podiatrist issaquah

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Tuesday, 17 November 2020 18:40

Dr. Brandon Nelson Discusses Heel Pain in Children

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I currently have two children and actually have had one that was experiencing some heel pain. It was pretty classical symptoms of apophysitis or what we call Sever’s disease which is and inflammation of the growth plate. Kids often present with this type of pain after activities or after going barefoot. Most commonly we see this in young girls between the ages of 8 and 14 and young boys between the ages of 12 and 16. This is when kids often experience a growth spurt and the growth plates can become quite inflamed.

This inflammation of the growth plate can often be seen on x-ray and I highly recommend kids with heel pain get an x-ray. There are many great modalities that work well. I recommended starting with ice and stretching in the calf. However, I would discourage parents from doing home therapies until an accurate diagnosis is made. If your child is experiencing some heel pain we would like to help.

Give us a call at 425-391-8666 or make an appointment online today.
heel pain out of bed in the morning

Plantar fasciitis, heel pain or bone spurs of the foot can be extremely painful. Quite a few patients suffer from this and have been for years. We see patients that have had to change activities and even give up exercising. I personally suffered from plantar fasciitis and can empathize with patients when they are in extreme amounts of pain. Typically plantar fasciitis will exhibit pain in the morning or pain after prolonged periods of rest. However there can be many other presenting symptoms of plantar fasciitis. It is important to have heel pain evaluated as there are multiple causes and they all respond to different modalities.

I feel an x-ray is often warranted especially on the initial visit to rule out other causes. The x-ray can often reveal a bone spur or inflammation around the fascial band or even a stress fracture. Initial therapies for fasciitis usually include resting and stretching. There are many other initial treatment options and I can tell you the success rate is about 95% for our patients. There are a small number of patients who go on to have more of a chronic type issue and further diagnostic work workup is warranted. Often times an MRI or nerve conduction studies can be valuable for patients. Depending on the cause of the fasciitis there are many extremely successful long-term fixes for fasciitis. Often times or degenerative medicine or shockwave therapy can provide permanent fixes. If you suffer from heel pain and would like it fixed permanently come see Issaquah Foot and Ankle Specialists.

Give us a call at 425-391-8666 or make an appointment online. 
Tuesday, 20 October 2020 16:17

Hallux Rigidus

Hallux

Hallux rigidus is a mechanical arthritic condition of the big toe joint. Overtime hallux rigidus limits the bending of the toes. Initially, the condition is not very painful and only slightly limiting. However, over time, it can lead to severe pain and complete blockage of motion. At our clinic, we specialize in treating Hallux Limitus.

Although the initial pain can be only slight, you should definitely have your feet examined by a foot and ankle specialist, because once the big toe joint wears out, the damage will be extremely difficult to reverse. In its final stage, hallux rigidus fully destroys the joint. 

Our doctors at Issaquah Foot and Ankle Specialists have treated hallux rigidus for years. Give us a call today at 425-391-8666 or make an appointment online today.

bunionsurgery
Surgical bunion correction is a common procedure at our clinic and our Surgical Center. During bunion surgery after the skin incision, subcutaneous layer is also dissected and then the joint capsule. The joint capsule serves multiple functions. One is to help stabilize the joint–much like the ankle joint has ligaments that stabilize your ankle. The inner layer of the joint capsule produces synovial fluid to lubricate the joint.  

During surgery this joint fluid comes out during the procedure. It can be helpful to replenish this joint fluid to help get the joint functioning properly again and moving like it should. There are different ways to accomplish this. We often inject sympathetic joint lubricant into the joint during the early postoperative time frame. The brand that we utilize is called Supartz. This was originally FDA cleared to help protect the knee joint and treat knee joint  symptoms. We use Supartz in many different applications within the foot and ankle. But after bunion surgery to get the joint moving again, is certainly one of them. This can also be very helpful if the patient has arthritis of the great toe joint and has to have a joint cleanup procedure to remove some of the bone spurs and repair cartilage.
 
If you have questions about bunions or bunion surgery, please come to our office for a consultation to see myself Dr. Timothy Young or my partner Dr. Brandon Nelson.
b

We have talked previously about timing for bunion surgery and how bunions progress over time.  The challenge is that it is never the right time for bunion correction surgery.  So what are your alternatives, how can you buy some time.  There are some different options.

What to do while you are waiting for bunion surgery:

-If it is joint pain, then we can put sympathetic joint lubricant into the joint to protect the joint and reduce pain.  This can last for many months with no down side as far as the cartilage and joint status goes.
-Prescription orthotics.  Especially if it's not yet a severe bunion, orthotics can shift pressure off the joint and improve gait.  They will not reverse a bunion but they can slow the progression down in some cases.
-Very roomy shoes that have a stiff forefoot.  These can also help protect the joint and at the same time keep pressure off the joint.
-Various bunion splints and great toe spacers made of silicone gel.
-Topical pain relieving gels and anti-inflammatories such as Voltaren gel.

What not to do while you are waiting for bunion surgery:

-Avoid cortisone injections as they can damage the joint.
-Avoid tight fitting shoes and unsupportive flip-flops or sandals.
 
