The Achilles tendon is the work horse of the lower extremity. It provides forward propulsion and is the thickest, strongest tendon in the human body. It basically never has a chance to rest if you are walking. The tendon itself is made of three different muscles and contracts to provide power. That is why it is one of the most common tendons to experience tendonitis in.

It is probably the most common type of tendonitis we see in the office. I would also say it is one of the most challenging to treat. The challenge is it's constantly in use and the number one cause of Achilles tendonitis is overuse. We see a fair amount as the summer starts and people get outside. The other big culprit is a new exercise program. Most of these patients are usually men and around the age of 40.

I encourage patients to get in early and treat this aggressively. The Achilles tendon is notorious for taking a long time to return to a normal state and recover from tendonitis. The earlier and more aggressive the treatment the better the long-term outcomes. Focusing on eliminating the abnormal pull of the Achilles and stretching provide relief. There are numerous opportunities to administer more advanced treatment options that utilize the body's own ability to heal. These techniques seem to have the best long term outcomes. If you are suffering from Achilles’ tendon pain we can help.

Give us a call at 425-391-8666 or make an appointment online today. 

Most bunion surgeries require screws or plates (or a combination). It’s important during bunion surgery, in order to get full correction and realign the bones and joints, the bone is typically resected or effusions are done to realign the first metatarsal.  This requires hardware such as plates and screws. Once the hardware has done his job and the bone has healed and maintained the new corrected alignment and position, many of our patients elect to have hardware removed. The hardware can be medical grade stainless steel or titanium. These are the most common metal/metallic implants used. 

Sometimes the head of the screw causes minor irritation or part of the threads protrudes enough that there is irritation with some of the adjacent soft tissue. 

In other instances some patients seem to be sensitive to having a foreign body or a non-human item in the body. Some patients have minor skin manifestations although this isn’t common.  In general patients feel better once the hardware is out. 

If you are experiencing bunion pain, give us a call at 425-391-8666 or make an appointment online today. 

Metatarsalgia refers to pain and inflammation under the metatarsal heads in the foot. Patients often experience burning or tingling or even bruised type sensations in the ball of the foot with walking and exercise. This is often caused by the lose of fat pad or cushioning in the foot. This can occur as a normal aging process or as a genetic predisposition.

One of the best options available to treat fat pad atrophy or loss of fat pad or metatarsalgia are foot fillers. These foot fillers can be used to replace natural cushioning in the foot. There are many different types of foot fillers. I prefer to use adipose tissue as it is a naturally occurring product and provides no immune response. Adipose transplant can be highly effective long term and can be preformed in the office with local anesthetic. Most people find significant relief for long periods and have very little down time.

If you have metatarsalgia or loss of fat pad, contact my office today and request a consultation.

Give us a call at 425-391-8666 or make an appointment online today. 

Bunions can be very challenging for patients, especially if you are active and enjoy activities like hiking and running. The bunion itself is primarily an inherited foot structure issue that gets worse with time. I think that is a good point to revisit. The only way to stop your bunion from increasing with time is to stop walking. I say that to highlight the fact your bunion will get bigger, however the rate of development can be slowed or even fixed. There are many options for conservative measures and I will discuss a few.

Bigger and wider shoes, this is probably the most common measure. Buying your shoes like this will allow more room for the bunion and often alleviate some of the pressure issues. However, this does nothing to treat or even slow down the bunion.

Stretching, splinting, toe spacers, straps that are all over the internet and shoe stores. These do absolutely nothing to prevent or reverse your bunion. There are quite a few variations on these, but if your bunion could be fixed with a strap or padding we would never have the need to operate on a bunion. The main thing to remember this is a bone deformity, a mal-alignment of bones that is inherited. The bunion itself gets bigger when you place pressure on it. Strapping and toe spacers do sometimes provide a little bit of soft tissue stretching that can temporarily make your pain less.

Over the counter inserts, again not much help. Your feet are unique to you and the position of your bones are usually not in the correct place with a bunion. The best option here is to go with a custom molded prescription orthotic. Our clinic has worked with a local lab to develop a bunion specific orthotic that can actually slow down the development of your bunion. Do not waste your money on an over the counter, even the inserts that are molded to your foot are not enough.

If you have bunion pain, make an appointment today so we can help you slow your bunion growth and eliminate the pain.

Heel pain has a variety of causes and can be challenging for many patients. Most patients with heel pain describe it as a dull ache, or a bruised sensation but some have tingling and burning. The main causes of heel pain are plantar fasciits, bursitis and nerve entrapments. Sometimes there are overlapping symptoms and some patients even have multiple causes.

Plantar fasciitis is by far the most common cause of heel pain. It presents as pain when you get out of bed, or first step pain and often gets a little better as the morning goes on. However, typically the pain returns every time you stop and sit and then get back up. Plantar fasciitis usually feel like a bruise to the bottom of the foot.

Bursitis, or bursal sack formation is usually found in people with a high arch. The bursa forms to help cushion the foot and is important in situations where a heavy heel strike occurs. Many times you can feel the soft bursa, or what seems to be a bubble under the heel.

Nerve pain and entrapments can occur do to anatomical constrictions in the foot or the ankle. These are often the hardest to diagnosis and can cause a myriad of symptoms. However, the most common are burning and tingling.

