The child’s foot and ankle, like the adult, can be susceptible to injury.  Kids bones are more resilient than an adults bone and are less prone to stress fracture but may break due to acute stresses as a result of injury.  Since the child’s foot is still growing, open growth plates are susceptible to injury after a traumatic event.  “Consultation with a trained and experienced pediatric foot and ankle specialist is imperative if a child injures his or her foot or ankle,” states Dr. Eric Silvers of Advanced Foot and Ankle Center.   “Realigning a growing bone  in a timely fashion will lessen any problems as a result of a fractured child’s bone such as non union, malunion or avascular sclerosis,” Silvers says.

The Stonebridge Foot and Ankle Podiatrists at Advanced Foot and Ankle Center have years of training dealing with pediatric foot and ankle conditions.   “We see it all,” states Dr. Robert Hadfield.  “From warts, to ingrown toenails to extra toes and mishapened feet, we have the training and experience to treat it all.”    Pediatric foot and ankle pathology not only consists of trauma, but also skin conditions such as dermatitis, warts, ingrown toenails, insect bites and foot and ankle infections.    The Podiatrists at the McKinney Foot and Ankle office also treat foreign bodies and puncture wounds and lacerations to the foot and ankle.

“We see a lot of kids with flat feet of varying degrees,” states Dr. Dustin Lloyd.  “We often dispensed prefabricated orthotics or make impressions for custom molded foot orthotics and foot and ankle orthotics for children that have foot and ankle alignment problems.  We have our own in office physical therapy department that does a stellar job working with our pediatric patients.”

Advanced Foot and Ankle Center has also partnered with area surgery centers that are equipped to handle pediatric surgery.

From ingrown toenails and warts to congenital foot and ankle deformities, Drs. Silvers, Hadfield and Lloyd are the experts in pediatric foot and ankle care.


For an appointment, please call our office at 972-542-2155.  We have two convenient locations in McKinney and Prosper, Texas to serve you.

Would you look at that! What is that spot on my foot?

Have you checked your feet lately?  With the sunshine out, the rain is gone and summer if full swing everyone is ready to head to the lakes and pools and work on that summer tan.  Remember skin cancer has the ability to develop anywhere on your body including the tops and bottoms of your feet.  While most skin cancers are a result of sun exposure there are others that are common on the feet that don’t require any sun exposure at all.  Typically skin cancer starts out painless and unless you are paying close attention to those toes might go overlooked at your regular doctor appointment.  It’s always wise to check your feet regularly for any changes you may notice and get them examined by one of the Podiatrists at Advanced Foot and Ankle Center in McKinney or Prosper to decide if a biopsy is needed to ensure the lesion is non cancerous.  There are 3 main types of cancers that typically effect the feet including basal cell carcinoma, squamus cell carcinoma and malignant melanoma.

Basal Cell Carcinoma typically develops as a results of too much sun exposure thus more common on the tops that bottom of the feet.  It typically does not spread elsewhere in the body and stays localized to a single area of the skin.  This type is also the easiest to treat when caught early enough.  It typically shows up as the white bump on the foot similar to a callus.

Squamous Cell Carcinoma is the most common type of cancer to develop on your feet.  If it is not caught early and left untreated it can be more aggressive over time and spread to other parts of the body.  It typically starts as a small bump that appears inflames and sometimes appears to bleed and form a scab that does not resolve.  Many times people assume that they have a wart or foot fungus because it can be itchy and raised.

Malignant Melanoma is one of the most dangerous types of cancer due to the fast rate of spreading and high mortality rate associated with it.  In fact we lost a music legend Bob Marley to Melanoma that started on his feet.  As the melonoma worsens it can spread through the body via blood vessels.  It typically appears as a brown or black spot and many times simply look like a mole.

The best way to lower your risk of skin cancer is to decrease the exposure your body has to sun, always wear sunscreen on your feet and any lesion that you are unsure of have checked out by a Podiatrist who is trained in dermatology specific to the foot and ankles.

For a foot and ankle skin cancer screening call our office at 972-542-2155 and set up an appointment to be evaluated by Dr. Eric Silvers, Dr. Robert Hadfield, or Dr. Dustin Lloyd.  They are specifically trained in dermatology of the foot and ankle to evaluate you today.

Rheumatoid Arthritis and Its Effects on the Foot and Ankle

Rheumatoid arthritis is a common disorder that affects many joints of the body, in particular the joints of the hands and feet. It is an autoimmune disease, meaning the immune system attacks the body as though it is a foreign invader. When the immune system flares up, it causes inflammation in the small joints leading to increasing arthritis, swelling and pain.

