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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 2024

Tuesday, 30 July 2024 00:00

Solutions for Cracked Heels

Cracked heels may make you want to think twice about showing off your feet in warmer weather. However, cracked heels may be harmful to more than just the appearance of your feet. If deep fissures and cracks develop in your heels, they may make walking and standing painful for you. Additionally, these openings make way for germs to enter through your skin and cause infection.

There are several different causes of cracked heels. One of the most common reasons for this ailment is dry skin. This problem may make your keeps feel rough tight and itchy. Dry skin may be caused by cold air, extremely hot water, harsh soaps, and aging. Skin disorders such as eczema and psoriasis may eventually lead to dry skin. In some cases, complications may arise from cracked heels. Some of these complications are a loss of feeling in the heel, cellulitis, or a diabetic foot ulcer.

There are ways you can try to prevent getting cracked heels. One of the best ways to do so is to avoid wearing flip flops and sandals because these shoes increase your risk of drying out your feet. You should also avoid wearing shoes with a tall skinny heel, because these shoes cause your heel to expand sideways. At night, you should slather on a thick moisturizing cream on your feet and then cover them in socks to keep your feet moisturized overnight. Drinking water to stay hydrated is also a good way to ensure that your skin doesn’t become dry.

If you suffer from a severe case of cracked feet, you should make an appointment with your podiatrist to see what treatment methods are best for you.

Tuesday, 30 July 2024 00:00

Cracked Heels and Their Effects

Cracked heels, medically known as keratoderma, is a condition where the skin on the heels becomes thick, dry, and eventually splits. This often painful issue arises from prolonged pressure on the feet, leading to hard, callused skin that can fissure. Causes include standing for long periods, wearing open-backed shoes, and exposure to dry, cold weather. Medical conditions like diabetes and hypothyroidism also contribute by causing excessively dry skin. Excessive weight increases pressure on the heel pads, further worsening the problem. Preventing keratoderma involves regular moisturizing, wearing supportive, closed-back footwear, and avoiding prolonged standing on hard surfaces. Proper foot care routines, including gentle exfoliation and hydration, are essential to maintain soft, healthy skin and prevent the discomfort associated with cracked heels. This condition can be painful. If this applies to you, it is suggested that you visit a podiatrist who can effectively treat cracked heels, which often includes prescribed medication.

Cracked heels are unsightly and can cause further damage to your shoes and feet. If you have any concerns, 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.

Cracked Heels

Cracked heels appear unappealing and can make it harder for you walk around in sandals. Aside from looking unpleasant, cracked heels can also tear stockings, socks, and wear out your shoes. There are several methods to help restore a cracked heel and prevent further damage.

How Do You Get Them?

Dry skin is the number one culprit in creating cracked heels. Many athletes, walkers, joggers, and even swimmers suffer from cracked heels. Age and skin oil production play a role to getting cracked heels as well.

Promote Healing

Over the counter medicines can help, especially for those that need instant relief or who suffer from chronic dry feet.

Wear Socks – Wearing socks with medicated creams helps lock in moisture.

Moisturizers – Applying both day and night will help alleviate dryness which causes cracking.

Pumice Stones – These exfoliate and remove dead skin, which allows for smoother moisturizer application and better absorption into the skin. 

Change in Diet

Eating healthy with a well-balanced diet will give the skin a fresh and radiant look. Your body responds to the kinds of food you ingest. Omega-3 fatty acids and zinc supplements can also revitalize skin tissue.

Most importantly, seek professional help if unsure how to proceed in treating cracked heels. A podiatrist will help you with any questions or information needed. 

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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Tuesday, 23 July 2024 00:00

How to Stretch Your Feet

Your feet endure a great amount of stress each day from constantly allowing us to move around. It is important to stretch your feet to help prevent them from becoming injured. Your toes may easily deform into unhealthful positions if they are not stretched.

