An injury to the Big Toe (Turf Toe)

Turf Toe is a sprain of the ligaments around the big toe joint.  It is not a condition any football, soccer or other sports coach ever wants to hear his player has.

How does Turf Toe Occur?

Most commonly turf toe occurs when athletes play on artificial surfaces. It can, however happen to any athlete participating in other sports including cheerleading, dance, soccer, wrestling and gymnastics as well as others. It is caused by the jamming of the big toe or repetitive pushing off of the big toe when running, jumping, or cutting.  The big toe is hyperextended moving past its normal range of motion causing ligaments to become sprained.  A major risk factor in Turf Toe is wearing athletic shoes that are too flexible as well as shoes that do not provide appropriate support for the foot structure.

Symptoms include pain and tenderness in the ball of the foot especially around the big toe joint.  Commonly an athlete will be unable to push off of the big toe due to the pain or discomfort. Athletes are sometimes unable to bear weight on the ball of the foot due to the pain. Typically immediately after the injury occurs swelling and bruising are seen around the big toe joint.  Turf toe is an injury that potentially can keep an athlete out of participation in sports for 2-6 weeks.

At Advanced Foot and Ankle Center, Drs. Silvers, Hadfield and Lloyd will work with the athlete to get them back into their sport though methods of treatment and therapy.

Treatment consists of wearing a stiff soled walking boot to decrease the motion through the big toe joint and allow healing to occur.  The use of ice, resting the foot, as well as prescription anti-inflammatory medications are also typically utilized.  There are advanced taping techniques that may be performed to stabilize the big toe joint as it heals.  Advanced Foot and Ankle Center also offers class 4 K-Laser therapy to help decrease inflammation and pain on order to help the athlete get back into their sport.  At times advanced imaging is required to determine the extent of the injury with the use of X-Ray or MRI.  In some cases when a bone has been broken during the injury or if there is a complete rupture of the ligaments; the best option to reduce the chances of long term adverse effects is surgical correction of the injury.  This is reserved for only the most advanced cases.  An injured athlete when treated after the initial event will typically be able to return to their sport with the use of the conservative non-surgical treatments discussed above.    

 

If your athlete has a sports related foot or ankle injury, call our specialists at Advanced Foot and Ankle Center in McKinney and Prosper Texas at 972-542-2155.  We offer early morning, lunchtime, and evening appointments.  We look forward to providing you with a high standard of care and compassion.

 

 

 

Having your pedicure and healthy toe nails too

With summer in full swing in North Texas sandal season is at its peak.  We at Advanced Foot and Ankle Center understand that a good pedicure lets you show off your beautiful toes.  Dr. Silvers, Dr. Hadfield and Dr. Lloyd would like to offer some advice on how to choose that perfect salon.

It’s important when you go into a salon to not be afraid to ask questions. Here are some guidelines to follow at your next pedicure appointment:

  1. Make sure that they are using an autoclave to clean their instruments after every client.  The autoclave uses high heat and steam to make sure all bacterial and fungal spores are killed.
  2. Make sure that they have cleaned and disinfected the chairs as well as run the disinfectant through the jet system.
  3. Don’t let the nail technician dig into the corners of your toenail to remove the nail. This may allow bacteria to enter the nail fold causing an infected ingrown toenail.
  4. Bring your own polish with you to your salon appointment.

 

All of these will help prevent the chances of getting a bacterial or fungal infection. 

Dr. Lloyd reminds you that nail polishes at salons are used on many different clients therefore no matter how clean and sanitary the salon is; there is no way to clean the polish brushes in the polish bottles.  At Advanced Foot and Ankle Center we offer a line of polish that was developed to improve nail health.  Nourish Organic Enriched Nail Lacquer contains Lemongrass, Thyme and Tea Tree Essential Oils that contain natural anti-fungal properties as well as Vitamins C and E to help promote healthy nail growth.  Nourish Nail Lacquer is also toxic free which means No Formaldehyde, No Toluene and No DBP which are found in many other polishes on the market.

