heel pain

Displaying items by tag: heel pain

heel pain in the morning

Exercise for me is an integral part of my daily life. I enjoy going for a run before work or on the weekends with my daughter. It provides much needed stress relief and helps to recharge my mind and body. I have suffered from heel pain and it was both depressing and challenging to continue on with my exercise and even daily activities.

Heel pain can often be exacerbated by exercise so I am going to provide a few tips that can be helpful:

1. Ice after exercise

2. Warm up before exercise and cool down

3. Stretching after you exercise

4. Switch to low impact activities until pain is under control

If you have suffered from heel pain for more than a month, please give us a call at 425-391-8666 or make an appointment online today.


Ball of foot pain usually refers to pain in one’s feet right before or near where the toes start. This is a common area to experience pain and can be attributed to quite a few pathologies. Typically, we see certain foot structures that are associated with ball of foot pain, and these include high arched feet or a foot with a bunion deformity. These foot types can develop to two most common forefoot pathologies which are capsulitis or neuritis.

Capsulitis or metatarsalgia can create pain in the ball of one’s foot especially with activities. Most people that have capsulitis will see some swelling and sharp or a bruised type of sensation. It appears to be most common in the 2nd metatarsal and has a slow progression to worsening symptoms. Shoe gear usually makes it feel better and often there is some instability in the foot itself.

Neuritis or neuromas are often isolated to the 3rd interspace of the foot. We usually see this more often in females as opposed to males. Typically, it will be a burning or tingling type feeling. Shoes often exasperate the symptoms and foot structure does not usually have much of an influence on this pathology.

There are many different techniques to diagnosis and treat capsulitis, metatarsalgia or neuromas. It is important to obtain and x-ray and a thorough evaluation of the foot itself. There are a few instances where more advanced imaging like an MRI can provide some value. Treatment for either pathology is conservative in most cases and has a high resolution rate.

If you are suffering from ball of foot pain, make an appointment today and I will help you get back on your feet! 425-391-8666


With heel pain affecting so many Americans, surgery is a common question I receive in the office. Most people that are curious about surgery have suffered from heel pain for months or even years and have tried all the conservative measures. They have tried things like orthotics, injections, splints, physical therapy and are still having pain. The discussion of surgery is an appropriate next step but at my office we have a few options that most physicians do not offer.

Surgery for heel pain or plantar fasciitis is highly successful and there are a few different procedures, but all have similar results. Many of the surgeries involve cutting or releasing the fascia and stimulating the biology of the body. The stimulating of the biology is important as it will increase blood supply and help with healing. Another procedure that has been in the current research is a gastric recession. This is where you lengthen a fascial type of structure in a patients leg to help reduce the pull of the Achilles tendon. Lately this has received a lot of attention and is showing very promising results.

I think a discussion on biology is important for this blog as well. Part of the long-term problem is chronically inflamed tissues. One’s fascia becomes chronically irritated and if you change the biology, you can usually fix the problem. I have developed a protocol and technique that is non-surgical that helps to stimulate your bodies own natural healing techniques and fixes most of the plantar fasciitis permanently. If you are suffering from heel pain I can help make and appointment today. Give us a call today at 425-391-8666 or make an appointment online. 

pic heel pain 4

Heel pain
can be common in children especially as they return to sports. We typically see girls between the ages of 8-12 and boys around 10-14. This increased incidence of heel pain at this time can be correlated with growth spurts or changes in activities. There is often a family history of heel pain as well from a parent or siblings. Unlike adults, very few children will have plantar fasciitis as the cause of heel pain. So, what are the main causes of heel pain in children? I will discuss a couple below.

Coalitions, these are where you have an abnormal connection between bones in the feet that should not be connected. Often, we see this type of pathology becoming painful after an injury, like an ankle sprain. Usually, an x-ray in needed to diagnosis this. This can differ based on location and there are two general locations of the coalitions. The two main locations are a calcaneal navicular and a talar calcaneal as the most common. The types of coalitions can vary, from bone to cartilage and even soft tissue.

Another common cause of heel pain in kids is Sever’s disease. This is basically an irritation of a growth plate that was first described by Dr Sever. This is especially common in cleated sports like soccer or football. There is usually a family history and common in flatfeet and kids with tight calf muscles. While this list is not exhaustive of all types of heel pain it is two of the most common, others can include a bone tumor, stress fracture or even a nerve irritation. Please make an appointment online or give us a call at 425-391-8666 if your child is having heel pain so we can help.


Numbness and tingling can be quite common in people experiencing forefoot discomfort. Most people will describe symptoms like burning, pinching, numbness and tingling. These are often associated with nerve type issues and can continue to get worse without treatment. The most common causes of this in the foot are neuromas and capsulitis.

Neuromas are a nerve irritation that occurs in the foot and usually is a female between the ages of 40-60. The nerves that run between the toes are sensitive and any increases pressure can cause pain. This pain is usually made worse with tight fitting shoes or high heels. Patients usually have pain to the 3rd and 4th digit and often is only on one foot. Most people will say that rubbing the front of their foot seems to help as well as removing their shoes.

Capsulitis is usually around the base of the 2nd toe. There is often an underlying deformity like a bunion or tight calf muscle. Patients will often experience swelling and tingling or digit. It is usually made worse with walking and relieved with icing.

Neuromas and capsulitis both can be challenging for the patient and the doctor. It is important to identify the root cause and an x-ray is warranted. The treatment options available are usually very successful. If you are having forefoot pain we can help, make an appointment today.

