This is really key -- in case you're not aware, Google Translate will now translate images of printed text. Handwriting won't work reliably, but anything typeset will. So for instance, you could snap a picture of the menu, get an instant translation, and then point to the one you want.

We found that really helpful in restaurants where there were a lot of similar menu items (e.g., yeah, we know this is all pork tonkatsu, but what are the 12 set options?). Without it you'd still get something tasty, but it helps you get exactly what you want.

That said, we traveled to quite a few cities in Japan, and I think the only restaurant where no one spoke any English was a little cafe inside a department store in Hiroshima (and the waitress was very patient!)