heel pain

Displaying items by tag: heel pain

heel pain out of bed in the morning

Heel pain
can have many causes and can be extremely challenging for all patients.  Not all sore heels are caused by plantar fasciitis and it is important to understand the underlying cause.  Identifying the underlying cause will help to assure patients get the best treatment options.  Even with many other causes of a severe heel pain, the number one cause continues to be plantar fasciitis.

Plantar fasciitis is basically an inflammatory process of the main supporting network of the foot.  The primary cause of inflammation seems to be overuse and repetitive stress.  The plantar fascia in general has a relatively poor blood supply and this can lead to chronic inflammation.  Once we see chronic inflammation set in it can become extremely difficult to reduce pain and resolve one's heel pain. 

Heel pain treatment options are vast.  It really boils down to what the primary cause of the heel pain was and the activity level of the patient.  I like to break it down to foot structure and rear foot pathologies.  What I mean by foot structure is does the patient have a high arched foot or a low arched foot.  Is there a lot of pronation that occurs with ambulating or overloading of the foot?  Rear foot pathology can have a large effect on heel pain.  Is there a tight calf muscle or is there a dysfunctional supporting tendon?  The best long term outcome and shortest course to a pain free heel is to appreciate the deforming forces.

If you have severe heel pain or pain under your heel or even pain with running I can help! Give us a call at 425-391-8666 or make an appointment online today.

Sincerely,

Dr. Brandon Nelson

woman pink dress holding heel

The most common cause of heel pain continues to be plantar fasciitis.  This is usually caused by a foot structure that puts too much pressure on the fascia or tight muscle groups.  The majority of plantar fasciitis will go away with physician care and patients will return to normal activities.  However, there are a few patients that their heel pain does not get better and need additional treatment.

If you are one of these patients it is important to see a physician that specializes in heel pain.  There can be a few diagnoses that need to be considered for anyone that has recalcitrant heel pain.  These can range from nerve to bone issues and a careful work up is warranted.  Our practice has been home to the Washington Heel Pain Center for years.  We were actually the first heel pain center in Washington State and then saw many other offices try to follow suit.  However, our physician group finds heel pain fascinating and we diligently scour the latest research to remain up to date on causes and treatment options.

If you suffer from heel pain and have seen other doctors we can help.  Or maybe heel pain is new for you and you want the best care we can help.    We provide the best care and have the quickest options to get you back exercising or keep you exercising.  Make an appointment today and we can help. Give us a call at 425-391-8666 or make an appointment online today.

Sincerely,

Dr. Brandon Nelson

heel pain out of bed in the morning

Heel pain
is the most common presenting pathology at my practice.  In general, I would say 1 out of every 6 patients is for heel pain.  This can be common for both adults and children.  The adult usually has heel pain that is caused by plantar fasciitis and for children this is usually apophysitis or Sever’s disease

Adult heel pain is common as one starts an exercise program or as our mileage on our feet increases.  The symptoms usually begin with pain in the morning or after a walk.  The feeling is often described as a bruised sensation or a burning pain.  It is important to identify the underlying causes and address these.  I do think an x-ray is warranted and the earlier the treatment the better. 

Children usually seem to have heel pain between the ages of 10-14.  The typical child has been playing sports, especially cleated sports.  They usually describe a soreness that can result in limping.  It is again important to take an x-ray and for underlying foot conditions. 

Both plantar fasciitis and apophysitis seem to be most common in certain foot structures.  These include flatfeet and tight Achilles’ tendons.  I recommend stretching the calf for the tight achilles.  However, the flatfoot needs to be thoroughly evaluated to prevent long term issues.  I really enjoy treating both of these conditions and have great long-term protocols to eliminate this pain once and for all.

If you or your child is suffering from heel pain please call so I can help. Make an appointment online or give us a call at 425-391-8666. 