One of the most common reasons for toe deformities are the shoes you may be wearing. Shoes that are too tight may fold and shift the toes out of place. Heeled shoes may also push your toes upward. Forcing your toes into an unnatural position which may cause the muscles to tighten and prevent them from reverting to normal length. Another common reason is improper use of foot muscles. Many people fail to use the muscles in their feet or toes when they walk. Lastly, the positioning of your feet while walking may also cause toe deformities. If you walk with your feet facing outward, your “push-off” phase is on the side of your big toe instead of the bottom of your foot. This may cause the big toe to eventually tighten into a new shifted position.

There are many reasons why stretching your toes may be helpful. One reason is that healthy spacing may aid in avoiding calluses and other injuries that are caused by rubbing.  Stretching will also prevent you from developing toes that curl, hammertoes, or bunions.

A great way to stretch your toes is to place them in your hands and bend them all downward; this will help you stretch the top of your foot. Next, you should repeat this process but instead bend them upward enough to feel a nice stretch in the bottom of your foot. You should then try to pull each toe apart from the next and pull any toes that are bent upward until they are back downward.

If you are looking to practice stretching your entire foot, you can try a towel stretch. This is done by sitting on the floor with your legs in front of you. Take a towel and wrap it around your toes. Afterward, pull the towel toward you with your toes and hold this position for 15 to 30 seconds before releasing. Practice this stretch for three sets. Another stretch your feet are towel lifts. This is done by sitting in a chair and trying to pick a towel up from the ground with your toes. Try lifting the towel with your little toes for five sets before switching feet.

If you are an athlete, or exercise often, it is especially important for you to practice stretching your feet. Those who suffer from foot pain caused by poor footwear, plantar fasciitis, or long hours of standing at work may also benefit from foot exercises.

Keeping feet in top shape involves regular exercises and stretches that enhance flexibility, strength, and overall health, reducing the risk of injuries. Limbering up with a foot roll using a tennis ball helps massage and loosen the bottom of the foot. The bottom of the foot stretch, where you pull back on the toes while sitting, targets the plantar fascia, easing tension and preventing conditions like plantar fasciitis. The top-of-the-foot stretch is achieved by pointing the toes and gently pressing down, helping to alleviate tension and improve flexibility in the extensor muscles. Calf and Achilles stretches, such as leaning into a wall with one leg extended back, enhance the flexibility and strength of the calf muscles and Achilles tendon, essential for maintaining proper foot mechanics. The seated hamstring stretch, where you reach for your toes while seated, supports the overall flexibility of the leg, reducing strain on the feet. If you would like personalized advice on foot stretches and to address any foot concerns you may have, it is suggested that you consult a podiatrist.

Stretching the feet is a great way to prevent injuries. If you have any concerns with your feet 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.

Stretching the Feet

Being the backbone of the body, the feet carry your entire weight and can easily become overexerted, causing cramps and pain. As with any body part, stretching your feet can serve many benefits. From increasing flexibility to even providing some pain relief, be sure to give your feet a stretch from time to time. This is especially important for athletes or anyone performing aerobic exercises, but anyone experiencing foot pain or is on their feet constantly should also engage in this practice.

Great ways to stretch your feet:

  • Crossing one leg over the others and carefully pull your toes back. Do 10-20 repetitions and repeat the process for each foot
  • Face a wall with your arms out and hands flat against the wall. Step back with one foot and keep it flat on the floor while moving the other leg forward. Lean towards the wall until you feel a stretch. Hold for 30 seconds and perform 10 repetitions for each foot
  • Be sure not to overextend or push your limbs too hard or you could risk pulling or straining your muscle

Individuals who tend to their feet by regular stretching every day should be able to minimize foot pain and prevent new problems from arising.

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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Tuesday, 16 July 2024 00:00

What are Achilles Tendon Injuries

The Achilles tendon is the strongest tendon in the human body. Its purpose is to connect the lower leg muscles and calf to the heel of the foot. This tendon is responsible for facilitating all types of movement, like walking and running. This tendon provides an enormous amount of mobility for the body. Any injuries inflicted to this tissue should be immediately brought up with a physician to prevent further damage. 

