Orthotics in Athletics

Orthotics in Athletics

Since the 1980s orthotics have been a mainstay of all professional and collegiate athletics. The most commonly injured areas in nearly all sports are the foot and ankle and many can be debilitating. The mechanics of the foot and ankle are very complex and when they are not finely tuned, a decrease in athletic performance results. In this day of finding every competitive edge, serious athletes turn to custom orthotics to improve their performance and lessen the chances of injury.

Almost every day we are asked for recommendations on the “right kind” of athletic shoes, whether it be a running shoe, cleat or even a hockey skate. The answer is dependent on the person’s individual foot type. A variety of types of athletic shoes exist because of the variation in foot types. However, even the highest quality shoe is essentially a blank, made on an average for the whole population and in most cases is insufficient to properly support a persons foot, especially a highly competitive athlete.

An orthotic is designed to customize a shoe, making it fit the person’s foot and optimizing mechanics. There are different varieties of orthotics, ranging from the over-the-counter types available at the pharmacy, to prefabricated orthtoics dispensed by a podiatrist for a person’s individual foot type, to custom orthotics. Custom orthotics are made after an exact mold is taken of the person’s foot and this mold is sent to a lab that makes a device that exactly fits the arch contour. There is a prescription given by the doctor to customize the mechanics of the device to correct imbalances in the person’s foot for optimum performance.

Challenges arise in getting any type of orthotic into certain types of athletic shoes, most specifically cleats ane hockey skates. Each presents its own set of challenges as these types of footwear place abnormal stresses on areas of the foot. Proper training and experience is very important in properly balancing the foot for these stresses, and once this balance is achieved performance can improve dramatically. A custom orthotic is usually necessary for best results and they can be fully customized to fit the desired type of footwear. The doctors at Advanced Foot and Ankle center have extensive experience working with specialized athletic footwear. Dr. Silvers has worked for almost 20 years with athletes in all types of sports. Dr. Hadfield has worked with high school, collegiate and professional athletes, including professional hockey players, making customized orthotics for all types of cleats and skates. Dr. Lloyd has worked with a variety of athletes in a many types of sports.

No matter what sport you or your child participates in, the doctors at Advanced Foot and Ankle Center can help customize a treatment strategy to fit your needs. Whether it be running, football, basketball, baseball, hockey, track, ballet, gymnastics, tae kwon do, drill team or marching band, we have the training and experience to improve your performance and decrease your pain. Call for an appointment today.

Advanced Foot and Ankle Center
Dr. Eric Silvers, DPM
Dr. Robert Hadfield, DPM
Dr. Dustin Lloyd, DPM


Fifth Metatarsal Fractures

What is the Fifth Metatarsal?
The metatarsal bones are the long bones in the middle of the foot that the toes are connected to. Each metatarsal has a base, a shaft, a neck, and a head. The fifth metatarsal is the long bone connected to the 5th toe on the outside of your foot.
What is a Fifth Metatarsal Fracture?
There are typically 2 common types of fractures (breaks) that occur in the 5th metatarsal. These include Avulsion Fractures and Jones Fractures. Less common are mid-shaft fractures which are a result from trauma or twisting of the foot and head or neck fractures. Avulsion Fractures occur when a small piece of bone is pulled off of the bone by either a tendon or ligament. This type of fracture typically occurs with a bad ankle sprain. Jones Fractures occur in a small area of the 5th metatarsal that has a poor vascular (blood) supply which then makes this type of fracture prone to poor healing. A Jones Fracture can occur as a stress fracture or with an acute traumatic event.
What are the Symptoms?
Symptoms typically are pain, swelling, difficulty walking, bruising on the outside of the foot and tenderness on the outside of the foot.
How is a Fifth Metatarsal Fracture diagnosed?
If you are experiencing symptoms of a 5th Metatarsal Fracture you should make an appointment with one of the Foot and Ankle Surgeons at Advanced Foot and Ankle Center in McKinney or Prosper as soon as possible for proper diagnosis and treatment. Your foot will be examined followed by an in office digital x-ray. In some instances further imaging may be required such as an MRI or CAT scan.
How is a Fifth Metatarsal Fracture Treated?
Depending on the severity of the injury and the location of the fracture conservative treatment may be used to treat the fracture. Typically bone takes 6-8 weeks to completely consolidate and heel and in the case of a Jones Fracture may be 12 weeks or more. Conservative treatment can consist of Immobilization with either a fiberglass cast or removable CAM walker boot. Bone Stimulators may also be ordered with are pain-free external devices that are worn for a short amount of time each day and are proven to improve healing of fractures.

