heel pain out of bed in the morning

Plantar Fasciitis Treatment Success with Shockwave Therapy


Plantar fasciitis is a common and often debilitating condition characterized by heel pain, especially in the morning or after prolonged periods of standing or walking. It occurs when the plantar fascia, a thick band of tissue that runs along the bottom of the foot, becomes inflamed or damaged. While there are several treatment options available, one that has gained increasing attention for its success is shockwave therapy. In this blog, we'll explore plantar fasciitis and delve into how shockwave therapy has emerged as a highly effective treatment option, offering hope and relief to those individuals suffering from this condition.

Understanding Plantar Fasciitis

Before reviewing shockwave therapy, it's essential to understand what plantar fasciitis is and why it can be so challenging to treat. The plantar fascia is a crucial component of the foot's structure, acting as a shock absorber and supporting the arch of the foot. When this tissue becomes damaged or inflamed, it can lead to persistent heel pain and reduced mobility.

Common Causes of Plantar Fasciitis:

Overuse or repetitive strain on the plantar fascia, often due to activities like running or standing for extended periods.
Obesity, as excess weight puts extra stress on the feet.
Improper footwear with inadequate arch support.
Tight calf muscles or Achilles tendon.

Traditional Treatment Approaches

Plantar fasciitis treatment typically begins with conservative methods, including:

Rest: Reducing activity levels to allow the plantar fascia to heal.
Ice: Applying ice to the affected area to reduce inflammation.
Stretching exercises: Focusing on calf stretches to improve flexibility.

Orthotics: Custom shoe inserts to provide arch and biomechanical support.

Non-steroidal anti-inflammatory drugs (NSAIDs): Medications to manage pain and inflammation.
While these methods can be effective for some individuals, others find themselves facing chronic, persistent pain that doesn't respond well to these treatments. This is where shockwave therapy comes into play.

Shockwave Therapy for Plantar Fasciitis

Shockwave therapy, also known as extracorporeal shockwave therapy (ESWT), is a non-invasive procedure that has shown remarkable success in treating plantar fasciitis when other treatments have failed. Here's how it works:

Application of Shockwaves: During the procedure, high-energy shockwaves are directed at the affected area. These shockwaves create microtrauma within the damaged tissue, stimulating the body's natural healing response.

Pain Reduction and Healing: Shockwave therapy has been shown to reduce pain by disrupting pain signals and improving blood flow to the damaged tissue. This, in turn, promotes tissue regeneration and healing.

Quick Procedure with Minimal Downtime: Shockwave therapy sessions typically last 15-20 minutes, and most patients can resume their regular activities shortly afterward. Five weekly sessions typically offer optimal results.

Success with Shockwave Therapy

The success of shockwave therapy in treating plantar fasciitis is supported by numerous patient testimonials and clinical studies. Here are a few reasons why it has gained popularity:

High Success Rate: Many patients experience significant pain reduction and improved mobility after undergoing shockwave therapy.

Non-Surgical: Shockwave therapy is non-invasive, eliminating the need for surgery and its associated risks and recovery time.

Long-Lasting Relief: For many, the benefits of shockwave therapy are long-lasting, providing relief from chronic pain.

Improved Quality of Life: Patients who have struggled with plantar fasciitis for years often find that shockwave therapy finally allows them to regain their quality of life and return to their favorite activities.

Available treatment: We have been proving this treatment at our clinic with high success for over 8 years


Plantar fasciitis can be a stubborn and painful condition, but there is hope for those who have tried various treatments without success. Shockwave therapy has emerged as an effective and non-invasive option, offering relief and improved quality of life for individuals suffering from this condition. If you're struggling with plantar fasciitis, please contact our clinic at 425-391-8666 or make an appointment online.

surgery circle

Bunion surgery has been around for over 100 years.  Historically, there were about 120 different types of bunion surgeries that could be performed.  This has changed over the years as long-term data became available and we could see different outcomes with different procedures.  This has shaped bunion surgery and now there are only about 4 commonly used procedures in the United States with 2 of the 4 being the most popular.

