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Friday, 15 February 2019 11:56

Pain in the Big Toe

Pain in the big toe is a common occurrence for many people. We see quite a few people at our clinic that have increased pain with activities and ambulating. There are many reasons for people to have big toe pain including arthritis or deformities like bunions or hammertoes. The most common condition is arthritis. This often presents as pain with swelling and limited range of motion. Arthritis is easily diagnosed with an x-ray that will demonstrate joint space narrowing.

Many people have a history of trauma that they can recall like a turf type injury or stubbing with an activity. Arthritis of the big toe is important to get addressed as it can be progressive and eventually limit activities people can participate in. There are many great treatment options for conservative care as well as surgical care of the big toe joint. The majority of these are highly successful in both reduction of pain in the limited evening the development or slowing the development of arthritis. If you have pain in your big toe region schedule an appointment with Issaquah Foot & Ankle Specialists or give us a call at 425-391-8666.

Friday, 08 February 2019 11:54

Big Toe Arthritis Treatments

Arthritis of the big toe or first metatarsal phalangeal joint is extremely common and happens to be one of the most common things we treat. Arthritis of the big toe is a progressive deformity that can dramatically impact ones way of life. It can make exercising painful and can really cause one to alter their lifestyle. There are many great options for treating this condition and at our clinic we provide the most advanced care that is not available at other clinics. We have special injection therapies to relieve arthritic pain, lubricate the joint and help the joint function return to normal.

In addition we have techniques to provide a decrease in mechanical wear and tear of the joint which is the most common cause of arthritis in the toe. Many practitioners are quick to tell patients fusion is the best option or steroid injections. We prefer to provide longevity to the joint and help patients avoid surgical intervention. When patients require surgery we help evaluate patient lifestyles and habits to help patients select the most appropriate procedure. We are here to help and can provide lasting relief of big toe joint pain, schedule an evaluation today or give us a call at 425-391-8666.

That is a tough question. It is really hard to know what the bump is. However, some of the most common bumps include a plantar fibroma or a porokeratosis (a plugged sweat gland and a plantar verruca wart). That being said you should always have them examined by a foot and ankle physician.

Plantar Fibromas are usually located in the arch and are often a hard small bump. They can spread and enlarge with time. These are growths of collagen that can often be found in people of Scandinavian descent. The treatment of choice was once considered surgical excision but no longer is that the case. Issaquah Foot & Ankle Specialists has a non-surgical approach that has about a 90% success rate. So if other physicians have told you there is nothing to be done get a second opinion from us.

Porokeratosis is usually located in the front of the foot or under the metatarsal bones. There are many theories on these from plugged sweat glands to mechanical friction. The best treatment options for these are to address the cause, ie mechanics or bone spurs or plugged glands. Treatment usually entails removing the source and/or applying topical medications.

Plantar Verucca typically we see on children and a few adults. These look like a normal wart but are on the foot. They can be found singularly or in groups. The hardest ones to treat are on the bottom of the foot as this is the thickest skin in the human body. Most wart treatments consist of trimming and apply medications to them. They can usually be cleared up in two or three visits.

Do not take a wait and see approach to lumps and bumps. The majority are very easy to treat and can be resolved with minimal effort. If you have a lump or bump contact Issaquah Foot & Ankle Specialists or give us a call at 425-391-8666.

Achilles Tendinitis and Planter Fasciitis are some of the most common problems that we see at our clinic. We have treatment options that are very effective for most people, but the timeline can be frustrating because you had this for so long that you want fast results. For those people that want the most efficacious and clinically proven results, I recommend adding shockwave therapy to the treatment protocol immediately. Why wait? The EPAT Shockwave System that we have in our clinic has been the most effective treatment to complement the other treatments that I’ve seen in all my years of experience treating these problems.

Not everybody wants a shot like Cortisone and this can be temporary. Shockwave has the most effective long-term results for people who don’t want any downtime and want to get going again. Professional athletes have this treatment. You can too. Let us know if this is something you want to look into. Please see myself Dr. Timothy Young, or my partner Dr. Brandon Nelson. Give us a call at 425-391-8666 or make an appointment online today.

Image result for joint commission certificate

Both Dr. Young and Dr. Nelson have years of experience doing bunion surgery and reconstruction. Dr. Young and Dr Nelson do 2-3 bunion surgeries every week.


Our staff are familiar with our postoperative protocols and how to help ideal care for our patients after surgery.

Both Dr. Young and Dr. Nelson work together on virtually all bunion surgeries, so you have an experienced expert team.


Know that Dr. Young and Dr. Nelson use specialize instruments to ensure that you have the best possible result. Some of these instruments are not available at the local hospitals. So when they do surgery at the hospitals they bring them with them, to make certain that you have the best possible equipment and supplies.  The same equipment and supplies are always available at Foot Surgical Center of Issaquah, the certified surgical suite directly adjacent to our clinic.


