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I remember performing my first bunion surgery over 15 years ago and was so excited to help my patient.  I also remember learning all the different types of bunion surgeries and how each one was slightly different.  It made me ponder why there were so many different types of bunion surgeries for one pathology.  It was about this time I was introduced to the Lapidus bunionectomy by an attending physician.  He discussed how this was his favorite procedure, how it provided great outcomes but was difficult to execute.

Well fast forward 15 years and now the Lapidus is one of the most common bunion surgeries in the United States.  Things have really changed with the Lapiplasty system.  A group of doctors worked with a medical device company to develop a series of gigs and clamps to make the Lapidus reproducible and easier to perform.  This has really revolutionized bunion surgery and I anticipate Lapidus will eventually be the most common surgery worldwide.

I feel lucky having trained in the Northwest as I am very familiar with the Lapidus procedure and even before the Lapiplasty system it was one of my go to bunion corrections. 

If you have a bunion, you know how uncomfortable they can be.  If you would like a consultation on your bunion I can help.  Call to make an appointment with me at 425-391-8666 or schedule an appointment online


Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Achilles Tendon

Dr Timothy Young, a Board-certified Foot Surgeon Discusses Tenex Procedure for Achilles Tendonitis: A Revolutionary Approach to Healing


Achilles tendonitis is a common condition that occurs when the Achilles tendon, the large tendon connecting the calf muscles to the heel bone, becomes inflamed and causes pain and discomfort. Achilles tendinosis is a more accurate term when there is thickening of the tendon itself with degenerative changes within the tendon. Traditional treatment methods often involve rest, physical therapy, and anti-inflammatory medications. However, for those seeking a more advanced and minimally invasive solution, the Tenex procedure has emerged as a groundbreaking option. Furthermore the Achilles tendon problems can involve the insertion of the tendon lower at the heel, or further up above the heel. In either case these can be chronic painful conditions.

What is the Tenex Procedure?

The Tenex procedure, also known as percutaneous tenotomy or TX1 MicroTip technology, is a minimally invasive treatment designed to target and remove damaged tissue in the Achilles tendon. This is especially effective for Achilles tendinosis. This cutting-edge approach can effectively alleviate pain and promote the natural healing process without the need for open surgery.

How Does the Tenex Procedure Work?

The Tenex procedure utilizes ultrasonic energy to precisely target and break down diseased or damaged tissue within the Achilles tendon. Overall the non-damaged portions of the Achilles tendon left intact which speeds the overall healing. The process involves the following key steps:

1. Diagnosis: Before recommending the Tenex procedure, a thorough evaluation of the patient's condition is conducted, typically including imaging studies such as ultrasound or MRI to pinpoint the location and extent of the tendon damage.

2. Local Anesthesia or IV sedation combination: The patient is given local anesthesia to numb the targeted area, ensuring a pain-free experience during the procedure.

3. Ultrasonic Energy Application: A small incision is made to access the damaged area. A specialized ultrasonic tool is then inserted through the incision, delivering precise ultrasonic energy to break down and remove the damaged tissue without affecting healthy surrounding tissue.

4. Aspiration: Simultaneously, a suction mechanism removes the broken-down tissue, promoting the body's natural healing response.

5. Minimal Scarring: Due to the minimally invasive nature of the procedure, scarring is typically minimal, and the recovery period is shorter compared to traditional open surgery.

Benefits of the Tenex Procedure:

1. Minimally Invasive: The Tenex procedure is performed through small incisions, reducing the risk of infection, minimizing scarring, and allowing for a quicker recovery.

2. Targeted Treatment: The ultrasonic energy precisely targets and removes damaged tissue, preserving healthy tendon fibers and promoting more effective healing.

3. Outpatient Procedure: The Tenex procedure can be performed on an outpatient basis, allowing patients to return home the same day.

4. Quick Recovery: Patients often experience a faster recovery compared to traditional surgical methods, enabling them to resume normal activities sooner.

5. High Success Rate: Clinical studies have shown positive outcomes and high patient satisfaction rates with the Tenex procedure, making it a great option for those suffering from recalcitrant Achilles tendonitis.


