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heel pain out of bed in the morning

Plantar Fasciitis Treatment Success with Shockwave Therapy


Plantar fasciitis is a common and often debilitating condition characterized by heel pain, especially in the morning or after prolonged periods of standing or walking. It occurs when the plantar fascia, a thick band of tissue that runs along the bottom of the foot, becomes inflamed or damaged. While there are several treatment options available, one that has gained increasing attention for its success is shockwave therapy. In this blog, we'll explore plantar fasciitis and delve into how shockwave therapy has emerged as a highly effective treatment option, offering hope and relief to those individuals suffering from this condition.

Understanding Plantar Fasciitis

Before reviewing shockwave therapy, it's essential to understand what plantar fasciitis is and why it can be so challenging to treat. The plantar fascia is a crucial component of the foot's structure, acting as a shock absorber and supporting the arch of the foot. When this tissue becomes damaged or inflamed, it can lead to persistent heel pain and reduced mobility.

Common Causes of Plantar Fasciitis:

Overuse or repetitive strain on the plantar fascia, often due to activities like running or standing for extended periods.
Obesity, as excess weight puts extra stress on the feet.
Improper footwear with inadequate arch support.
Tight calf muscles or Achilles tendon.

Traditional Treatment Approaches

Plantar fasciitis treatment typically begins with conservative methods, including:

Rest: Reducing activity levels to allow the plantar fascia to heal.
Ice: Applying ice to the affected area to reduce inflammation.
Stretching exercises: Focusing on calf stretches to improve flexibility.

Orthotics: Custom shoe inserts to provide arch and biomechanical support.

Non-steroidal anti-inflammatory drugs (NSAIDs): Medications to manage pain and inflammation.
While these methods can be effective for some individuals, others find themselves facing chronic, persistent pain that doesn't respond well to these treatments. This is where shockwave therapy comes into play.

Shockwave Therapy for Plantar Fasciitis

Shockwave therapy, also known as extracorporeal shockwave therapy (ESWT), is a non-invasive procedure that has shown remarkable success in treating plantar fasciitis when other treatments have failed. Here's how it works:

Application of Shockwaves: During the procedure, high-energy shockwaves are directed at the affected area. These shockwaves create microtrauma within the damaged tissue, stimulating the body's natural healing response.

Pain Reduction and Healing: Shockwave therapy has been shown to reduce pain by disrupting pain signals and improving blood flow to the damaged tissue. This, in turn, promotes tissue regeneration and healing.

Quick Procedure with Minimal Downtime: Shockwave therapy sessions typically last 15-20 minutes, and most patients can resume their regular activities shortly afterward. Five weekly sessions typically offer optimal results.

Success with Shockwave Therapy

The success of shockwave therapy in treating plantar fasciitis is supported by numerous patient testimonials and clinical studies. Here are a few reasons why it has gained popularity:

High Success Rate: Many patients experience significant pain reduction and improved mobility after undergoing shockwave therapy.

Non-Surgical: Shockwave therapy is non-invasive, eliminating the need for surgery and its associated risks and recovery time.

Long-Lasting Relief: For many, the benefits of shockwave therapy are long-lasting, providing relief from chronic pain.

Improved Quality of Life: Patients who have struggled with plantar fasciitis for years often find that shockwave therapy finally allows them to regain their quality of life and return to their favorite activities.

Available treatment: We have been proving this treatment at our clinic with high success for over 8 years


Plantar fasciitis can be a stubborn and painful condition, but there is hope for those who have tried various treatments without success. Shockwave therapy has emerged as an effective and non-invasive option, offering relief and improved quality of life for individuals suffering from this condition. If you're struggling with plantar fasciitis, please contact our clinic at 425-391-8666 or make an appointment online.

heel pain in the morning

I have had heel pain in the past, specifically plantar fasciitis and it really was challenging to go about your day.  My pain when I got out of bed was uncomfortable until it loosened up but if I sat down for any period of time it came right back.  Does this sound familiar?  If it does and this pain just will not go away, I can help.

