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. 

Sincerely,

Dr Brandon Nelson

An ankle sprain occurs when one or more ankle ligament gets overly stretched. Ligaments are strong bands of tissue that bind and support the bones and other structures that make up the ankle. In more severe ankle sprains, the ligament(s) tear—either partially or completely—and there may be an audible popping noise at the moment of injury.

Ankle sprains are quite common and can occur when the ankle rolls outwardly (eversion) or inwardly (inversion), causing the ligament(s) to stretch beyond normal limits, or even tear. Falls, twists, or blows to the ankle during sports or other activities can cause this injury, as well as wearing improper footwear, running on uneven surfaces, or having weak ankles.

Depending on the injury’s severity, an ankle sprain will be classified as Grade I, Grade II, or Grade III. Grade I sprains involve ligament(s) being overly stretched but not torn, with symptoms of mild pain, swelling, and ankle instability. There may also be some difficulty bearing weight. A Grade II sprain usually involves a partial tear of the ligament which brings more intensity in these symptoms, along with possible bruising. With a Grade III sprain, the ligament is completely torn, the symptoms are severe, and it may not be possible to put weight on the affected foot at all. 

To diagnose and grade an ankle sprain, a podiatrist will perform a physical examination, checking for tenderness and range of motion in the ankle. For more severe sprains, X-rays or other imaging studies may be necessary. 

It is vitally important to have an ankle sprain treated properly as improper healing often leads to future ankle sprains and possibly even chronic ankle stability. Treatment for an ankle sprain will vary, depending on its severity, and may include the RICE method (Rest/Ice/Compression/Elevation), physical therapy, bracing, medications, and possibly even surgery to repair a torn ligament. Rehabilitation is very important for the sprain to heal properly and to restore functionality.

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. 

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. 

Sesamoiditis is a condition that affects the joint that is just behind the big toe in the area known as the ball of the foot. It is most common in younger people and people who have just begun an exercise program. Since the sesamoid bones are like a pulley controlling the big toe, they can rub against each other and cause a gradual onset of pain. Pain may also be caused by the inflammation of tendons surrounding the bones. If ignored, sesamoiditis can lead to other, more serious problems such as severe irritation and fractures of the bones.

The cause of sesamoiditis is sudden increase in activity. The ball of your foot acts as a springboard to help you lift off when you are jogging or running. Sudden increase in the use of these bones or the tendon that controls them can cause irritation. The tendon then begins to develop inflammation and the joint begins to swell. People with smaller, bonier feet or those with a high arch are typically more susceptible to this condition.

Sesamoiditis is fairly simple to diagnose since the symptoms have a gradual onset rather than a sudden impact. The symptoms begin with slight irritation around the joint shortly after the increase in activity. The discomfort eventually turns to pain with light swelling and possibly redness. Although redness or bruising are rare, this may be a symptom. After each session of exercising, the aggravated joint becomes more irritated and increases into a very intense throbbing.

Treatment for sesamoiditis can vary depending on the severity of the situation. However, treatment is almost always approached in a noninvasive way. For a case that is just beginning the doctor may recommend a very strict rest period that will limit the activity allowed on the joint. If you must be active, a recommendation for as modified shoe or insole, along with bandaging and immobilizing the big toe will be made to ensure that pressure is not placed on the joint. For severe cases, it is typically recommended that the joint and the big toe be completely immobilized to allow adequate time to heal. Ice and an over the counter anti-inflammatory may can help with the pain and discomfort while you are at rest.

When you return to your regular exercise activities, it is recommended that you use an insole that will allow even distribution of impact to your entire foot, rather than just the balls of your foot. This will prevent further aggravation of the injury.