The Tenex procedure represents a significant advancement in the treatment of Achilles tendonitis, offering a minimally invasive and targeted approach to alleviate pain and promote healing. As with any medical procedure, it is essential to consult with a qualified healthcare professional to determine the most suitable treatment plan based on individual needs and circumstances. With the Tenex procedure, individuals may find a path to recovery that aligns with their desire for effective, efficient, and minimally disruptive treatment. If you have Achilles tendon symptoms please consider a consultation at our clinic. Achilles tendon evaluation and treatment is a specialty at our clinic.

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

Bunion xray

Bunions can make life difficult.  They can get in the way of exercising and other activities that we enjoy.  They can make shoe choices impossible and cause pain daily.  This often leads to patients needing surgical intervention to remove the bunion.  The Lapiplasty is revolutionizing bunion surgery and creating great outcomes for patients that need to have their bunion removed. 

I encourage anybody that is deciding to have their bunion removed to see a surgeon that has experience with Lapiplasty.  I have been operating on bunions for over 15 years and have seen the evolution of bunion surgery.  I have seen minimally invasive surgery trends; I have seen open surgery trends and now over the last 5 years have seen Lapiplasty move to the forefront.  Lapiplasty is different from other bunion surgeries in many ways.

The Lapiplasty addressed the root cause of a bunion.  Bunions are created when we have an unstable foot and joint.  The Lapiplasty works at the apex of the bunion deformity and at the same addresses the mechanical instability of the foot.  It has proven to have great long term outcomes and will soon be the most common bunion surgery correction technique.

If you would like a consultation on your bunion I can help.  Call to make an appointment with me at 425-391-8666 or contact us online


Dr Brandon Nelson

American College of Foot & Ankle Surgeons


Hammer toes refer to a curling downward of the toes.  This can occur in one or more toes and can be a stand-alone pathology or with another type of foot condition like a bunion.  The hammer toe is often caused by shoe gear choices, trauma or inherited from mom and dad.  It typically gets worse with time and makes it hard to exercise or fit in shoes properly.

 The conservative options for hammer toes can sometimes relieve pain.  These options are such things as wearing larger or wider shoes, taping the toes, or using pads or spacers.  It is important to note that this does not fix the hammer toe.  Additionally, with time it usually gets worse and the toe curls more.

Long term or surgical correction is the usuals course for most patients.  This involves addressing the underlying causes of the hammertoe or toes.  It is important to look at the overall foot structure and any contributing factors.  The surgical procedure to correct a hammer toe can be removal of a bone or removal of a bone and soft tissue balancing.  Sometimes it requires pinning of the hammer toe to allow the new position to heal and correct itself. 

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


Dr Brandon Nelson

American College of Foot & Ankle Surgeons


Dr Brandon Nelson, A Board-Certified Physician & Surgeon Discusses The Lapiplasty Bunion Procedure

Bunion and bunion pain affects millions of people per year.  It creates pain around your big toe and can decrease quality of life.  The pain can become so intense or make it difficult to wear shoes often people would like it removed.  Bunion surgery has been around for over 100 years however recently a new technique called the Lapiplasty has changed the recovery times and improved outcomes.

The lapiplasty is a 3-D bunion correction system that has helped to address the bunion at its origin.  This procedure works to stabilize the foot and realign the metatarsal bone.  It has been shown to have very low recurrence rates and great long-term outcomes. 

There are a few reasons it has proved to be a game changer.  One, is correcting the bunion deformity by fixing both the angular and rotational deformity of the bunion.  Two, it has a faster recovery over the traditional bunion surgery.  Three, it reduces complications including stiffness and improved joint stability.

I have found this new system to be revolutionary for my patients.  I find it to be the future of bunion surgery. If you would like a consultation on your bunion I can help.  Call to make an appointment with me at 425-391-8666 or schedule an appointment online. 


Dr. Timothy Young, a Board Certified Foot Surgeon, Discusses My Top 5 Reasons Why I Recommend the Lapiplasty Bunion Repair


Bunions can be painful and disruptive, affecting the quality of life for many individuals. Traditional bunion surgery, also known as a bunionectomy, has been the standard approach for decades. However, in recent years, a groundbreaking surgical technique called Lapiplasty has emerged as a game-changer in the field of bunion repair. Surgeons worldwide are increasingly recommending Lapiplasty for several compelling reasons. In this blog, I will review the top 5 reasons why I recommend the Lapiplasty Procedure for bunion surgery.

