Advanced Foot and Ankle Center Blog

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Many people visit our office for pain to the back of the heel.  Usually the pain is gradual and there is no trauma that they can remember.  There may even be a bump that they can feel.  Most of the time, this pain is due to inflammation of the achilles tendon and/or a spur on the back of the heel.  This is usually due to having too short of an achilles tendon.  The tendon becomes inflamed where it inserts into the back of the heel bone if it is constantly being strained because it is too short.  Eventually, if the achilles continues to pull on the back of the heel bone, you will develop new bone formation in the direction of the pull which looks like a spur coming from the back of the heel.  Not only is the Achilles tendon inflamed and painful but now the spur is prominent and hurts with pressure.  After a thorough lower extremity physical exam , we will usually take xrays of the affected foot to evaluate for spurring, calcifications within the achilles tendon or any other bony pathology we may suspect.  Treatment begins conservatively and usually starts with  anti inflammatories, aggressive stretching exercises for the short achilles tendon and heel lifts to provide some slack for the tendon.  Other conservative treatment modalities including K-Laser treatment, Physical Therapy, short course of oral steroids and walking boots.  If conservative options fail, surgery may be needed which includes lengthening the achilles tendon and removing the spur from the back of the heel.  At Advanced Foot & Ankle, all of our providers have experience dealing with this issue.  If you suffer from this or any other foot/ankle disorder, please call us at 972-542-2155 for an appointment.

January 18, 2018
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The Achilles tendon is the thick tendon at the back of the leg. It is the thickest tendon in the body and attaches the calf muscles to the calcaneus (heel bone). The achilles tendon’s main function is plantarflexion of the foot at the ankle joint such as with walking, running, and jumping. The three most common painful conditions affecting the achilles tendon are Achilles Tendinitis, Insertional Achilles Tendinitis, and Retrocalcaneal Bursitis/Haglund Deformity.

Achilles Tendinitis

Signs and symptoms of achilles tendinitis are pain, inflammation, and sometimes thickening of the tendon. The pain may be located at 2 different locations; at the insertion where the tendon connects to the heel bone or higher up behind the ankle. Pain is typically aggravated by weight bearing activity, running, jumping, and direct pressure.

Retrocalcaneal bursitis/Haglund’s deformity

Signs and symptoms of bursitis or Haglund’s deformity include pain, inflammation, and a painful bump to the back of the heel where the tendon inserts into the heel bone. Pain is typically aggravated by activity and direct pressure from shoe gear.


Treatment includes NSAIDs for pain and inflammation control, rest, ice, and a heel lift to decrease the stress. If the achilles tendinitis is not at the insertion and higher behind the ankle, studies have shown great results with the Alfredson eccentric exercise protocol. In more severe conditions that are not treatable or do not respond to conservative treatment then an MRI may be ordered to determine if there are any tears present in the tendon. Tears in the tendon or conditions that do not respond to conservative treatment may respond to a new treatment called amniotic injection therapy. Severe conditions may require surgical intervention.

Your foot and ankle specialist at Advanced Foot & Ankle Center in Mckinney and Prosper TX will perform a thorough history and physical exam. They will order any necessary X-rays and/or MRIs. A treatment plan will be outlined to get you back on your feet pain free as quickly as possible.

If you have achilles tendon, ankle, and/or heel pain then call us at (972) 542-2155 to schedule your appointment today!

Jan M. Veloso, DPM
(972) 542-2155

Having a foreign body in the foot is a common problem we see in the office.  Most commonly the issue is a splinter or a piece of glass.  There are many other foreign bodies that we have removed including portions of a nail, metal wiring, sea urchin spine, portion of sea shells, animal hair and dishware as well as insulin needles.  If you think you have a foreign body, avoid “digging” at it at home because you can easily push it in further and make your condition worse.  If the foreign body is deep in your foot, it can wall itself off and form an abscess that can become infected.  When you see us in the clinic for a suspected foreign body, we will perform a thorough lower extremity physical exam.  If the foreign body is superficial, we can remove it in the clinic either with or without local anesthesia.  If there is deep or multiple foreign bodies than you may need to have a procedure at a surgery center under anesthesia to safely remove the pieces.  We will also prescribe appropriate antibiotics if needed and give you bandaging instructions.   If you are experiencing this or any other foot and/or ankle issue, please call us at 972-542-2155 to be evaluated.  We have same day and walk in appointments available.

December 13, 2017
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Have you noticed a bony bump at the outside ball of your foot beneath your 5th toe?  If so, you may have a Tailor’s bunion.  This is a bony abnormality to the 5th metatarsal, the most outer long bone of your foot.  It is similar to a bunion which is on the inside of your foot. The bump can be there for several different reasons.  Usually it is caused by the 5th metatarsal either splaying too far outwart, the neck of the metatarsal bows out or the head of the 5th metatarsal is enlarged.  The bump can also be soft tissue inflammation of the bursa that is between the skin and the 5th metatarsal head.  Symptoms are usually pain, swelling, redness to the bony prominence.  To ensure this is your diagnosis, a thorough history is obtained, a lower extremity exam is performed and you will probably have X Rays obtained  to rule out any other bony pathology.  Treatment begins conservative to try to reduce pressure and pain.  This usually starts with OTC products to try to offload the area and possibly custom orthotics.  If these options fail than surgery can be done to help realign the 5th metatarsal bone and take away the prominence.  If you suffer from this condition or any other foot and/or ankle issues, please call us at 972-542-2155 for an evaluation.

There are a lot of different foot and ankle products available at your pharmacy, sporting goods store and especially the internet.  It is easy to self diagnose yourself and find products online that are “guaranteed” to help your problems.  Sometimes these products can help you but we also get a lot of patients that come in after they have tried multiple products that do not work.  We also see people whose symptoms have gotten worse after trying these items. 

Because of this, it is important to see us if you are experiencing any foot or ankle issue.  Not only will we obtain a thorough history and physical but we can also obtain X-rays in the office to accurately diagnose your pathology.  Once the diagnosis is established, we can help get you on your way to recovery with various treatment options that we have seen work for your specific condition.  You do not have to sift through reviews online hoping to make sure you’re not wasting your time and money on something that may not work.    We offer treatment options and products the office that we have seen work first hand. 

If you are experiencing foot and/or ankle issues, please call us at 972-542-2155.