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Sesamoid Bone


It is summer time and nobody wants to be laid up with a fracture that won't heal.


Sesamoid injuries can be particularly difficult to heal. The sesamoid bones are tethered at one end, and they are being pulled by a tendon at the other end. These bones are almost always under some type of traction unless there is absolute nonweightbearing. Being nonweightbearing is the ideal approach to treating sesamoid fractures. But even with nonweightbearing these fractures don't always heal. The blood supply is not good to these bones and they can be vulnerable to all kinds of injuries.


The traditional approaches include casting, bone healing supplements (Ortho ProBono), bone stimulator devices.

Additional approaches now can also include Platlet Rich Plasma Injections combined with EPAT (shockwave therapy). These treatments can help your body recruit additional blood supply to the area to promote healing, along with increasing local healing factors. The great thing about these additional treatments is that you are able to use your own bodys healing power!


If you have had a foot or ankle injury and are looking for medical treatment, please contact myself Dr Timothy Young or my partner Dr Brandon Nelson, or give us a call at 425-391-8666.

Friday, 29 June 2018 06:13

5th Metatarsal Fractures


One of the most common fractures we see are the 5th metatarsal fracture. We often get referrals from local urgent care clinics or emergency departments. 5th metatarsal fractures are seen quite frequently after ankle sprains or other inversion type injuries. The location of the fracture can determine whether surgery is warranted in order to maximize healing or prevent future debilitation. Jones fractures, a certain type of 5th metatarsal fracture, can be quite challenging to heal. Typically these patients require surgical intervention or can progress to a non-healing fracture.


We typically place one screw down the center of the bone and augment with bone graft to accelerate the healing time frame. Avulsion fractures of the 5th metatarsal are another common type we treat at our clinic. The majority of these types of fractures will heal without any type of surgery but some larger ones may require a screw to hold the fragment in place. We highly recommend anybody with a 5th metatarsal fracture to get evaluated, even if you have been to the emergency room a follow up with a podiatrist is essential.


If you are experiencing any foot or ankle pain, please do not hesitate to give us a call at 425-391-8666 or contact us online for an appointment.

Friday, 22 June 2018 06:11

Post Foot Injury Exercise


How do you keep working out after an injury?


It all depends upon the injury and what level of activity that you need to do. For the most intense injuries it is very rare that you can initially still do your normal exercise. 


Once you get the green light for exercise, the next question is what can you do.


Absolute minimal impact category:

Aqua jogging: go to the deep end of the pool and put on a flotation waist strap around your waist and then run while suspended in the pool. This way the flotation allows you just to do jogging. The hydraulic action of the water against your legs gives you a very good workout.  But the same time you're not kicking like you would be with swimming, so your toes are not pointed.


A stationary bike can be very effective because you can even do this while wearing a cast boot. The next next option would be to use your heel instead of the ball of your foot on the injured side.


The next category would be very mild impact and more midfoot force exercise:

Elliptical machine, if you can do this exercise keeping your heel down you'll have much less impact and forefoot force.  

A stationary bike using your midfoot or forefoot fits here also. Swimming has virtually no impact but still can really work out the whole midfoot and forefoot.


Mild to moderate impact:

Walking on a treadmill with a short stride.  The longer the stride the more weight and force the goes through the front of your foot. More vigorous exercise bike using the ball of your foot.


In general, you will want to stay in the one category until you get the green light to go to the next category.

For example with a fracture, he would want to wait until there is some x-ray evidence of adequate bone healing before you go from one category to the next. Make sure to discuss this with your Doctor. 


If you have any injury or would like a consultation or second opinion please see myself Dr. Timothy Young, or my partner Dr. Brandon Nelson. 

If you are experiencing any foot or ankle pain, give us a call at 425-391-8666 or contact us online to make an appointment.

