I have to say that exercise for me helps with my mental health and overall wellbeing.  I typically workout 6/7 days a week and enjoy running, biking, rucking and walking the dog.  It is a great stress relief and helps me clear my head after a day of work.  I am sure many of you can relate and as the weather clears more of us are getting back into an exercise routine.

That being said, I always see a spike in heel pain patients this time of year.  It makes sense with the weather drying up and everyone wanted to get outside and ready for summer.  Heel pain can really sideline you as you return to activities.  It can come on suddenly and stick around for months.  As a side note, the earlier you get treatment the faster you can recover.  It is usually caused by inflammation of your plantar fascia. 

The plantar fascia is the main support network of the foot.  It is a soft tissue structure that runs from your heel to your toes.  It has the function of controlling the foot and helping with propulsion.  It can get worn out with time or tired from increased loads.  It is by far the most common condition I treat. 

Some patients wait quite a while before coming in and these cases are often what I call “stubborn heel pain” or “chronic fasiitis”.   This is because the inflammation has now become chronic, and the body has given up on trying to fix it and now coexists with this pathology.  These cases are harder to treat and usually require more extensive care.  I think it is important to understand that once it becomes chronic, part of the treatment usually requires a reactivation of the body’s ability to recognize this condition.  You must take the chronic state of inflammation and turn it back to an acute state. 

I really enjoy helping my patients get their life back and their feet pain free.  If you would like a consultation for your heel pain I can help.  Call to make an appointment with me at 425-391-8666 or make an appointment online.

Sincerely,

Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Issaquah’s Top Podiatrist

Heel pain can affect people of all ages, lifestyles and activity levels.  You can be an avid exerciser, a home body or just spend all day working on your feet.  I will discuss some of the causes of heel pain, the symptoms and when to seek medical attention.  I have been a practicing podiatrist in Issaquah for over 25 years and have treated and helped 1000’s of patients. 

There are many common causes of heel pain.  However a few are the most common and these include; plantar fasciitis, Achilles tendonitis, stress fractures and Baxter’s neuritis. 

Plantar fasciitis is caused from an inflammation of a band of tissue running on the bottom of the foot.  The job of the fascia is to support the arch of the foot and control 3 dimensional movement.  It often occurs with repetitive stress like standing all day or running. 

Achilles tendonitis is usually located more towards the back of the heel.  The Achilles tendon helps to push off the foot during the gait cycle.  Often any activity that increases load like jumping rope can cause the Achilles to become inflamed.  People often feel swelling or a thickening of this tendon in the ankle.

Stress fractures are usually related to overtraining and time.  They occur with repetitive loading of a bone.  The bone I am speaking of in this case is the calcaneus.  These can be tricky to diagnose. 

Baxter’s neuritis is rare but is often confused for plantar fasciitis.  There is usually more of a burning or tingling that occurs.  Often there is not an increase in activities and no correlation with time spent on your feet and pain. 

I recommend seeking early treatment for heel pain.  I see that patients that wait longer have a harder time recovering and often need more therapeutic interventions.  This is especially true for athletes, get in early and get a head of the pathology. 

If you have heel pain and would like an appointment with Issaquah’s top Podiatrist at 425-391-8666 or make an appointment online.

Sincerely,

Dr Brandon Nelson

Board Certified Foot & Ankle Surgeon

Bunions are present in many different sizes and shapes.  I see bunions on the inside of the foot, the outside of the foot and both.  It is important to remember that some small ones can be painful, and some large ones can be pain free.  It often seems to be dependent upon activity levels and shoe gear.  If they hurt or limit your lifestyle then maybe it is time to fix them. 

Fixing your bunion

Bunion surgery has two main procedures that are done.  One is what is called a head procedure.  This is basically cutting the bone and realigning it through transposition of the bone.  Usually fixated with one or two screws.  The other involves fusion of a joint, specifically the joint that is involved with the creation of the bunion.  This procedure is called a Lapidus bunionectomy. 

