Foot Pain Treatment Videos | Issaquah Podiatry Services | Issaquah Foot & Ankle Specialists

Are you wondering what your foot will look like after surgery? Our videos offer a wealth of hard to explain (but easy to see) information, including before and after views of common foot conditions. Click here for a fast and easy way to learn more about our podiatry treatments.
  • Achilles Tendon Stretching
    Ashley from the Issaquah Foot & Ankle Specialists shows you how to do Achilles Tendon stretches. 
  • Flexible Flatfoot
    Brandon Nelson, DPM
    by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.

    What Is Flatfoot?

    Flatfoot is often a complex disorder, with diverse symptoms and varying degrees of deformity and disability. There are several types of flatfoot, all of which have one characteristic in common: partial or total collapse (loss) of the arch.

    Other characteristics shared by most types of flatfoot include:

    • “Toe drift,” in which the toes and front part of the foot point outward
    • The heel tilts toward the outside and the ankle appears to turn in
    • A tight Achilles tendon, which causes the heel to lift off the ground earlier when walking and may make the problem worse
    • Bunions and hammertoes may develop as a result of a flatfoot.

    Flexible Flatfoot

    Flexible flatfoot is one of the most common types of flatfoot. It typically begins in childhood or adolescence and continues into adulthood. It usually occurs in both feet and progresses in severity throughout the adult years. As the deformity worsens, the soft tissues (tendons and ligaments) of the arch may stretch or tear and can become inflamed.

    The term “flexible” means that while the foot is flat when standing (weight-bearing), the arch returns when not standing.

    Symptoms

    Symptoms, which may occur in some persons with flexible flatfoot, include:

    • Pain in the heel, arch, ankle, or along the outside of the foot
    • “Rolled-in” ankle (over-pronation)
    • Pain along the shin bone (shin splint)
    • General aching or fatigue in the foot or leg
    • Low back, hip or knee pain.


    Diagnosis

    In diagnosing flatfoot, the foot and ankle surgeon examines the foot and observes how it looks when you stand and sit. X-rays are usually taken to determine the severity of the disorder. If you are diagnosed with flexible flatfoot but you don’t have any symptoms, your surgeon will explain what you might expect in the future.


    Non-surgical Treatment

    If you experience symptoms with flexible flatfoot, the surgeon may recommend non-surgical treatment options, including:

    Activity modifications. Cut down on activities that bring you pain and avoid prolonged walking and standing to give your arches a rest.

    Weight loss. If you are overweight, try to lose weight. Putting too much weight on your arches may aggravate your symptoms.
    Orthotic devices. Your foot and ankle surgeon can provide you with custom orthotic devices for your shoes to give more support to the arches.

    Immobilization. In some cases, it may be necessary to use a walking cast or to completely avoid weight-bearing.

    Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce pain and inflammation.

    Physical therapy. Ultrasound therapy or other physical therapy modalities may be used to provide temporary relief.

    Shoe modifications. Wearing shoes that support the arches is important for anyone who has flatfoot.

    When is Surgery Necessary?

    In some patients whose pain is not adequately relieved by other treatments, surgery may be considered. A variety of surgical techniques is available to correct flexible flatfoot, and one or a combination of procedures may be required to relieve the symptoms and improve foot function.

    In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

  • Fractures Of The Calcaneus Heel Bone
    Brandon Nelson, DPM
    by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.

    What is the Calcaneus? 
    The calcaneus, also called the heel bone, is a large bone that forms the foundation of the rear part of the foot. The calcaneus connects with the talus and cuboid bones. The connection between the talus and calcaneus forms the subtalar joint. This joint is important for normal foot function.

    Calcaneal1

    The calcaneus is often compared to a hard boiled egg, because it has a thin, hard shell on the outside and softer, spongy bone on the inside. When the outer shell is broken, the bone tends to collapse and become fragmented. For this reason, calcaneal fractures are severe injuries. Furthermore, if the fracture involves the joints, there is the potential for long-term consequences such as arthritis and chronic pain.

    How do Calcaneal Fractures Occur?
    Most calcaneal fractures are the result of a traumatic event—most commonly, falling from a height, such as a ladder, or being in an automobile accident where the heel is crushed against the floorboard. Calcaneal fractures can also occur with other types of injuries, such as an ankle sprain. A smaller number of calcaneal fractures are stress fractures, caused by overuse or repetitive stress on the heel bone.

    Types of Calcaneal Fractures 
    Fractures of the calcaneus may or may not involve the subtalar and surrounding joints.  Fractures involving the joints (intra-articular fractures) are the most severe calcaneal fractures, and include damage to the cartilage (the connective tissue between two bones). The outlook for recovery depends on how severely the calcaneus was crushed at the time of injury.

    Fractures that don’t involve the joint (extra-articular fractures) include:

    • Those caused by trauma, such as avulsion fractures (in which a piece of bone is pulled off of the calcaneus by the Achilles tendon or a ligament) or crush injuries resulting in multiple fracture fragments
    • Stress fractures, caused by overuse or mild injury.