If you notice thickening, discoloration or changes to your toenails schedule an appointment with Dr. Silvers, Dr. Hadfield, or Dr. Lloyd at 972-542-2155 or visit us online at www.advancedfoottexas.com

We have offices located in McKinney and Prosper, Texas. We offer early morning, lunchtime and evening appointments.

Ankle Arthroscopy in McKinney, TX

Do you suffer from chronic ankle pain? Ankle arthroscopy may be the answer for you!
Ankle arthroscopy is a minimally invasive procedure that helps to clean out the tissues and fluid that create the inflammation, which causes the pain. The procedure takes about an hour and is outpatient surgery. The recovery time is very short (in most cases you can walk in 3-4 days) and the results can be much longer lasting than a steroid injection or pain medicine.

What Happens During the Procedure?
Using a small camera and instruments inserted through tiny incisions, the ankle joint can be inspected and many causes of ankle pain can be repaired. These causes include synovitis (inflammation of the lubricating tissues), damage to the cartilage, loose pieces of bone, damaged ligaments and bone spurs. Each of these problems can be effectively treated with ankle arthroscopy, helping to reduce pain and improve mobility.

What Needs To Be Done First?
An x-ray and/or an MRI, as well as a physical exam by a foot and ankle specialst, are necessary to see if you are a candidate for ankle arthroscopy. The doctor will explain the goals, expected benefits, complications and alternatives during this visit. In most cases, arthroscopy of the ankle is a low risk and high reward procedure that can quickly and effectively decrease ankle pain and get patients back to their desired activities. Depending on the reason for the ankle pain, the recovery period can be short or a little longer and proper workup is important to determine the prognosis.

What Is the Recovery Like?
Again it depends on the extent of the procedure but in most cases patients only need to be on crutches 3-4 days and usually can go back to work after that time if they work at a desk. If work requires a lot of walking or heavy lifting, 2-3 weeks may be needed before a return to work.

How Much Pain Will I Be In?
Pain medication is usually needed for 3-7 days following the procedure, depending on the extent of the procedure and a person’s pain tolerance. In most cases, the pain is improved compared with before the surgery in about a week.

The doctors at Advanced Foot and Ankle Center are well versed in all forms of ankle arthroscopy and would love to assist you in improving your ankle pain. If you would like more information about ankle arthroscopy please call our office at 972-542-2155

Base ball injuries of the foot and ankle

North Texas has a very active crowd.  With many after school sport leagues in the area such as the McKinney Sports Organization, Allen Sports Organization and Plano Sports Organization and kids will be active.  However, with activity the possibility of injury comes also.  Some of these injuries can be prevented and others cannot.

This week, Advanced Foot and Ankle Center in McKinney and Prosper Texas is focusing on Common Foot and Ankle Baseball Injuries.  With over 20 million participants playing baseball annually, it has proven to be an enjoyable and relatively safe sport.  In fact studies show that there are only 1.26 baseball injuries per 1000 athletic exposures and we are here to treat those injuries.

Prevention of injury is always important as well as athlete’s preseason physical health.  It is always advised to have a pre season physical to confirm the athlete’s physical health will be conducive to the stresses of the sport.

When shopping for baseball cleats make sure that the shoe has 1) rigidity to torsion 2) a heel counter that is firm and stable 3) adequate give or flexion in the forefoot region of the shoe 4) a firm upper leather material and has appropriate cushioning.

Baseball is filled with sprinting, abrupt stopping, turning, and twisting, sudden stopping, rounding bases, sliding and jumping.   Due to these varied movements the athletes are involved in, injuries can occur.  Included in those injuries are ill-fitted shoes.  Shoes that are too tight, small or loose can cause blisters, neuritis and increase the risk of foot and ankle injury.  Did you know the majority of injuries during base running happen at home base as this is when players tend to slide more?

At both of our locations in McKinney and Prosper, Texas, we see a variety of baseball related injuries of the forefoot.  These include sesamoiditis, digital fractures, turf toe, neuritis, neuromas and capsulitis.  Treatment of these conditions includes rest, immobilization, accommodative padding and/or custom orthotics.  Rarely surgery is need but with advanced soft tissue injury, it may be necessary.