There are several symptoms associated with rheumatoid arthritis:

1-Joint stiffness for more than 6 weeks

2-Joint stiffness in the morning for more than 30 minutes

3-More than one joint is affected

4-Small joints are affected (thumb, wrist, fingers, toes, foot joints)

5-The same joints on both sides are affected

6-Dry, painful, red and sensitive eyes

7-Dry mouth and gum irritation

8-Small lumps under the skin over joints, especially in the hands

9-Anemia, which is a lower than normal number of red blood cell count, that can lead to fatigue

Rheumatoid arthritis affects the feet and ankles in many ways. It causes chronic inflammation in the joints, especially in the toes and the joint where the toes meet the foot which can get progressively more severe over time. The degeneration of these joints is accelerated by rheumatoid arthritis if it is not treated and it is very important to have a multi-disciplinary approach to treatment, meaning that several specialists must be involved for best results: these include primary care physicians, rheumatologists and extremity joint specialists (such as podiatarists and hand specialists).

Rheumatologists are specialists in the diagnosis and treatment of joint disorders such as rheumatoid arthritis, psoriatic arthrits and reactive arthritis. They perform diagnostic testing to confirm the proper diagnosis and prescribe medications to control the inflammation caused by these disorders.

Treatments for the foot and ankle issues associated with rheumatoid arthritis are numerous and there are both conservative and surgical options for care. It is important to start with a proper diagnosis for best results. Xrays, blood testing and various other scans can help aid in the proper diagnosis. The severity of the arthritis in the joints of the foot and ankle determines the treatment course and prognosis.

The main treatment options for issues in the foot and ankle related to rheumatoid arthritis are medications, orthotics and surgical correction. Medication therapy is a joint effort with your podiatrist and rheumatologist and it can be tailored to fit your individual needs. There are two main varieties of orthotics, which is an insert that goes in the shoe that helps to correct instability or abnormality in the joints of the foot: prefabricated and custom orthotics. Prefabricated orthotics range from those that can be purchased at the pharmacy to ones that are dispensed by a doctor and are specifically selected to fit your particular foot type. Custom molded orthotics are inserts that are made exactly for your foot: a mold is taken of your foot and a prescription is added to them to help put your foot in the most optimum position for walking.


Surgical intervention for joints severely affected by rehumatoid arthritis are various and are aimed at alleviating the chronic inflammation that causes the pain. The selection of surgical procedures is based on your particular foot and xrays and an evaluation by you podiatrist is need to determine what is best. In general these procedures include fusion of arthritic joints, replacing the joint with an implant, or removing bone from the joint to decrease the inflammation caused by it. These procedures, when indicated, are very successful in reducing the debilitating pain caused by rheumatoid arthritis.

The doctors at Advanced Foot and Ankle center have specialized training and experience in treating all issues of the foot and ankle related to rheumatoid arthritis. Call for an appointment today.


Dr. Eric Silvers, DPM

Dr. Robert Hadfield, DPM

Dr. Dustin Lloyd, DPM

Cerebral Palsy and Its Effects on the Foot and Ankle

Cerebral Palsy is disorder of the central nervous system that can have effects on many parts of the body and usually involves the arms and legs in some way. There are various levels of the disorder, ranging from little to no effect on the extremities all the way to severe and debilitating deformities of the hands, arms, legs and feet. Cerebral Palsy is classified as a “non progressive” disorder, meaning that the effects it has on the body do not worsen over time, however they also do not improve with time, making the more debilitating forms difficult to treat without some form of surgery.

The specific effects of Cerebral Palsy on the foot and ankle are various, but nearly always include some level of tightness in the Achilles tendon (known as equnius). A tight Achilles tendon leads to many other effects, including severe flattening of the foot, tendinitis in various locations, bunions, hammertoes, pain in the ball of the foot, accelerated arthritis and significant pain.

The tightness in the Achilles tendon gives it increased strength and is usually combined with weakness in the muscles in the front of the leg. This combination can lead to tripping and a feeling of instability when walking. There is weakness in other muscles of the leg which cross the knee as well, leading to a walking pattern that can make it difficult to get around.

In some cases the tendon can be stretched with physical therapy but in many cases it needs to be surgically lengthened. Lengthening can be necessary at a young age in some cases, which helps allow the foot to grow with improved function that it otherwise would have. As is the case with any surgical procedure, conservative measures are attempted before surgical intervention is warranted. Surgical lengthening of the Achilles tendon can greatly improve the way the patient walks, increasing mobility and reducing the tendency to trip.

In some patients with Cerebral Palsy a high arched foot develops. This foot type does not absorb shock very well and can lead to a lot of foot pain and early arthritis. This foot type is usually combined with a tight Achilles tendon as well, which decreases the foot’s ability to absorb shock and leads to chronic pain.

Whether the arch is high, low or in between, they can usually be corrected by non surgical methods and the most important of these is custom orthotics. Orthotics are designed to correct he mechanical instability in the foot that causes pain and foot deformities such as bunions, hammertoes, tailor’s bunions, neuromas as well as arthritis in all joints of the foot. Custom orthotics support the arch and transfer the forces in a more normal way and can be a long-term alternative to surgical correction in many cases.


