Sunday, 13 October 2019 13:59

Inflammatory or Degenerative?

Many foot problems have an inflammatory component. But surprisingly some foot problems have a degenerative aspect also. For example Achilles problems often involve degenerative changes within the tendon itself. The tendon can also have thickening (Achilles tendinosis). Over time this degenerative process changes and calcification of portions of the Achilles tendon can occur. For example near the insertion site of the Achilles tendon at the heel bone or calcaneus.  


This is different than a heel spur on the bottom of the foot. This is very common and often happens on both the right side and left side. Sometimes these degenerative changes are quite extensive and the long-term calcification can actually convert to bone-like spurs that need to be surgically removed (Achilles tendon surgery).  


If you have Achilles problems or enlargement on the back of your heel and would like to have evaluation, please contact our office at 425-391-8666 or make an appointment online. Our Issaquah Podiatrists would love to see you!

Sunday, 13 October 2019 13:57

Foot Anatomy & Biomechanics


Many foot problems have both mechanical and inflammatory components. The treatment plan should address both of these components. For example plantar fasciitis has a mechanical (biomechanical) component that includes the weight-bearing function of the heel and the foot.  


Therefore addressing the biomechanics with prescription orthotics, wearing supportive shoes, and athletic taping will help this. Another mechanical component involves adjacent soft tissue structures such as the attachment of the calf muscle and Achilles on the heel. The constant pull of the calf and Achilles has to be addressed. That is why a night splint can help along with a runner's stretch our also essential parts of the treatment.


If you have heel pain or plantar fasciitis-like symptoms and you would like to have evaluation, please contact our office at 425-391-8666 or make an appointment online. Our Issaquah Podiatrists would be happy to see you.

When considering bunion surgery it’s important to have the bunion evaluated by a foot and ankle physician who performs a significant amount of these procedures. At Issaquah Foot and Ankle Specialists we perform bunion surgeries every single Monday and have performed thousands of procedures. We perform primary and revisional bunion surgeries weekly and have great success rates. There are many different types of bunion surgeries that can be performed from open to minimally invasive. We will help patients decide which is appropriate at this stage of their bunion.

Some patients we see we recommend no bunion procedure should be done at this point. However others are candidates for corrective bunionectomies at this stage. The great thing about our clinic is we have an on-site surgery center which is a huge cost and time savings. IV sedation is performed and a nerve block which eliminates any sort of pain during the operative procedure. If you have a bunion and are considering having surgery or would like to review some other conservative measures make an appointment with our Issaquah Podiatrists today or give us a call at 425-391-8666.

Friday, 06 September 2019 13:53

Should you take extra collagen?


When you think about it, collagen is one of the more ubiquitous proteins in the body. Your skin hair nails tendons and bone all have a significant amount of collagen in them. So if you have a tendon or ligament injury, I often recommend supplemental collagen to help your body get through that injury and supply to building blocks for tendon healing. Some studies also suggest supplemental zinc and arginine. Here at Issaquah Foot and Ankle Specialists, our Issaquah Podiatrists recommend collagen as a supplement. 


If you are experiencing foot or ankle pain, give our Issaquah Podiatrists a call today at 425-391-8666 or make an appointment online.

Friday, 30 August 2019 13:50

What's an Ingrown Toenail?


An ingrown toenail is a lot like a sliver. Slivers may be a piece of wood or possibly metal. They are a foreign body. There is no blood supply and they are a great place for bacteria to hang out. Inherently they are usually “dirty and/or contaminated." Toenails on the other hand are not a foreign body. They also do not have a blood supply and are a place that tends to have a higher bacteria count than other parts of the body and skin. 


Therefore when you get inflammation around the toenail and an infection develops, it is hard for your blood supply to bring the antibiotic where it’s needed. Again the toenail really doesn’t have a blood supply and so the bacteria can just “hide" around that area. When this happens with our patients our doctors have to do an I&D. An I&D is also called an incision and drainage. By removing that ingrown toenail or portion of the toenail, you’re basically “removing a sliver. The bacteria no longer have a place to hide and it will heal quite quickly once this is done. 


If you have an ingrown toenail, contact your Issaquah Podiatrists today. Give us a call at 425-391-8666 or make an appointment online. 


Friday, 23 August 2019 13:48

Ankle Sprains Are Common in Athletics

Ankle sprains continue to be the one of the most common injuries in all of Athletics. We see quite a few ankle sprains from pediatrics playing basketball to mature athletes playing tennis. The most common type of ankle sprain continues to be the inversion-type were your foot rolls inward. In addition it continues to be one of the most undertreated injuries in healthcare.