Midfoot injuries may also occur, these include metatarsal fractures, Lisfranc Injuries, cuboid and navicular fractures.  Diagnosis is done with an evaluation, X-ray, MRI and/or CT studies.  Many times immobilization with a walking boot or a cast is all that is needed, however with more extensive injury, surgery may need to be performed to realign the bone or joint.

Rearfoot injuries are also commonly seen in baseball players.  These include calcaneal apophysitis (Sever’s Disease), ankle sprains and fractures, plantar fasciitis, plantar fascia ruptures and peroneal tendon issues.  Catchers are especially prone to anterior ankle joint impingement and plantar fasciitis.  Custom Molded Foot Orthotics are often very helpful in relieving plantar fasciitis symptoms.  Plantar fascia ruptures recover well with immobilization and custom orthotic use whereas  Sever’s disease and posterior heel pain can be treated with rest, heel lifts, NSAIDs and/or custom orthotics.  In severe cases, a walking boot or cast immobilization may be needed.  Achilles tendonitis is seen and treated with heel lifts, a walking boot or cast immobilization.  Peroneal tendon problems are best treated with rest and immobilization.  An MRI may be needed for further evaluation in the case of a tear of the tendon or peroneal subluxation and and in cases of extensive injuries may require surgical repair.

CONTUSIONS:  A Bruise of the bone.  This happens when a baseball hits the athlete’s foot or when a player collides with another player.   Treatment included Rest, Ice, Compression and Elevation (RICE).  It is advised for foot and ankle contusions that the player see Dr. Silvers, Dr. Lloyd or Dr. Hadfield at Advanced Foot and Ankle Center in McKinney and Prosper for an x-ray to rule out a fracture or dislocation.

TOE CONDITIONS:  Ingrown toenails, blood accumulation under the nail plate (subungual hematoma), corns and calluses are all often seen as a result of playing baseball.  It is important that good foot hygiene be practiced with washing between the toes and drying the feet well after bathing.  In addition, ingrown toenail procedures are advised at the immediate onset of an ingrown toenail problem.  Topical antifungals work well to treat athletes foot. Various antifungal and antibacterial spray are advised to cut down on the number of bacteria and fungus that can inhabit the athletes shoe gear.

ORTHOPEDIC INJURIES:  Most orthopedic baseball foot and ankle injuries are acute or sudden.  The athlete will experience pain, swelling, bruising, redness and/or an inability to bear weight.  If an individuals foot or ankle is injured, seek immediate evaluation with one of our doctors.

When it is time for your athlete to return to play, their symptoms must be resolved completely so it is best for the player to gradually increase their activity over the course of a week.

If your athlete has a baseball related injury, call our specialists at Advanced Foot and Ankle Center in McKinney and Prosper Texas at 972-542-2155.  We offer early morning, lunchtime and evening appointments.  We look forward to hearing from you.

Brachymetatarsia

Brachymetatarsia

 

Drs. Silvers, Hadfield and Lloyd are foot and ankle specialists that have had advanced training in the correction of brachymetatarsia using the most cutting edge techniques.

Brachymetatarsia is a condition that causes one of the toes on the foot to appear shorter than the others.  The problem is not with the toe itself; but the long metatarsal bone behind the toe that is shortened.  The cause of this shortening is a premature closure of the growth plate of the metatarsal. Most patients’ parents initially notice the problem when their child is between the ages of 5 and 14 due to the increased bone growth during this time. Why this happens is not completely understood. There is, however, an increased incidence of this condition in people with Downs Syndrome, Albrights Syndrome and parathyroid alteration conditions.  Brachymetatarsia is more common in females with an increased incidence of about 25:1compared to males and 72% of the time occurs on both feet. Typically a patient will present to our office because they are self conscious about the appearance of the shortened toe or they are experiencing pain in the foot.