The first one is called an Austin bunionectomy.  This procedure is executed at the head of the 1st metatarsal.  It involved cutting the bone and realigning the joint.  It is usually secured with 1 or 2 screws.  Most patients can walk on this in a boot following surgery.  The average time to heal is typically 4-8 weeks.  This procedure is primarily reserved for smaller bunions.  It is the most popular bunion procedure done to date.

However, some of us surgeons that do a lot of bunion surgery have been utilizing a procedure called the Lapidus bunionectomy.  It is a little more technically challenging but has better long-term outcomes.  This type of bunion correction holds up the best and is best for people with large bunions or young children.  Recently Treace Medical has come out with a system to make the Lapidus easier and more reproducible for surgeons.  This system is called Lapiplasty.  I have found it can be helpful and is getting a lot of traction in health care currently. 

If you have bunion pain I can help, call to make an appointment with me at 425-391-8666 or fill out a contact form online


Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Bunion xray

Bunions are a common presentation in my office.  I see at least one new bunion patient a day.  It is a common condition that can produce pain daily.  We know that many bunions are inherited and get larger with time.  They usually become painful as time goes on and the bunion spreads affecting the forefoot making activities uncomfortable. 

Bunions are a separation of the first metatarsal from the second metatarsal.  The first metatarsal begins to shift away from the other metatarsals or towards the other foot.  When this occurs the big toe then begins to deviate in a direction away from the arch or towards the second toe.  This is when things begin to change rapidly. If the first toe now slides under the second a crossover toe formation begins and the bunion changes in size rapidly.  This is when most people present to my office and need help with the pain. 

There are some conservative measures that are helpful for bunions including wider shoes and not going barefoot.  It is important to note that no conservative measures will change the size of the bunion.  I see all sorts of online appliances come into the office.  These include splints, strapping devices and other items that state they will fix a bunion.  But remember a bunion is from a bone moving out of alignment and this is impossible to correct on the outside of the foot. 

If you have bunion pain I can help, call to make an appointment with me at 425-391-8666 or fill out a form online


Dr Brandon Nelson

American College of Foot & Ankle Surgeons

heel pain in the morning

I have had heel pain in the past, specifically plantar fasciitis and it really was challenging to go about your day.  My pain when I got out of bed was uncomfortable until it loosened up but if I sat down for any period of time it came right back.  Does this sound familiar?  If it does and this pain just will not go away, I can help.

Plantar fasciitis is by far the leading cause of heel pain.  The plantar fascia is a tough soft tissue structure that provides the most structural support to your foot.  It works to prevent your foot from flattening out and helps control your foot for the gait cycle.  It is vital for foot function and is under chronic tension.  These factors make it one of the most common causes of foot pain.

Treating plantar fasciitis can often be difficult as well.  There are many people that have seen a physician and still have been or have been working on their pain at home.  I encourage you if this is you to see a physician that specializes in heel pain.  I have been working with heel pain patients for over 15 years.  I have seen every type of pain and can help cure even the most stubborn cases.  If you want to get your life back and live without heel pain I can help, call to make an appointment with me at 425-391-8666.


Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Bunion xray

Bunion surgery has been around for more than 100 years.  It is one of the most common surgeries performed in the United States.  Over 100,000 are done annually and the majority are on women.  In recent years new advancements have been made to speed recovery and success of the operation.

The Lapiplasty system by Treace Medical is at the forefront of bunion repair.  This system has taken years to develop and has undergone evolution as it has been utilized.  It has now proven to be one of the work horses of bunion surgery.  It provides reproducible results and long-term correction.  It has an ease of use that makes the surgical procedure faster and improves recovery.  This has changed bunion surgery for patients and surgeons.  The Lapiplasty system is based on a long-standing surgical technique.