Sincerely,

Dr Brandon Nelson

Board-Certified Foot & Ankle Physician & Surgeon

heel pain out of bed in the morning

Pediatric heel pain
or kids with heel pain are a common presentation.  This heel pain is often correlated with the start of new activities or any sport season.  The most common sports that heel pain occurs with children are basketball and soccer.  Basketball seems to make sense as the hardwood floor can be tough and with soccer cleats seem to be an aggravating factor.  It is important to have your child properly evaluated for heel pain, however the most common cause is inflammation of the growth plate.  These growth plate issues are easy enough to diagnose based on clinical evaluation and radiographic findings.  It is important to have x-ray heel pain because there are other causes and the treatment is tailored towards the specific pathology.  Traditionally with proper implementation of a treatment plan, heel pain is usually amenable to conservative measures including clear fairly quickly.

Adult heel pain by far is most commonly caused from plantar fasciitis.  Plantar fasciitis usually involves an inflammation of the plantar fascia or the supporting network of the bottom of the foot.  There are many common clinical symptoms that we see each year including pain after rest or burning throbbing type sensation of the heel.  Typically for adults this heel pain starts in one heel and gets worse with activities and time.  Again it is important to have a thorough workup including radiographs or ultrasound examination of the heel.  I believe it’s important to get in and see a foot and ankle physician fairly early in this process as this makes treatment easier.  Again the majority of patients with this pathology clears up with conservative measures and returned activities.

If you suffer from heel pain or trauma suffering from heel pain I can help.  Please feel free to contact the office and we will get you back on your feet pain-free. Give us a call today at 425-391-8666 or make an appointment online today. 

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Dr. Timothy Young
, a board-certified foot surgeon discusses, Shockwave therapy for stubborn Achilles tendinitis and plantar fasciitis. (EPAT) 

Many of our plantar fasciitis and Achilles tendinitis patients respond well to traditional therapy.  This includes appropriate gym shoes, prescription orthotics, braces, a night splint and stretching.   

However, some patients have more stubborn cases.  In these cases shockwave therapy is highly effective.  In Dr Young's experience, this can be 80–90 percent effective for patients who have not had adequate relief with the traditional treatments.  There are some cases that are so severe that we also use PRP (platelet rich plasma).   

The shockwave therapy is typically done once a week for 5 treatments.  There is no down time with shockwave therapy and there are no injections.   

The Shockwave therapy protocol includes avoiding nonsteroidal anti-inflammatories like Aleve or Advil, avoiding icing, and taking supplemental boron - 3 mg per day and collagen.  The clinical improvement after shockwave can continue to progress over 3-4 months. 

Shockwave therapy is a form of regenerative medicine.  The shockwave therapy itself is a fairly intense treatment and the targeted tissue benefits from the shockwave therapy with increased blood flow and increased local healing factors much like other forms of regenerative medicine.  The body  responds to shockwave therapy such that the local tissues respond as though there is trauma and this triggers many of the bodies own natural healing.   

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

pic heel pain 4

Pediatric or child heel pain is a common condition that begins to affect most young girls between the ages of 10 and 14 and young boys between the ages of 12 and 14.  There seems to be a large correlation with previous family history where parents relate that they experienced heel pain as children.  Most kids will describe a throbbing-like sensation that is worse with activities and increases with the more they do and normally resolves with rest.  The #1 cause remains an inflammatory condition of the growth plate or what is called apophysitis or Sever’s disease.

Sever’s disease or apophysitis is very treatable condition and the early intervention easier is to recover.  Most kids that have apophysitis typically have a flatter foot or playing a sport in cleats.  I do recommend an x-ray and a thorough evaluation because there are other causes of heel pain including bone pathology like stress fractures or tumors.  Typically there will be less pain with shoes and icing can be helpful.  

If your child is having heel pain I can help.  Please make an appointment to have them evaluated and get them on the road to recovery.

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

Achilles Tendon

The Achilles tendon is the thickest strongest tendon in the human body.  There are more pounds per square inch going across the Achilles tendon than any other tendon.  It is important to realize that during an active gait cycle the Achilles tendon is under chronic mechanical load.  This tendon in general can become overused and is usually attributed to an increase in activity or change in activities.

