal plantar fasciitis, it may take 3-4 sessions to start working. After treatment, patients typically notice a dull pain in the area which was treated. However, this pain rarely lasts more than 24 hours.

Nevertheless, there are pros and cons that come along with Shockwave Therapy. The most obvious pro is that this treatment is noninvasive, meaning surgery will not be required. Another upside is that there have been very little complications that have been found with this procedure. On the other hand, those who opt for surgery are at risk for continued pain, wound problems, and infections. The biggest con for ESWT is that it is very expensive; it typically costs around $1,000 before insurance. Another con is that the effectiveness of the treatment is questionable. Usually, if this treatment is helpful, the difference is small.

If you are curious about Shockwave Therapy, you should talk to your podiatrist to see if this treatment method is right for you. At times, patients will find that there are other treatment options that are more efficient for their individual cases.

For people suffering with chronic plantar fasciitis which has not responded to traditional treatment, Extracorporeal Shock Wave Therapy may be an option. Extracorporeal refers to something outside of the body, and in this case, Extracorporeal Shock Wave Therapy (ESWT) is a non-invasive alternative to surgery that may offer relief. In ESWT, ultrasound is used to find the location of the damage to the plantar fascia, and a calibrated current of shock waves is targeted directly into this area to facilitate the creation of new tissue cells and eventual healing. Contact a podiatrist to see if you may be a good candidate for ESWT.

Shockwave therapy is a treatment commonly used to treat various injuries and conditions, particularly plantar fasciitis in the feet. To learn more, consult with 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.

Shockwave Therapy

Shockwave therapy is a new treatment option designed to treat bone conditions such as tennis elbow, shoulder pain, and others. Shockwave therapy uses high intensity sound waves that are directed to the affected tissues of the body with pinpoint accuracy. The effects are very beneficial, leading to a production of collagen fibers, eliminating inflammation.

Who Benefits from Shockwave?

Shockwave is recommended for patients suffering from heel pain and associated problems. Heel pain is a common condition which can be caused by obesity, overexertion, and spending a substantial amount of time on hard floors with your feet exposed and unsupported.

Fast and Easy

The therapy is actually a simple process that can leave patients feeling better the very next day. Shockwave therapy is not as dramatic as it sounds. It enables more blood flow to effected areas, addressing the source of the problem and allowing treatment to last for a long time.

Treatment & Recovery Time

Shockwave treatment will enable your feet to recover quickly. This is especially important since surgery is not required. It is cost effective and does not require the use of anesthesia. This treatment is a better option to surgery, since it is proven safe.

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.

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Monday, 05 April 2021 00:00

How to Deal with Athlete's Foot

Athlete’s foot is a type of fungal infection that affects the skin on the feet. It is caused when the tinea fungus grows on the foot. It is possible to catch the fungus through direct contact with someone who has it or by touching a surface that is contaminated with it. This type of fungus thrives in warm, moist environments such as showers, locker room floors, and swimming pools. Your risk of getting it may also increase by wearing tight-fitting, closed-toe shoes, or by having sweaty feet.

Symptoms of athlete’s foot include itching, stinging or burning sensations between the toes. You may also experience toenails that are discolored, thick, crumbly, or toenails that pull away from the nail bed.

Your podiatrist may diagnose athlete’s foot by detecting these symptoms or by doing a skin test to see if there is a fungal infection present. The most common exam used to detect Athlete’s foot is a skin lesion potassium hydroxide exam. To use this method, your doctor will scrape off a small area of the infected skin and place it into potassium hydroxide. The potassium hydroxide will destroy the normal cells and leave the fungal cells untouched so that they are visible under a microscope.

There are a variety of treatment options for athlete’s foot. Some medications are miconazole (Desenex), terbinafine (Lamisil AT), clotrimazole (Lotrimin AF), butenafine (Lotrimin Ultra), and tolnaftate (Tinactin). While these options may be able to treat your fungus, it is best that you consult with a podiatrist in order to see which treatment option may work best for you.

In some cases, Athlete’s foot may lead to complications. A severe complication would be a secondary bacterial infection which may cause your foot to become swollen, painful, and hot.

There are ways that you can prevent athlete’s foot. Washing your feet with soap and water each day and drying them thoroughly is an effective way to prevent infections. You also shouldn’t share socks, shoes, or towels with other people. It is crucial that you wear shower sandals in public showers, around swimming pools, and in other public places. Additionally, you should make sure you wear shoes that can breathe and change your socks when your feet become sweaty. If you suspect that you have Athlete’s foot, you should seek help from a podiatrist as soon as possible.

The medical condition known as athlete’s foot is contagious and often accompanied by noticeable symptoms. These symptoms may include cracked skin on the sole of the foot or in between the toes, and many patients also experience severe itching. This ailment is caused by a fungus that generally lives and thrives in warm and moist environments. These can include public swimming pools, locker rooms, and shower room floors. The fungus typically enters the body through small cracks in the skin and may even spread to other parts of the body, such as the hands, if not promptly treated. If you or your child have symptoms of this uncomfortable foot condition, it is strongly suggested that you seek the advice of a podiatrist who can offer you proper treatment solutions.

Athlete’s Foot

Athlete’s foot is often an uncomfortable condition to experience. Thankfully, podiatrists specialize in treating athlete’s foot and offer the best treatment options. If you have any questions about athlete’s foot, consult with John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will assess your condition and provide you with quality treatment.

What Is Athlete’s Foot?

Tinea pedis, more commonly known as athlete’s foot, is a non-serious and common fungal infection of the foot. Athlete’s foot is contagious and can be contracted by touching someone who has it or infected surfaces. The most common places contaminated by it are public showers, locker rooms, and swimming pools. Once contracted, it grows on feet that are left inside moist, dark, and warm shoes and socks.

Prevention

The most effective ways to prevent athlete’s foot include:

  • Thoroughly washing and drying feet
  • Avoid going barefoot in locker rooms and public showers
  • Using shower shoes in public showers
  • Wearing socks that allow the feet to breathe
  • Changing socks and shoes frequently if you sweat a lot

Symptoms

Athlete’s foot initially occurs as a rash between the toes. However, if left undiagnosed, it can spread to the sides and bottom of the feet, toenails, and if touched by hand, the hands themselves. Symptoms include:

  • Redness
  • Burning
  • Itching
  • Scaly and peeling skin

Diagnosis and Treatment

Diagnosis is quick and easy. Skin samples will be taken and either viewed under a microscope or sent to a lab for testing. Sometimes, a podiatrist can diagnose it based on simply looking at it. Once confirmed, treatment options include oral and topical antifungal medications.

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.

 

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