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Sunday, 02 August 2020 17:11

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Bunion xray

I like to make sure all my patients are well informed for any procedure they are considering, especially bunion surgery. It is important to note both the pros and cons of bunion surgery as well as what the recovery looks like. The majority of bunion procedures allow patients to walk immediately afterwards. However there can be some discomfort. It’s important to understand that pain, swelling and bruising are normal prior to the surgical process.

I encourage my patients ask questions at their pre-operative appointment, as this makes the surgical process much easier. Additionally, I provide all my patients with multiple handouts on what to expect and how to decrease down time and their recovery period. At our clinic we are lucky enough to have an on-site surgical center so this is both a huge time and cost savings for all of our patients. This also affords us the opportunity to perform more bunion surgeries than the average foot and ankle physician and we take great pride and specializing in bunion care. If you’re contemplating bunion surgery or just want an opinion on your bunion we are here to help.

Give us a call today at 425-391-8666 or make an appointment online. 
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Shockwave therapy
is one of the newer and most effective treatments for stubborn plantar fasciitis. It is also an excellent treatment for Achilles tendinitis and other tendon and musculoskeletal problems that we see. It is typical for shockwave therapy to be done anywhere from 3-5 treatments usually with 1-2 week intervals. The treatment results in progressive reduction in your symptoms over a period of 3–4 months from the onset of treatment. Once the treatment is complete most patients do not need additional treatment in this regard.  

There are a few exceptions where a short mini series of 2 or 3 treatments may be done at 3 or 4 months from the start of treatment for exceptionally stubborn cases. For the majority of our patients that have this treatment they are pain-free and do not have recurrence of the plantar fasciitis symptoms for a period of years.  It is important to keep doing proactive "maintenance such as making sure that you wear your orthotics, stretching your calf, and not going barefoot at home. Failure to do some of these treatments could result in recurrence of plantar fasciitis or reinjury.
 
If you have plantar fasciitis or other foot or ankle problems, please come to our clinic for a consultation. Give us a call at 425-391-8666 or make an appointment online.
Mortons Toe

Neuromas often cause a considerable amount of pain for patients. Typically a neuroma will cause a burning pain between the 3rd and 4th digit. Patients often experience increased pain with wearing shoes and walking. A common phrase we hear is a patient will feel like their sock is balled up in their shoe. Neuromas typically progress and become increasingly painful. I find it to be important to treat them early, this seems to help my patients to get back to normal activities as soon as possible.

I find alcohol injection therapy to be the most effective tool in getting rid of neuromas. I see patients that have had multiple cortisone injections and physical therapy all to no avail. The sclerosing injection therapy works extremely well for patients. The literature success rate is reported to be almost 90%. I find it to be helpful even for patients that are contemplating surgical removal of the neuroma. If you have burning or tingling in your toes or have been diagnosed with a neuroma we can help.

Give us a call at 425-391-8666 or make an appointment online.
Monday, 20 July 2020 00:11

Bunion Information Center

What is a Bunion?  

A bunion is often described as a bump on the side of the big toe.  However, a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straightahead. This throws the bones out of alignment – producing the bunion’s “bump.”

Causes

Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Symptoms usually appear at later stages, although some people may never have symptoms. Bunions are a common foot deformity that can be inherited or occur as a result of repeated stress to the joint.  It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion. Not wearing proper sized footwear that crowd one’s toes will not cause bunions, however it can contribute to the progression of the deformity. As a result, symptoms may appear sooner with improper footwear.

Symptoms

Symptoms, which occur at the site of the bunion, may include:

• Pain or soreness

• Inflammation and redness

• A burning sensation

• Possible numbness

Symptoms occur most often when wearing shoes that crowd the toes, such as shoes with a tight toe box or high heels. This may explain why women are more likely to have symptoms than men. In addition, spending long periods of time on your feet can aggravate the symptoms of bunions.

Diagnosis

Bunions are readily apparent – the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don’t go away, and will usually get worse over time. But not all cases are alike – some bunions progress more rapidly than others. Once your surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.

Non-Surgical Treatment

Most people however, find relief from wearing soft, pliable shoes, and arch supports, and from applying ice to the sore toe joint Sometimes observation of the bunion is all that’s needed. To reduce the chance of damage to the joint, periodic evaluation and x-rays by your surgeon are advised.

 

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Dr. Young Talks About Lateral Column Pain and Lateral Overload

This is a subject that I have talked about previously. I wanted to revisit this and summarize this problem and condition. The lateral column of the foot encompasses the fourth and fifth metatarsals. This is the outside of the foot that includes the fifth toe and the fifth metatarsal phalangeal joint. It also includes the fifth metatarsal base which is the insertion point for the peroneal brevis tendon. Finally it also includes the cuboid bone and some patients with this may be diagnosed with "cuboid syndrome".

This is a common condition that I see in our clinic. It is frustrating for our patients because often this is not something that comes with a real nice clear diagnosis like let's say a bunion. But what happens is the patient will present to our clinic and say that they have pain on the outside of their foot (lateral column). Often times the patient will have a high arch foot or they will have compensated for another problem such that the weight is shifted to the outside of the foot. The lateral column is not designed for significant weightbearing. This is primarily the function and job for the great toe joint and the medial column. Therefore all it takes is a small change in weightbearing or the pattern of gait and the extra load going through the outside of the foot causes pain and symptoms. It is very rare to have a stress fracture in this location but that can happen. What can happen as there is just fatigue and pain on the lateral column and the stress load is such that it is short of that needed to cause a stress fracture. So stress fracture rarely occurs in this location. It is possible to develop pain at the insertion of the peroneal tendon of the fifth metatarsal base. It's also possible to have a tailor's bunion and have that pain flareup.

