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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


Have you experienced burning in your heel?   Does your heel feel like it is on fire?  Are you getting pins and needles in your heels?  This could be a condition called Baxter’s neuritis or an entrapped nerve in your foot.  This can often be confused with plantar fasciitis and the two can be difficult to distinguish. 

I saw a few patients this last week that had Baxter’s neuritis and it made me want to write a few words about it.  This condition was brought to popularity by Dr Baxter and prior to that this pathology was often thought of as plantar fasciitis.  It should be noted that many patients I see have both conditions present.  The most notable difference seems to be the burning pain and radiating nerve pain that can be reproduced by tapping the nerve.  However, a nerve study can be helpful to confirm the diagnosis and help with planning treatment.

There are a few conservative measures that can provide pain relief.  Orthotics, injections, and some medications prove to be successful.  However, some patients do not find any improvement and surgical decompression of the nerve is done at that point.  The constricting structures around the nerve are freed up and the pain typically resolves.  I always recommend trying conservative measures first before considering surgical intervention.

If you have burning heel pain 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, Discusses the Lapiplasty Procedure for The Best Possible Correction of a Bunion

Bunions can be quite painful for people especially as they get larger and make it difficult to fit in shoes.  Bunions tend to get bigger as time goes on and eventually push the other toes out of alignment.  But what can be done to stop the bunion or even slow it down?

Many people want to know what can be done from a conservative standpoint to slow a bunion.  I have seen all sorts of devices to pull the toes around to try and straighten a bunion.  But, it should be known that the bunion is a bony pathology that is related to a change in position of the bone.  This makes it impossible to apply something to the outside of the foot to fix a bone on the inside.  However, there are a few things that can slow down a bunion.  Most important is to understand a bunion gets larger the more pressure that is exerted on it. 

Meaning the more you walk the bigger the bunion gets.  This is where conservative therapy begins.  The best now measure to intervene here is a prescription orthotic for bunion correction.  I am not talking about an insert from a shoe store or online this must be done by a physician.  This is a prescription medical device where biomechanical measurements and 3-D measurements of the foot are taken.  The good news about this is most insurances cover this device as long as it is prescribed by your foot and ankle physician. 

Surgical correction is the ultimate stop gate to the bunion getting bigger.  There are many options for surgical correction but the one moving to the forefront of medicine today is the Lapiplasty.  This procedure is based upon the Lapidus which has been utilized for almost 100 years.  This is a tried and true method for getting amazing bunion correction and providing lasting results.  If you have a bunion I can help.  Give me a call at 425-391-8666 or make an appointment online today.


Dr Brandon Nelson

Dr. Timothy Young Discusses Shockwave Therapy for Achilles Tendonitis: A Promising Treatment Option


Achilles tendonitis is a common and painful condition that affects the Achilles tendon, the thick cord that connects the calf muscles to the heel bone. This condition often results from overuse or repetitive stress, causing pain, swelling, and stiffness in the back of the ankle. While conservative treatments like rest, physical therapy, and anti-inflammatory medications can help manage Achilles tendonitis, some cases may require more advanced interventions. Shockwave therapy is one of the newer treatment options for resistant Achilles tendonitis.

In this blog post, I will discuss what shockwave therapy is, how it works, its benefits, and its effectiveness in treating Achilles tendonitis.

What is Shockwave Therapy?

Shockwave therapy, also known as extracorporeal shockwave therapy (ESWT), is a non-invasive medical procedure that uses high-energy acoustic waves to stimulate healing and tissue repair. Originally developed to break down kidney stones, this technology has found its place in sports medicine, offering a promising alternative for various musculoskeletal conditions, including Achilles tendonitis.

How Does Shockwave Therapy Work?

Shockwave therapy works by delivering high-energy sound waves to the affected area, creating microtrauma within the damaged tendon. This microtrauma triggers the body's natural healing response, increasing blood flow, promoting collagen production, and stimulating tissue regeneration. In the case of Achilles tendonitis, shockwave therapy targets the degenerated tissue and encourages the formation of healthy tendon fibers.