Will I have to have Surgery?
If the fracture is displaced (not properly lined up with the other pieces of bone), has multiple breaks, or has failed to heal with conservative treatment surgery may be indicated. Dr. Silvers, Dr. Hadfield, and Dr. Lloyd are each trained in the most advanced and effected treatments using specialty plates, screws and wires to reduce the fractures to allow for good bony union.

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.

At Advanced Foot and Ankle Center we not only treat fractures of the 5th Metatarsal but all fractures including toe, metatarsal, midfoot, heel, and ankle fractures. We offer same day appointments in both our McKinney and Prosper offices with one of our Residency Trained Podiatric Surgeons.

Call us today!


Ultrasound Isn’t Just For Seeing Babies

Diagnostic ultrasound has a long established use in medicine for diagnosing many health problems. It is most commonly known for use in imaging of a fetus but it has many more applications, in particular use in looking for tendon and ligament tears.

Ultrasound can also be used to guide injections, assuring they are placed in the exact location needed for maximum effect. This precision can help reduce side effects as well as improve the patient’s comfort during the procedure.

Ultrasound units use sound waves to see the soft tissues, including skin, ligaments and tendons, which are not well seen on an xray. Ultrasound can help avoid the need for an MRI, which is much more costly and time consuming.

At Advanced Foot and Ankle Center we offer the some of the most state-of-the-art techniques in the Metroplex to improve the diagnosis and treatment of all your foot and ankle problems, and that includes the use of a diagnostic ultrasound unit.

Call for an appointment today!


Eric M Silvers, DPM, FACFAS
Robert A Hadfield, DPM, AACFAS
Dustin M Lloyd, DPM, AACFAS

When is it time to get new shoes?

Everyone has that favorite pair of gym shoes that they don’t want to replace because they just seem to feel so good. Keeping those shoes around may actually be causing more harm than good putting your feet at risk for injury. Replacing your running or gym shoes on a regular basis can prevent many foot and ankle conditions including tendonitis, stress fractures, ball of the foot pain, heel pain and plantar fasciitis from developing.

Each type of activity has specific shoes designed to provide the most protection and support. Typically with running shoes a good rule to follow is to replace them every 400 miles. If you notice that your shoes are causing you to change your running gait or you are experiencing pain you didn’t have before you may need to change your shoes before that 400 mile mark.

Cross Training shoes that you are using primarily at the gym should be replaced every 6-9 months depending on how often they are used and how hard you are training. It is good habit to perform a monthly check of the bottom of your shoes for wear. Typically people will notice certain wear patterns on their shoes at the heel and in the ball of the foot. If you notice reduced tread on the bottom of the shoe this is signaling it is time for a new pair.

At Advanced Foot and Ankle Center we offer both Aetrex and Spira athletic shoes which provide excellent comfort and quality. Different foot types require different shoes to help properly cushion and support throughout activity. Feel free to stop by and try on a pair of Spira or Aetrex athletic shoes in both women’s and men’s colors and styles. You may also make an appointment with one of our foot and ankle specialists to be fully evaluated and provided with expert recommendations for the best footwear to keep you injury free and performing at your best.

Remember we have moved!  Our new location is: 5531 West Virginia Parkway, Suite 100, McKinney, TX 75071.


Dr. Eric Silvers, DPM, FACFAS

Dr. Robert Hadfield, DPM, AACFAS

Dr. Dustin Lloyd, DPM, AACFAS

Do High Heels Cause Bunions and Hammertoes?

This is a very common question amongst patients and the real answer is: it depends. The largest determining factor in the development of bunions and hammertoes is genetic inheritance of a foot type. Like many other health conditions, a combination of genetic and environmental factors contribute to the overall severity of a disease or disorder and bunions and hammertoes are no exception.