If you have a bunion and would like to discuss treatment options.  We recommend that you come into our clinic for consultation. Give us a call at 425-391-8666 or make an appointment online today. 
woman running

Some patients begin to notice a bump that is developing on the inside of their foot. They start to get pain with walking and exercise and they wonder what is happening. Often a patient will visit the shoe store or seek advice from nonmedical personnel as to what it is. It is important when been dealing with medical issues to seek the advice of someone who has had years of training and experience in that particular field. Your foot and ankle health is essential for long-term well-being of your overall general health. Bunions are the most common cause of pain and irritation around the big toe joint. The bunion is a bony deformity that often appears as a protuberance around the joint.

The majority of bunion deformities are an inherited foot structure. Patients can often trace to other relatives that have similar foot conditions. The pathology itself continues to progress with time and there is no conservative measures that reduce or correct the deformity. It is important to understand that conservative measures can sometimes help alleviate pain and increase overall functional performance. However, the bunion can only be fixed surgically. The surgical procedures depend on the patient’s overall foot structure, degree of deformity and activity levels. All bunion deformities that require surgical correction are done in the office and no longer require any hospitalization. All bunion procedures that we perform at Issaquah Foot and Ankle Specialists allow patients to be weight bearing and do not require prolonged periods using crutches or knee scooters. If you have a bunion deformity and would like to have it evaluated for either conservative or surgical measures please give us a call at 425-391-8666 or make an appointment online today.
Thursday, 28 May 2020 15:35

Dr. Timothy Young Talks About Crossover Toe

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This typically involves the second toe. This is where the second toe deviates toward the great toe and can even ride over the top of the great toe. When this happens, the structure back at the knuckle behind the toe itself (second MTP joint) becomes out of alignment and can be subluxed. In severe cases the joint can also dislocate. This causes a tremendous amount of stress on the 2nd MTP joint capsule. It's not uncommon for the capsule to become attenuated or stretched and thinned out. It can have partial tearing. This can lead to pain in the joint and inflammation with local swelling.
 
When this happens, it is important to address the underlying cause of this. It's very common for this to be aggravated by other associated condition such as a bunion. It is important to address all of the associated problems so for example in this case when should address both the crossover toe and the associated bunion. It is important to get the joint back into alignment and no longer subluxed. In most pronounced cases surgery is the only way to reestablish the correct alignment to the joint.
 
If you have concerns about your feet or crossover toe or bunion please come see us. Make an appointment online or give us a call at 425-391-8666. Both myself Dr. Timothy Young, and my partner Dr. Brandon Nelson
person jumping on hill during sunset

I’m still constantly surprised on a daily basis how many people live with chronic heel pain. Plantar fasciitis or heel pain can be so challenging for patients and really be detrimental to their life. I see a lot of patients that have suffered for years and years from heel pain and have seen multiple physicians and are still having pain. I empathize with these patients and understand their frustration as this can really impact their life and the things they want to do. Having suffered from plantar fasciitis and heel pain myself and knowing how it impacted my life, I really enjoyed treating heel pain patients.

I now important it is for me to maintain an active and healthy lifestyle and I really want to provide this for my patients as well. Often times the majority of heel pain gets treated as plantar fasciitis when there are quite a few other pathologies that can cause heel pain. I can’t stress enough compounded is to find the underlying causes of heel pain which allows proper treatment plan to occur. If you suffer from heel pain for plantar fasciitis and are continuing to suffer please make an appointment or give us a call today at 425-391-8666 today and we will help you stop it once and for all.
four boy playing ball on green grass

At Issaquah Foot & Ankle Specialists we are the leaders in treating pediatric patients. We are the number one referral center for Pediatricians that are looking for a foot and ankle specialist. We have over 40 years of experience treating pediatric patients. The most common presentation we see is a child with heel pain. Kids begin to present with heel pain as sports start back up, especially soccer and basketball.

Typically children relate a pain that wraps around the back of their heel that often feels like a bruise and gets more painful with activities. Sometimes there is a family history of heel pain in a brother or sister or even mom and dad. I encourage parents to have their child examined as there are many causes of heel pain and those should be ruled out. Apophysitis or Sever’s Disease can be the cause of heel pain in children. This is a type of growth plate irritation that can be extremely uncomfortable. However, it should be noted that there are other causes and I would stress that parents should have their child evaluated before beginning treatment for apophysitis. If your child is suffering from heel pain give us a call today at 425-391-8666 or make an appointment online and we will help.

 

By far the most common conditions we treat at our clinic is plantar fasciitis or heel pain. We see both children and adults for this condition. It is very common for people, especially once they get back to exercising. Plantar fasciitis can be quite painful and debilitating. A lot of patients experience pain in the morning or pain after sitting for prolonged periods of time. Often times there are a lot of discussions about home remedies including stretching and icing and taping of the foot.

There are many different techniques to take the foot. One of the best is called a Low-Dye taping. I’m going to demonstrate this on our Youtube channel, which you can view here. In addition I have placed link to our free heel pain book which gives other great techniques to relieve heel pain.

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