Benefits of Shockwave Therapy for Achilles Tendonitis

1. Non-Invasive: Shockwave therapy is a non-surgical and non-invasive treatment option, making it suitable for patients who want to avoid surgery or those who have not responded well to conservative treatments.

2. Reduced Pain: Many patients experience a significant reduction in pain after shockwave therapy, which can improve their overall quality of life and enable them to return to their normal activities.

3. Accelerated Healing: Shockwave therapy accelerates the natural healing process by promoting tissue repair and regeneration, allowing patients to recover faster.

4. Minimal Side Effects: Compared to surgery, shockwave therapy carries fewer risks and side effects. It generally has a much shorter recovery time and does not require a lengthy rehabilitation period.

Effectiveness of Shockwave Therapy

Numerous studies and clinical trials have examined the effectiveness of shockwave therapy for Achilles tendonitis, and the results have been promising. It is important to note that individual responses to the treatment may vary, and not all patients will experience the same level of relief.

In a typical treatment plan, patients receive multiple shockwave sessions over several weeks (typically 1X/week for 5 weeks). Each session lasts around 15-20 minutes, and most patients report improvement in pain and function after completing the recommended treatment course.

It's essential to consult with a qualified healthcare professional who can evaluate your specific condition and determine if shockwave therapy is a suitable option for you.


Achilles tendonitis can be a debilitating condition that hinders daily activities and sports performance. While traditional treatments have their merits, shockwave therapy offers a promising alternative for those who seek non-invasive and effective solutions.

Before considering shockwave therapy, it's crucial to consult with a healthcare provider who can assess your condition, discuss treatment options, and tailor a plan that best suits your needs. With the potential to reduce pain, accelerate healing, and improve overall quality of life, shockwave therapy may be the answer for many individuals suffering from Achilles tendonitis

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


This week I saw quite a few neuromas in the office.  This was more than usual so I wanted to discuss neuromas and what we can do to help patients with neuromas.  I think it is appropriate to first discuss what a neuroma is then what we can do to treat them.

Neuromas seem to be more common in women than men and often present in the 4th-6th decade of life.  The first symptoms often include burning and tingling with activities that can be relieved with removal of shoes and rubbing one’s feet.  The neuroma itself is usually between the 3rd and 4th digits and is believed to be an enlargement of the nerve.  This is the most common location as two nerves come together in this spot.  The prevailing theory is mechanical stress from the adjacent bones pinch and irritate the nerve.  The response is the nerves can swell from this irritation and a cycle develops.

Treatment can take many forms for a neuroma but some seem to have much better outcomes than others.  I think a steroid injection is a great place to start to see if you can get the inflammation of the nerve to calm it down.  Next I like to try and spread the metatarsal bones out to take pressure off the nerve.  The next stop if patients continue to have been can be a series of dehydrated alcohol injections.  These have great literature support and a success rate of 89%.  I always make sure patients try this before removal of the nerve.  Removal can be accomplished if conservative measures fail and itself is highly effective.

If you have neuroma pain I can help please call 425-391-8666 to request an appointment with Dr Brandon Nelson.  

Bunion xray

Bunions are an inherited foot deformity that is made worse with time and shoe gear.  The size of a bunion increases as a person puts more mileage on their feet.  It is the natural progression of a bunion to get larger and eventually become painful or make it difficult to fit shoes.   I encourage anybody with a bunion to get evaluated early as there are tools to slow the progression of a bunion.  But let’s focus on when you should think about having your bunion fixed.

Bunion surgery has really changed in the last couple years and more people than ever are having their bunions fixed.  This is because research and techniques have advanced.  We have seen a shift to correcting bunions at the apex or center of rotation where they occur.  The most prevalent procedure is making a shift towards the Lapiplasty.  I personally have been using this procedure for years and find it has the best long-term outcomes.  So that leads us to when is the right time to fix a bunion.

