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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 2021

Tuesday, 27 July 2021 00:00

Sports Related Foot and Ankle Injuries

Foot and ankle injuries are common among athletes and those who exercise frequently. Most of these injuries are non-life-threatening and can heal in weeks with proper treatment and care. Serious injuries, however, require urgent medical treatment.

Common minor injuries include ankle sprains, ankle strains, Achilles tendonitis, plantar fasciitis, stress fractures, and turf toe. An ankle sprain is when the ligaments in the ankle have either become stretched or torn. When the muscle or tendon is stretched or torn, it is an ankle strain. When the big toe is sprained, it is known as turf toe. Achilles tendonitis is the overuse and inflammation of the Achilles tendon. Plantar fasciitis is the inflammation of the plantar fascia and generally occurs from overuse in athletics. Stress fractures are also caused from overuse and are small cracks in the bone.

Achilles tendon ruptures are common, but more serious. This injury occurs when the Achilles tendon, the largest tendon in the body, ruptures. In most cases, this causes severe pain and difficulty walking; some who have experienced this injury have reported, however, no signs or symptoms. A laceration is a deep cut that can occur anywhere on the body. Lacerations on the foot are rarer, but can occur from things like metal cleats landing on the foot.   

Treatment options cover a wide range of methods based upon the injury and its severity. Conditions like plantar fasciitis, stress fractures, Achilles tendonitis, turf toe and ankle sprains/ strains can heal on their own without immediate medical care, but seeing a podiatrist to monitor the injury is always recommended. Following the RICE (Rest, Icing, Compression, and Elevation) protocol is generally enough to treat minor injuries. This means resting the foot by either keeping pressure off the foot or not walking at all. Icing the injury will help reduce swelling and pain. Compressing the wound with a wrap will immobilize and help promote healing. Finally, keeping the wound elevated will also reduce swelling and also help the healing process.

It is important to note that even minor injuries can vary in severity, with grade one being a minor injury and grade three requiring urgent care by a podiatrist. Achilles tendon ruptures and lacerations on the foot generally require urgent medical care and treatment options that need a podiatrist. These could include imaging tests, stitches for cuts, rehabilitation, and casts or braces. Every case is different, however, so it is always recommended to see a podiatrist when pain in the foot does not disappear.

Tuesday, 27 July 2021 00:00

Bone Contusions

Contusions occur when an injured blood vessel leaks blood into the surrounding areas. On your skin, this typically means that a bruise will appear, with skin discoloration, tenderness, and pain. But did you know that you can also bruise a bone? Bones are made of tissues and blood vessels. An injury to the area, from a car accident, fall, or high impact sport for example, could make a blood vessel leak, creating a contusion. Symptoms of a bone contusion include stiffness, swelling, tenderness, difficulty using the affected area, and pain that lasts longer than the pain caused by a bruise elsewhere on the body. Bone bruises can take anywhere from a few days to a few months to heal, and recommended treatments vary based on the severity of the injury. If you are experiencing any foot or ankle pain, it is suggested that you consult with a podiatrist.

Ankle and foot injuries are common among athletes and in many sports. They can be caused by several problems and may be potentially serious. If you are feeling pain or think you were injured in a sporting event or when exercising, 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.

Common Injuries

The most common injuries that occur in sporting activities include:

  • Achilles Tendonitis
  • Achilles Tendon Rupture
  • Ankle Sprains
  • Broken Foot
  • Plantar Fasciitis
  • Stress Fractures
  • Turf Toe

Symptoms

Symptoms vary depending upon the injury and in some cases, there may be no symptoms at all. However, in most cases, some form of symptom is experienced. Pain, aching, burning, bruising, tenderness, tightness or stiffness, sensation loss, difficulty moving, and swelling are the most common symptoms.

Treatment

Just as symptoms vary depending upon the injury, so do treatment options. A common treatment method is known as the RICE method. This method involves rest, applying ice, compression and elevating the afflicted foot or ankle. If the injury appears to be more serious, surgery might be required, such as arthroscopic or reconstructive surgery. Lastly, rehabilitation or therapy might be needed to gain full functionality in the afflicted area. Any discomfort experienced by an athlete 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 care needs.

Read more about Sports Related Foot and Ankle Injuries
Tuesday, 20 July 2021 00:00

Vascular Testing in Podiatry

In foot care, vascular testing may be required in the diagnosing and treatment of certain podiatric conditions. Vascular testing is particularly relevant for patients with high-risk diabetes, poor circulation, peripheral artery disease (PAD), and chronic venous insufficiency (CVI). Procedures typically involve the examination of blood vessels throughout the body for blockages or buildup.

Vascular testing is very important for the diagnosis of various conditions, including peripheral artery disease and chronic venous insufficiency, as these conditions can greatly affect one’s quality of life and cause pain in the lower limbs. Circulatory problems in the feet and ankles can reflect issues throughout the body, making testing of the blood vessels pertinent.

Testing methods vary between practitioners and can be specific to certain foot and ankle problems. Modern technology has brought about the ability to perform vascular testing using non-invasive methods, such as the cuff-based PADnet testing device. This device records the Ankle-Brachial Index (ABI)/Toe-Brachial Index (TBI) values and Pulse Volume Recording (PVR) waveforms. Contact your podiatrist to determine what vascular testing is available for your needs.