Our patients will have an x-ray to make certain there is no other pathology in this location. This condition responds very well to prescription orthotics tuned to shift the pressure off the lateral column of the foot, especially if it is a chronic condition. Some athletic shoes are better than others for this also. If there is a component of peroneal tendon symptoms, and there is a special ankle brace that may be helpful also.

These are some the conditions that may be associated with lateral column pain:

-Tailor's bunion or pain affecting the fifth MTP joint

-Stress fracture of the fourth or fifth metatarsal (rare)

-Stress reaction of bone of the fourth and fifth metatarsal (rare)

-Nonspecific Bone "fatigue and pain" of the fourth and fifth metatarsal (common)

-Insertional peroneal brevis tendinitis

-Cuboid area pain "cuboid syndrome"

If you have foot pain and need evaluation, please see myself Dr. Timothy Young, or my partner Dr. Brendon Nelson. Give us a call at 425-391-866 or make an appointment online. 

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Most foot and ankle physicians, podiatrist and sports medicine doctors like me will see a considerable amount of heel pain and heel spurs during their career. The majority of this heel pain will be caused by plantar fasciitis and present with multiple symptoms including burning, stabbing and throbbing of the heel. However, it is important to rule out other causes of heel pain including nerve entrapments, stress fractures and bursitis. It is essential to see a physician to get the correct diagnosis before implementing treatment plans.

Often times patients spend a considerable amount of time on the Internet to implement treatment in this can be detrimental to their long-term well-being in healing of the pathology. I recommend seeing your foot and ankle physician, podiatrist in order to get a correct diagnosis. The patient workup often includes physical examination and x-rays and a detailed history. Patients with complicated heel pain may benefit from more advanced studies like an MRI or EMGs NCV’s. If you’re suffering from heel pain, heel spurs or plantar fasciitis we would like to help you be pain free.

Give us a call at 425-391-8666 or make an appointment online today.
Sunday, 12 July 2020 20:41

Three Ways To Prevent Cracked Heels

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Standing or walking on hard surfaces all day can cause calluses to form on your feet. Being overweight and sedentary can also be a factor to having thickened skin on your feet, including heel calluses and heel fissures. Cracked heels can become worse without treatment and lead to bleeding and infection.

Here are three ways to help treat and prevent cracking heels we recommend at Issaquah Foot and Ankle Specialists:

1. Protect your feet with properly fitted shoes and orthotics. Wear properly fitted, supportive and comfortable shoes. The use of heel pads and other custom orthotic inserts can help isolate problem areas while they heal.

2. File away cracked and dead skin and moisturize. Dead skin can be removed using a pumice stone or file after soaking the feet to soften the skin.

3. Apply skin cream or lotion several times a day and allow it to soak in. In addition, wearing a sock over the foot while sleeping will provide for maximum absorption.

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

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Issaquah Foot and Ankle Specialists has been performing bunion surgery for more than 20 years and have performed thousands of bunionectomies. Having performed so many bunion procedures has allowed us to perfect our skills and provide patients with the most up-to-date bunion procedures. Currently there are almost 50 different bunion procedures that can be performed. However, the majority of these procedures are divided into 3 categories;

1. fusion or arthrodesis

2. head procedures

3. base procedures

It is important to note that not everyone is a candidate for one of these procedures. I can tell you it is important to have the entire foot structure evaluated as well as having x-rays done. I continue to get a lot of second opinions in my office due to the fact that I do perform so many bunionectomies. I do really enjoy discussing bunions and bunion procedures with patients in providing him with answers further questions and help with their feet. If you’re suffering from a bunion and are contemplating conservative care or surgical care consider making an appointment with us today.

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Does your work involve standing on your feet all day long?


Whether you work in a restaurant, a hair salon, or a school, taking care of tired feet is an effort that can't be ignored. When your feet don't have the proper support, your legs, knees, and ankles suffer due to not ‘standing’ properly.

What Can You Do To Reduce Standing-Related Injuries?

There are many things you can do to minimize the problems related to prolonged standing. Here are some easy steps you could make to get you through your day while preventing or at least minimizing damage to your feet and ankles.

Take Frequent Short Breaks

Find the time to be seated if you are standing for extended periods. Take advantage of your break time and relax your feet and leg.

Wear Comfy and Supportive Footwear

Make sure you invest into nice, comfortable shoes. There are many choices, such as Nike and Adidas, but make sure they fit well and you feel comfortable wearing them for several hours a day. 

Get Customized Orthotics

Prescription Orthotics are custom medical appliances that were traditionally made from a cast of your foot. We are now using the latest technology that records three dimensional images of your feet. Your foot is placed in its best functional position and then scanned using the scanner pictured to the right. The images are used as a form to make the custom orthotics. The doctor completes a unique prescription, depending upon your specific problem and foot type. From this, the orthotic fits inside of your shoe to change and improve the biomechanics of your gait. Orthotics may be prescribed for a variety of specific applications including running shoes, soccer shoes and ski boots. They fit your feet perfectly!

Give us a call at 425-391-8666 or make an appointment online today to get your prescription orthotics.
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