This long-standing technique was first described around the turn of the century by Paul Lapidus.  He advocated that the bunion started from the tarsometatarsal joint, and correction needed to occur there.  Since his original thought we have only worked to improve and support this theory in the surgical community.  It has been shown this is the center of most bunions and the correction is best done here.  If you have a bunion the time has never been better to have it fixed.   

Lapiplasty is by far the most successful bunion surgery technique I have seen.    If you are experiencing bunion pain, I can help call to make an appointment with me at 425-391-8666.


Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Bunion (1)

Bunion surgery has been utilized for more than 100 years.  Recent advances in bunion surgery have created better outcomes and faster recoveries.  I have been practicing now for 15 years and have not seen such a revolutionary product come to the market before.  The lapiplasy system has changed bunion surgery for the better.

Lapiplasty has created a unique set of instruments to create reproducible outcomes.  Previously surgeons relied on resecting bone without the use of cutting guides.  The Lapiplasty system has guides and reduction clamps to get the same amount of correction every time.  This has changed long-term results, making them more reliable with time. 

Recovery has also changed.  In the past patients could be non-weight bearing for up to 8-10 weeks.  This new system often allows patients to bear weight at 2-4 weeks.  Bearing weight sooner allows for improved function and less atrophy.  

Lapiplasty is by far the most successful bunion surgery technique I have seen.    If you are experiencing bunion pain, I can help call to make an appointment with me at 425-391-8666 or contact us online


Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Screenshot 2023 09 04 at 10.25.26 AM

Surgery in general can be an overwhelming endeavor.  There are often a lot of new instructions, medications, and appointments to keep track of.  I have a few recommendations that can be helpful for anybody undergoing bunion surgery

One of the first things to do is make a list.  I love it when my patients show up with a list of questions at their pre-op appointment.  This helps to make sure all topics are covered, and nothing is a mystery come surgery day.  In that list often is a shopping list is helpful things like bandages, supplements, otc medications and healthy foods.

Getting a base of operation set up before surgery can help with easing the recovery.  I recommend a place on the 1st floor if you have multiple levels.  Somewhere that is close to the bathroom and is relatively quiet to aid in recovery.  Ideally you have room for your post-op supplies nearby.  It is also nice to have something in the room to help pass the time like a TV or music.

Personal hygiene is another area to touch on.  I find it helpful for my patients to have some sort of stool to sit on in the shower.  This helps reduce pressure on the operated foot.  Additionally, if you are non-weight, bearing a toilet seat can be helpful.  Practice, practice, and practice have some dry runs of showering and using the toilet before surgery to see if you need any other items.  I think it is trickier than most of us remember to be off one foot. 

Lastly a few miscellaneous tips;

1.    Couch potato for the first 72 hours.

2.    Elevating makes a big difference in long term swelling.

3.    Take any recommended supplements.

4.    Do not change the dressings unless instructed.

5.    Lots of fluids.

6.    Take a stool softener.

I hope these were helpful.  If you are experiencing bunion pain, I can help call to make an appointment with me at 425-391-8666 or contact us online


Dr Brandon Nelson

American College of Foot & Ankle Surgeons


Dr Timoth Young, Board Certified Foot Surgeon talks about Lapidus and Lapiplasty Fixation: Advancements in Foot and Ankle Surgery Part 2

Benefits of Lapidus and Lapiplasty Fixation:

  1. Improved Alignment: Both procedures aim to correct the alignment of the foot bones, which not only relieves pain but also helps restore normal foot function.

    Faster Recovery: Lapidus and Lapiplasty procedures enable patients to return to weight-bearing activities sooner than traditional methods, reducing downtime.

    Reduced Risk of Recurrence: Lapiplasty fixation, in particular, targets the underlying cause of bunions, reducing the likelihood of recurrence.

    Long-Term Results: The fusion achieved through these fixation methods creates stable and lasting joint alignment, offering enduring relief from pain and discomfort.

