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heel pain out of bed in the morning

Heel pain, especially that causes pain in the morning or after we get up from a seated position can be very challenging. The most common cause is from plantar fasciitis and we are here to help. We are the number one heel pain center and have the most experience in treating heel pain. We have developed techniques to get fast relief, even on the first visit.

There are no other clinics like us in Washington State, we have seen others try and impersonate us even naming themselves as a heel pain center. However, Issaquah Foot & Ankle Specialists home to the original heel pain center. Do not let heel pain stop you from enjoying your time outside or get in the way of your summer. Schedule an appointment online today or give us a call at 425-391-8666 and cure your heel pain once and for all.
Sunday, 29 March 2020 16:58

Minimally Invasive Bunion Surgery

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Minimally invasive bunion surgery does provide a few advantages compared to traditional bunion surgery. It often can leave smaller scars, have a faster recovery speed and have less pain. The term minimally invasive is rather vague and can be misleading. The most important part of bunion surgery is proper procedure selection. Procedure selection is based on the clinical evaluation and x-rays.

Minimally invasive techniques do have limitations and are not useful in large bunion deformities. The best way to determine whether or not you are a candidate is to schedule an appointment with us. We have an onsite surgical suite and can provide you with all the details to make a decision. We are even able to offer conservative measures for bunion pain. Don’t delay we are here to help at Issaquah Foot & Ankle Specialists. Give us a call at 425-391-8666 today.
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Dr Timothy Young discusses how to resume exercise and sports

In some cases it is possible to return to exercise and normal activities fairly soon after an injury or foot/ankle problem. With many acute injuries it is necessary to wait 3–4 weeks or longer, before attempting to return to activity. Depending upon the problem and level of recovery it may be necessary to wait until there is significant progress with the healing and recovery.

Pain is the key. Use pain as your guideline. Sometimes our patients will not know if they are okay with their activity level or exercises until later that day or even the following day. For example let's say you are a "walker" who would do 3-5 miles "preinjury" and you decide to return to your walking. That day you're fine but the next day may be telling, you can tell if you did too much too soon. In this case you know it is too soon to return to activity and you have to give it more time, possibly 1 week or longer. Listen to your body, and let pain help guide you.

Start slowly!  After a foot problem or injury when you are ready to start resuming some activity, always start at a reduced level. For example if you typically walk 3–5 miles then try walking just 1 mile when you first return to activity. Do this for the first week and again use pain as your guideline, if all goes well then add a half mile the next week and continue that pattern.

Consider crosstraining: Aqua jogging and a stationary bike are often ways that you can do exercises without any impact. When using the stationary bike it is often necessary to use your heel and not the front of your foot on the injured side.

Use taping and braces: We have handouts on foot and ankle taping (KT tape).  Taping and braces often allow you to get back to activity sooner than you would otherwise. Often you don't have to tape every day, just on those days were you will be on your foot much more or when you are doing weigh bearing exercises.

If you have any injury or problem that needs attention please come see us.  

Dr. Timothy Young and Dr. Brandon Nelson at Issaquah Foot and Ankle Specialists.
Sunday, 22 March 2020 17:04

Boards Certification and Foot Surgery

Boards certification in foot surgery provides assurance to my patients that I, as a surgeon have a high level of education, training, certification, and also that I continue to stay up on the latest medical and surgical techniques.  This assures patients that they are having the highest level of care and surgical treatment.  In addition, to be a Fellow of the American College of Foot and Ankle Surgery, the surgeon must be board-certified. The American Board of Foot and Ankle Surgery (ABFAS) provides certification for those Doctors/Surgeons who submit cases and pass the written and oral examinations. After the initial examination, approximately every 10 years a recertification examination is required.
 
In February 2020, I completed the recertification exam, and I just received notice that I successfully passed examination and am officially "recertified". As mentioned, this is for Board Certification in Foot Surgery by the American Board of Foot and Ankle Surgery.  
 
Dr Timothy Young
Board Certified in Foot Surgery, ABFAS
Fellow, American College of Foot and Ankle

American Board of Foot and Ankle Surgery
Sunday, 22 March 2020 16:52

Recent Developments in Bunion Surgery

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Bunion surgery continues to evolve and techniques continue to change. Recently there has been a lot of talk about the Lapiplasty technique. The Lapiplasty technique is used for large bunions or people with hypermobile foot structures. The procedure basically involves the use of a jig. The surgeon aligns the jig on the foot in the correct orientation.

