Big toe arthritis continues to be a debilitating condition on a daily basis for many patients. We evaluate and treat multiple patients a week with this condition. We continue to see quite a few patients can benefit from nonsurgical therapies.

However some patients continue to not respond with conservative measures and surgical intervention is warranted. There have been some great developments with big toe arthritis including the Cartiva implant which at this time seems to have promising results. If you have big toe arthritis and are looking for alternative therapies, give us a call at 425-391-8666 or make an appointment online. 

At Issaquah Foot and Ankle Specialists, we see hundreds of patients a year for bunion advice. We see people that are interested in both conservative and surgical intervention and provide care for both. It is important to identify the source of the bunion, as this determines the proper procedure. It is also important to see someone who deals with a lot of bunions, as there is no universal treatment for all of them. I typically recommend my patients receive an x-ray as this can help evaluate the cause of the bunion deformity.

In addition it’s important to look at the overall foot structure and the gait pattern as this can change outcomes and treatment scenarios. If surgical intervention is warranted we have an on-site surgery center which reduces both time and cost for patients. In a typical week, we perform 3-5 bunion surgeries and most of them take less than 2 hours. Outcomes for bunion surgeries of proper procedure selection are excellent and patients experience overall improvement in foot comfort and stability

Shockwave therapy is highly beneficial for many different foot or ankle conditions, including tendonitis, neuromas or plantar fasciitis. It works by creating mico-trauma that releases growth factors that induce the formation of new blood vessels and stimulate the healing response. It is highly effective and can change a degenerative state to a regenerative state. Patients report very little pain with the procedure and maximum effect can take up to 12 weeks. Typically the procedure is done 3-5 times about 1 week apart.

There is no down time and no immobilization, making it is great for athletes and active patients. The ideal candidates suffer from plantar fasciitis, Achilles tendonitis, shin splints, neuromas and even stress fractures. If you are interested in seeing if you are a candidate for shockwave contact our office at 425-391-8666.

Foot drop can occur for many reasons. These include injury to the nerve following knee surgery or paralysis from polio or other neurological disorders. There are many common procedures that we perform for foot drop. One of the most common is an isolated posterior tibial tendon transfer. This procedure is used to help what is called a slapping gait or foot drop. Another common procedure performed for this as well is the bridle procedure, which is very similar to the posterior tibial tendon transfer. However it incorporates other tendons as well to provide increased stabilization.

Often times these tendon transfer procedures can allow patients to get out of a brace and provide brace-free ambulation. It is important before performing a tendon transfer procedure that patients obtain a neurological workup including nerve conduction studies. We also find it necessary to address a tight calf muscle and review with the patient their expectations. The surgery can be performed in an outpatient setting and the outcomes for this procedure are highly successful. With the procedure most people spend about 6-8 weeks non-weightbearing at which time they can begin to walk in a boot and return to ambulation. This includes physical therapy and can be up to 3 months.

If you experience foot drop and would like to no longer use a brace and be evaluated to see if you’re candidate for one of these procedures please contact our office at 425–391–8666. Myself, Dr. Brandon Nelson, or my partner Dr. Timothy Young would be happy to see you.

A Plantar fibroma can be difficult to treat. At our clinic, we have come up with a very effective treatment protocol. A plantar fibroma is a combination of scar tissue, inflammation and swelling/edema involving the plantar fascia in the mid arch. It is often noticeable as a nodule or marble-like bump in the mid arch on the bottom of the foot. It is important to address the biomechanics involved, so a prescription custom orthotic with a specific accommodation for the fibroma is essential. In addition, injections of cortisone combined with dry needling are extremely effective. 

This is usually done under ultrasound guidance. Topical verapamil is an excellent adjunctive treatment. Because this is so effective the majority of our patients do not require surgery. Surgical excision of a plantar fibroma can have a high recurrence rate so its nice to have other options for our patients.

If you have these type of symptoms or problems, both myself Dr. Timothy Young, and my partner Dr. Brandon Nelson have had excellent experience and results in this regard.

Osteoarthritis of the big toe manifests as swelling and pain around the inside of your foot near the base of your big toe. Patients often experience increased pain with activities and walking that is elevated by rest. Trauma can be the primary cause of osteoarthritis but position of bones can have a large influence as well.

We have many great treatment options for arthritis of the big toe included both surgical and non-surgical options. The best indicator of which category of treatments is appropriate is based of radiological examination, an x-ray. If you suffer from big toe pain, make a appointment so we can evaluate your joint and get you pain free. Myself, Dr. Brandon Nelson, or my partner Dr. Timothy Young would be happy to see you.