Quite a few people still think ankle sprains or minor injury and they can be treated for home. The previously prescribed treatment regime of “PRICE” which stands for "Protect, Rest, Ice, Compress and Elevate" no longer is appropriate in all cases. Untreated ankle sprains can lead to long-term ankle instability and ankle arthritis. Anybody that has an ankle sprain we stress importance of being evaluated as soon as possible to avoid these long-term complications.

If you have foot or ankle pain, give your Issaquah Podiatrists a call today at 425-391-8666 or make an appointment online. 

Friday, 23 August 2019 13:45

Stress Fractures are Pretty Common

Stress fractures are a common injury we see especially with nice weather and people getting outdoors. We often see patients that have increased activities like running or hiking and have a sudden onset of foot pain and swelling. Stress fracture can occur in the lower extremity especially the metatarsals. The most common are the 2nd metatarsal or the 5th metatarsal.

Just like Chargers All-Pro safety Derwin James who was recently diagnosed with a 5th metatarsal stress fracture. The 5th metatarsal stress fracture can be one of the hardest to heal as this metatarsal is known to have a poor blood supple and receives a lot of force especially with activities like football. Another important part of evaluating for stress fractures is checking the overall foot structure. Certain foot structures are more likely to develop stress fractures. Remember ease into new activities, maintain a good diet and if you have pain and swelling in your feet get to your Podiatrist.

If you are experiencing foot or ankle plain, contact your Issaquah Podiatrists today for an appointment at 425-391-8666 or make an appointment online.

The goal for most patients with bunion surgery is correction of the bunion deformity with the best procedure that provides great long-term outcomes. Bunion surgery can provide predictable consistent results. With proper procedure selection, patients are extremely happy and have great long-term results. There are over 100 different procedures for bunion deformities with the majority focusing on fusions, osteotomies and soft tissue balancing procedures. The most tried and true method continues to be the tarsal metatarsal arthrodesis.

This often allows for more of a triplanar correction as well as stabilization of large bunions and hypermobile foot structures. This procedure, the Lapidus bunionectomy has been around for years and provides clear correction of all 3 cardinal planes. We continue to read literature stating the importance of correcting the frontal plane deformity and realigning the sesamoids for the best long-term outcomes. If you have a bunion and would like to have an opinion as to whether or not you’re candidate for long-term surgical fix please give us a call at 425-391-8666 or make an appointment online.

Thursday, 09 May 2019 13:39

How to Fix Your Bunion Once and For All

This is a common question we receive at our practice. The only way to fix your bunion once and for all is surgically. There are many different types of bunion surgeries. Bunion surgeries can be broken down into distal, mid-shaft and proximal procedures. Distal procedures are for smaller bunions and proximal are for larger bunions and people with ligamentous laxity. Mid-shaft procedures are usually reserved for bunion that are neither small nor large.

The best way to avoid reoccurrence is to have the proper procedure selected and follow the post-operative protocol. Bunion surgery can take 6-12 weeks to recover from depending on adjunctive procedures and the bunionectomy performed. If you would like to be evaluated for a bunionectomy and have the procedure explained and recovery explained make an appointment online today or give us a call at 425-391-8666. We have an onsite surgery center that can be a huge time and financial savings. 

Morton's neuroma is a common problem that we see at our clinic. Morton's neuromas are located between the third and fourth metatarsals in the forefoot. It is also possible to get a neuroma between the second and third metatarsals. Treatment for both of these conditions is quite similar. We often recommend special prescription orthotics and also have special shoe recommendations. There are cortisone injections and dehydrated alcohol injections. In addition, there is also the option of surgery. The typical surgery involves resection of the nerve. If the neuroma is not particularly large (you can determine this with an MRI) then another toned down surgical option is to simply release the deep transverse intermetatarsal ligament rather than resect the nerve.

In many ways this is a way to provide relief without "burning any bridges". In some ways this is similar to doing tarsal tunnel surgery or the primary procedures just to "decompress the nerve". If you have a neuroma or believe you may have a neuroma we would be happy to see you.  If you believe you may need an injection but are reluctant to have this our clinic specializes in a technique for a much more comfortable injection. My partner Dr. Brandon Nelson and myself Dr. Timothy Young, both provide all of these treatment options, and we would be happy to see you in consultation.

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