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Dr. Timothy Young
 Discusses Achilles Tendon Injuries
Part 3
Dr. Timothy Young discusses Achilles tendon injuries without major tearing or rupture.

For these individuals, if it is a significant injury we will use a cast boot to protect Achilles tendon from further injury and or potential rupture. This is usually for minimum of four weeks. During this timeframe we can start shockwave therapy (EPAT). These individuals also will benefit from PRP injections. Once the initial acute phase has passed, patients can wear a special Achilles tendon brace and start nonimpact exercises such as aqua jogging or modified stationary bike exercises.

Some of this can be done under the direction of the physical therapist. One of the most effective long-term exercises to augment any Achilles problem is eccentric Achilles strengthening. This also can be done at home or under the direction of the physical therapist. There are numerous YouTube videos on this including a short one that we have provided from our clinic.

For some individuals with extremely large calf muscles and extremely tight calves and Achilles they may need to have a protective procedure done call a gastroc recessi. This is primarily for patients with chronic symptoms or who are at very high risk of reinjure of the Achilles tendon.

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

heel pain in the morning

Heel pain can be very challenging no matter when it occurs.  It can be common in the morning or after exercise.  There are many causes of heel pain and the most common is plantar fasciitis.  Plantar Fasciitis is a condition in which the plantar fascia in your foot becomes inflamed. 

An inflamed plantar fascia is often characterized by burning or a bruised type sensation one's heel.  Many patients describe the fact they feel like they are walking on a marble or pebble.  This can get worse as time and activity levels go on and can become quite debilitating.  This can be brought on by many causes but most notable is overuse.

Overuse is by far the most common cause.  Patients often relate the start of a new exercise program or a new activity.  This new activity can put new stresses on your fascia which ultimately leads to inflammation and pain.  It is always best to ease into activities as this can help minimize fascial pain.  Another key characteristic of facial pain is morning stiffness or irritation.

Morning pain is a hallmark of fasciitis.  This is very common and one of the most challenging parts of having plantar fasciitis.  This is often because when you sleep and then step down on your foot your fascia instantly becomes irritated.  This can be extremely difficult to get rid of and often sticks around for months.  This is when it is time to make an appointment with a heel pain specialist.  I have been treating heel pain for 15 years and can help you get rid of it quickly.  Give us a call today at 425-391-8666 or make an appointment online today. 


Dr Brandon Nelson

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Dr. Timothy Young
 Discusses Achilles Tendon Injuries and Rupture- Part 2

For those individuals that elect not to have surgical repair for an Achilles rupture, there will be a significant clot surrounding the damage portion of the Achilles tendon. This does serve a function and will help serve as a substrate that can later become scar tissue that helps augment the body's own Achilles repair. Because this is present from the original injury, additional treatment may be less beneficial for these individuals then with an open surgical repair.

After approximately three weeks post injury I would then recommend augmenting the Achilles injury with shockwave therapy (EPAT). The shockwave therapy is done at once per week, for total of five treatments. I always recommend supplemental collagen when there has been tendon damage and especially tendon rupture, whether open surgical repair or nonsurgical repair.

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

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Dr. Timothy Young
 Discusses Achilles Tendon Injuries and Rupture

Part 1

We see a number of Achilles injuries in our clinic. For most active individuals with a complete rupture the Achilles tendon we advocate surgical repair. During the surgical repair any of the significant internal bleeding or hematoma is removed to facilitate the repair itself. After the repair has been done during the surgery we often augment this with other treatment. The original injury blood clot itself does have components that may be beneficial but some of those components also can become excessive scar tissue. Eventual augmentation with shockwave therapy can also benefit these patients who have had open surgical repair of an Achilles rupture.

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

Dr. Timothy Young, a Board-Certified Foot and Ankle Surgeon, Discuss His Treatment For Anterior Tibial Tendinitis

Whenever possible addressing the underlying mechanics is helpful. Also decreasing the activity that exacerbates is the problem and cross training is helpful. For example when playing tennis one might have to switch from singles to doubles and be aware of abrupt and sudden movements that will cause the foot to hit the ground quickly and with runners this may involve avoiding running hills and doing flat work instead.

Additional treatments can include decrease in workload on the anterior tendon itself such as anterior tibial athletic taping such as KT tape, especially during activity.
A lace-up ankle brace can also be quite helpful for this but can be bulky and difficult to fit into shoes. Prescription orthotics hold the foot in a more stable position so that when it does contact the ground there’s less mechanical force through the foot and ultimately decreasing the workload on the anterior tibial tendon.

Icing, rest, taping, orthotics and braces are all very helpful.

And for stubborn cases we also can treat this with shockwave therapy.   For severe cases, PRP combined with shockwave therapy is an excellent treatment.
If you have tendinitis-like symptoms, please schedule a consultation at our clinic. Give us a call at 425-391-8666 or make an appointment online today.
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Dr. Timothy Young, a Board-Certified Foot Surgeon, Discusses Anterior Tibial Tendinitis

In our practice I see anterior tibial tendon symptoms as one of the common tendon conditions of the foot and ankle. The anterior tibial muscle is commonly thought of as the shin muscle and is on the front of the leg. Toward the ankle and foot the muscle transitions into the anterior tibial tendon and then inserts into the inside or media last to the foot directly at the level of the first metatarsal – cunieform joint.   This tendon condition is more commonly seen in tennis players and sometimes runners. Tennis players commonly have high impact foot planting on the hard concrete tennis surface. This engages the anterior tibial tendon especially during heel strike and foot planting.
One of the functions of the anterior tibial tendon is to decelerate the foot as it lands on the ground after heel strike. This can happen more properly during certain sports and activities such as tennis.  And also for runners when they’re going downhill to avoid foot slap just after heel strike.  Anterior tibial muscle shin splints can have a similar mechanism especially with runners.