Foot Surgical Center of Issaquah is certified by The Joint Commission.  This is the same certifying board that hospitals use for their certification.


Know that you will will have anesthesia and you will be sedated by a CRNA (certified nurse anesthetist), you will virtually sleep through your surgery and you will not remember or feel anything.  When you do wake up, your foot will be numb from the local anesthetic that was administered by Dr. Young or Dr. Nelson while you were sleeping.


If you have any other questions regarding this type of surgery available through our clinic please contact our office or give us a call at 425-391-8666.

Friday, 18 January 2019 11:36

Questions to Ask Before Bunion Surgery

We see a lot of patients for bunion consults and we perform 2 to 3 bunion surgeries every week.


Over the course of time, we’ve had multiple questions from patients prior to surgery and here are some of the most important ones to ask your surgeon.


How are you going to make sure that my bunion doesn't come back after surgery?

Do you do the surgery by yourself or is there an assistant surgeon?

Are you board-certified or board qualified in foot surgery?

How will you make sure that I don’t have too much pain or swelling after surgery?

What do you do to help minimize pain and swelling after surgery?

What do you do to make sure that I heal as quickly as possible?

How do you protect the surgical site afterwards to make sure that heals correctly?

Do use a boot or a real cast?

Am I able to bear weight after surgery, and what are the normal time frames to expect for healing and weight bearing?


If you have a bunion or have questions about it we would be happy to see you in consultation. Give us a call at 425-391-8666 or make an appointment online.

I hear this question a lot from our patients. There are several different things to consider. But there are other things to think about, for example is the bunion rapidly getting worse? As our patients get older over time that's another consideration - you want to treat it while you still can heal without problems. For example as we all get older our bone healing capacity slows down and can be more of a challenge. If you wait or put it off 10 or 20 years even though it is still quite significant, then there is the risk that as you get older you are no longer a good candidate for surgery that involves significant bone healing. And the problem is that over time some problems such as bunions can become so deformed and crippling that they limit physical activity and the ability to wear normal shoes.


The other problem is that sometimes the type of procedure needed to fix the bunion is more involved as you procrastinate, as the bunion becomes more and more deformed. Also in some cases, the surgical treatment would be partial correction because the full correction procedure is one that you can't heal from if you wait too long.


Remember that bone healing capacity always seems to slow down with age, and women are more affected than men. With this in mind, you do not want to leave a bunion that could be crippling later in life and could no longer be treated successfully or fully corrected. You do want to make sure that you get it treated while you are healthy and young and able to heal quickly without complications.


If you have a bunion and would like to have evaluation and discuss when the right time for treatment is please let us know. Give us a call at 425-391-8666 or make an appointment online today.

Friday, 28 December 2018 11:31

Arthritis of the Big Toe Joint

Big toe arthritis continues to be a debilitating condition on a daily basis for many patients. We evaluate and treat multiple patients a week with this condition. We continue to see quite a few patients can benefit from nonsurgical therapies.

However some patients continue to not respond with conservative measures and surgical intervention is warranted. There have been some great developments with big toe arthritis including the Cartiva implant which at this time seems to have promising results. If you have big toe arthritis and are looking for alternative therapies, give us a call at 425-391-8666 or make an appointment online. 

Friday, 28 December 2018 11:29

Bunion Surgery, Advice From an Expert

At Issaquah Foot and Ankle Specialists, we see hundreds of patients a year for bunion advice. We see people that are interested in both conservative and surgical intervention and provide care for both. It is important to identify the source of the bunion, as this determines the proper procedure. It is also important to see someone who deals with a lot of bunions, as there is no universal treatment for all of them. I typically recommend my patients receive an x-ray as this can help evaluate the cause of the bunion deformity.

In addition it’s important to look at the overall foot structure and the gait pattern as this can change outcomes and treatment scenarios. If surgical intervention is warranted we have an on-site surgery center which reduces both time and cost for patients. In a typical week, we perform 3-5 bunion surgeries and most of them take less than 2 hours. Outcomes for bunion surgeries of proper procedure selection are excellent and patients experience overall improvement in foot comfort and stability

Friday, 21 December 2018 11:27

EPAT or Shockwave Therapy

Shockwave therapy is highly beneficial for many different foot or ankle conditions, including tendonitis, neuromas or plantar fasciitis. It works by creating mico-trauma that releases growth factors that induce the formation of new blood vessels and stimulate the healing response. It is highly effective and can change a degenerative state to a regenerative state. Patients report very little pain with the procedure and maximum effect can take up to 12 weeks. Typically the procedure is done 3-5 times about 1 week apart.

There is no down time and no immobilization, making it is great for athletes and active patients. The ideal candidates suffer from plantar fasciitis, Achilles tendonitis, shin splints, neuromas and even stress fractures. If you are interested in seeing if you are a candidate for shockwave contact our office at 425-391-8666.

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