The cuts to correct the bunion are then performed and then the joint is compressed. Once controlled compression is achieved the joint is fixated in multiple planes. The Lapiplasty technique is a highly effective tool that can make bunion correction easier. Issaquah Foot & Ankle Specialists have been performing Lapidus procedures for more than 20 years. If you have a bunion and would like to be evaluated give us a call at 425-391-8666 or make an appointment online. We have an onsite surgical suite to save you time and money.
achilles tendonitis pain

Achilles tendinitis can be a very frustrating condition for both the patient and the physician alike. We see quite a few patients of Achilles tendinitis on a daily basis. We continue to see common Achilles tendon modalities not being effective for all patients. This can cause significant amount of pain and continued morbidity for patients. Often physical therapy and stretching and bracing does not alleviate the Achilles tendinitis and patients are looking for improvement outcomes and quicker return to activity. carpet cleaning seattle

Physical therapy continues to often be a mainstay for many physicians treating Achilles tendinitis. Over the years we have worked hard to develop advance protocol to alleviate even the most chronic cases of Achilles tendinitis. We have found promising new injection therapy combined with shockwave therapy of the Achilles tendon to be most successful. We have seen patients that have had numerous other treating physicians and physical therapist that have not improved get significantly better with this treatment protocol. Don't continue to struggle with Achilles tendinitis, give us a call at 425-391-8666 or make an appointment today and will help you get back on your feet.
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The common ankle sprain continues to be one of the most undertreated injuries in sports medicine today. At our clinic we see a lot of long-term pathologies that developed secondary to the undertreated ankle sprain. Many times patients present 2-3 months after an ankle sprain and continue to have pain and dysfunction secondary to the injury.

There are a lot of possibilities. Sometimes patients have scar tissue and the ankle or small ligament or tendon tears. It is important to be evaluated at this point especially if you have swelling and pain with activities. Often times an MRI can be useful at this point to evaluate the integrity of the joint structures surrounding the joint. I strongly encourage patients to seek medical intervention with a foot and ankle specialist. With an ankle sprain, the long-term ramifications can be great. Give us a call at 425-391-8666 or make an appointment online. 
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Many of the severe bunion surgeries that we perform involve fusion of the first metatarsal–cuneiform joint. This is also sometimes called a Lapidus bunionectomy. When we do this procedure we are correcting the first metatarsal misalignment. We can correct a severe bunion misalignment with this procedure. Once we realign this joint and then position it for fusion, the 2 surfaces do not always match up perfectly. In addition to this we are now planning on having a joint fuse. Fusing the joint is not always technically easy, have developed techniques to perfect this and we  are very good at these joint fusions. We remove all the cartilage, and then realign the bone and then small holes in the bone are drilled to allow for better blood flow during the healing process.

This process is similar to fooling the body into thinking that there has been a fracture, and then the bone healing of the fracture has to occur. Adding bone graft of this process is always helpful. We are filling in any small deficits at the fusion site and we are also putting in bone healing elements from one part of the body into another. There are other options to enhance bone healing. However, nothing is good as your own body including one's own bone graft material. This is called autogenous bone graft material (meaning it comes from yourself) rather than allograft  (which would come from another person).  With virtually all of our joint fusions including for severe bunion correction we use autogenous bone graft material to maximize bone healing for our patients.
 
If you have a severe bunion and would like consultation or to discuss treatment options please let us know.
Monday, 10 February 2020 02:20

Are your feet killing you?

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Every one seems to like the new TV show: My Feet Are Killing Me.

What are you waiting for? Your feet should not hurt! Many of our patients come in, asking if their foot pain is something they will just have to live with. The answer for the vast majority of people is NO! You should not have to live with foot pain (there are very few exceptions). There are so many new great treatment options. Sometimes it's worth it to just come in to have evaluation and if needed x-rays or ultrasound imaging, and then an examination and definitive diagnosis. Then we can give you treatment options.

Don't just live with it, on in and lets figure out what's going on and what your options are.
Either myself Dr. Timothy Young, or my partner Dr. Brandon Nelson would be happy to do your evaluation and give you treatment options. Give our office a call at 425-391-8666 or make an appointment online today!


