I see quite a few pediatric patients and a number of juvenile bunions.  The major factor to development of a juvenile bunion is family history or genetics.  Almost every child I see with a bunion has a family history of bunions.  Usually mom and/or grandma have a bunion and often even their siblings have one.  When bunions present early in development they can be difficult to manage.  It is hard to find success in the conservative realm with bunions and quite a few require surgery.

Surgery for the juvenile bunion can be very rewarding and provide excellent long term results.  First and foremost, it requires a physician work up and x-ray.  Often there can be an underlying flatfoot with a juvenile bunion and not addressing this can lead to increased rate of recurrence.  After a thorough history and physical the appropriate procedure can be selected.  Typically a juvenile bunion will be fixed with a Lapidus type procedure.

The Lapidus or Lapiplasty is a highly successful procedure and has great long term outcomes.  This involves a rotation correction of the bunion and a reduction in the splaying of the forefoot.  There are many ways to fixate this type of correction for bunions and is surgeon dependent.  It is amazing how quickly children heal from a procedure like this!  If you have a child with a bunion and would like to have a consultation please make an appointment today. Give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr. Brandon Nelson

The most common cause of heel pain continues to be plantar fasciitis.  This is usually caused by a foot structure that puts too much pressure on the fascia or tight muscle groups.  The majority of plantar fasciitis will go away with physician care and patients will return to normal activities.  However, there are a few patients that their heel pain does not get better and need additional treatment.

If you are one of these patients it is important to see a physician that specializes in heel pain.  There can be a few diagnoses that need to be considered for anyone that has recalcitrant heel pain.  These can range from nerve to bone issues and a careful work up is warranted.  Our practice has been home to the Washington Heel Pain Center for years.  We were actually the first heel pain center in Washington State and then saw many other offices try to follow suit.  However, our physician group finds heel pain fascinating and we diligently scour the latest research to remain up to date on causes and treatment options.

If you suffer from heel pain and have seen other doctors we can help.  Or maybe heel pain is new for you and you want the best care we can help.    We provide the best care and have the quickest options to get you back exercising or keep you exercising.  Make an appointment today and we can help. Give us a call at 425-391-8666 or make an appointment online today.

Sincerely,

Dr. Brandon Nelson

Morton's Neuroma, also called Intermetatarsal Neuroma or Plantar Neuroma, is a condition that affects the nerves of the feet, usually the area between the third and fourth toe. Neuroma refers to a benign growth that can occur in different parts of the body. Morton's Neuroma strictly affects the feet. This condition causes the tissue around the nerves that lead to the toes becoming thick, causing pain in the ball of the foot.

This condition can be caused by injury, pressure or irritation. Normally no lump will be felt, but instead burning pain in the ball of the foot will be experienced. Numbness and tingling may also occur. With the onset of this condition, a person may feel pain when tight or narrow shoes are worn. As the condition worsens, the pain may persist for days, or even weeks.

Persistent foot pain should always be a concern. The foot should be examined by a podiatrist if pain persists longer than a few days with no relief from changing shoes. The earlier the foot is examined and treated, the less chance there will be for surgical treatment.

There are some factors that can play a role in the development of Morton's Neuroma. These include wearing ill-fitting shoes that cause pressure to the toes, such as high heels. Also, high impact exercise may contribute to the cause of this condition. Morton’s Neuroma may also develop if the foot sustains an injury. Another cause includes walking abnormally due to bunions or flat feet. This causes excessive pressure and irritates the tissue. At times, people are affected for no determinable reason.

Podiatrists can alleviate the effects of this condition using a treatment plan to help decrease the pain and heal the foot tissue. Depending upon the severity of the Morton's Neuroma, the treatment plan can vary. For cases that are mild to moderate, treatments may include applying padding to the arch to relieve pressure from the nerve and reduce compression while walking. Ice packs can also help reduce swelling. The podiatrist may also create a custom orthotic device to support the foot and reduce compression and pressure on the affected nerve. The doctor will probably advise against partaking in activities that cause constant pressure on the affected area. They may provide wider shoes to ease the pressure from the toes. If these treatments do not relieve the symptoms of this condition, the doctor may use injection therapy.