1. Superior Three-Dimensional Correction

One of the most remarkable aspects of Lapiplasty is its ability to correct bunions in three dimensions, addressing the root cause of the deformity. Traditional bunion surgery often focuses on the visible bony bump, leaving the underlying bone misalignment uncorrected. Lapiplasty, on the other hand, repositions the metatarsal bone, restoring its proper alignment in all three planes—sagittal, transverse, and frontal. This three-dimensional correction not only provides better cosmetic results but also reduces the risk of bunion recurrence, making it a preferred choice among surgeons.

2. Faster Recovery and Reduced Downtime

Lapiplasty's minimally invasive approach and stable fixation results in faster recovery times for patients. Unlike traditional bunion surgery, which often requires patients to remain off their feet for an extended period, Lapiplasty allows patients to bear weight on their feet and start walking within days. This accelerated recovery can significantly improve a patient's overall experience and quality of life during the healing process.

3. Long-Lasting Results

Surgeons recommend Lapiplasty due to its track record of providing more durable and longer-lasting results. Traditional bunion surgery may offer temporary relief, but recurrence rates can be high. The Lapiplasty's comprehensive correction of the deformity decreases the likelihood of bunions returning, allowing patients to enjoy a more permanent solution to their foot pain.

4. Stable Fixation

The Lapiplasty utilizes very stable plates. These allow earlier weightbearing and return to activities. This fixation helps to promote optimal bone healing and long term stability. Surgeons who recommend Lapiplasty often highlight the fixation benefits of this innovative technique, which can boost patients' confidence and satisfaction with their results.

5. Evidence-Based Success

Surgeons have confidence in recommending Lapiplasty due to the strong evidence supporting its success. Numerous clinical studies and real-world cases have demonstrated the effectiveness of this procedure in addressing bunions, relieving pain, and improving patient outcomes. These data-driven results reassure both surgeons and patients that Lapiplasty is a reliable and proven treatment option.


Lapiplasty has revolutionized the field of bunion repair with its three-dimensional correction, quicker recovery times, long-lasting results, stable fixation, and evidence-based success. Surgeons worldwide recommend Lapiplasty as a superior alternative to traditional bunion surgery for patients seeking a more comprehensive and permanent solution to their foot pain. If you're considering bunion repair, please contact my office so I can evaluate your specific needs and discuss the benefits of Lapiplasty as a potential solution to your bunion woes.

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

Screenshot 2023 11 08 at 10.59.36 AM

Heel pain can be difficult for patients and physicians alike.  It can provide a challenge for all parties involved.  I have seen hundreds or maybe even thousands of second opinions for heel pain.  Over the years I have learned many valuable lessons that can be extremely beneficial to treating heel pain.

One of the first lessons I learned was to listen to the patient.  Often patients provide great clues to the cause and origin of heel pain.  The history and story a patient tells often paints the perfect picture for how the pain is continuing to cause discomfort.  Not all heel pain is the same and although plantar fasciitis is the number one cause remain open to other sources.  This leads me to lesson number two.

Lesson number two not all heel pain is plantar fasciitis.  I have seen so many other causes and as a provider we need to be diligent.  The back can be a source of chronic heel pain.  Patients with back issues can have manifestations in the feet.  Another common cause is nerve pain.  Over the years I would say this is the most common reason heel pain does not get better.  The clinician is missing a nerve entrapment.  This is not all of the other reasons for heel pain but a few examples to illustrate the importance of recognizing there are other sources of heel pain. 

Lesson three is to understand not all heel pain can be treated the same.  I have seen patients over the years that have similar heel pain but similar treatments do no work.  This is why it is important to treat all patients as individuals.  To make sure to look at foot structure, gait cycles and daily routines to see how each individual can be treated for the best possible outcome. 

If you have heel pain and are in need of a second opinion or are just fed up with daily pain make an appointment with me today I can help. Give us a call at  425-391-8666 or make an appointment online


Dr Brandon Nelson


Bunion surgery has been around for over 100 years. There are many techniques that have been utilized for correction of a bunion.  The majority involve cutting a bone and realigning a joint.  The goal of these surgeries are to straighten the 1st metatarsal and eliminate the deviation of the bone.  Today with new research and modern technology we have a better understanding of function anatomy and have begun to look at bunion surgery outcomes.  This has led the majority of us surgeons to utilizing the Lapiplasty technique for better long term outcomes.