Neuromas of the foot continue to be quite a challenge for a majority of patients. Neuromas are often characterized by a burning or tingling pain in the foot, especially the front of the foot. Typically patients are female between the ages of 40 and 60. Often times this pain is exacerbated by shoes or high heels. Other symptoms include numbness of the forefoot, especially to the third and fourth toes. Some people describe it as a balled up sock on the bottom of their foot. One of the best available and long-term treatments that we have found for neuromas are alcohol injection therapy.

This procedure involves using a TENS unit to stimulate the foot to decrease the pain of the injection. We then use freezing cold spray and the smallest needle available to decrease pain and then, under direct ultrasound imaging, inject the neuroma with alcohol. The alcohol is dehydrated alcohol that via osmosis removes the water from the nerve covering. The nerve covering then can no longer transmit pain signal to the brain. The nerve that causes a neuroma is a sensory nerve that controls pain and temperature to the skin but does not control motor movement of the toes. We have found an extremely high success rate utilizing this procedure. If you have a neuroma and are contemplating surgery or have tried multiple other therapies with no success please feel free to give us a call at 425-391-8666 or contact us online for an appointment.

Friday, 15 June 2018 06:07

Do I Need Bunion Surgery?

Quite a few patients come into the office wondering if they need bunion surgery. I usually ask the following questions:

1. Do you have pain daily at your bunion?

2. Are you having a hard time participating in the activities you enjoy, such as hiking, biking, etc?

3. Do you have a family history of bunion deformities?

4. Are you having difficulties fitting in your shoes?

Most of the patients I advise to have bunion surgery answer “Yes” to the majority of these questions. Bunion surgery and bunion surgery recovery vary by the size of your bunion and a few other factors. We have fixed thousands of bunions and use the latest techniques to minimize down time and scar appearance. We do everything from minimally invasive bunion surgery to reconstructive bunion surgery. The best thing to do is schedule an appointment and have your bunion evaluated, even if you do not want surgery we have techniques to slow the progression of your bunion.

If you are experiencing any bunion pain, do not hesitate to give us a call at 425-391-8666 or contact us online for an appointment today.

Neuromas are extremely painful. Patients often experience pain and burning in their toes that is worse with shoes. Most often these neuromas are more common in women than men and usually become more painful with time. Some people feel pins and needles, some experience numbness and some just have a pain in their toes with walking. A neuroma usually occurs in the front of one's foot between the toes. Typically it is located between the 3rd and 4th metatarsals and affects woman in the 4th to 6th decade of life. High heel shoes and pointed shoes often make the pain worse and it is common to take off your shoes and want to rub the front of your foot.

One of the most highly successful therapy options we have available is injections of dehydrated alcohol. The alcohol acts to dehydrate the nerve and stop the transmission of the pain signal. In our clinic we use an ultrasound guided injection. This allows us to visualize the nerve and the needle at the same time making sure we inject perfectly every time. The success rate for this procedure and the elimination of pain approaches 90%. If you are contemplating surgery and would like a second opinion to see if this therapy is appropriate for you contact us today. 

If you are experiencing any foot or ankle pain, give us a call at 425-391-8666 or contact us online.

Thursday, 10 May 2018 06:04

Bunion Surgery Tips

The questions that arise before bunion surgery are numerous. Here are some of the most common and their answers.

1. How long is the recovery following bunion surgery?

The recovery really depends on the procedure that is performed. Some bunion surgeries you can walk on immediately and some require a cast. The great news about our bunion surgeries is that none of them require any period of non-weight bearing. We use the latest technology to minimize down time.

2. Will my bunion come back?

The most important part of bunion surgery is proper procedure selection. There are many different types of bunion surgery so it is important to choose a podiatrist that treats a lot of bunions. We have treated thousands of bunions and always have two doctors present for your operation.

3. When can I get back to activities or running?

Again, this depends on the bunion procedure you required in order to fix the pathology. Some can resume activities in a few weeks and some it is a few months. It is very important to follow the post-operative instructions for the best results.