I like to focus on the foot as an entire unit as the primary driver of when to fix a bunion.  If you look down at your foot when you unload it or take it off the ground what does the big toe position look like?  Is it crossing over or under the second digit?  If it is, you are ready to have your bunion fixed.  I advise my patients to have it fixed before this occurs.  If you catch the bunion early and have the foot stabilized with bunion surgery before it crosses over the second toe that is even better.  If you wait for the second toe to get involved, you will often need to have that toe operated on as well. 

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


Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Dr Timothy Young reviews Shockwave Therapy: The Ultimate Solution for Stubborn Plantar Fasciitis


Plantar fasciitis is a painful and persistent condition that can severely impact one's quality of life. Characterized by intense heel pain, especially during the first steps in the morning or after prolonged periods of rest, it's a condition that affects millions of people worldwide. While there are various treatment options available, shockwave therapy has emerged as a leading choice for those struggling with stubborn plantar fasciitis. In this blog, we'll explore why shockwave therapy is often considered the best treatment for this challenging ailment.

Understanding the Frustration of Stubborn Plantar Fasciitis

Plantar fasciitis occurs when the plantar fascia, a thick band of tissue that runs along the bottom of the foot, becomes inflamed or damaged. This condition can be particularly frustrating because it often resists traditional treatments, such as rest, ice, and stretching exercises. When conservative measures fail to provide relief, individuals may face ongoing pain, reduced mobility, and decreased quality of life.

Why is Shockwave Therapy the Best Option for Stubborn Plantar Fasciitis?

Non-Invasive and Minimally Disruptive: Unlike surgical options, shockwave therapy is a non-invasive procedure. Patients can undergo treatment without the need for incisions, anesthesia, or a lengthy recovery period. This makes it an attractive option for those looking to avoid the risks and downtime associated with surgery.

High Success Rates: Numerous studies and clinical trials have demonstrated the effectiveness of shockwave therapy for stubborn plantar fasciitis. Many patients experience significant pain reduction and improved function after a series of shockwave sessions.

Stimulates Natural Healing: Shockwave therapy works by delivering high-energy shockwaves to the affected area. These shockwaves create microtrauma within the damaged tissue, stimulating the body's natural healing response. This process promotes tissue regeneration and reduces inflammation.

Quick and Convenient: A typical shockwave therapy session lasts only 15-20 minutes, and most patients can resume their daily activities immediately afterward. The procedure is typically performed in an outpatient setting, making it a convenient option for those with busy schedules.

Addresses the Root Cause: Unlike some treatments that merely mask the pain, shockwave therapy targets the root cause of plantar fasciitis. By promoting healing and reducing inflammation, it offers long-term relief rather than just temporary pain management.

Minimal Side Effects: The side effects of shockwave therapy are generally mild and short-lived. Some patients may experience temporary soreness or bruising at the treatment site, but these effects are typically minor compared to the potential benefits.

Reduced Reliance on Medications: Shockwave therapy can often reduce the need for pain medications, which can have side effects and long-term risks. This is particularly important for individuals seeking to avoid the potential downsides of pharmaceutical interventions.


Stubborn plantar fasciitis can be an incredibly frustrating and painful condition, but there is hope. Shockwave therapy has emerged as a highly effective and non-invasive treatment option, offering relief and improved quality of life for those who have struggled for far too long. If you've been dealing with the relentless discomfort of plantar fasciitis, consult with a healthcare professional to discuss whether shockwave therapy is a suitable treatment for you. While no treatment is guaranteed to work for everyone, shockwave therapy has proven to be a game-changer for many individuals, providing the opportunity to regain their mobility and enjoy life without the constant burden of pain. Please contact our clinic to see if this treatment is right for you. Give us a call at 425-391-8666 or make an appointment online.
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