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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!

January 2025

Friday, 31 January 2025 00:00

Do You Suffer From Painful Feet?

Painful deformities, such as hammertoes, can be treated. Stop living with foot pain, and have beautiful feet again!

Tuesday, 28 January 2025 00:00

Ankle Pain

The ankle joint is the point at which the bones of the leg and foot join. This joint is crucial because it is responsible for the foot’s mobility. Ankle pain is typically the result of inflammation from an injury to bones, joint space, cartilage, ligaments, tendons, or muscles in the area. Commonly associated symptoms with ankle pain are bruising, redness, numbness, stiffness, weakness, and tingling.

The most common causes of ankle pain are sprains and injuries. Ankle sprains are one of the most common musculoskeletal injuries. Sprains occur when the ligaments of the ankle become partially or completely torn due to sudden stretching. Sprains can occur on either the inner or outer sides of the ankle joint. Usually, these injuries occur when the ankle is twisted in an activity by stepping off an uneven surface. More specific causes include rheumatoid arthritis, gout, osteoarthritis, and Achilles tendonitis.

If you are experiencing ankle pain, you should consult with your podiatrist to choose the best method of care. Your doctor will conduct an examination of your ankle to determine the underlying cause of the pain.

Tuesday, 28 January 2025 00:00

Five Types of Ankle Injuries

There are five common types of ankle injuries, each of which can significantly impact mobility and require medical attention. The inversion sprain, caused by the ankle rolling inward, stretches the lateral ligaments and is the most frequent type of ankle injury. In contrast, an eversion sprain occurs when the foot twists outward, affecting the more stable medial ligaments, often resulting in a more severe injury. High ankle sprains involve the syndesmotic ligaments that connect the tibia and fibula and are typically seen in sports when the leg and foot twist outward. Fractures, which involve breaks in one or more ankle bones, can range from minor to severe, often requiring surgery and extensive recovery time. Lastly, an ankle dislocation occurs when the joint is forced out of alignment, frequently accompanied by fractures. This severe injury typically necessitates surgery to restore proper function. A podiatrist can assess these injuries, guide treatment plans, and monitor recovery to help patients regain strength and prevent future complications. If you have an ankle injury, it is suggested that you schedule an appointment with a podiatrist for an exam, diagnosis, and treatment.

Ankle pain can be caused by a number of problems and may be potentially serious. If you have ankle 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.

Ankle pain is any condition that causes pain in the ankle. Due to the fact that the ankle consists of tendons, muscles, bones, and ligaments, ankle pain can come from a number of different conditions.

Causes

The most common causes of ankle pain include:

  • Types of arthritis (rheumatoid, osteoarthritis, and gout)
  • Ankle sprains
  • Broken ankles
  • Achilles tendonitis
  • Achilles tendon rupture
  • Stress fractures
  • Bursitis
  • Tarsal tunnel syndrome
  • Plantar fasciitis

Symptoms

Symptoms of ankle injury vary based upon the condition. Pain may include general pain and discomfort, swelling, aching, redness, bruising, burning or stabbing sensations, and/or loss of sensation.

Diagnosis

Due to the wide variety of potential causes of ankle pain, podiatrists will utilize a number of different methods to properly diagnose ankle pain. This can include asking for personal and family medical histories and of any recent injuries. Further diagnosis may include sensation tests, a physical examination, and potentially x-rays or other imaging tests.

Treatment

Just as the range of causes varies widely, so do treatments. Some more common treatments are rest, ice packs, keeping pressure off the foot, orthotics and braces, medication for inflammation and pain, and surgery.

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 Ankle Pain
Tuesday, 21 January 2025 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.

Pickleball, one of the fastest-growing sports, offers fun and fitness but comes with risks for sprains, fractures, and falls that affect the ankles and feet. Sudden pivots, quick lateral movements, and uneven court surfaces can strain ligaments or even lead to fractures. Proper warmups are essential to reduce injury. It is important to spend a few minutes stretching calves, Achilles tendons, and hamstrings, and practice gentle ankle rotations. Gradually increasing your heart rate with light jogging or dynamic stretches can prepare your muscles for the game’s demands. Wearing supportive footwear and paying attention to court conditions are additional ways to minimize falls. If you experience foot pain after a pickleball game, it is suggested that you consult a podiatrist who can assess the injury and provide treatment.

