heel pain

Displaying items by tag: heel pain

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One of the most common patient complaints to a foot and ankle physician is heel pain. It is important for patients to understand there are many other causes of heel pain and we will review some of those today. A short list of these would include lumbosacral radiculopathy, plantar fascial rupture, tarsal tunnel syndrome, Baxter’s nerve entrapment and fat pad atrophy.

Lumbosacral radiculopathy:

The most common cause of back pain leading to heel pain is nerve entrapment around L4-S1 vertebral level. Most patients will have a history of back pain or heel pain that manifests. It is important to consider an MRI of back for this or any EMG NCV which are nerve conduction studies. Often times physical therapy for nerve medication can help control the symptoms.

Plantar fascial rupture:

Ruptures of the plantar fascia are relatively uncommon, but can occur for patients that have had ongoing heel pain. The majority of patients that we see rupture their fascia have had some sort of high impact activity like football players or long distance runners. Diagnosis of the rupture often includes an MRI treatment can depend on the varying degree of the rupture in the site of the rupture. There many options for plantar fascial rupture including repair.

Tarsal tunnel syndrome:

Tarsal tunnel syndrome is a nerve entrapment that is similar to carpal tunnel. Usually involves the posterior tibial nerve and branches that wrap around the heel. Many patients will describe burning or tingling in predispositions, this include patients with diabetes or a flatfoot. Often times an MRI or nerve conduction study is needed to verify this. Treatment often can require steroid injections or decompression of the nerve.

Baxter’s nerve entrapment:

This is a common condition that a lot of physicians will not recognize as this is a tough diagnosis. This can be undiagnosed or underdiagnosed relatively easily. This often times can be confused a tarsal tunnel syndrome as well. One of the key diagnostic indicators for this is inability to move your fifth digit. Again often times advanced imaging is utilized and a steroid injection and sometimes decompression the nerve is required.

Fat pad atrophy:

Fat pad atrophy is typically seen in older or obese patients. The majority us have a nice cushion on the bottom of the heel to help with shock and provide support. Often times there are thinning in other areas of the foot that can be identified help clue physicians in. This usually can be solid with a prescription orthotic and a rocker-bottom soft tissue.

If you have heel pain, call Issaquah Foot and Ankle Specialists today at 425-391-8666 or make an appointment online. 

Tuesday, 17 November 2020 18:40

Dr. Brandon Nelson Discusses Heel Pain in Children

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I currently have two children and actually have had one that was experiencing some heel pain. It was pretty classical symptoms of apophysitis or what we call Sever’s disease which is and inflammation of the growth plate. Kids often present with this type of pain after activities or after going barefoot. Most commonly we see this in young girls between the ages of 8 and 14 and young boys between the ages of 12 and 16. This is when kids often experience a growth spurt and the growth plates can become quite inflamed.

This inflammation of the growth plate can often be seen on x-ray and I highly recommend kids with heel pain get an x-ray. There are many great modalities that work well. I recommended starting with ice and stretching in the calf. However, I would discourage parents from doing home therapies until an accurate diagnosis is made. If your child is experiencing some heel pain we would like to help.

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

Heel pain can be one of the most challenging conditions to deal with as a patient. Heel pain can really impact everyday activities including just walking and working. Some of the most common causes of heel pain include plantar fasciitis, plantar bursitis, nerve entrapments and tarsal coalitions. The #1 cause by far is plantar fasciitis, which is usually amenable by conservative measures.

Heel pain usually responds to stretching and icing. However, if you have constant heel pain that is debilitating or painful in the morning I recommend seeing a foot and ankle physician. An x-ray is vital to identifying the pathology that is causing the pain. Often times on the x-ray you can see arthritis or a heel spur. A heel spur can take condition a little more challenging for both the physician and the patient. Issaquah Foot and Ankle Specialists is the #1 referral center for heel pain. We see patients from Seattle, Bellevue, Issaquah, Kirkland, Redmond and Snoqualmie. If you have heel pain we can help. The majority of our patients are 60-70% better in less than a week. carpet cleaning Seattle

Give us a call today at 425-391-8666 or make an appointment online.
Monday, 21 September 2020 23:49

Dr Brandon Nelson Discusses Heel Pain after Walking

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There are many sources of heel pain. Heel pain can be caused from a bone spur, stress fracture or the most common reason plantar fasciitis. Plantar fasciitis is caused by inflammation within your plantar fascia which is a big thick ligament like structure that supports the bottom of your foot. The fascia begins in your heel and runs to your toes.

This is why the most common spot for heel pain is right where the fascia attaches to your calcaneus or heel bone. With an increase in exercise or walking we see more stress on the fascia. This in turn can begin to create and inflammatory cycle and the beginning of plantar fasciitis. One of the best things we can do in the beginning is to stretch your calf muscles. I recommend stretching at least 3 times a day for about 2-3 minutes each session. One must make sure to stretch both the gastroc and soleous muscles. 

If you are suffering from heel pain or plantar fasciits we can help. Give us a call today at 425-391-8666 or make an appointment online.

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Most foot and ankle physicians, podiatrist and sports medicine doctors like me will see a considerable amount of heel pain and heel spurs during their career. The majority of this heel pain will be caused by plantar fasciitis and present with multiple symptoms including burning, stabbing and throbbing of the heel. However, it is important to rule out other causes of heel pain including nerve entrapments, stress fractures and bursitis. It is essential to see a physician to get the correct diagnosis before implementing treatment plans.

Often times patients spend a considerable amount of time on the Internet to implement treatment in this can be detrimental to their long-term well-being in healing of the pathology. I recommend seeing your foot and ankle physician, podiatrist in order to get a correct diagnosis. The patient workup often includes physical examination and x-rays and a detailed history. Patients with complicated heel pain may benefit from more advanced studies like an MRI or EMGs NCV’s. If you’re suffering from heel pain, heel spurs or plantar fasciitis we would like to help you be pain free.