Poor circulation in the lower limbs can be a sign of peripheral artery disease (PAD). This is a serious condition that can cause leg cramps, muscle weakness, numbness, tingling, foot and ankle wounds, and difficulty walking. Older individuals and those with a history of cardiovascular problems are said to be particularly at risk. Your podiatrist can play a major role in detecting, diagnosing, and helping you manage PAD. Podiatrists can perform diagnostic vascular tests in the clinic. These tests are safe and noninvasive ways to assess blood flow in your lower limbs. Frequently used tests include the Ankle-Brachial Index test and Doppler ultrasonography. To learn more about PAD and to get tested, schedule an appointment with a podiatrist near you.  

Vascular testing plays an important part in diagnosing disease like peripheral artery disease. If you have symptoms of peripheral artery disease, or diabetes, 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 Vascular Testing?

Vascular testing checks for how well blood circulation is in the veins and arteries. This is most often done to determine and treat a patient for peripheral artery disease (PAD), stroke, and aneurysms. Podiatrists utilize vascular testing when a patient has symptoms of PAD or if they believe they might. If a patient has diabetes, a podiatrist may determine a vascular test to be prudent to check for poor blood circulation.

How Is it Conducted?

Most forms of vascular testing are non-invasive. Podiatrists will first conduct a visual inspection for any wounds, discoloration, and any abnormal signs prior to a vascular test.

 The most common tests include:

  • Ankle-Brachial Index (ABI) examination
  • Doppler examination
  • Pedal pulses

These tests are safe, painless, and easy to do. Once finished, the podiatrist can then provide a diagnosis and the best course for treatment.

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 Vascular Testing in Podiatry
Thursday, 15 July 2021 00:00

Do Your Child's Feet Hurt?

Have your child's feet been examined lately? Healthy feet are happy feet. If your child is complaining of foot pain, it may be a sign of underlying problems.

Tuesday, 13 July 2021 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.

The big toe is most commonly affected when an ingrown toenail develops. An ingrown toenail is defined as the nail growing into the skin instead of over it. This can develop for several reasons including a recent toe injury, wearing shoes that do not fit properly, or from trimming the toenails incorrectly. A common symptom of this condition is pain in the big toe and surrounding areas, followed by redness and swelling. Mild relief may be found when the affected toe is soaked in warm water, and this can make it easier to gently pull the skin away from the toenail. It is also beneficial to wear shoes that have ample room for the toes to move freely in, in addition to refraining from putting pressure on the ingrown toenail. If you have symptoms of an ingrown toenail it is strongly suggested that you meet with a podiatrist who can effectively treat this condition.

Ingrown toenails may initially present themselves as a minor discomfort, but they may progress into an infection in the skin without proper treatment. 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 are caused when the corner or side of a toenail grows into the soft flesh surrounding it. They often result in redness, swelling, pain, and in some cases, infection. This condition typically affects the big toe and may recur if it is not treated properly.

Causes

  • Improper toenail trimming
  • Genetics
  • Improper shoe fitting
  • Injury from pedicures or nail picking
  • Abnormal gait
  • Poor hygiene

You are more likely to develop an ingrown toenail if you are obese, have diabetes, arthritis, or have any fungal infection in your nails. Additionally, people who have foot or toe deformities are at a higher risk of developing an ingrown toenail.

Symptoms

Some symptoms of ingrown toenails are redness, swelling, and pain. In rare cases, there may be a yellowish drainage coming from the nail.

Treatment

Ignoring an ingrown toenail can have serious complications. Infections of the nail border can progress to a deeper soft-tissue infection, which can then turn into a bone infection. You should always speak with your podiatrist if you suspect you have an ingrown toenail, especially if you have diabetes or poor circulation.

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 Ingrown Toenails
Tuesday, 06 July 2021 00:00

Flat Feet

Flatfoot is a foot condition in which the arch of the foot has either partially or totally dropped or has never developed. While it is common in babies and small children, it can become a problem for them in adulthood if the arch never forms. For adults, the development of flat feet can be brought upon by injury, as a result of pregnancy due to increased elasticity, or obesity. Those who have health concerns such as rheumatoid arthritis or diabetes may also be at greater risk for developing the condition.

If you suspect that you have flat feet, it is best to consult your podiatrist. Your foot doctor will examine the suspected foot and observe how it looks while you sit and stand. He or she may take an X-ray to determine how serious the condition is. Some common signs of flatfoot include toe drift, in which the toes and front part of the foot point outward, a short Achilles tendon, and a heel that tilts outwardly while the ankle tilts inward.

Once flatfoot has been diagnosed, your podiatrist may suggest one of several treatment options. Flat feet can be rigid, in which the feet appear to have no arch even when the person is not standing; or flexible, in which the person appears to have an arch while not standing, but once standing the arch disappears. Those with flexible flatfoot may be told to reduce any activities that cause pain and to avoid extended periods of walking or standing. Another suggestion may be weight loss, as excessive weight may be placing pressure on the arches

In few cases, if the condition is severe and all other methods have been exhausted surgery may be required. This is normally avoided, however, due to a lengthy recovery time and high cost.

Feet come in many different shapes and sizes, and so do their arches. The arch is the curved area that is located along the bottom of the foot, roughly at the foot’s center. Not everyone is born with and arch and not everyone develops an arch. Many people have flat feet, where their arch is not visible, either all the time or just while bearing weight. Flat feet are common and can be present from birth or acquired later in life. Flat feet may cause foot pain or a dysfunctional walking pattern, but in many cases, they are asymptomatic. High arches are a rarer occurrence where the arches are unusually raised. High arches may cause pain while going about your daily activities and make it harder to find shoes that fit comfortably. If you have flat feet or high arches that are bothering you, it is suggested that you seek the care of a podiatrist. 

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
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