Surgical treatment may be recommended by the podiatrist if all other treatments fail to provide relief. Normally, the podiatric surgeon will decide on either a surgical procedure that involves removal of the affected nerve or will choose surgery to release the nerve. After examination, the surgeon will decide on the best approach to treat the problem.

Recovery varies according to the type of surgical procedure. The patient will also be instructed on the best shoe wear to prevent the return of this condition, along with changes to workout routines, if this was a cause. Preventative measures are important in ensuring the condition does not return.

Pain in the forefoot can range from tingling and burning to a dull ache or throb.  The majority of forefoot pain can be broken down into nerve pain ie a neuroma or mechanical pain ie capsulitis.  Both can cause similar type symptoms and differentiating between the two can be difficult. 

Capsulitis is the most common forefoot type of pain.  It is basically an overloading of the metatarsal phalangeal joints.   Most patients will experience a combination of burning and aching.  There are many causes of forefoot capsulitis or overloading.  This can be from tight muscle groups or abnormal anatomy.  The majority of patients will find conservative therapies successful and will completely recover.

Neuromas usually occur in a specific anatomical location, the 3^rd interspace.  This pain is almost exclusively a burning or tingling.  It is almost always worse with shoes and primarily affects females.  Neuromas occur from irritation to the nerve that is mechanical or anatomical in nature.  Again the conservative success rate for this is high.

If you are experiencing burning or tingling in the foot I can help.  I have an exceptional protocol for both capsulitis and neuritis.  If you have foot pain, call today.

Sincerely,

Dr. Brandon Nelson

Bunion surgery is one of the most common procedures performed in the United States.  It is almost exclusively done in an outpatient setting and the majority of procedures can be completed in less than 2 hours.  Most patients will experience pain that lasts a few days and can begin weight bearing fairly soon.  There are many different types of bunion surgery and not all are equally effective. 

There are a few things that will help patients get a better outcome with bunion surgery.  I will discuss these tips that can be helpful along with selection of the surgeon.

#1. The most important thing after having any type of surgery is to follow postoperative protocol.  There are many tips that can improve your outcome after bunion surgery and careful adherence to postoperative protocols is essential.

#2. Bone healing supplementation, there are many different types of bone healing supplementation that are not all created equal however some of them can be highly effective in decreasing healing times.  I have a brand that I recommend for all my patients that often shaves weeks off of healing time.

#3. Couch potato for your first week, set yourself up for success.  During that first week just really take it easy, take your medications as prescribed, ice and elevate your foot.

#4. Surgeon selection, the majority of us have very similar training and most foot and ankle physicians are highly trained in this procedure.  One question I would ask any surgeon is how many bunion surgeries they perform annually.

I hope this is helpful and can be utilized by you in the future.

Sincerely,

Dr. Brandon Nelson

Blisters are pockets of fluid that occur under the top layer of your skin. These fluid pockets are usually filled with pus, blood, or serum. Blisters may itch or hurt and can appear as a single bubble or in clusters.

The most common types of blisters are friction blisters. This type of blister may be caused by wearing shoes that are too tight. Friction blisters can also occur on the hands. A change in temperature may also cause blisters on the feet. In the freezing air, frostbite on your toes can lead to blisters, as well as sunburn from hot weather.

The best way to treat a blister is to keep it clean and dry. Most blisters will get better on their own. Once the skin absorbs the fluid within the blister, it will flatten and eventually peel off. You should avoid popping your blister unless you podiatrist does it for you. Additional treatment options include applying an ice pack to the blister or using over-the-counter blister bandages to cover the affected area.

If your blister becomes discolored, inflamed, or worsens it is advised that you speak to your podiatrist. Blisters that are yellow, green, or purple may be infected and require immediate medical attention. Blisters that are abnormally colored may be a sign of a more serious underlying health condition such as herpes.