    The severity and treatment of extra-articular fractures depend on their location and size.

    Signs and Symptoms 
    Calcaneal fractures produce different signs and symptoms, depending on whether they are traumatic or stress fractures.

    The signs and symptoms of traumatic fractures may include:

    • Sudden pain in the heel and inability to bear weight on that foot
    • Swelling in the heel area
    • Bruising of the heel and ankle

    The signs and symptoms of stress fractures may include:

    • Generalized pain in the heel area that usually develops slowly (over several days to weeks)
    • Swelling in the heel area

    Diagnosis 
    To diagnose and evaluate a calcaneal fracture, the foot and ankle surgeon will ask questions about how the injury occurred, examine the affected foot and ankle, and order x-rays. In addition, advanced imaging tests are commonly required.

    Treatment 
    Treatment of calcaneal fractures is dictated by the type of fracture and extent of the injury. The foot and ankle surgeon will discuss with the patient the best treatment—whether surgical or non-surgical—for the fracture.

    For some fractures, non-surgical treatments may be used. These include:

    • Rest, ice, compression, and elevation (R.I.C.E.) Rest (staying off the injured foot) is needed to allow the fracture to heal. Ice reduces swelling and pain; apply a bag of ice covered with a thin towel to the affected area. Compression (wrapping the foot in an elastic bandage or wearing a compression stocking) and elevation (keeping the foot even with or slightly above the heart level) also reduce the swelling.
    • Immobilization. Sometimes the foot is placed in a cast or cast boot to keep the fractured bone from moving. Crutches may be needed to avoid weightbearing.

    For traumatic fractures, treatment often involves surgery to reconstruct the joint, or in severe cases, to fuse the joint. The surgeon will choose the best surgical approach for the patient.

    Rehabilitation 
    Whether the treatment for a calcaneal fracture has been surgical or non-surgical, physical therapy often plays a key role in regaining strength and restoring function.

    Complications of Calcaneal Fractures 
    Calcaneal fractures can be serious injuries that may produce lifelong problems. Arthritis, stiffness, and pain in the joint frequently develop. Sometimes the fractured bone fails to heal in the proper position. Other possible long-term consequences ofcalcaneal fractures are decreased ankle motion and walking with alimp due to collapse of the heel bone and loss of length in the leg. Patients often require additional surgery and/or long term or permanent use of a brace or an orthotic device (arch support) to help manage these complications.

  • Fracture Of The Fifth Metatarsal
    Timothy W. H. Young, DPM
    by Timothy W. H. Young, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.

    What is a Fifth Metatarsal Fracture?

    Fractures (breaks) are common in the fifth metatarsal – the long bone on the outside of the foot that connects to the little toe. Two types of fractures that often occur in the fifth metatarsal are:

    • Avulsion fracture. In an avulsion fracture, a small piece of bone is pulled off the main portion of the bone by a tendon or ligament. This type of fracture is the result of an injury in which the ankle rolls. Avulsion fractures are often overlooked when they occur with an ankle sprain.
    • Jones fracture. Jones fractures occur in a small area of the fifth metatarsal that receives less blood and is therefore more prone to difficulties in healing. A Jones fracture can be either a stress fracture (a tiny hairline break that occurs over time) or an acute (sudden) break. Jones fractures are caused by overuse, repetitive stress, or trauma. They are less common and more difficult to treat than avulsion fractures.

    Other types of fractures can occur in the fifth metatarsal. Examples include mid-shaft fractures, which usually result from trauma or twisting, and fractures of the metatarsal head and neck.

    Symptoms

    Avulsion and Jones fractures have the same signs and symptoms. These include:

    • Pain, swelling, and tenderness on the outside of the foot
    • Difficulty walking
    • Bruising may occur

    Diagnosis

    Anyone who has symptoms of a fifth metatarsal fracture should see a foot and ankle surgeon as soon as possible for proper diagnosis and treatment. To arrive at a diagnosis, the surgeon will ask how the injury occurred or when the pain started. The foot will be examined, with the doctor gently pressing on different areas of the foot to determine where there is pain.

    The surgeon will also order x-rays. Because a Jones fracture sometimes does not show up on initial x-rays, additional imaging studies may be needed.

    Non-surgical Treatment

    Until you are able to see a foot and ankle surgeon, the “R.I.C.E.” method of care should be performed:

    • Rest: Stay off the injured foot. Walking may cause further injury.
    • Ice: Apply an ice pack to the injured area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
    • Compression: An elastic wrap should be used to control swelling.
    • Elevation: The foot should be raised slightly above the level of your heart to reduce swelling.

    The foot and ankle surgeon may use one of these non-surgical options for treatment of a fifth metatarsal fracture:

    • Immobilization. Depending on the severity of the injury, the foot is kept immobile with a cast, cast boot, or stiff-soled shoe. Crutches may also be needed to avoid placing weight on the injured foot.
    • Bone stimulation. A pain-free external device is used to speed the healing of some fractures. Bone stimulation, most commonly used for Jones fractures, may be used as part of the treatment or following an inadequate response to immobilization.