Bunion recovery

Recovery really depends on the procedure that is performed.  Head procedures recover faster and usually involve no periods of non-weight bearing.  The fusions often involve a period of crutches or knee scooters.  This can be as short as 3 weeks or as long as 10 weeks.  The weight bearing status can be dictated by other procedures that are done as well. 

Which bunion surgery is right for me?

This is a hard question to answer.  I believe this is where your consultation with your surgeon is extremely important.  Other factors like lifestyle, recovery support, expectations and experience can play a major role.  I think it is important to get an entire overview of the process and have a discussion with your surgeon.   

If you would like a consultation for your bunion I can help.  Call to make an appointment with me at 425-391-8666 or make an appointment online.

Sincerely,

Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Plantar fasciitis or heel pain is the most common cause to seek help from a foot and ankle physician.  There are many causes of heel pain but by far the most common is plantar fasciitis.  So, let’s discuss first what the plantar fascia is, second why it occur and lastly how to fix it. 

What is your plantar fascia?  The plantar fascia is located on the bottom of your foot.  It runs the entire length of your foot from your heel to your toes.  It starts with an attachment at the calcaneus, your heel bone, and runs to your metatarsal head, where your toes start.  It is a thick dense fascial type of tissue.  Its main function is to support your arch.  It also helps flex your toes and provides stability to your foot with ambulation.

Why does plantar fasciitis happen?  There are many schools of thought on this one but let’s talk about a few of the most common.  The first and probably most accepted theory is overuse.  The fascia never gets a chance to rest, it is the workhorse of the foot.  Every step you take it is activated and over time this can fatigue the structure.  Secondly foot genetics can play a role in it as well.  People with a flatfoot tend to need more arch support and this can put pressure on the plantar fascia.  Lastly there is a thought that tight calf muscles can pull on the fascia making it irritated.  I think all of these can have merit in certain circumstances and I often see multiple etiologies. 

Lastly, how do we treat plantar fasciitis?  This is a more complex question.  I think this one is very hard to answer as every case can be different.  I think a careful history and physical is essential for proper treatment.  I also find length of time and activity level to be important.  But a couple general things can help like calf stretching and activity medication can be essential. 

If you would like a consultation on your heel pain, I can help.  Call to make an appointment with me at 425-391-8666 or schedule an appointment online today. 

Sincerely,

Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Heel pain can be difficult for patients and physicians alike.  It can provide a challenge for all parties involved.  I have seen hundreds or maybe even thousands of second opinions for heel pain.  Over the years I have learned many valuable lessons that can be extremely beneficial to treating heel pain.

One of the first lessons I learned was to listen to the patient.  Often patients provide great clues to the cause and origin of heel pain.  The history and story a patient tells often paints the perfect picture for how the pain is continuing to cause discomfort.  Not all heel pain is the same and although plantar fasciitis is the number one cause remain open to other sources.  This leads me to lesson number two.

Lesson number two not all heel pain is plantar fasciitis.  I have seen so many other causes and as a provider we need to be diligent.  The back can be a source of chronic heel pain.  Patients with back issues can have manifestations in the feet.  Another common cause is nerve pain.  Over the years I would say this is the most common reason heel pain does not get better.  The clinician is missing a nerve entrapment.  This is not all of the other reasons for heel pain but a few examples to illustrate the importance of recognizing there are other sources of heel pain. 

Lesson three is to understand not all heel pain can be treated the same.  I have seen patients over the years that have similar heel pain but similar treatments do no work.  This is why it is important to treat all patients as individuals.  To make sure to look at foot structure, gait cycles and daily routines to see how each individual can be treated for the best possible outcome. 

If you have heel pain and are in need of a second opinion or are just fed up with daily pain make an appointment with me today I can help. Give us a call at  425-391-8666 or make an appointment online. 

Sincerely,

Dr Brandon Nelson

The number one cause of heel pain is Plantar Fasciitis.  Plantar Fasciitis is an inflammation of a band of tissue on the bottom of one’s foot.  The most common reason is overuse.  Overuse can come in many forms, people that work on their feet, or avid exercisers and even just long term wear and tear on your feet.  It is important to know that your fascia is the main supporting network of one’s feet and is under chronic mechanical load.