Plantar fasciitis is by far the leading cause of heel pain.  The plantar fascia is a tough soft tissue structure that provides the most structural support to your foot.  It works to prevent your foot from flattening out and helps control your foot for the gait cycle.  It is vital for foot function and is under chronic tension.  These factors make it one of the most common causes of foot pain.

Treating plantar fasciitis can often be difficult as well.  There are many people that have seen a physician and still have been or have been working on their pain at home.  I encourage you if this is you to see a physician that specializes in heel pain.  I have been working with heel pain patients for over 15 years.  I have seen every type of pain and can help cure even the most stubborn cases.  If you want to get your life back and live without heel pain I can help, call to make an appointment with me at 425-391-8666.


Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Bunion xray

Bunion surgery has been around for more than 100 years.  It is one of the most common surgeries performed in the United States.  Over 100,000 are done annually and the majority are on women.  In recent years new advancements have been made to speed recovery and success of the operation.

The Lapiplasty system by Treace Medical is at the forefront of bunion repair.  This system has taken years to develop and has undergone evolution as it has been utilized.  It has now proven to be one of the work horses of bunion surgery.  It provides reproducible results and long-term correction.  It has an ease of use that makes the surgical procedure faster and improves recovery.  This has changed bunion surgery for patients and surgeons.  The Lapiplasty system is based on a long-standing surgical technique.

This long-standing technique was first described around the turn of the century by Paul Lapidus.  He advocated that the bunion started from the tarsometatarsal joint, and correction needed to occur there.  Since his original thought we have only worked to improve and support this theory in the surgical community.  It has been shown this is the center of most bunions and the correction is best done here.  If you have a bunion the time has never been better to have it fixed.   

Lapiplasty is by far the most successful bunion surgery technique I have seen.    If you are experiencing bunion pain, I can help call to make an appointment with me at 425-391-8666.


Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Screenshot 2023 09 04 at 10.25.26 AM

Surgery in general can be an overwhelming endeavor.  There are often a lot of new instructions, medications, and appointments to keep track of.  I have a few recommendations that can be helpful for anybody undergoing bunion surgery

One of the first things to do is make a list.  I love it when my patients show up with a list of questions at their pre-op appointment.  This helps to make sure all topics are covered, and nothing is a mystery come surgery day.  In that list often is a shopping list is helpful things like bandages, supplements, otc medications and healthy foods.

Getting a base of operation set up before surgery can help with easing the recovery.  I recommend a place on the 1st floor if you have multiple levels.  Somewhere that is close to the bathroom and is relatively quiet to aid in recovery.  Ideally you have room for your post-op supplies nearby.  It is also nice to have something in the room to help pass the time like a TV or music.

Personal hygiene is another area to touch on.  I find it helpful for my patients to have some sort of stool to sit on in the shower.  This helps reduce pressure on the operated foot.  Additionally, if you are non-weight, bearing a toilet seat can be helpful.  Practice, practice, and practice have some dry runs of showering and using the toilet before surgery to see if you need any other items.  I think it is trickier than most of us remember to be off one foot. 

Lastly a few miscellaneous tips;

1.    Couch potato for the first 72 hours.

2.    Elevating makes a big difference in long term swelling.

3.    Take any recommended supplements.

4.    Do not change the dressings unless instructed.

5.    Lots of fluids.

6.    Take a stool softener.

I hope these were helpful.  If you are experiencing bunion pain, 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


Dr Timoth Young, Board Certified Foot Surgeon talks about Lapidus and Lapiplasty Fixation: Advancements in Foot and Ankle Surgery Part 2

Benefits of Lapidus and Lapiplasty Fixation:

  1. Improved Alignment: Both procedures aim to correct the alignment of the foot bones, which not only relieves pain but also helps restore normal foot function.

    Faster Recovery: Lapidus and Lapiplasty procedures enable patients to return to weight-bearing activities sooner than traditional methods, reducing downtime.

    Reduced Risk of Recurrence: Lapiplasty fixation, in particular, targets the underlying cause of bunions, reducing the likelihood of recurrence.