Conservative treatments for brachymetatarsia include padding the ball of the foot, custom foot orthotics in order to help better distribute the patient’s weight throughout the foot and splinting the shortened toe.

brachymetatarsia-225x300

Many times patients will elect to have a surgical correction of the shortened metatarsal.Surgical correction is used to relieve pain, restore function, and improve cosmetic appearance of the foot.  There are 2 common types of procedures used in correction of brachymetarsia.  The first: a small external fixator device is implanted on top of the foot and left in place for 2-3 months.  The patient will then turn the dial on the device multiple times a day to help gradually lengthen the metatarsal.  The second, and preferred method, is a 1 stage lengthening technique.  The metatarsal is precisely cut and a bone graft is inserted to increase the length in the bone which is then fixated with a small bone plate and screws and are left in place.  Dr. Lloyd states “With 1 stage brachymetatarsia lengthening there is a decreased chance of infection and a more predictable surgical end result.”  This procedure may be done as an outpatient surgery with the patient going home the same day.

To schedule an appointment with Dr. Silvers, Dr. Hadfield or Dr. Lloyd for an evaluation of your brachymetatarsia, please call us at 972-542-2155 or visit us online at www.advancedfoottexas.com.

We have offices located in McKinney and Prosper. We offer early morning, lunchtime and evening appointments.

 

Lapidus Bunionectomy

THE LAPIDUS BUNIONECTOMY

 

Drs. Silvers, Hadfield and Lloyd are foot and ankle specialists in McKinney and Prosper Texas that routinely perform the Lapidus Bunionectomy utilizing the latest techniques and hardware.

Bunions are a common cause of foot pain that interferes with daily activity and foot comfort.  Bunions can vary from subtle deformities to extreme bunions where the big toe crowds the second toe to the point where the second toe rides on top of the big toe.  Bunions are hereditary and the chances are that if you have a large bunion, a parent or grandparent has issues with bunions also.

In cases where there is instability of the foot and an advanced bunion is noted, the surgeons at Advanced Foot and Ankle Center in McKinney and Prosper, Texas often chooses to perform a Lapidus Bunionectomy.

Lapidus

 

Conservative Treatment for Bunions

Although bunion surgery is the only option for correction of the bunion deformity, there are non surgical options available to ease the bunion symptoms.  Changing your shoe gear to shoes that have a wide or square toe box is an option. Using felt, foam or silicone padding can also help as another option.  Range of motion exercises can also help with joint stiffness.  Custom molded foot orthotics will help to address the hyper mobility of the foot and in turn will help to slow down the progression of the bunion deformity.

Surgical Correction of Bunions

There are many types of bunion procedures that the foot and ankle surgeons at Advanced Foot and Ankle Center in McKinney and Prosper perform.  The Lapidus Bunionectomy is the procedure of choice for advanced bunion deformities. However, children with open growth plates are not candidates for the Lapidus Bunionectomy surgery as damage to the growth plate can occur during joint resection and during fixation placement.

The Lapidus Bunionectomy addresses the unstable first metatarsal cuneiform joint.  The surgeons at Advanced Foot and Ankle will take a predetermined wedge of bone from the first metatarsal cuneiform joint, reduce the first intermetatarsal angle, temporarily fixate the first metatarsal and medial cuneiform and then apply a locking plate and a compression screw for stable fixation.  In addition, our surgeons will remodel the first metatarsal head and release any soft tissues around the great toe joint that act as deforming forces to the bunion.  The Lapidus Bunionectomy realigns the bunion deformity at the midfoot and stabilizes the once unstable foot.  This type of bunionectomy is very stable and in turn lessens the chances the recurrence of the bunion deformity.

The Lapidus Bunionectomy is typically performed under general anesthesia either at a surgery center or a hospital.  Typical recovery is 6-8 weeks without weight on the operated foot followed by a walking boot for 2 more weeks.

Using specialized screws and plates; the surgical results have been very favorable with the Lapidus Bunioctomy surgery and are better than they ever have been.

 

Left Foot is after surgery and Right Foot is before surgery

To schedule an appointment with Dr. Silvers, Dr. Hadfield or Dr. Lloyd for an evaluation of your bunion deformity, please call us at 972-542-2155 or visit us online at www.advancedfoottexas.com

We have offices located in McKinney and Prosper, Texas. We offer early morning, lunchtime and evening appointments.

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McKinney Office
4501 Medical Drive
Suite 300
McKinney, TX 75069

Prosper Office
221 North Preston Road
Suite C
Prosper, TX 75078

(972) 542-2155

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