An excellent analogy is smoking cigarettes. While we know that cigarettes increase the risk of lung cancer, not everyone who smokes will get lung cancer in their life. And there are those who do not smoke at all that get lung cancer, which is due to genetic inheritance. However, those who have an increased risk for lung cancer will further increase that risk by smoking or being exposed to cigarette smoke. In the same way, those who have an increased risk for bunions and hammertoes can greatly increase their risk by wearing poorly supportive shoes, and high heels fall into this category.

The most common foot type that makes a person prone for bunions and hammertoes is a hyperflexible or hypermobile foot type. In this foot type a person has an arch when they are not standing but the arch collapses with weight bearing causing what is called a flexible flat foot (or collapsing pes valgus). When the arch collapses, it causes instability in the foot which changes the way the foot pushes the body forward in space, causing the person to push more off the side of the foot than from the front. This pressure puts the joints where the foot meets the toes (or metatarso-phalangeal joints) at a mechanical disadvantage and causes bunions and hammertoes.

The best way to counteract the process of a collapsing arch is with proper arch support, which consists of prefabricated and custom types. Prefabricated orthotics are pre-made and shaped with an average foot type in mind. This type can work well for many people. However, arches that collapse severely usually require custom orthotics for proper support. Custom orthotics are made by taking an exact mold of the person’s foot and placing prescription changes into the orthotic to improve the person’s mechanics.

The doctors at Advanced Foot and Ankle Center have specialized experience and training to treat all types of foot and ankle conditions and are very well versed in all types of orthotic inserts. Call for an appointment today to have your feet evaluated.


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

10 Basic Foot Care Tips

  1. You don’t have to suffer from foot pain.  Don’t ignore your feet.  If you are experiencing pain contact Advanced Foot and Ankle Center in McKinney and Prosper to be seen for an evaluation.
  2. Pay attention to changes in color or temperature on your feet.  Look for thick or discolored nails as this may be a sign of toenail fungus.  Check for cracks or cuts in your feet as they can be a pathway for bacteria and infection.  Peeling skin on the bottom of your feet may indicate Athletes Foot.   New moles or freckles that appear abnormal in their shape or color may be a sign of skin cancer.  Inspect your feet regularly and be aware of any changes.
  3. Wash your feet daily with soap and water.  Be sure to clean well between your toes.  It is not simply enough to stand in the shower and let the dirty water and soap rinse off of them.
  4. Try to trim your toenails strait across and be sure not to cut the nails into the corners as it can lead to an ingrown toenail.
  5. Make sure you are wearing a proper fitting shoe.  It is best to be fitted by a professional to ensure proper width and length.  A good trick if you are unable to be professionally fitted is to have someone trace your footprint on a piece of paper while you are standing.  Then any shoe that you have or are purchasing you can simply pull the foot bed insert out of the shoe and be sure it is proper length and width.  Do your shoe shopping later in the day when your feet are most swollen from activities throughout the day.
  6. Select and wear an appropriate shoe for the activity you are participating in.  For example running shoes when running, court shoes when playing tennis, hiking boots when walking hiking trails and uneven terrain.
  7. Don’t wear the same pair of shoes every day.  Remove the insert and let the shoe fully dry from your daily perspiration before wearing again.  This can decrease the chances of catching a fungal infection on the skin or nails of your feet as fungus likes warm, dark, moist environments.
  8. Avoid walking barefooted as it will increase the change of injury to the feet.
  9. When you wear sandals or are barefoot at the pool don’t forget to apply sunscreen frequently.  Your feet are susceptible to skin cancer and UV radiation just as much as the rest of your body.
  10. If you are diabetic schedule a foot check up at least once a year to evaluate your blood flow as well as any sensory deficits you might be unaware of.

Contact Advanced Foot and Ankle Center at 972-542-2155 to discuss any foot or ankle care needs.

Eric Silvers, DPM, FACFAS

Robert Hadfield, DPM, AACFAS

Dustin Lloyd, DPM, AACFAS

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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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