Hammer toes are a common condition that we see at our practice. They are often painful and uncomfortable for patients to exercise or even walk with. The most common digit we see affected by hammering is the second digit. Hammer toes can often occur with a bunion and if left untreated can become what is called a cross over toe. There are quite a few different treatment options for hammer toes. It depends on the root cause and the amount of deformity that is present. Some hammer toes are slight and do not need any treatment, more extreme hammer toes may require surgery.

The underlying cause of the hammer toe needs to always be addressed or else they will continue to progress. Some patients with time will see all their digits affected and shoe gear can become an issue. Another common area of foot we see this occur in are the 4th and 5th digits or the baby toe and the one next to it. Sometimes these two digits can develop a painful corn between them and cause a significant amount of pain. We don’t recommend over the counter corn treatment products as they can create sores and infections. A bone spur can be present between these two digits so an x-ray is warranted. We have been treating hammer toes for years and have treated thousands of them. If you would like yours evaluated please give us a call at 425-391-8666 or contact us online.

Our clinic sees a lot of patients with pain in the balls of their feet. This type of pain can often be attributed to neuromas. Most people with neuromas will experience electrical type pain or burning pain. This type of pain usually occurs between the 3rd and 4th toes, but can also be seen between the 2nd and 3rd as well. Neuromas are more common in females than males and seen to usually occur between the 4th and 6th decade of life.

Some patients may experience more pain with shoes on than without shoes and hard surfaces such as wood floors or tiles can exacerbate symptoms. Currently there are many treatment options available for neuromas including steroid injections, shockwave, padding, and surgery and sclerosing therapy. Sclerosing therapy or alcohol injections are highly successful in the treatment of neuromas and have close to a 90% resolution of symptoms rate.

The process involves injecting dehydrated alcohol near the painful neuroma. The alcohol works to dehydrate the nerve and stopping the pain signal conduction. The typical neuroma takes approximately 4 to 6 injection spaced about 2 weeks apart each. We perform this treatment on patient that are contemplating surgery and see excellent results and often times do not need to progress with surgical removal of the neuroma. If you are thinking about having your neuroma removed or have daily pain from a neuroma a consultation could be extremely beneficial.

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If you are experiencing any foot or ankle pain, do not hesitate to call us at 425-391-8666 or contact us online. 

The top of the midfoot is a common area to have foot problems. It's a very common area to have a bump on the top the midfoot.  These bumps can be due to underlying arthritis (like degenerative joint disease or osteoarthritis). The most common location of this would be the second metatarsal-cuneiform joint. This is where an arthritic spur or osteophyte tends to form. There is irritation of the joint both deep inside the joint and on top. The reactive bone builds up on the top forming a large lump that can be painful in shoes. The pain can be both from the pressure from the bump and also from the underlying arthritis. 

You can have a similar situation with the first metatarsal-cuneiform joint. This is a bit different because some people get a bump here without significant arthritis and this is often in a high arch foot type. This particular point in the arch can be the apex of the arch when one thinks about a triangle it's the top of the triangle in regard to the top of the arch also. Another common cause of bumps on the top of the foot is a ganglion cyst. He had a less common bump would be a gouty tophi or deposit of uric acid. The good news is these are simple things to evaluate and determine what is actually causing this whether it is because of bone spur or ganglion cyst or other soft tissue issue.

If you have concerns like this please feel free to contact myself–Dr. Timothy Young, or my partner Dr. Brandon Nelson. 

Avulsion fractures are very common foot injuries. There is quite a range of different potential injuries and scenarios. One example is a large avulsion fracture of the base of the fifth metatarsal. The peroneal brevis tendon attaches here, and the tendon is stronger than bone. Like with some ankle sprains and twisting of the ankle, the peroneal tendon is put under violent rapid strain including at its attachment site. And it pulls a large section of bone away from the rest of the larger bone–fifth metatarsal. 

On a smaller scale, other examples include where a ligament attaches to bone. For example the ligaments on the outside of your ankle. Or the ligaments that connect the larger heel bone (calcaneus) with the next bone (cuboid). The lateral ligaments over the calcaneal cuboid joint are also quite strong.  With some foot injuries these ligaments are strained under tension, and rather than the ligament rupturing they pull a section of bone where they are attached to the larger section of bone (and it looks like a chip fracture). 

These larger chip fractures often can be seen on x-ray. Sometimes they are small enough and difficult to isolate that they are best seen with ultrasound imaging and can easily be missed with an x-ray. Therefore, avulsion injuries can involve a small or larger section of bone that is pulled and fractured. Again these can be diagnosed with an x-ray, fluoroscopy, ultrasound imaging, MRI or CT scan. Once they are diagnosed, the treatment is often a cast or cast boot to protect and immobilize the area. These can be treated similar to a bad ankle sprain or in some cases they are treated like a regular fracture. Because the avulsion fragment can be large and attached to the tendon, it can be difficult for this to reattach to the bone from the constant pulling of the tendon. 

If you have any injury that needs treatment or evaluation, or second opinion please let us know. Dr. Brandon Nelson and myself, Dr. Timothy Young, see and treat many of these injuries and have on-site xray, fluoroscopy, and ultrasound imaging.

If you are experiencing any foot or ankle pain, do not hesitate to call us at 425-391-8666 or contact us online.

At Issaquah Foot & Ankle Specialists we do approximately 2-4 bunion surgeries every single Monday. It is important to seek out surgeons that are doing multiple procedures a week of the type of procedure you are having done. There are a plethora of bunion surgical procedures available and proper procedure selection is the most important part of this. Often times our clinic is sought out for a second opinion and it is important to recognize that not all procedures are the same .

I like to discuss the long-term benefits of a bunionectomy in the procedure and support the long-term functioning of the joint. One of the great things about our clinic is that we have an on-site surgical Center and this allows us to provide a huge cost savings to most patients. The typical bunion surgery can be anywhere from 1 out of 3 hours and can involve cutting and repositioning bones or fusing joints. All of our procedures allow patients to walk after surgery. This can be a big benefit especially for people that have a hard time using crutches. If you have a bunion and would like it evaluated for either conservative or surgical measures please make an appointment and we would be happy to help.