4. What is the post-operative course like?

We have taken years to develop our post-operative course to maximize the best possible outcomes for our patients. We start early, aggressive range of motion exercises and physical therapy. We see our patients get back to pre-surgical activity levels sooner and with less pain and swelling. We provide a list of supplements andactivities to our patients to improve healing times and range of motion.

In closing, the best advice I can give you is to see a podiatrist that preforms a lot of bunion surgeries. At Issaquah Foot & Ankle, we have the most advanced treatment protocols available for bunions. We have an onsite surgery center that can save both time and money. If you would like a second opinion or a first opinion we would love to help you. Give us a call at 425-391-8666 or contact us online to make an appointment today.


The weather is turning and we are all getting outdoors to enjoy it. Some of the more common conditions that begin to come into the office with this change are stress fractures and shin splints. Shin splints, or medial tibial stress syndrome, usually occurs with increased activities especially running. This syndrome is often characterized by pain running along the inside of one's legs or shin. There is typically no swelling and pain slowly increases with more physical activity. The average patient that develops shin splints have a foot that is pronating or flattening out too much.

In addition, usually a tight calf muscle is present and a recent change in activities. We have perfected an advanced protocol that is highly successful for patients with shin splints. Our clinic specializes in modern therapies for athletes that allow them to continue to exercise and resolve the pathology at hand. Shockwave therapy or EPAT, increases blood supply to the irritated tibia and helps restore muscle function. EPAT, extracorporeal Pulse Activation Technology has been used on Olympic and professional athletes alike to help them return to activates faster and healthier. We have used this for years on our shin splint patients in conjunction with a prescription orthotic and stretching exercises and have seen excellent results. If you are sidelined and are ready to enjoy the summer please come visit us and we will help get you back on your feet.

Give us a call at 425-391-8666 or contact us online to make an appointment today.

Thursday, 03 May 2018 05:59

Foot & Ankle Injuries In Baseball


Baseball season is just around the corner and foot and ankle injuries are commonplace with this warm weather sport. One of the most likely injuries with baseball is the ankle sprain. The ankle sprain can occur on the inside of the ankle, the outside of the ankle or even a high ankle sprain. The ankle sprain can lead to permanent pain or disability and is important to have evaluated. Initial treatment should be ice and an anti-inflammatory and no weight bearing until evaluated by a podiatrist. If pain and swelling persist it could be necessary to obtain and MRI to rule out any soft tissue damage.

Another common injury is heel pain, this can be from plantar fasciitis, heel bursitis or even a bone bruise to the heel bone. Players often experience pain with their first couple steps or pain at the end of the day. Stretching of the calf and icing of the heel are usually very helpful for this condition. However, it is important to have this evaluated to prevent it from getting worse and decrease the amount of time a player will be dealing with this condition. Overall, we recommend players do a warm up and then take a good 10 minutes to work on stretching of the lower extremity. Good luck and play ball!

If you are experiencing any foot or ankle pain, do not hesitate to call us at 425-391-8666 or contact us online.

Thursday, 26 April 2018 05:57

Hammer Toes

Hammer toes are a common condition that we see at our practice. They are often painful and uncomfortable for patients to exercise or even walk with. The most common digit we see affected by hammering is the second digit. Hammer toes can often occur with a bunion and if left untreated can become what is called a cross over toe. There are quite a few different treatment options for hammer toes. It depends on the root cause and the amount of deformity that is present. Some hammer toes are slight and do not need any treatment, more extreme hammer toes may require surgery.

The underlying cause of the hammer toe needs to always be addressed or else they will continue to progress. Some patients with time will see all their digits affected and shoe gear can become an issue. Another common area of foot we see this occur in are the 4th and 5th digits or the baby toe and the one next to it. Sometimes these two digits can develop a painful corn between them and cause a significant amount of pain. We don’t recommend over the counter corn treatment products as they can create sores and infections. A bone spur can be present between these two digits so an x-ray is warranted. We have been treating hammer toes for years and have treated thousands of them. If you would like yours evaluated please give us a call at 425-391-8666 or contact us online.

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