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Bunion xray

There are a few things patients can do to heal faster from bunion surgery.  I will review some ideas that patients can utilize that may decrease healing time frames.  Most importantly one must follow the postoperative course as directed by your surgeon.  It is important to realize that 2 things need to heal following surgery: soft tissues and bone.

Soft tissues consist of skin, subcutaneous tissues and capsular tissue around the joint.  These structures are primarily sutured closed and will typically have sutures in for 10-14 days depending on the site.  There are a few supplements that can help to improve healing.  I like to have my patients take collagen and zinc and hydrate as these can influence skin healing.  Once the wound is closed I encourage the use of silicone and moisturization of the wound.   Additionally it is important to start the range of motion of the toe to free up and adhesions.

Bone is the other structure that must heal after bunion surgery.  Usually, a bone cut, or fusion is performed.  This is dependent on the procedure but there are a few things you can do to speed bone healing.    The first being additional calcium and other bone healing nutrients.  I like to have my patients take a bone healing supplement and increase the consumption of green leafy vegetables.  Additionally, if a bone stimulator is available this can be helpful. 

Regardless of the bunion procedure these tips can be helpful in your recovery process.  Take care and wish you a speedy recovery. If you are experiencing foot or ankle pain, give us a call at 425-391-8666 or make an appointment online

Dr. Brandon Nelson

Achilles Tendon

Many athletes will suffer from the dreaded Achilles tendonitis.  Increased training and often a change in activities can precipitate this pathology.  It is quite frustrating and can sideline many active patients.  I personally have dealt with this issue and can understand the challenges associated with it. 

The Achilles tendon is the main unit in the lower extremity for the push off phase of gait.  It contracts and helps individuals with forward motion.  It is constantly under load and being utilized with every step.  It is a wonder that more people don’t suffer from tendonitis.

The main cause continues to be overuse.  It often is seen in runners and joggers and triathletes.  In my office, runners seem to suffer from it.  Runners seem to have the biggest demand on this tendon and overuse is quite easy.  However, they are not the only one’s, basketball players seem to be affected as well.  Probably related to the loading requirements of jumping.   Regardless of the causes, it is important to seek help early in the process. 

Early intervention seems to be the key in recovering from Achilles tendonitis.  I also encourage stretching to all my athletes.  It is an easy thing to skip as it is time consuming and we can be pinched for time.  Additionally, hydration is essential and I find collagen supplements to be beneficial as well.  If you have any signs or symptoms do not delay.  I can help get you back out participating in your favorite activities. If you are experiencing foot or ankle pain, give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr. Brandon Nelson 

Bunion xray

There are many different types of bunion surgeries.  The majority that are performed currently can be divided into two types.  The first being a procedure at the head of the first metatarsal and the second at the base of the first metatarsal.  The recovery and healing time frames vary according to which procedure a patient has.

Head procedures or an Austin type bunionectomy is the most common bunion surgery in the United States.  I believe this represents something like 70% of all bunion surgeries.  These procedures are much faster to heal and typically a patient can bear weight the entire postoperative course.  The typical patient can be back in a shoe at about 6 weeks and return to full activities about 3 months. 

Base procedures or a Lapidus type or Lapiplasty often requires longer to heal.  Additionally there is variation among weight bearing with these cases.  Some doctors will allow immediate weight bearing and some will require 6-8 weeks of non-weight bearing.  Again, most people can return to activities about 3 months and into a normal shoe around this time as well.

Things that can improve bunion healing are diet, supplements and bone stimulators.  From a dietary standpoint it is important to incorporate lots of green leafy vegetables during the postoperative phase.  Supplements can play a role in healing as well.  One of my favorites is called ProBono.  This product provides all the minerals and nutrients for bone healing and helps to reduce time to heal.  Bone stimulators can be applied to stimulate bone growth.  These are harder to come by and often insurers will not approve these devices unless you have significant comorbidities.  If you have a bunion and would like to have it fixed and have the least amount of down time I can help. Give us a call at 425-391-8666 or make an appointment online today. 

normalfoot

Neuromas
are a benign proliferation of a nerve in the forefoot.  There are many different theories on why this happens.  Most doctors believe it is a compression of the nerve that causes the pain.  The pain is often described as a sharp shooting electrical type of pain.  This usually occurs between the 3rd and 4th digits in the foot.  Neuromas are more common in women than men and usually occur between the 4 and 6th decade of life.