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After foot surgery, it’s not uncommon to have edema that can last from just 2 or 3 weeks, up until 2 or 3 months or even longer. It is always advantageous to try to reduce swelling when possible. There are multiple strategies for reducing swelling. Reducing swelling very often helps reduce postoperative discomfort and reduces the need for post procedure pain medications. Note postoperative swelling can be persistent. Once one or several techniques are done to reduce it, an effort has been made to maintain this because the swelling tends to want to keep coming back. This will happen until several weeks or longer have gone by and additional soft tissue and/or bone healing has occurred.

Outside physical therapy: We often wait for outside physical therapy until least 3 weeks postoperatively because this gives the incision to get a chance to have some initial healing to "seal up" the wound so to speak and to therefore minimize the risk of a postoperative infection.

Home treatments:

RICE: Rest Ice Compression and Elevation - this is always helpful. But our patients often forget.

Rest: Avoid going back to work or doing activities too soon. After initially being a couch potato for the first 3-5 days, some people just get too busy, and some people start to resume full weightbearing activities (too soon) with one's feet dependent or hanging down allowing gravity to pull more fluid down to the feet and ankles. This is often a time when initially you are feeling great, and then you start to overdo it and all of a sudden it starts hurting again and it may start swelling also. Remember, if you have to go back to work and your feet start to swell, you may have to compensate by really pampering yourself at home. Often it is helpful to go back to work for reduced hours during the first few weeks of returning to work. For example for major foot surgery, working just 4 hours per day 3 days a week the first week, than 4 hours per day 5 days a for several weeks, and then returning to work 6 hours 5 days a week, and finally a full 8 hour shift.

Ice: Whenever there is swelling, ice can be of some help. It's usually the most helpful during the first 48 hours of an injury but with surgery this can be more like the first 7 days.

Elevation: In particular, whenever possible if you're just sitting, try to keep your feet elevated above heart level.

Compression: An Ace wrap office compression. Sometimes it's helpful to do fairly intense compression with the Ace wrap leave it on for 20 minutes and then loosening the Ace wrap to more moderate pressure.

Remember to never remove the dressing including Ace wrap and last unit if the doctor is okay during the first 3-4 days. Remember, Ace wraps can lose some of their compression over time.

There are special forefoot compression sleeves that we can order or may be available through our clinic.

Contrast baths: After the first 1 to 2 weeks, there can be a benefit to doing contrast baths. Ask Dr. Nelson or Dr. Young before doing this. But, one technique is to have a very light sterile dressing on the foot, and then use a brand-new garbage bag and have the foot go into one top of warm water for 3-4 minutes at one top of his water for 1-2 minutes. This is a 5 minute cycling total, the 5 minutes cycled is repeated for 20-30 minutes.

Home interferential electrical stimulation (IF 4000 unit). These units are often available to check out from our clinic. These use a set of 4 gel electrodes that are placed per your doctors’ recommendations. Typically these are done for 20-30 minutes 1-2 times a day. Also typically icing is done during this treatment and/or immediately after this treatment. The units are usually used for 2-3 weeks duration. This helps reduce swelling and pain both.

Massage and ROM (range of motion): Gentle massage away from the surgical site can be very beneficial. One technique is for example, if bunion surgery was done then the side of the foot adjacent to the great toe is avoided. But the outside of the foot that may still have some swelling and/or edema is gently massage well the foot is elevated above heart level. This massage is worked from the toes back toward the midfoot toward the ankle and then up towards the leg. Most of the time is concentrating on the foot and ankle. The goal is to physically work some as swelling out by gently manually "moving" the fluid. After this can be very beneficial to place a compressive sleeve and/or Ace wrap over the foot to help avoid the swelling from immediately returning.ROM can be very helpful especially well the foot is elevated above heart level.

Supplements: It is always helpful to take supplements the help of bone healing such as calcium, magnesium, vitamin D 3 and vitamin K 2.

But in addition, it can help to take other supplements such as Omega essential fatty acids (fish oil), some people swear by tumeric and Arnica.

Rx Oral anti-inflammatories: Some anti-inflammatories may have properties that inhibit and/or slow bone healing. Taking Advil or Aleve once in a while should not be a problem, but taking it consistently or taking prescription anti-inflammatories can be a concern.

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