The most common injuries that can trouble the Achilles tendon are tendon ruptures and Achilles tendinitis. Achilles tendinitis is the milder of the two injuries. It can be recognized by the following symptoms: inflammation, dull-to-severe pain, increased blood flow to the tendon, thickening of the tendon, and slower movement time. Tendinitis can be treated via several methods and is often diagnosed by an MRI. 

An Achilles tendon rupture is trickier to heal, and is by far the most painful injury. It is caused by the tendon ripping or completely snapping. The results are immediate and absolutely devastating, and will render the patient immobile. If a rupture or tear occurs, operative and non-operative methods are available. Once the treatment begins, depending on the severity of the injury, recovery time for these types of issues can take up to a year. 

Simple preventative measures can be taken as a means to avoid both injuries. Prior to any movement, taking a few minutes to stretch out the tendon is a great way to stimulate the tissue. Calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses are all suggested ways to help strengthen the lower legs and promote Achilles tendon health. 

Many problems arise among athletes and people who overexert themselves while exercising. Problems can also happen among those who do not warm up properly before beginning an activity. Proper, comfortable shoes that fit correctly can also decrease tendon injuries. Some professionals also suggest that when exercising, you should make sure that the floor you are on is cushioned or has a mat. This will relieve pressure on the heels. A healthy diet will also increase tendon health. 

It is very important to seek out a podiatrist if you believe you have an injury in the Achilles region. Further damage could result in severe complications that would make being mobile difficult, if not impossible.

Tuesday, 16 July 2024 00:00

Achilles Tendon Injury Diagnosis

Diagnosing an Achilles tendon injury, such as a tear or rupture, involves several precise steps to ensure accurate identification and treatment. First, a podiatrist will discuss your symptoms, focusing on any sharp pain in the ankle or back of the leg, difficulty walking, or an audible snap at the time of injury. A thorough physical examination follows, often starting with the Thompson test, where the podiatrist will squeeze your calf muscle while you lie face down. A lack of foot movement suggests a tear. Plantar flexion tests assess your ability to flex the foot and stand on your toes. Visible signs, like a soft spot or bruising near the tendon, also may indicate damage to the Achilles tendon. Weight-bearing tests evaluate your capacity to stand on the injured foot and detect limping. For a more detailed view, imaging tests such as ultrasound or MRI may be performed. An ultrasound provides 2D images to pinpoint partial tears, while an MRI offers 3D images, which are particularly useful for identifying complete ruptures where tendon ends are detached. If you suspect an Achilles tendon injury, it's suggested that you make an immediate appointment with a podiatrist for a diagnosis and treatment. 

Achilles tendon injuries need immediate attention to avoid future complications. If you have any concerns, 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.

What Is the Achilles Tendon?

The Achilles tendon is a tendon that connects the lower leg muscles and calf to the heel of the foot. It is the strongest tendon in the human body and is essential for making movement possible. Because this tendon is such an integral part of the body, any injuries to it can create immense difficulties and should immediately be presented to a doctor.

What Are the Symptoms of an Achilles Tendon Injury?

There are various types of injuries that can affect the Achilles tendon. The two most common injuries are Achilles tendinitis and ruptures of the tendon.

Achilles Tendinitis Symptoms

  • Inflammation
  • Dull to severe pain
  • Increased blood flow to the tendon
  • Thickening of the tendon

Rupture Symptoms

  • Extreme pain and swelling in the foot
  • Total immobility

Treatment and Prevention

Achilles tendon injuries are diagnosed by a thorough physical evaluation, which can include an MRI. Treatment involves rest, physical therapy, and in some cases, surgery. However, various preventative measures can be taken to avoid these injuries, such as:

  • Thorough stretching of the tendon before and after exercise
  • Strengthening exercises like calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses

If you have any questions please feel free to contact our office located in Chelan, WA . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.