Neuromas treatments can vary from injections to wider shoes to surgical resection of the nerve.  One of the most effective techniques for resolving neuroma pain is alcohol injections.  This is where a physician injects dehydrated alcohol that helps to deaden the covering around the nerve.  I have been utilizing this type of therapy for over 15 years.  It continues to be the most effective treatment for neuromas I have seen.  The success rate is close to 90%.  This is a great option for long term relief of neuroma pain

Patients that fail alcohol injection therapy usually require surgical resection of the nerve.  This involves a small incision on the top or bottom of the foot and dissection to the nerve which is then removed.  This nerve that is removed is a sensory nerve so there is no loss of function but usually a small patch of numbness.

If you have been suffering from neuroma pain make an appointment today and I can help. Give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr Brandon Nelson

heelpain

Heel pain
can usually be broken down into a few main causes.  The first and most common is plantar fasciitis.  This is usually pain right at the bottom of the heel bone towards the inside arch.  The second most common cause is Achilles tendonitis.  This pain is more found towards the back of the heel.  Lastly there is a condition called Baxter’s neuritis that can cause burning in the foot.  This pain is usually on the inside of the foot.

Plantar fasciitis is by far the most common cause of heel pain.  It is typically seen in adults between the ages of 40-60.  Typical symptoms are pain in the morning or pain after rest.  It is often an overuse type injury.  Plantar fasciitis can usually be treated successfully and the protocol I use keeps people exercising for the duration of treatment. 

Achilles tendonitis usually presents with swelling near its insertion towards the back of the heel.  Sometimes a catching or popping can be felt.  This is also another pathology associated with overuse.  I cannot stress enough that this should be evaluated immediately.

Baxter’s neuritis is a little trickier.  This condition usually presents as a burning in the heel but can mimic plantar fasciitis.  I usually see this in conjunction with plantar fasciitis.  This pathology usually requires special testing to identify.

If you have heel pain I can help.  I think this is some of the most frustrating injuries to deal with especially for the people that are training.  If you are experiencing heel pain, give us a call at 425-391-8666 or make an appointment online today

Sincerely,

Dr Brandon Nelson

Bunion xray

In the average week I see quite a few patients that are ready to finally have their bunion fixed.   The large majority of patients I have seen for years and their bunions are becoming bigger and more painful.  They are having a hard time fitting in shoes and going about daily activities.  The decision to fix their bunion is an exciting one and today's repairs of a bunion are much easier than in the past.

Fixing your bunion is a big decision and it can be overwhelming sometimes.  I really enjoy helping my patients through this process and eliminating the concern and apprehension around surgical correction.  Surgery for bunions has really come a long way and new techniques have created an almost foolproof approach.

The newest technique that I am really excited about is the Lapiplasty.  This is a great procedure that is reliable and has great long term results.  The Lapiplasty is excellent for patients that even have large bunions.  This procedure can be done in my office at our on-site surgery center.  This can provide huge time and cost savings. 

Do you have a bunion and have you always thought about fixing it?   Give me a call and I can help.  I look forward to fixing your bunion!!!! Give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr Brandon Nelson

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Dr. Timothy Young
, a Board-Certified Foot Surgeon, Discusses Children's Foot Problems

Today we are discussing a lump or bone that sticks out on the inside of the foot near the ankle joint. This is the navicular bone. The navicular bone can be enlarged or have an extra bone (accessory navicular). In both these cases, there can be a significant firm bony protrusion in this part of the foot. This can be painful just from direct pressure. This can also be painful because there is an important tendon that attaches to this bone to help support the foot. This is the posterior tibial tendon. Its job is to help provide support both medial and vertical support to the inside of the arch to keep it from collapsing and to help stabilize the entire foot.