The most common cause of Achilles tendon pain is what is described as watershed region Achilles tendinitis.  I encountered this in a lot of people that have begun to run or do plyometrics type activities like box jumping or jumping rope.  I encouraged people not to plunge into new activities to begin to train slowly.  With activities the changing and loading of the Achilles tendon can lead to Achilles tendinitis-type problems.  Typically this will present as pain and swelling in the Achilles tendon.  Oftentimes patients will experience increased pain that they try to push through this in addition they are at the risk of rupturing the Achilles tendon during this time.

It is extremely important that anytime a patient has Achilles tendon pain medicines evaluated by a physician.  Long-term wear and tear can delay the return to normal activities.  The longer patients have had these conditions there is a correlation with the longer it takes to recover.  Achilles tendinopathy is one of the most common pathologies that I see if with recent developments in treatment protocols patients can return to activities sooner.

Sincerely,

Dr. Brandon Nelson

Board-Certified Foot and Ankle Physician and Surgeon

heelpain

There are quite a few causes of heel pain of heel pain and it can vary by age.  We tend to break it up by pediatric meaning anybody less than 18 and adult heel pain anybody over 18.  Regardless of the age and the patient heel pain can be extremely challenging and very painful.  We see quite a few adults and children that are highly athletic and struggling with resolving their heel pain.

Heel pain and children is typically sourced to a disorder called calcaneal apophysitis.  This is a condition where the growth plate of the heel is affected.  Often times with young man this occurs between the ages of 14 and 16 and for young limited between the ages of 12 and 14.  We see a high correlation with sport activities especially cleated sports.  It is important to have an x-ray and follow-up with the foot and ankle physician in order to evaluate the other underlying causes.

Adults tend to have pain that occurs in the morning especially when getting out of bed or after activities.  We see the majority of people have often increased their exercise routine or started a new activity.  The #1 cause of heel pain and adults remains plantar fasciitis.  The plantar fascia is the main supporting network of the foot and can become tired and worn out with age.  Again it is important to seek help from a foot and ankle physician to determine whether or not this is the underlying cause.

Heel pain in both pediatrics and adults is highly treatable and early intervention is better.  The majority of these causes can be distinguished of the first visit and felt can be implemented immediately.  If you’re having heel pain please make an appointment today and I can help.

Sincerely Dr. Brandon Nelson

Board-Certified Foot and Ankle Physician and Surgeon

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One of the essential tools for evaluation of heel pain is ultrasound high definition imaging. With this diagnostic tool,  we can see if the planter fascia is excessively thickened and to what extent.  For example typical thickness would be 3- 4 mm. But in severe cases it can be 7 mm or even up to 11 mm thick.  This can be especially helpful when comparing to baseline or the non-symptomatic side.

In some cases there has been plantar fasciitis in the past on the non-symptomatic side or some individuals have plantar fasciitis affect on the both the right and left foot which does make baseline comparison a challenge.  So when we see a severe case of plantar fasciitis with severe thickening of the fascia then we know it will be even more resistant than typical.  That means that we have to consider some some of the treatment options for resisting cases such as shockwave therapy or PRP.  We still have to do all of the other traditional treatments for plantar fasciitis.   

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

heel pain out of bed in the morning

The most common cause of heel pain continues to be plantar fasciitis in adults and apophysitis (or Sever’s Disease) in children. With adults it seems to be correlated with an increase in exercise or activities and with children it is common with growth spurts. The two conditions often have similar presentations and can be treated with similar protocols. I recommend having any pain evaluated by a physician as other pathologies can cause heel pain.

They are many different treatment options for heel pain, especially plantar fasciitis. I have now observed different conservative and surgical techniques come in and out of favor. It is important to first get the correct diagnosis and then see what factors are contributing to the pain before implementing treatment. It can be helpful to have and x-ray, an ultrasound or even an MRI before tackling heel pain.

In recent years I have began to approach plantar fasciitis from both a mechanical and biological perspective. I believe foot structure and training can play a large part in the development of heel pain. I also believe once this heel pain starts it often can become chronic and this chronicity is what allows the pain to spiral out of control. Since implementing a protocol that addresses both of these aspects I have seen a huge swing in long term effectiveness. If you are suffering from heel pain for months or even years I can help you fix this once and for all. I know how painful, frustrating and exhausting it can be.

Dr Brandon Nelson

Board Certified Physician and Surgeon

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