The doctors at Advanced Foot and Ankle Center have specialized training and experience in the treatment of the foot and ankle disorders related to Cerebral Palsy. Call for an appointment today! 972-542-2155

Dr. Eric Silvers, DPM

Dr. Robert Hadfield, DPM

Dr. Dustin Lloyd, DPM

Pain in the Ball of the Foot

Forefoot pain sure can be a “pain in the foot.” The physicians at Advanced Foot and Ankle Center in McKinney and Prosper, Texas see this type of foot problem on a daily basis. Often referred as “Metatarsalgia,” forefoot pain can be caused by other pathology as well. Some other causes of forefoot pain are Neuromas, inflamed joint capsules, avascular necrosis of the metatarsal head, warts, porokeratotis, fat pad atrophy, plantar plate tears, stress fracture or inflammatory arthridities.

To simplify this blog for you, we will focus on Metatarsalgia and define it as forefoot pain that is not due to other causes listed above. Metatarsalgia cause is biomechanical, that is, due to how the bones are aligned or in this case, mis-aligned in the forefoot. This can cause extra stress on the metatarsals (long bones in the forefoot) and as a result, inflammation and pain. Often, Metarsalgia is treated with a Custom Molded Foot Orthotic. The physicians at Advanced Foot and Ankle Center located in Stonebridge Ranch in McKinney, Texas, have treated thousands of patient s with Metatarsalgia with Custom Molded Foot Orthotics.

Often, the Custom Orthotic is modified with metatarsal pads, metatarsal bars, or additional top cover padding. With compliant use, Custom Foot Orthotics have proven to be very effective for this condition. The purpose of these pads is to redistribute weight from the forefoot to an area proximal (closer to the metatarsal shafts). Pad placement can vary from patient to patient and our providers will work with the patient and adjust the pad location on the orthotic to a position that is most therapeutic in providing relief of the symptoms.

Other treatment options that that are offered at Advanced Foot and Ankle Center in Prosper and McKinney, Texas to treat metatarsalgia are: NSAIDs, Cold Laser Therapy, Physical Therapy, Change of shoegear, walking boots, and topical medications. It is rare that surgery is indicated, however, if all conservative options fail, our Providers will explore and perform surgical care for your forefoot pain.

To schedule a consultation with Dr. Eric Silvers, Dr. Robert Hadfield or Dr. Dustin Lloyd at either our McKinney or Prosper Location, please call 972-551-4139.

9 Steps to help you get the best fitting shoes

  1. Your feet change sizes throughout your life and typically will get larger as the years go by. Make sure to have your feet measured each time you buy new shoes to ensure the best starting point for finding the correct fitting shoe.
  2. When buying shoes go shopping at the end of the day as your feet will be the largest at that time.
  3. It is not uncommon for you to have 1 foot that is larger than the other so it is important to make sure your shoes fit your larger foot.
  4. Each shoe manufacture and shoe type is made from a different last (the model the shape of the bottom of the shoe is made from). Be sure to look at the bottom of your shoe and ensure it is appropriate for the shape of your foot.
  5. Don’t purchase a shoe simply based on the size. Each manufacture has variation to their shoe sizing.  It is best to purchase a shoe that fits and is comfortable regardless of size.
  6. Just like your parents used to do when you were young…put the shoe on and make sure there is about 1 thumb width past your longest toe to the end of the shoe. This will ensure a proper amount of space for your toes to wiggle and move.
  7. Don’t buy a shoe if it feels too tight thinking that it will “stretch out” to feel better. If the shoe is too tight it is not the right size by either length or width.
  8. When purchasing an athletic shoe squeeze the heel and make sure it does not collapse. A good heel counter keeps your foot moving in the right direction with each step.
  9. The width of the shoe is very important. A good trick is to stand on a piece of blank paper and have someone trace your foot.  Take that tracing with you when you go shopping.  Pull out the insole in the shoe and place it on your tracing.  If there is any of your tracing that the insole doesn’t cover the shoe is not the right size.

At Advanced Foot and Ankle Center we have trained shoe specialist to help you make the best shoe purchase for your foot that will be comfortable and keep you going.  Come in to The Foot Store and try on a pair today without need for an appointment.  We carry a large variety of Women’s and Men’s athletic shoes, dress shoes, and sandals.

Dr. Eric Silvers, DPM, FACFAS
Dr. Robert Hadfield, DPM, AACFAS
Dr. Dustin Lloyd, DPM, AACFAS

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To make an appointment call
(972) 542-2155

McKinney Office
5531 Virginia Parkway
Suite 100
McKinney, TX 75071

Prosper Office
301 North Preston Road
Suite A
Prosper, TX 75078

McKinney Office
5531 Virginia Parkway
Suite 100
McKinney, TX 75071

Prosper Office
301 North Preston Road
Suite A
Prosper, TX 75078

(972) 542-2155

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