    Long-Term Results: The fusion achieved through these fixation methods creates stable and lasting joint alignment, offering enduring relief from pain and discomfort.

    Minimal Soft Tissue Disruption: These procedures typically involve less disruption of soft tissues, leading to reduced scarring and a potentially smoother recovery process.

Conclusion: Lapidus and Lapiplasty fixation procedures are innovative approaches to correcting foot and ankle deformities, especially bunions. With their focus on achieving proper bone alignment and stability, these procedures offer patients improved quality of life, reduced pain, and faster recovery times. If you're experiencing foot and ankle issues, consult a qualified orthopedic surgeon to determine whether Lapidus or Lapiplasty fixation could be the right solution for you. Always remember that personalized medical advice is crucial before making any decisions regarding surgical interventions.

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


Dr Timoth Young, Board Certified Foot Surgeon talks about Lapidus and Lapiplasty Fixation: Advancements in Foot and Ankle Surgery Part 1

Introduction: Foot and ankle disorders can significantly impact a person's quality of life, affecting their ability to walk, stand, and perform daily activities. Over the years, surgical techniques and technologies have evolved to address these issues effectively. One of the notable advancements in foot and ankle surgery is the Lapidus and Lapiplasty fixation procedures. In this blog, we'll delve into what these procedures are, how they work, and their benefits for patients.

Lapidus Fixation: The Lapidus procedure, also known as the first tarsometatarsal (TMT) joint arthrodesis, is a surgical technique designed to correct deformities in the first metatarsal and medial cuneiform bones of the foot. This procedure is commonly used to treat conditions such as hallux valgus (bunions) and hypermobility of the first TMT joint. The primary goal of the Lapidus procedure is to achieve stability in the joint, alleviate pain, and improve the alignment of the foot.

During the Lapidus procedure, a surgeon makes an incision on the top of the foot near the first TMT joint. The joint is then realigned, and screws or other fixation devices are used to hold the bones in their corrected positions. Over time, the bones fuse together, creating a stable and properly aligned joint. This fusion eliminates the pain associated with joint movement and provides long-lasting relief.

Lapiplasty Fixation: The Lapiplasty procedure is a modern advancement in foot surgery that specifically targets bunions by addressing the root cause of the deformity. Unlike traditional bunion surgeries that focus on removing the bony bump, the Lapiplasty procedure aims to correct the misalignment of the metatarsal bone responsible for the bunion formation. This technique not only provides a more aesthetic result but also reduces the risk of bunion recurrence.

During the Lapiplasty procedure, a surgeon makes a precise cut in the metatarsal bone to realign it to its proper position. Specialized instrumentation is used to stabilize the bone, and fixation plates and screws are inserted to secure the corrected alignment. This approach allows patients to bear weight on the treated foot shortly after surgery, resulting in a faster recovery compared to traditional methods.

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

Bunion (1)

Bunions are often a painful condition especially when trying to fit certain shoes or exercise.  Let us first discuss what a bunion is then how we can relieve the pain. 

A bunion results from a combination of familial inheritance and environmental factors.  Meaning that if you do not have a genetic predisposition for a bunion, you will not create one by adding outside forces to your foot.    Where this becomes important for example is high heel shoes.  If you have a family history of bunions and you wear high heels you can accelerate the process of development of the bunion.  Or if you are an avid exerciser like a runner this can speed up the development of a bunion. 

So what is a bunion?  Well, there is a common misconception that a bunion is growth.  This is not true nothing grows with a bunion it is from a misaligned bone in the foot.  The culprit is the 1st metatarsal.  This bone begins to shift out of place and cause a bulge on the inside of the foot and continues to get worse until the big toe has rotated.  The bunion will get bigger as time goes on and often can begin to force the other toes out of position.  Bunions at this point become painful and hard to fit in shoes.

What can be done for bunion pain?  There are a lot of different things I can provide to relieve bunion pain.  It really requires an evaluation of the bunion.  But generally, wider shoes can help and prevent going barefoot.  There are other options that provide more relief, but it really depends on the stage of the bunion.