    Minimal Soft Tissue Disruption: These procedures typically involve less disruption of soft tissues, leading to reduced scarring and a potentially smoother recovery process.

Conclusion: Lapidus and Lapiplasty fixation procedures are innovative approaches to correcting foot and ankle deformities, especially bunions. With their focus on achieving proper bone alignment and stability, these procedures offer patients improved quality of life, reduced pain, and faster recovery times. If you're experiencing foot and ankle issues, consult a qualified orthopedic surgeon to determine whether Lapidus or Lapiplasty fixation could be the right solution for you. Always remember that personalized medical advice is crucial before making any decisions regarding surgical interventions.

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


Dr Timoth Young, Board Certified Foot Surgeon talks about Lapidus and Lapiplasty Fixation: Advancements in Foot and Ankle Surgery Part 1

Introduction: Foot and ankle disorders can significantly impact a person's quality of life, affecting their ability to walk, stand, and perform daily activities. Over the years, surgical techniques and technologies have evolved to address these issues effectively. One of the notable advancements in foot and ankle surgery is the Lapidus and Lapiplasty fixation procedures. In this blog, we'll delve into what these procedures are, how they work, and their benefits for patients.

Lapidus Fixation: The Lapidus procedure, also known as the first tarsometatarsal (TMT) joint arthrodesis, is a surgical technique designed to correct deformities in the first metatarsal and medial cuneiform bones of the foot. This procedure is commonly used to treat conditions such as hallux valgus (bunions) and hypermobility of the first TMT joint. The primary goal of the Lapidus procedure is to achieve stability in the joint, alleviate pain, and improve the alignment of the foot.

During the Lapidus procedure, a surgeon makes an incision on the top of the foot near the first TMT joint. The joint is then realigned, and screws or other fixation devices are used to hold the bones in their corrected positions. Over time, the bones fuse together, creating a stable and properly aligned joint. This fusion eliminates the pain associated with joint movement and provides long-lasting relief.

Lapiplasty Fixation: The Lapiplasty procedure is a modern advancement in foot surgery that specifically targets bunions by addressing the root cause of the deformity. Unlike traditional bunion surgeries that focus on removing the bony bump, the Lapiplasty procedure aims to correct the misalignment of the metatarsal bone responsible for the bunion formation. This technique not only provides a more aesthetic result but also reduces the risk of bunion recurrence.

During the Lapiplasty procedure, a surgeon makes a precise cut in the metatarsal bone to realign it to its proper position. Specialized instrumentation is used to stabilize the bone, and fixation plates and screws are inserted to secure the corrected alignment. This approach allows patients to bear weight on the treated foot shortly after surgery, resulting in a faster recovery compared to traditional methods.

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

Bunion xray

Bunions are one of the most painful foot conditions for patients that are active and can be extremely challenging for shoe gear.  This is related to the fact that the forefoot begins to widen, and the 1st metatarsal phalangeal joint can become dislocated.  If you are experiencing these issues, it could be time to consider fixing the problem permanently. 

Bunion surgery techniques have changed dramatically over the last 5 years.  This is primarily due to the advent of Lapiplasty.  Historically the Lapidus bunion procedure has had an outstanding result.  However, the limiting factor was recovering times.  The new Lapiplasty system has changed this and improved outcomes and decreased recovery times.  This has led me to change my technique to take advantage of this newer system to help my patients. 

My patients have been extremely happy with the newer system. They have seen the normal recovery time cut in half.  I used to see patients get into normal shoes at about 3 months and now this is around 6 weeks.  If you want a quicker return to normal shoes, come, see me and we can evaluate whether you are a candidate for lapiplasty.  I truly believe the best long-term results can be achieved and this is correlated with better stability of the foot.  Bunion surgery has never been easier!

If you are experiencing bunion pain, I can help call to make an appointment with me at 425-391-8666 or fill out a contact form online

Sincerely,Dr Brandon Nelson

American College of Foot & Ankle Surgeons

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