Give us a call at 425-391-8666 or make an appointment online today.
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Getting up in the morning is hard enough without adding foot pain. Many patients present to our clinic with morning pain or first step pain that has been present for months. I believe this has to be a very challenging way to start your day and I empathize with anybody that suffers from this. The most common cause of morning pain or first step pain is plantar fasciitis, heel pain or bone spurs. Typically once calf muscle and plantar fascia have a chance to relax with sleeping a contracture occurs. This contracture makes for a tight fascia and heel cord so that when patients steps down after sleeping or after resting that tightness creates pain.

This morning or first step pain can create a cycle of chronic pain making plantar fasciitis hard to treat. I really encourage my patients to do a significant amount of calf and plantar fascia stretching. It is very important for patients to work on overall tightness of your calf and facia, utilizing tools like a foam rolling, calf stretching techniques or a theraband can help. I also encourage early intervention by a foot and ankle physician to avoid chronic fasciitis. Once patients reach a chronic fasciitis state can be extremely challenging and frustrating for both the patient and physician alike. At Issaquah Foot and Ankle Specialists, we pride ourselves on utilizing the most advanced treatments available to cure plantar fasciitis once and for all. If you’re suffering from morning pain or plantar fasciitis, give us a call at 425-391-8666 or make an appointment online today.
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At Issaquah Foot & Ankle Specialists we are the leaders in treating pediatric patients. We are the number one referral center for Pediatricians that are looking for a foot and ankle specialist. We have over 40 years of experience treating pediatric patients. The most common presentation we see is a child with heel pain. Kids begin to present with heel pain as sports start back up, especially soccer and basketball.

Typically children relate a pain that wraps around the back of their heel that often feels like a bruise and gets more painful with activities. Sometimes there is a family history of heel pain in a brother or sister or even mom and dad. I encourage parents to have their child examined as there are many causes of heel pain and those should be ruled out. Apophysitis or Sever’s Disease can be the cause of heel pain in children. This is a type of growth plate irritation that can be extremely uncomfortable. However, it should be noted that there are other causes and I would stress that parents should have their child evaluated before beginning treatment for apophysitis. If your child is suffering from heel pain give us a call today at 425-391-8666 or make an appointment online and we will help.
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The weather is starting to get nice and all of us are wanting to get outside. I know I have dusted off my running shoes and have began to pound the pavement. I have suffered from heel pain in the past and as I start to run again it can rear its ugly head. I will often be a little sore after my run and it reminds me I need to take care of my feet. I once again start my routine of calf stretching and make sure to ease into my mileage. I will find my pro-stretch and specifically start targeting my plantar fascia. I will search the freezer for my frozen water bottle and start rolling my heels out after my runs.  Does all this sound familiar? Heel pain can really derail our exercise routines. 

I have found if I stretch and wear my prescriptive orthotics my heel pain is nonexistent. My prescriptive orthotics are specifically designed for running.  These are not inserts that are purchased at a shoe store or a running store. These are prescriptive medical devices that can only be made by a foot and ankle physician. I have been running for years and have spent year perfecting my orthotics. I love to pass on this knowledge to other runners that have suffered from heel pain. I even see a lot of runners that just want to prevent injury and wear and tear on their joints and these running orthotics really help your lower extremities. If you are a runner and are ready to take care of yourself give us a call today 425-391-8666 or make an appointment online.
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First I think it’s really important to acknowledge the fact that we are all doing are part in Washington State to protect each other by staying home and staying safe. This is an unprecedented time like we’ve never experienced and it’s important for the health and well-being of our community that we continue to put our best effort forward by continuing to respond appropriately to Covid-19. That being said our office continues to get a lot of patients that are experiencing significant heel pain.

The primary source of heel pain is plantar fasciitis. Plantar fasciitis of the heel presents most commonly with pain in the morning pain after prolonged periods of rest. It is important that a proper diagnosis is made as many other pathologies can cause heel pain. I encourage patients to see an experienced foot and ankle doctor, podiatrist to evaluate your cause and present you with the best treatment options. It's also important to note that not all plantar fasciitis cases respond to similar treatments and each individual case is unique. I highly recommend having your foot evaluated by a physician that treats a lot of heel pain as sometimes the underlying causes missed and just assumed to be plantar fasciitis. At Issaquah Foot and Ankle Specialists we specialize in heel pain and have spent years perfecting our treatment protocols.

If you’re suffering from heel pain, give us a call at 425-391-8666 or make an appointment online today. 
Tuesday, 21 April 2020 17:54

How To Heal Plantar Fasciitis

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It is the little things! Plantar fasciitis is often an extremely stubborn problem. It often takes a combination of treatments to get this to resolve. Some of the core treatments involve appropriate shoes, prescription orthotics, night splints, icing and other anti-inflammatory treatments. However, sometimes it is surprising how effective it can be to do a little "fine tuning" to the treatment program.

We may have a patient where we have been doing all the right things as mentioned above. And then we question our patient: have you been stretching 4 times a day and the answer is no. And just something like ramping up the stretching to 4 times a day and/or being very consistent with a night splint can make all the difference.

Another example can be wearing the right shoes. Wearing flats or Converse shoes or other shoes that just don't have much structure or support are not helpful for this problem. It is critical to get the shoes that are recommended. For example very good athletic shoes with both a combination of structure and support. This is yet another example where adding this one item while continuing to do everything else, and finally the problem gets better!

If you have heel pain, give us a call at 425-391-8666 or make an appointment online today. Myself, Dr. Timothy Young, or my partner Dr. Brandon Nelson would love to see you. 

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