    When is Surgery Needed?

    If the injury involves a displaced bone, multiple breaks, or has failed to adequately heal, surgery may be required. The foot and ankle surgeon will determine the type of procedure that is best suited to the individual patient.

  • Equinus
    Brandon Nelson, DPM
    by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.
    Equinus is a condition in which the upward bending motion of the ankle joint is limited. Someone with equinus lacks the flexibility to bring the top of the foot toward the front of the leg. Equinus can occur in one or both feet. When it involves both feet, the limitation of motion is sometimes worse in one foot than in the other.
  • Deep Vein Thrombosis
    Brandon Nelson, DPM
    by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.
    What is deep Vain Thrombosis?

    The blood supply of the leg is transported by arteries and veins. The arteries carry blood from the heart to the limbs; veins carry blood back to the heart. The leg contains superficial veins, which are close to the surface and deep veins, which lie much deeper in the leg. Deep Vein thrombosis is a condition in which a blood clot forms in a deep vein. While these clots most commonly occur in the veins of the leg, they can also develop in other parts of the body.
  • Chronic Ankle Instability
    Brandon Nelson, DPM
    by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.
    Chronic ankle instability is a condition characterized by a recurring “giving way” of the outer (lateral) side of the ankle. This condition often develops after repeated ankle sprains. Usually the “giving way” occurs while walking or doing other activities, but it can also happen when you’re just standing. Many athletes, as well as others, suffer from chronic instability.
  • Charcot Foot
    Brandon Nelson, DPM
    by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.
    Charcot foot is a condition causing weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture, and with continued walking the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance.
  • Gout
    Timothy W. H. Young, DPM
    by Timothy W. H. Young, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.

    What Is Gout?

    Gout is a disorder that results from the build-up of uric acid in the tissues or a joint. It most often affects the joint of the big toe.

    Causes

    Gout attacks are caused by deposits of crystallized uric acid in the joint. Uric acid is present in the blood and eliminated in the urine, but in people who have gout, uric acid accumulates and crystallizes in the joints. Uric acid is the result of the breakdown of purines, chemicals that are found naturally in our bodies and in food. Some people develop gout because their kidneys have difficulty eliminating normal amounts of uric acid, while others produce too much uric acid.

    Gout occurs most commonly in the big toe because uric acid is sensitive to temperature changes. At cooler temperatures, uric acid turns into crystals. Since the toe is the part of the body that is farthest from the heart, it’s also the coolest part of the body – and, thus, the most likely target of gout. However, gout can affect any joint in the body.

    The tendency to accumulate uric acid is often inherited. Other factors that put a person at risk for developing gout include: high blood pressure, diabetes, obesity, surgery, chemotherapy, stress, and certain medications and vitamins. For example, the body’s ability to remove uric acid can be negatively affected by taking aspirin, some diuretic medications (“water pills”), and the vitamin niacin (also called nicotinic acid). While gout is more common in men aged 40 to 60 years, it can occur in younger men as well as in women.

    Consuming foods and beverages that contain high levels of purines can trigger an attack of gout. Some foods contain more purines than others and have been associated with an increase of uric acid, which leads to gout. You may be able to reduce your chances of getting a gout attack by limiting or avoiding shellfish, organ meats (kidney, liver, etc.), red wine, beer, and red meat.

    Symptoms

    An attack of gout can be miserable, marked by the following symptoms:

    • Intense pain that comes on suddenly – often in the middle of the night or upon arising
    • Signs of inflammation such as redness, swelling, and warmth over the joint.

    Diagnosis

    To diagnose gout, the foot and ankle surgeon will ask questions about your personal and family medical history, followed by an examination of the affected joint. Laboratory tests and x-rays are sometimes ordered to determine if the inflammation is caused by something other than gout.

    Treatment

    Initial treatment of an attack of gout typically includes the following:

    • Medications. Prescription medications or injections are used to treat the pain, swelling, and inflammation.
    • Dietary restrictions. Foods and beverages that are high in purines should be avoided, since purines are converted in the body to uric acid.
    • Fluids. Drink plenty of water and other fluids each day, while also avoiding alcoholic beverages, which cause dehydration.
    • Immobilize and elevate the foot. Avoid standing and walking to give your foot a rest. Also, elevate your foot (level with or slightly above the heart) to help reduce swelling.
    • Cortisone injections.  Help reduce pain, swelling and inflammation.

    The symptoms of gout and the inflammatory process usually resolve in three to ten days with treatment. If gout symptoms continue despite the initial treatment, or if repeated attacks occur, see your primary care physician for maintenance treatment that may involve daily medication. In cases of repeated episodes, the underlying problem must be addressed, as the build-up of uric acid over time can cause arthritic damage to the joint.

  • Cavus Foot High Arch
    Brandon Nelson, DPM
    by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.
    Dr. Brandon Nelson of the Issaquah Foot & Ankle Specialists explains what a Cavus Foot High Arch is.