This attachment point can be overstressed with a pronated low arch foot structure. Basically the tendon has to work too hard and there can be pain and inflammation with the tendon attaches to the navicular. In other cases the tendon attaches to the accessory navicular bone which then attaches to the main navicular bone. This weakens the attachment point and creates more potential problems. In some cases, the accessory navicular has to be removed. This foot surgery procedure is called a Kidner procedure and is done at approximate 13 years of age with a range of 9 to 16 years of age for children. This is sometimes done in adults also. When the accessory bone is removed and the tendon is repaired it often improves the mechanical function of the tendon at this point. It also eliminates the inflamed and symptomatic accessory bone. The accessory navicular very common and is present in approximately 5-10% of the population. For milder cases, ankle braces orthotics and athletic taping can all offer some symptomatic and functional improvement with the painful accessory navicular.

If you or your children are experiencing foot or ankle pain, give us a call today at 425-391-8666 or make an appointment online today. 
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Dr. Timothy Young
, Board-Certified Foot Surgeon, Discusses Painful Bumps and Bones That Stick Out on Children's Feet

We see a lot of children at our clinic. There are a number of different problems that they come in for. A common complaint is a painful bone that sticks out on the inside of the foot or sometimes the outside of the foot. On the inside of the foot or medial aspect it may be that they have the beginning of a bunion or juvenile bunion. This is similar but often more aggressive than the adult form of a bunion involving prominence of the first metatarsal head. Further back on the foot on the inside (medial) aspect the navicular bone often has an accessory bone or accessory navicular.

Up to 10% of the population may have this. Also the navicular bone itself even without the extra or accessory bone may be quite prominent. This is much more of a problem in children that have low arches/hyperpronation or flat feet. The posterior tibial tendon that attaches this location is at a strong mechanical disadvantage. On the outside or lateral aspect of the foot there may be a tailors bunion or bunionnette. And a smaller percentage of the pediatric population will have a growth plate or and apophysis of the 5th metatarsal base. This is called Iselin's disease. We will go over each of these more detail in some of our following blogs and discussion.

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

Bunion xray

I have been operating on bunions now for over 15 years and have seen all sizes and shapes of bunions.  It is interesting to see the techniques that have come in and out of favor.  I have had an opportunity to watch as the Lapiplasty has moved to the forefront of surgical procedures for bunion correction.  I believe this is a great option for bunion repair and am excited to see what the future holds in regard to the Lapiplasty.

I find the Lapiplasy highly successful for large bunions or patients with flatfeet.  The Lapiplasty provides great correction and faster recovery.  It is an easily reproducible procedure with gigs and guides to help with correction.  It provides for stable fixation and allows for early weight bearing.  It can be used at all ages and helps to maintain long term correction.  The system is revolutionary for surgeons and has taken years to develop.

I can say I am excited to continue using this system and to help my patients with bunions.  It is wonderful to have a tool set like the Lapiplasty at my surgery center and to help so many patients walk normally again.  If you have been contemplating bunion correction I would love to share this exciting new technology with you. Give us a call today at 425-391-8666 or make an appointment online today.

Sincerely,

Dr Brandon Nelson

Screen Shot 2023 02 08 at 10.13.11 AM

When I created the Washington Heel Pain Center I was excited to bring my years of treating heel pain to patients.  I had seen and even experienced heel pain from all types of pathology and was ready to provide the best possible care for heel pain.  Heel pain continues to be the most common reason for a patient to visit our clinic and we still provide the best care in Washington, Issaquah, Bellevue and Seattle.  There are even offices now that have tried to imitate our heel pain center.

However, being the first heel pain center in Washington and the longest running heel pain center in Washington we continue to provide the best possible care.  We have the most advanced technology to diagnose and cure heel pain.  Our center provides the latest treatment options available to get patients pain free quickly and back to their favorite activities.  Patients come to us from all over the Northwest including Alaska, Canada, Oregon and Idaho.

If you suffer from heel pain I can help.  I see the average patient improve their symptoms by 50-70% in a week with my protocol.  If you are in pain with every step or have pain when getting out of bed or after rest I can help.  If you are experiencing foot or ankle pain, give us a call today at 425-391-8666 or make an appointment online today.

Sincerely,

Dr Brandon Nelson

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