I personally have been a Lapidus surgeon for over 15 years.  I trained in the Northwest and have had the opportunity to work with some of the pioneers of bunion surgery.  We have seen through research that the Lapidus procedure holds up the best over time.  The long term outcomes show very little recurrence and better overall patient happiness.  The lapiplasty system has allowed us to take the lapidus bunion procedure and make it more reproducible. 

Lapiplasty is a system created by Treace Medical that has taken some of the technically challenging parts of the lapidus bunionectomy and simplified them.  It has a system of cutting jigs and guides that make it simple to correct the bunion.  I find patients are extremely happy and have seen incredible long term results.  If you have a bunion schedule and appointment with me, I can help you review your options. Give us a call at 425-391-8666 or make an appointment online today. 


Dr Brandon Nelson 

Morton's Toe

Morton’s neuromas can be extremely painful for many people.  I think nerve pain is one of the most challenging pathologies to treat.  I see quite a few patients each week with neuromas.  I find there are a few things that can make a big difference in neuroma pain.  Let’s review them and see if we can help you if you are experiencing nerve pain or neuroma pain. 

Neuromas are very susceptible to alcohol injection therapy.  This is one of the best available treatment options we have currently.  This technique has been around for about 30 years and the literature reports an average success rate of 89%.  I have been utilizing it now for about 15 years and find it highly effective for patients.  The average patient needs 4-6 injections about 2 weeks apart.  I have even had great success with stump neuromas and patients that have tried many other conservative treatments.    

Orthotics can be a big help as well.  I am not talking about a shoe insert, or something over the counter or at a shoe store.  These are prescription orthotics devices made by a physician.  A gait analysis and overall biomechanical examination needs to be done to identify causes contributing to the nerve irritation.  I like to utilize a 3-D scan of the foot to get an extremely accurate copy of the foot structure. I find active people do well with these devices and find significant pain relief.

Nerve supplements and laser, FDA approved laser, can also be used to help nerve pain.  We currently have a laser that has shown extremely promising results with no complications.  I like to combine nerve supplements with laser and infra-red-light therapy.  The best part of this is no interference with any other medications, no down time, and no side effects. 

If you have a neuroma, I can help, call to make an appointment with me at 425-391-8666 or schedule an appointment online


Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Bunion (1)

Dr Timothy Young Discusses What to Expect After Lapiplasty Bunion Surgery: Road to Recovery


Bunions, those painful bony bumps that form at the base of the big toe, can be incredibly uncomfortable and limit your mobility. For those who have chosen to undergo bunion surgery to alleviate the pain and discomfort, it's important to be well-prepared for what comes next. In this blog, we'll discuss what to expect after bunion surgery including Lapiplasty bunion surgery and provide insights into the recovery process to help you make the journey as smooth as possible.

Day of Surgery

1. Arrival at the Surgery Center: On the day of your surgery, you'll arrive at the surgery center, where you will be prepped for the procedure. The medical team will ensure you're comfortable and informed about the process.

Anesthesia: Bunion surgery is typically performed under local anesthesia with sedation. You'll discuss this with your surgeon before the procedure.

The Surgical Procedure: The surgery usually takes approximately 2 hours, depending on the complexity. The surgeon will make incisions, remove the bunion, and realign the toe joint. With the Lapiplasty procedure there will be 2 plates. With some the other Lapidus procedures there may be 2 or possibly 3 screws.

Recovery Timeline

1. Post-Operative Recovery Room: After the surgery, you'll spend some time in the recovery, where the medical staff will monitor your vital signs and ensure you're comfortable.

Returning Home: Most patients return home on the same day of surgery.

The First Weeks After Surgery

1. Pain Management: Expect some pain and discomfort, which is normal after bunion surgery. Your surgeon will prescribe pain medication to help manage this. Follow their instructions carefully.

Swelling and Bruising: Swelling and bruising are common. You can use ice packs and elevate your foot to reduce swelling.

Dressings and Bandages: You will have a dressing on your foot to protect the incision. Keep it clean and dry. Your surgeon will give you instructions on when to change the dressings.

2. Weight-bearing timeline. This varies from patient to patient.

First 2 weeks with the Lapiplasty typically you are using a scooter or crutches and keeping weight off.

Week number 3 – 6 you progressively bear weight with your boot.

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

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