It is important in the process of trying to cure plantar fasciitis to identify any outlying reasons for fasciitis.  These outliers can be systemic causes, training errors or general overuse injuries.  I think an x-ray is always warranted as well as an overall skeletal exam.   The earlier one sees a foot and ankle physician the faster we can get you on the road to recovery.

Once an exam has been performed the next stop is how do we fix the underlying causes and cure the fascia long term.  There are many options you can read about but the mainstay is reducing mechanical burdens and inflammation.  I have a protocol I have used for more than 10 years and on 1000’s of patients.  The majority of my patients are 50-70% better within the first week of seeing me.

Then there are the patients that have chronic fasciitis or long term fasciitis.  The workup for these patients should be a little different and more extensive.  Once plantar fasciitis has been identified as the root problem more advanced modalities will usually cure the fasciitis.  The focus of these modalities is usually to stimulate one’s own biology to actively heal the underlying inflammation.  These are some of the most cutting edge techniques and technologies available and our office has the 2 most effective modalities to fix your heel pain. 

If you have heel pain, schedule an appointment with me, Dr. Nelson and I will get you fixed and ready to enjoy your summer! Give us a call at 425-391-8666 or make an appointment online. 
Voted by Holistic Magazine as a top holistic provider.

Sincerely,

Dr Brandon Nelson

Board Certified Physician & Surgeon 

Heel pain is by far the most common thing I see in the office.  The number one cause is still being plantar fasciitis.  Most patients with heel pain will have resolution of their pain within a month of seeing me.  However, there is a small percentage of patients that do not get better and further work up is warranted.  We call these patients the outliers or red herrings.  There are about 2 main causes of outliers or red herrings.  These are nerve issues, i.e., Baxter’s neuritis or a stress fracture. 

Baxter’s neuritis is not as common as plantar fasciitis.  It is basically an entrapment of a nerve near the heel.  The nerve becomes irritated and compressed.  The symptoms can be similar to plantar fasciitis.  The most common symptom seems to be burning in the heel.  Burning or tingling are often associated with nerve pain.  Usually, a nerve conduction study is required to diagnose this entrapment.  Once it is diagnosed sometimes a local injection of the nerve can help or a prescription orthotic to offload the area can be quite helpful.  Baxter’s neuritis differs from a stress fracture in presentation usually. 

A stress fracture of the heel bone or calcaneus both can cause heel pain however usually in different areas.  With the stress fracture it is usually a constant pain that is a dull ache or throb.  Additionally, there is often an increase in training that has resulted in a stress fracture.  Usually, a stress fracture will require an MRI and most resolve with time and protected weight bearing.  If you are suffering from heel pain, especially if it has been going on for more than a couple weeks I can help. If you are experiencing foot or ankle pain, give us a call at 425-391-8666 or make an appointment online. 

Sincerely,

Dr Brandon Nelson

Heel pain can usually be broken down into a few main causes.  The first and most common is plantar fasciitis.  This is usually pain right at the bottom of the heel bone towards the inside arch.  The second most common cause is Achilles tendonitis.  This pain is more found towards the back of the heel.  Lastly there is a condition called Baxter’s neuritis that can cause burning in the foot.  This pain is usually on the inside of the foot.

Plantar fasciitis is by far the most common cause of heel pain.  It is typically seen in adults between the ages of 40-60.  Typical symptoms are pain in the morning or pain after rest.  It is often an overuse type injury.  Plantar fasciitis can usually be treated successfully and the protocol I use keeps people exercising for the duration of treatment. 

Achilles tendonitis usually presents with swelling near its insertion towards the back of the heel.  Sometimes a catching or popping can be felt.  This is also another pathology associated with overuse.  I cannot stress enough that this should be evaluated immediately.

Baxter’s neuritis is a little trickier.  This condition usually presents as a burning in the heel but can mimic plantar fasciitis.  I usually see this in conjunction with plantar fasciitis.  This pathology usually requires special testing to identify.

If you have heel pain I can help.  I think this is some of the most frustrating injuries to deal with especially for the people that are training.  If you are experiencing heel pain, give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr Brandon Nelson