If you are suffering with heel pain we can help get you pain free. Heel pain is the most common pathology we see and are treatment protocols work quickly and effectively. Do not suffer for the summer make an appointment so we can help.

Give us a call at 425-391-8666 or make an appointment online today. 

If you have had plantar fasciitis you know how frustrating it can be to your everyday life. Often you wake up and have pain with your first step, and then it returns again at the end of the day or every time you sit down. You have been icing and stretching and talking to all your friends and still are not getting better.

Why, why will this heel pain not go away? The number one cause of plantar fasciitis or heel pain is overuse. The overuse begins to wear down the fibers of your plantar fascia and they become fragile and often tear. Most patients with heel pain that will not go away have microscopic tearing.

Well how do you fix this tearing? One of the most advanced and effective treatment options is shockwave therapy. It has no downtime, no anesthesia, is non-innvassive, no scarring and is fast and effective in healing the torn fascia. This is a great option for active or athletic patients. The best shockwave avaible is the EPAT or Extracorporeal Pulse Activation Technology by CuraMedix. There are a lot of other types out there but this has the best results and the most long term data. If you want to heal your fasciitis fast and with no down time this is the device.

How it works? We typically employ 5 sessions all about 1 week apart. Each session takes about 10 minutes and is pain free and can be done in the office. The shockwave, EPAT, stimulates your bodies own healing cascade to recruit new cells and a new blood supply to heal your fascia. It is so effective that most professional sports teams have a unit to treat their athletes. If you are suffering from heal pain and want to get rid of it once and for all schedule and appointment with us today. Give us a call today at 425-391-8666 or make an appointment online today. 

If you have had plantar fasciitis you know how frustrating it can be to your everyday life. Often you wake up and have pain with your first step, and then it returns again at the end of the day or every time you sit down. You have been icing and stretching and talking to all your friends and still are not getting better.

Why, why will this heel pain not go away? The number one cause of plantar fasciitis or heel pain is overuse. The overuse begins to wear down the fibers of your plantar fascia and they become fragile and often tear. Most patients with heel pain that will not go away have microscopic tearing.

Well how do you fix this tearing? One of the most advanced and effective treatment options is shockwave therapy. It has no downtime, no anesthesia, is non-innvassive, no scarring and is fast and effective in healing the torn fascia. This is a great option for active or athletic patients. The best shockwave avaible is the EPAT or Extracorporeal Pulse Activation Technology by CuraMedix. There are a lot of other types out there but this has the best results and the most long term data. If you want to heal your plantar fasciitis fast and with no down time this is the device. kangen water 

How it works? We typically employ 5 sessions all about 1 week apart. Each session takes about 10 minutes and is pain free and can be done in the office. The shockwave, EPAT, stimulates your bodies own healing cascade to recruit new cells and a new blood supply to heal your fascia. It is so effective that most professional sports teams have a unit to treat their athletes. If you are suffering from heal pain and want to get rid of it once and for all schedule an appointment with us today. Give us a call at 425-391-8666 or make an appointment online today. 

Bunions are a common pathology that presents to my practice. The majority of bunions are seen on women between the ages of 30-50. Most have noticed the bunion at an early age and slowly have noticed them grow. A lot of patients feel their shoe selection has contributed to the growth or their activities like running. We know that bunions are an inherited foot structure that gets worse with time and usage.

Bunion correctors are common on the internet and I have seen them all. What we know about bunion correctors are they can help relieve some pain that is related to soft tissue contractures. The bunion itself is a bony malalignment of the foot and the bunion corrector cannot move bone back into position. The bunion corrector can help stretch some of the soft tissues as the bunion gets larger. However, it should be noted no bunion split or corrector will fix you bunion or change the shape of your bunion.

Bunion surgery is the only way to realign the bones that cause a bunion. I recommend bunion surgery for anybody that is having pain or difficulty fitting shoes. I consult and hundreds of bunions a year and can tell you that they are not all the same. It is very important to have a complete workup including physical exam and x-ray of the bunion. Proper procedure selection is key to fixing the bunion correctly.

If you are experiencing bunion pain and would like a consultation please call us at 425-391-8666 or make an appointment online and I will review all your options from conservative to surgical at your appointment.

Capsulitis/metatarsalgia is a term we use to describe inflammation of the forefoot. It specifically refers to inflammation of the joints in the front of the foot. This condition is usually associated with an underlying foot pathology like a bunion, an elevated bone or a tight calf muscle. This foot structure is usually inherited but can be brought on by injury.

Patients often describe a burning or swelling at the base of the toes and it gets worse with activities. Often patients will state they rub their feet and it feels better or even ice and notice some improvement. Tingling or numbness is another description we often hear. This sometimes improves with shoe removal.

The cause is usually from genetics, foot structure and mechanics. From a genetic standpoint there is often a bunion that is inherited or a flatfoot. The foot structure aspect is typically a long second metatarsal or an elevated 1st metatarsal. Mechanics can play a large role as well with tight Achilles tendons or increased pronation.

Treatment consists of addressing any contributing factor. I like to focus on the mechanics and foot structure specifically. An x-ray is helpful along with a detailed physical exam. If you are suffering from tingling, burning or swelling in your feet, or think you have capsulitis/metatarsalgia we can help.

Give us a call at 425-391-8666 or make an appointment online today.