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, 14 January 2025 00:00

What is Flexible Flat Foot?

Flatfoot is classified as having the entire sole of the foot in contact or near contact to the ground while standing. The disorder is also known as fallen arches, because those affected have no arch in their feet. Flexible flatfoot and rigid flatfoot are the two types of flatfoot.

A person has flexible flatfoot if when sitting or standing on their toes, they have an arch that disappears when they stand with the entire foot on the ground. Flexible flatfoot may also be called “pediatric flatfoot” because the condition first appears in childhood. It is common among infants because the arch does not develop until the age of 5 or 6 years. Rigid flatfoot is not as common in children as it is with adults. This type of flatfoot is developed due to the weakening of tibialis posterior muscle tendon, a major supporting structure of the foot arch. Development of this deformity is progressive and shows early signs of pain and swelling that begins at the inside arch of the foot and moves to the outside of the foot below the ankle. More severe cases can possibly lead to arthritis of the foot and ankle joints.

Although most cases of flatfoot involve people born with the condition, some less common causes are obesity, diabetes, pregnancy, and osteoporosis. In some cases, flatfoot may come with no symptoms at all and does not require any type of treatment. With other cases though, symptoms may include pain in the shin, knee, hips and lower back. If a person with flatfeet experiences such symptoms, a health care provider may suggest using orthotic devices or arch supports, which may reduce the pain. Wearing supportive shoes can also prove more comfortable with flatfeet and staying away from shoes with little support such as sandals. Other methods to relieve pain also include stretching the Achilles tendon properly and using proper form when doing any physical activity. In addition, losing weight can reduce the stress on your feet and reduce the pain.

Tuesday, 14 January 2025 00:00

Symptoms and Diagnosis of Flat Feet

Flat feet, also known as fallen arches, is a condition where the arch of the foot collapses or does not form properly. This leads to the entire sole of the foot making contact with the ground. The most common symptoms of flat feet include foot pain, particularly in the arch or heel area, swelling along the inner part of the foot, and difficulty standing or walking for extended periods. People with flat feet may also experience problems with balance and a tendency to tire quickly. Diagnosing flat feet typically involves a physical examination by a podiatrist, who will look for visible signs of the condition. X-rays or other imaging tests may be used to assess the alignment of the bones in the foot. If you have flat feet that are causing pain and discomfort, it is suggested that you consult a podiatrist who can offer you effective relief and treatment solutions.

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 What is Flexible Flat Foot?
Tuesday, 07 January 2025 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.

Tuesday, 07 January 2025 00:00

Key Facts About Morton’s Neuroma

Morton's neuroma, also known as interdigital neuroma, is a painful condition that affects the nerves between the toes, most commonly between the third and fourth toes. Named after Dr. Thomas George Morton, this condition causes sharp, burning pain, tingling, or a feeling of having a lump in the ball of the foot. The pain often worsens when wearing tight shoes or during activities like walking or running. The cause of Morton's neuroma is usually excessive pressure on the nerve, often due to wearing ill-fitting shoes, high heels, or repetitive stress from activities. Risk factors include foot deformities like bunions or flat feet. Treatment typically starts with conservative measures, such as wearing adequately cushioned shoes, and using orthotics, or corticosteroid injections. If these do not relieve symptoms, surgical excision of the neuroma has shown promising long-term results in reducing pain and improving function. If you are experiencing symptoms of Morton's neuroma, it is suggested that you schedule an appointment with a podiatrist for proper diagnosis and treatment.

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.

Read more about What is Morton's Neuroma?
Wednesday, 01 January 2025 00:00

Plantar Warts Can Be Treated!

Plantar warts are small growths that develop on parts of the feet that bear weight. They're typically found on the bottom of the foot. Don't live with plantar warts, and call us today!

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