foot surgery issaquah

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heel pain out of bed in the morning


Plantar fasciitis affects millions of people worldwide. It is often a debilitating condition that limits people’s activities. It is characterized by pain in one’s heel, pain when we get out of bed or can even be a bruised sensation to the bottom of the foot. Today I will discuss some of the causes, symptoms, diagnosis, and treatment. The plantar fascia itself is a thick ligament like tissue that runs on the bottom of the foot to provide support.

Causes:

The number one cause is overuse. This can be exercise or standing all day or a change in the amount of either of these. Other causes can be shoe gear, weight or even the foot structure one is born with.

Symptoms:

The most common symptom is sharp heel pain, especially when you first get up from a seated position. This usually improves as we walk but returns at the end of the day. Some people experience stiffness or even burning.

Diagnosis:

A good clinical examination can help identify plantar fasciitis for most people. The is usually pain with palpation of the heel, specifically at the heel bone where the fascia attaches. An x-ray can be useful to detect bone spurs.

Treatment:

The mainstay of treatment is to work on stretching of the foot and Achilles. Additionally, increasing support for the feet can be helpful. Often by the time I see patients an injection is needed to calm down the inflammation and help with recovery.

If you would like a consultation on your heel pain, I can help. Call to make an appointment with me at 425-391-8666 or schedule an appointment online.

Sincerely,

Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Bunion (1)

Dr. Brandon Nelson, A Board Certified Physician & Surgeon, Discusses Bunion Surgery and Tips for Recovery

Bunion surgery is one of the most common foot and ankle surgeries in the United States.  On average I personally operate on around 100 bunions every year.  It is a very rewarding surgery for patients with great outcomes.  The hardest part is the recovery and I thought I would give some tips for patients that I have learned over the last 15 years.  I will break this down into pain control, healing and rehab. 

Pain control is essential for the first part of the surgical process.  I find it beneficial for patients to be on a narcotic with an anti-inflammatory.  I prefer Ibuprofen and usually only need any type of pain medication for the first couple days.  Additionally, I recommend keeping your foot elevated for the first week and making sure to ice for 10 minutes every hour while you are awake.

Healing is another important factor for recovery.  First bone healing this is usually the dictating factor for recovery.  The average bone takes 12 weeks to heal so target therapy to decrease bone healing times can be helpful.  I recommend always taking a bone healing supplement i.e. ProBono or Bone Up are two of my favorite over the counter supplements.  Next would be skin and soft tissue, taking collagen, biotin and zinc can increase production of new skin cells.  Once the wound has closed I like some sort of scar care cream or scar care product.   You must use some sort of silicone based cream for best results.

Rehabilitation after bunion surgery often depends if other procedures were performed as well.  Often times physical therapy can be helpful.  I recommend that patients start moving their toes through range of motion as soon as the stitches are out.  It is important to actively and passively move the toe joint to prevent stiffness.  The ankle joint should be mobilized as well with such exercises as writing the alphabet with your foot multiple times a day.  I hope you find these helpful. 

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

Sincerely,

Dr. Brandon Nelson

austin bunionectomy

This is probably one of the most common questions I hear when patients come in for a consultation. I think this question is easy to answer, however does have a few details that need to be addressed. I think the most important details are family history, activity level and expectations.

Family history, most bunions have a family history component. There is usually a parent or grandparent that has had a bunion. I think of this as the future of one’s foot structure. Does a relative take off their shoe and all their toes are crossing over? Is there a history of other members having their bunions fixed? These are good questions to answer and can be helpful in deciding to fix your bunion.

Activity level is another important thing to consider. Are you having a hard time exercising due to the pain? Is it getting difficult to fit shoes or boots? I also like patients to think about what your long-term fitness goals are. Will your feet hold up for these? It is vital for our overall health and sense of well being to stay active.

Expectations should be clearly stated and discussed with your surgeon. Do you expect your bunion foot to be exactly like the foot without a bunion? What are your time frames regarding healing? Do you have any up coming obligations like a vacation or wedding? I think taking a critical look at how you hope the surgery goes and how you want to recover can be helpful

These are not inclusive of every detail to help with decision making but are a good place to start. The most important thing is to have your foot evaluated and discuss your goals with your surgeon. If you have a bunion and want to have it evaluated and a detailed plan put in place please give us a call at 425-391-8666 or make an appointment today.

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Don’t forget that if you take narcotic pain medication, it may have Tylenol in it. Medication such as Percocet and Vicodin may have Tylenol in it and there’s a maximum daily dose of Tylenol, approximately 3000 mg per day. This is why it’s important to keep a log of your medications. If you’re not comfortable with this then make sure to ask your doctor for narcotic pain medication that is a stand-alone item such as pure oxycodone instead of Percocet.

It’s recommended to have a family member help you keep track of these pain medications with a log. Set your clock or phone so that you have a schedule because you want to stay on top of the pain. 

