Tendons are fibrous tissues that connect muscles with bone. The Achilles tendon is the largest tendon in the body. It connects the calf muscles at the back of the leg with the heel, and facilitates movements such as jumping, running, and walking. 

Because the Achilles tendon is engaged so frequently and bears a great deal of pressure and stress throughout the day, it can become injured. Achilles tendon injuries cause the tissue to become irritated, inflamed, and swollen. Pain can come on gradually or be immediate, and will vary from mild to severe depending upon the injury. Where the pain occurs will vary as well, from just above the heel up through the back of the leg. There may also be stiffness in the tendon.

Achilles tendon injuries can often be caused by repetitive stress. They may also occur while running, playing tennis, gymnastics, football, basketball, dancing, soccer, baseball or other sports that require speeding up, slowing down, or pivoting quickly. Wearing high heels, falling from an elevation, stepping in a hole, having flat feet, bone spurs, tight leg muscles or tendons, wearing improper athletic shoes, exercising on uneven surfaces, or starting a new type of exercise can also cause Achilles tendon injuries.

The two most common Achilles tendon injuries are tendonitis and ruptures. Tendonitis causes painful inflammation and can occur in different parts of the tendon. Non-insertional Achilles tendonitis occurs when the fibers in middle of the tendon begin to break down, thicken, and swell. This condition typically affects younger, more active adults. Insertional Achilles tendonitis occurs where the tendon inserts into the heel bone. It is common for bone spurs to form with this type of injury. This condition can affect people of any age and level of activity.

Achilles tendon ruptures are a tear in the tendon. These breaks may be partial or complete. There may be an audible popping noise at the moment of injury and the pain will be sudden and severe.

An Achilles tendon injury can be diagnosed by your podiatrist after they examine you, check your range of motion, and possibly perform a calf squeeze test or review an X-ray or MRI. Depending on the type and severity of your injury, your podiatrist may treat your condition with rest/ice/compression/elevation (RICE), nonsteroidal anti-inflammatory medications, heel lifts, and stretching and strengthening exercises. If you have torn your Achilles tendon, treatment may include physical therapy, ultrasound, shockwave therapy, or possibly even surgery.

Bunions are often a painful condition especially when trying to fit certain shoes or exercise.  Let us first discuss what a bunion is then how we can relieve the pain. 

A bunion results from a combination of familial inheritance and environmental factors.  Meaning that if you do not have a genetic predisposition for a bunion, you will not create one by adding outside forces to your foot.    Where this becomes important for example is high heel shoes.  If you have a family history of bunions and you wear high heels you can accelerate the process of development of the bunion.  Or if you are an avid exerciser like a runner this can speed up the development of a bunion. 

So what is a bunion?  Well, there is a common misconception that a bunion is growth.  This is not true nothing grows with a bunion it is from a misaligned bone in the foot.  The culprit is the 1^st metatarsal.  This bone begins to shift out of place and cause a bulge on the inside of the foot and continues to get worse until the big toe has rotated.  The bunion will get bigger as time goes on and often can begin to force the other toes out of position.  Bunions at this point become painful and hard to fit in shoes.

What can be done for bunion pain?  There are a lot of different things I can provide to relieve bunion pain.  It really requires an evaluation of the bunion.  But generally, wider shoes can help and prevent going barefoot.  There are other options that provide more relief, but it really depends on the stage of the bunion.

If you are experiencing bunion pain I can help call to make an appointment with me at 425-391-8666 or fill out a contact form online. 

Sincerely,
Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Hammer toes are a curling of the digits of the feet.  Specifically the middle of the toes bend downwards and from the side looks similar to a hammer.  There are other digital deformities as well like claw toes and mallet toes.   But today we will just discuss hammer toes. 

Most of the time it is an inherited foot structure that causes hammer toes.  An example of this is a flatfoot.  A person is born with a flat foot and over time the tendons that run to the toes have been working to create an arch for so long the toes permanently deform creating a hammer toe.  There are other causes but the number one cause is the flexor tendons on the bottom of the toe overpowering the other tendons.  Once the tendon imbalance occurs hammer toes are the results. 

There are a few options for treatment of hammer toes.  It is based upon the flexibility of the hammer toe.  Is the hammer toe flexible or rigid?   If the hammer toe is flexible you can release a tendon and the toe will lay flat.  However if the hammer toe is rigid you must remove a small piece of bone in order to get correction.  I also recommend looking at the foot structure that is influencing the hammer toe and correct that as well. 

If you have hammer toes and would like to discuss how I can help make an appointment with me today.  Give us a call at 425-391-8666 or make an appointment online today.

Sincerely, Dr. Brandon Nelson 

Heel pain can be difficult to deal with, especially if you do not know what the underlying cause is. If you ignore your heel pain, the pain can magnify and potentially develop into a chronic condition. Depending on the location of your heel pain, you have developed a specific condition.  

One condition is plantar fasciitis.  Plantar fasciitis is caused by the inflammation of the plantar fascia, or the band of tissue that connects the heel bone to the base of the toes. The pain from this condition is initially mild but can intensify as more steps are taken when you wake up in the morning. To treat this condition, medication will likely be necessary. Plantar fasciitis is often associated with heel spurs; both require rest and special stretching exercises.

There are various options your podiatrist may suggest for heel pain.  Treatment options for heel pain typically include non-steroidal anti-inflammatory drugs (NSAIDS), which may reduce swelling and pain. Other options are physical therapy, athletic taping, and orthotics. In severe cases of heel pain, surgery may be required.

Preventing heel pain is possible.  If you are looking to prevent heel pain from developing in the future, be sure to wear shoes that fit you properly and do not have worn down heels or soles. Be sure to warm up properly before participating in strenuous activities or sports that place a lot of a stress on the heels. If you are experiencing any form of heel pain, speak with your podiatrist to determine the underlying cause and receive the treatment you need.