The tendon also helps to hold the foot up during the swing phase of gait.  Therefore this muscle/tendon complex works during two different phases of gait both with the swing phase and also the contact phase of gait.

If you are experiencing foot or ankle pain, give us a call 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 performed 1000’s of bunionectomies.  I continue to enjoy working on bunions as the surgical results are satisfying for both the patient and physician.  Bunions come in all sizes and present in all ages from teenagers to adults.  Many patients seek out care for bunions and some choose to have them fixed.  It is important to note that not everyone is a surgical candidate and not every bunion requires surgical intervention

Surgical care for a bunion can provide excellent results.  One of the most common procedures is the Lapiplasty bunionectomy.  It has shown exceptional follow up and long term outcomes.  I find the Lapiplasty to be very reproducible and have high patient satisfaction.  It is not appropriate on every patient nor is it the only bunion procedure I find highly successful.  

My office has an onsite surgical center that we utilize for bunion surgery.  It is a significant cost savings and time savings for patients.  It utilizes monitored anesthesia care with a nerve block of the lower extremity.  If you have a bunion and would like a consultation please feel free to call the office at 425-391-8666 or schedule an appointment online.


Dr Brandon Nelson

Bunion (1)

After years of experience and 1000s of bunion surgeries I have taken some time to reflect back on different techniques and procedures.  I have seen new products and new surgeries come in and out of fashion.  Every few years a new health care company will introduce fancy new products that they want us surgeons to utilize.  I have seen many new instruments and new ideas that are supposed to revolutionize outcomes and provide time and cost savings.  It is interesting that things seem to always come back to the tried and true techniques that have been around for years. 

The two most prolific bunion correction surgeries are the Lapidus and Austin bunionectomy.  These two procedures have been around for years and have corrected 100’s of thousands of bunions.  They continue to be the work horses of bunion surgery as they have predictable outcomes and long term follow up.  I utilize both and have found the majority of bunions have great correction when one of these two techniques are used. 

There is currently a lot of buzz around the Lapiplasty procedure and for good reason.  It employs a surgical technique, the Lapidus, that has been around for almost 100 years.  This procedure was brought to the forefront by a Surgeon in Seattle named Sigvard Hansen.  Dr Hansen has since retired and is considered by many to have been a pioneer in the field.  Some of us were lucky enough to spend time with him and learn his techniques and continue to utilize the Lapidus bunionectomy.  The Lapiplasty is a tool kit that helps surgeons perform this procedure.  It has helped to make outcomes more reproducible and simplified the technique. 

The Lapiplasty is one of my most common procedures and I find it to have predictable and reproducible outcomes.  If you have a bunion and would like to see what kind of candidate you are please contact my office and I would be happy to help. Give us a call at 425-391-8666 or make an appointment online today. 


Dr Brandon Nelson


Bunion surgery
is by far the most common surgery I perform.  In the average week I usually do 3-5 bunion surgeries. I really enjoy helping patients with bunions. The before and after is exciting for everyone.  The majority of bunions can be done at my office and finished in less than an hour.  Larger or more complex bunions often take 2 hours to correct.  Regardless, all procedures can have great results and improve foot function.

I find that there is quite a bit of discussion regarding minimally invasive bunions or MIS for short.  These are great procedures and can provide excellent outcomes.  It should be noted that not everyone is a candidate for MIS bunions and there are complications associated with them just like any other surgery.  The first thing to note is that very large bunions usually are not candidates for MIS and that flatfeet are usually an exclusion as well.  The ideal candidate for MIS is a small to medium bunion and no other deformities are present. 

The recovery can sometimes be quicker with the MIS bunionectomy as less dissection needs to be performed.  Sometimes there is less swelling as well and less pain.  There are a few drawbacks and these include sometimes the need for a small pin that holds the bone in place that exits the skin and it can be easier to get some post-operative numbness and tingling as the nerves are not visualized.

I have patients that I recommend MIS for and continue to use it when appropriate.  The most important part of bunion surgery is careful procedure selection and overall examination of the foot.  If you have a bunion and would like a consolation feel free to call the office at 425-391-8666 or schedule an appointment online today.


Dr Brandon Nelson

Lis Franc injuries refer to a midfoot injury that can occur when force is applied to the foot.  The original injury was named for a Napoleonic Surgeon that saw quite a few soldiers fall from horse back and injure their foot.  This injury now is most common in sports and can be quite devastating to the player. 

Lisfranc injury is a dislocation or fracture in the midfoot area. It is very rare, however, vital that it is not missed because long-term damage can occur.

Chet Holmgren, the number 2 pick overall in the NBA draft recently injured his foot.  He was drafted by the Thunder and a standout from Gonzaga, this 7 footer is expected to be a force in the NBA.  He was guarding Lebron James when the injury occurred. 

Click or tap to follow the link. 

It is clear this was a Lis Franc’s injury, and he has undergone surgery already.  This will be a long recovery and he may miss the entire season.  We wish this young man the best and a speedy recovery.

In my practice I see quite a few athletes that present with a delayed presentation of this injury.  Typically, they will present to the ER with an injury that is diagnosed or assumed to be a sprain.  However, weeks later they are still in pain and find their way to my office.  Careful exam and x-ray can usually reveal this problem but sometimes an MRI is warranted.  Treatment then proceeds and most patients make a great recovery depending on the severity of the injury.  If you have a foot sprain and are in pain, please don’t delay and contact the office immediately at 425-391-8666 or make an appointment online.


Dr Brandon Nelson

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