Read more about What are Achilles Tendon Injuries
Tuesday, 09 July 2024 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.

Gout is a type of arthritis caused by high levels of uric acid in the blood, leading to the formation of sharp crystals in the joints. The big toe is often affected, and the pain may become debilitating, some patients have difficulty in walking and completing daily activities. This condition can be triggered by factors such as genetics, obesity, and certain medical conditions. Diet plays a significant role in managing gout. Foods high in purines, such as red meat, organ meats, and certain seafood like sardines and shellfish, should be avoided as they can increase uric acid levels. Additionally, sugary beverages and alcohol, particularly beer, can exacerbate gout symptoms. On the other hand, a diet rich in low-purine foods can help manage gout effectively. These include fruits, vegetables, whole grains, and low-fat dairy products. Drinking plenty of water and maintaining a healthy weight can also help reduce uric acid levels. Individuals who have gout often experience extreme pain and discomfort, especially in their big toe. If this applies to you, it is strongly suggested that you are under the care of a podiatrist who can treat this condition, and lead you to making correct food choices.

Gout is a foot condition that requires certain treatment and care. If you are seeking treatment, contact John Horlebein, DPM from Northern Cascades Foot & Ankle, LLC. Our doctor will treat your foot and ankle needs.

What Is Gout?

Gout is a type of arthritis caused by a buildup of uric acid in the bloodstream. It often develops in the foot, especially the big toe area, although it can manifest in other parts of the body as well. Gout can make walking and standing very painful and is especially common in diabetics and the obese.

People typically get gout because of a poor diet. Genetic predisposition is also a factor. The children of parents who have had gout frequently have a chance of developing it themselves.

Gout can easily be identified by redness and inflammation of the big toe and the surrounding areas of the foot. Other symptoms include extreme fatigue, joint pain, and running high fevers. Sometimes corticosteroid drugs can be prescribed to treat gout, but the best way to combat this disease is to get more exercise and eat a better diet.

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 Everything You Need to Know About Gout
Wednesday, 03 July 2024 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, 02 July 2024 00:00

Heel Pain

Have you ever gotten up from a chair or out of bed in the morning, and upon taking that first step, feel like your heel has stepped on a tack? Many people experience a feeling of sharp pain which radiates into their arch from their heel and which does not allow them to put their heel on the floor. Sometimes they need to sit back down, stand only on their toes and use the wall for balance. If you can take a few steps, it seems to go away and lessen, allowing you to then resume your activity. Later, throughout your day and after a period of rest, it can happen again. If this sounds familiar you may be suffering from your first attack of heel pain.

Heel pain is a debilitating condition that affects day to day activities. Running and walking both causes stress on the heel because the heel is the part of the foot that hits the ground first. This means that the heel is taking on your entire weight. Diagnosis and treatments for heel pain can be easily found through your podiatrist.

Plantar Fasciitis

One of the main causes of heel pain is a condition known as plantar fasciitis. The plantar fascia is a band of tissue that extends along the bottom of the foot, from the toe to the bottom of the heel. A rip or tear in this ligament can cause inflammation of these tissues, resulting in heel pain. People who do not wear proper fitting shoes are often at risk of developing problems such as plantar fasciitis. Unnecessary stress from ill-fitting shoes, weight change, excessive running, and wearing non-supportive shoes on hard surfaces are all causes of plantar fasciitis.

Achilles Tendonitis

Achilles tendonitis is another cause of heel pain. Similar to plantar fasciitis, inflammation of the Achilles tendon will cause heel pain due to stress fractures and muscle tearing. A lack of flexibility of the ankle and heel is an indicator of Achilles tendonitis. If left untreated, this condition can lead to plantar fasciitis and cause even more pain on your heel.

Heel Spur

A third cause of heel pain is a heel spur. A heel spur occurs when the tissues of the plantar fascia undergo a great deal of stress, leading to a separation of the ligament from the heel bone entirely. This results in a pointed fragment of bone on the ball of the foot, known as a heel spur.

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