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

anklesurgery1

Regarding post-surgical home recommendations and ideas, don’t forget that there are things to do at home that we always forget or do not plan for. For example, taking your family members to appointments school or etc. This can be a tough one. If you’re the sole parent taking care of your children, then some people will wait until a relative or another family member can fly in to help out;  or they may live close enough where they can simply come over as needed. 

Foot surgery timing can sometimes work better with a college break - like Christmas break or summer break.   Sometimes it’s a good idea to wait to have surgery until you have enough help that all your family’s needs can be taken care of but there’s also the needs of the surgery patient themselves.  Discuss this with your surgeon, each different type of foot surgery and the recuperation and post op time off your feet or in a walking boot will be different.

If you are considering bunion surgery or other foot surgery, please let us know if you would like a surgical consultation.

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



It may be helpful to have your house set up for easy navigation and getting around.

For example, if you’ve got crutches a scooter or a walker, then practice ahead of time and make sure it will all work in your location. If you’ve got a couch downstairs and you don’t want to go up and down your stairs you may want to plan on setting up some type of a bed on your couch on the main floor. If you have to go up and down the stairs, some of our patients will go up and down on their "rear-end" so that they don’t have to try and balance with crutches. 

We like to go over these details and more at your "preop" appointment.   

We are happy to further discuss in person, if you would like to see myself Dr. Timothy Young or my partner Dr. Brandon Nelson. Give us a call at 425-391-8666 or make an appointment online.

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There’s several different things to think about in preparation for upcoming foot surgery

It is important to think about these things before hand and to plan ahead of time. 

There will be things to do to your surgical site to help make sure things heal correctly. For example, you can get a shower protective sleeve to go over your foot and calf. 

When you have a bath or shower it will help to have a plastic chair outside of the shower.

And a plastic chair inside of the shower.  I recommend using a hand held shower head that has a long flexible hose. These are about $20 at Home Depot and very easy to install. This way you can be sitting in the shower and not worrying about having to keep your balance. Also having the plastic chair inside the shower gives you a place to sit while use that hand held shower head and hose. Once you’re done you then have a plastic chair outside of where you can dry off and again not be sitting there balancing yourself.  Note that it can be very hard to get in and out of a bathtub, the shower may be best (at least initially). 

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

Traditional foot surgery involves an open incision to fully expose and gain full access to the anatomical site being worked on. For example traditional bone spur surgery to clean up and arthritic bunion site may have an incision approximately 2–3 centimeters in length. With the minimal incision technique this incision could be fraction of that possibly just 1 cm or less. With a small incision the wounds heal faster. With a smaller incision and with less exposure it is possible that some of the bone spurs will not be fully removed.  

So it is a compromise. There are times when minimal incision surgery is extremely effective. For example smaller bone spurs on the toes can be removed with a small incision and a burr power. Sometimes a tight tendon can be released through a very small incision. There are some innovative new systems and medical instrument companies that are coming up with techniques to do some procedures through a small incision. The following is an example of minimal incision surgery to remove a spur on the fifth toe. There is a before and after image of the x-ray. The incision on this is typically only 4 mm in length.

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If you have questions about foot problems and or foot surgery please feel free to contact our office at 425-391-8666 or make an appointment online today. 

By Pagemaker787 - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=46455891
At Issaquah Foot & Ankle Specialists, we provide the best surgical treatment. We want to prepare our patients for their surgery. Here are some of the helpful things to prepare for before your foot surgery. Plan ahead for meals, driving, shopping, sleeping and bathing.

Do your errands ahead of time:

-get your post op Rx filled

-buy a cast shower protector

-have your meal planning done, you may want to get some premade dinners and easy meals

Prepare your house:

-set-up a bed on the main floor of the house, so you do not have to use stairs.

-set up your shower, get an inexpensive hand shower head

-get a plastic chair you can put inside the shower

-make sure your house is easy to move around in.

Family help:

-make sure a family member or friend can help during the 1rst 24 hours and

-arrange for help with driving

Prepare for some couch time:

-get books, movies, home office set-up.

Some planning before your surgery will make things easier during your post op time. You want the best long term out come and planning will help!

If you have more questions and would like a consultation let us know. Give us a call at 425-391-8666 or make an appointment online. 

Dr. Timothy Young and Dr. Brandon Nelson

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We often ignore the Tailor’s bunion. This is the painful bump that develops on the outside of the foot or lateral aspect of the foot just behind the small toe. Sometimes the surgery is very simple and basic and just involves shaving down the extra bone in the area and smoothing it down and then suturing things back together.
 
Other times patients have what we would call a splay foot and especially splaying of the fourth and fifth metatarsal. This is where the fifth metatarsal bows out. In this case, we have to reset the fifth metatarsal and surgically realign it back in its normal position. When this is done typically we will use at least one screw to help maintain the alignment of the bone in its new position. if you have a question about Tailor’s bunion correction or treatment options please contact our office at 425-391-8666 or make an appointment online. 
 
You can speak to myself Dr. Timothy Young or my partner Dr. Brandon Nelson. We both work at Foot Surgical Center of Issaquah. This serves the Greater Seattle Area, including Bellevue Issaquah and Redmond.
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