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

Wednesday, 15 September 2021 20:41

Bunion Surgery Recovery, Dr Brandon Nelson

austin bunionectomy

Quite a few patients ask about bunion surgery and bunion surgery recovery.  I hear a lot of stories from patients about neighbors, friends or family members that have had bunion surgery.  There seems to be some misconceptions about bunion surgery and some general misconceptions.  I want to help clarify this for patients and anybody thinking about fixing their bunion.

Bunion surgery can really be broken down into two different procedure locations.  Bunions can be corrected at the head of the metatarsal or the base of the metatarsal.  The head procedures are generally utilized for smaller bunions and base procedures are better suited for larger bunions. 

Head procedures are probably the most common bunion procedure.  This is often called an Austin bunionectomy and has been around for greater than 50 years.  It was one of the first bunion procedures and has great success and most patients can return to a normal shoe in about 4-6 weeks.  Patients can walk the entire time after surgery in a boot for about 4 weeks.

Base procedures are a little more involved surgery and therefore the recovery is longer.  Most base procedures can allow patients to walk in a boot in 2-4 weeks.  However, the total recovery from this type of surgery can be 8 weeks or longer.

I hope this helps to answer a few bunion surgery questions!  Give us a call at 425-391-8666 or make an appointment online today. 

walking barefoot through grass

Burning pain in the feet can be quite common for diabetics or people with what is called neuropathy. This is a condition that occurs when our nerves have some dysfunction. There are quite a few causes of neuropathy but the most common is diabetes. Diabetes can result in high levels of sugar in our blood that then causes irritation or damage to our nerves. The nerves involved are usually the nerves in our hands or feet, the peripheral parts of our body, hence the term peripheral neuropathy.

Tingling is another sign or peripheral neuropathy. Often times it feels similar to hitting your funny bone and can progress as time goes on. I recommend anybody with these symptoms should be evaluated and tested for nerve problems. A test I often order is called EMG/NCVs. These test will allow one to see if the numbness or tingling is coming from your nerves.

Treatment can usually begin right away and have dramatic effects. I like to use an FDA approved laser, that has zero side effects, in combination with a nerve supplement and infra-red light. I have had patients experience 80-90% improvement in symptoms. If you are suffering from neuropathy, fibromyalgia or burning and tingling in the feet we can help.

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

Bunion xray

A tailor's bunion is a problem, or the fifth metatarsal and the fifth metatarsal head protrude laterally or to the outside of the foot.  This causes pressure and pain especially with shoes ski boots etc.  This is usually a structural problem.  The fifth metatarsal tends to angle outward away from the adjacent fourth metatarsal.  Sometimes it is a simple problem and it's just enlargement of the head of the fifth metatarsal.  From a surgical perspective this can be treated by surgically shaving down the bump.  This tends to be a much quicker recovery.  

This would involve the incision, surgically incising the joint capsule then shaving down the bone and using a surgical orthopedic burr to smooth that down area.  After the bony prominence has been smoothed down and reduced the wound is flushed and the layers including the capsule subcutaneous layer and skin are all surgically repaired and sutured.  This tends to be a quick recovery it can be as short as 3 weeks in a cast boot.

If you have concerns about a tailor's bunion, please come to our clinic for surgical consultation.

Give us a call today at 425-391-8666 or make an appointment online today. 
Sunday, 22 August 2021 15:44

My Heel is Sore All the Time!


Heel pain
continues to be the most common reason a person visits the foot and ankle doctor or podiatrist. For us it constitutes about 1 out of every 4 patients and is one of the most important things we treat. We specialize in heel pain and have seen tens of thousands of patients for it. Our success rate with conservative measures to get rid of heel pain is close to 99%, very few people require surgical intervention.

Plantar fasciitis continues to be the number one cause of heel pain. Most people will get pain first things when they get out of bed in the morning or after standing for long periods. It is common for some with fasciitis to not have morning pain. There also is a correlation with a new exercise program and the development of plantar fasciitis. I always recommend getting in early to see us as it is much easier to treat early on.

Bursitis is another very common cause of heel pain. We often see this in a high arched foot or a runner. Patients will have symptoms like plantar fasciitis but usually on ultrasound we can see the bursal sack. Bursitis usually responds very well to the treatment program we provide and very few people need to sideline their activities.

Nerve entrapments can also create heel pain. This is usually a nerve called Baxter’s nerve. Most people will experience a lot of burning and tingling with this condition. However, this can be a tricky diagnosis and may require special testing. This condition can respond well to a steroid injection adjacent to the nerve.

If you are experiencing heel pain we are here to help give us a call at 425-391-8666 or make an appointment online today.

Screen Shot 2021 08 11 at 7.59.23 AM

Moring heel pain
is extremely painful and can cause quite a disruption to your daily routine. It is not only uncomfortable but also can become emotional upsetting to start one’s day with pain. It is estimated that about 60-70% of adults will experience this at some point in their life and it can last months without treatment.

The pain is one’s heel is usually related to inflammation of your plantar fascia. Your plantar fascia provides structural support to your foot and is activated when you walk. It runs the entire length of your foot and starts at your heel and continues to your toes.

Treatment of morning pain usually starts with stretching and icing. I recommend using a theraband or a belt to stretch before you get out of bed. Massage is another option and icing can provide help with the inflammation. It is important to consult a physician before beginning your treatment as not all heel pain is plantar fasciitis.

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