If you are experiencing bunion pain I can help call to make an appointment with me at 425-391-8666 or fill out a contact form online

Sincerely,Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Screenshot 2023 07 12 at 8.53.43 AM

Bunion surgery is one of the most common procedures done in the United States.  It is recommended most of these are done in an outpatient setting and patients can go home the same day.  Most procedures are done in about 2 hrs and patients can walk in a protective boot.  Most bunion procedures involve cutting bone or realigning joints. 

Since bone is cut it is important to take calcium or a bone healing supplement.  These can help decrease healing time and make recovery much easier.  Additionally, I like my patients to use a bone stimulator and remain home for the first couple days.  Sacrificing a little time on the front end of the surgery can make recovery much easier.  Another supplement like collagen can help with skin healing and provide better scar appearance.   

The vast majority of bunion surgeries can be done in our office.  A mild anesthetic and a little bit of local anesthetic will provide enough comfort to sleep right through the procedure.  Having it done in our office setting, in a sterile environment, provides large cost savings and time savings for patients. 

If you have a bunion and are in pain, I can help.  Make an appointment today with me at 425-391-8666 or contact us online

Dr Brandon Nelson

American College of Foot & Ankle Surgeons


The front of your foot or the area where your toes begin is called the forefoot.  This area consists of your toe bones, your phalanges and your metatarsals, the long foot bones.   This area is where you push off when ambulating and provides stability for forward propulsion.  This is a complex anatomical area and more than a few pathologies can exist in this location but I will discuss a few of the most common.  These include neuromas, capsulitis and stress fractures.

Neuromas are an entrapped nerve that can cause burning and tingling.  These usually occur in the 3rd interspace.  Most patients have a sensation that is electrical and is worse in shoes and relieved by taking off their shoes and rubbing the forefoot.  These seem to be more common in women than men and especially around the 4th-6th decade of life.   Neuromas have some great treatment options available one of most successful is dehydrated alcohol injections.  The success rate with these injections approaches 89%.

Capsulitis is a term we use to describe inflammation of a joint.  This most commonly occurs in the metatarsophalangeal joint of the foot.  We tend to see this in a patient with a bunion or high arched foot.  The main cause seems to be a biomechanical imbalance.  It is important to get an x-ray with capsulitis as arthritis can have a similar presentation. 

Stress fractures usually present with swelling.  They often occur as one begins a new training program and can cause pain for weeks.  Typically these will be relieved with rest and exacerbated by activity.  Most will heal with a change in activities and calcium supplementation.  However again an x-ray is warranted to rule out other pathologies and to monitor healing.   

If you are having forefoot pain I can help.  Schedule an appointment with Dr Brandon Nelson, give us a call at 425-391-8666 or make an appointment online


Dr Brandon Nelson

Board Certified Physician & Surgeon

Bunion (1)

Dr. Timothy Young Discusses Bunion Surgeries Part 3

After the surgery Dr. Young likes to keep close tabs on his patients' and their recovery. It is important that any post procedure pain is well-controlled. It is also important that they have proper instructions beforehand, so they are prepared at home when all the anesthetic wears off. This is where being a couch potato pays off. Keeping the feet elevated, using ice, and taking medication as prescribed is critical. It is also critical to protect the surgical site either using a special boot, splint, crutches, or scooter. All the presurgical advice like getting a shower protector keeping the dressing intact to protect the surgical site comes into play.  At each postoperative visit, the surgical site is checked to make certain it is healing properly and that there are no signs of infection.

Post acute recovery involves:

This involves bone remodeling and healing and soft tissue remodeling and healing. Sutures are removed. Post procedure x-rays are taken to verify the correction is maintained and that the bones are starting to bridge together properly. Our patients take special bone healing supplements also. We also often work with outside physical therapy clinics to help our patients heal faster and obtain proper range of motion and strength.

In conclusion, preparing for bunion surgery requires a comprehensive approach that considers the patient’s medical history, the extent of the deformity, and the type of surgery required. A skilled surgeon will carefully plan the surgery, provide detailed instructions for pre- and post-operative care, and closely monitor the patient’s recovery to ensure the best possible outcome. 

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

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