Advanced Foot and Ankle Center Blog

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Rheumatoid arthritis (RA) is an autoimmune disorder which means your body is attacking itself.  More than 90% of patients with RA will develop some type of symptom from the disease in the joints of the foot and ankle.  This occurs because the cartilage and the soft tissue lining surrounding the joints becomes thickened and inflamed.   After time, this can then alter the joint and cause the bones to be deformed around the joint.   In the foot this can manifest itself by causing a deformity such as hammertoes, bunions, overlapping toes, bone spurs, calluses, collapsing of your arch and of course pain.  You can also begin to develop soft tissue masses called rheumatoid nodules.  These are hard, rubbery lumps that usually develop near a pressure point. 

There is no cure for RA but with the right team approach, the disease is manageable.  This includes help from your primary care physician, your rheumatologist and of course your podiatrist.    Treatment of foot and ankle complications from RA usually begins conservative with anti-inflammatory medications, shoe gear changes, custom orthotics, custom braces, physical therapy and cortisone injections.  In the later stage of the disease, these options are not always appropriate and surgery may be needed to help reduce a deformity that RA has caused.

At Advanced Foot & Ankle Center, our providers have experience with both conservative and surgical treatment of RA in the foot and ankle.  If you have a question about this or any other foot/ankle disorder, please call us at 972-542-2155 to be evaluated. 

Have a wonderful day,

Dr. Witt

  1. Check your feet every day.  If you cannot see the bottoms of your feet, use a mirror or have someone else check your feet.
  2. Do not walk barefoot or only in socks.  There are all kinds of things on your floors and carpet that may have fallen that you could step on and cut yourself with.  This is especially important for diabetics with nerve damage (neuropathy) and may not feel the pain from the object.
  3. Keep good control of your blood sugars.  This will help prevent or slow the progression of your neuropathy and help you heal faster if you do have a wound. 
  4. Be sure to trim your toenails straight across and leave them just a little longer.  This will usually prevent ingrown toenails. 
  5. Wear supportive shoes that aren’t worn out.
  6. If you notice any changes to your skin, including a sore, increased redness, swelling, pain, warmth or other worsening conditions, it is important to see your podiatrist or seek medical attention to be evaluated. 
  7. See your podiatrist regularly for check ups to prevent foot issues. 

It’s that time of year again, kids are putting down the fortnite and getting back on the field and in gym class.  We see a lot of kids and teens during this time with new onset of heel pain. It can be one or both of the heels that are involved.  The patient will usually say that the pain is worse while playing sports or during gym class. Daily activity isn’t so bad but it can hurt if they go on extended walks like at the mall.  There is usually no injury that they can remember. In almost all cases, this is called Sever’s disease or Calcaneal Apophysitis. Most do not call it Sever’s anymore because it is not a true disease.  It is an inflammation of the growth plate in the heel bone due to an imbalance of the muscles and ligaments in the leg and foot. This is a very common problem that we see and treatment is usually very simple but it must be addressed.  Do not wait and, “see if it gets better”, because it will usually not and it will linger. This is especially troublesome for athletes because it can persist all season long and severely limit their potential on the field or court. At Advanced Foot and Ankle we have experience treating this and many other foot/ankle condition.  Please call us at 972-542-2155 to be evaluated so you child can take a step in the right direction.

Have a Wonderful Day,

Dr. Witt



If you currently own a pair of custom molded orthotics prescribed by us, you can now purchase a second pair for a discounted price of $200! *
Having a second pair of custom orthotics is a great option for:
  • A thinner, narrower orthotic that can fit easier into dress shoes, cleats, ice skates, golf shoes, etc.
  • Kids always have their orthotics in their athletic shoes.
  • Convenience of not having to constantly switch your orthotics between shoes. 
This is a limited time offer that will end
August 31, 2018 so call us now to get your second pair!
Steps to taking advantage of this special promotion:
  1. Call our office at 972-542-2155, press 0.
  2. Mention the email you received.
  3. Our staff will take it from there.




As always, we take pride in being your first choice for your foot and ankle needs. If you have any other questions or concerns please give us a call. 
Thanks for your time and have a wonderful day.
Advanced Foot and Ankle Center Team
*Some restrictions may apply











What is MicroVas Therapy?

MicroVas therapy is the most advanced form of ionic impulse therapy on the market today. Unlike other forms of electrical stimulation which penetrate only a fraction of an inch and have both positive and negative electrodes on the same surface, MicroVas therapy treatments pass completely through the limb or body area under treatment. The emitter pads are always 180 degrees from each other and are usually placed in multiples to treat an entire limb or body area. The emitter pads reverse polarity prior to each impulse resulting in an alternating directional pulse. This provides unrivaled tissue penetration especially in the extremities.


How Does MicroVas Therapy Work?

By using a digital current source to stimulate neuromuscular contractions that drive the venous muscle pumps, MicroVas therapy improves blood flow and tissue oxygenation, which in turn helps stimulate angiogenesis (a healing and rebuilding mechanism) within the body. MicroVas stimulates nerves, muscles and all 3 branches of circulation (arterial, venous & lymphatic).


How Long has MicroVas therapy been around?

The technology was developed between 1988 – 1989 by US military laboratories to treat hypothermia in Navy Seals. As its use expanded, the health benefits of MicroVas therapy became applicable to an ever expanding list of indications.


How does MicroVas Therapy help the Human Body?

1. Increased Circulation: Micro vascular therapy immediately and dramatically increases blood flow which perfuses the capillary beds and elevates tissue oxygenation, aids in fibroblast proliferation and collagen formation, up regulates platelet derived growth factors and boosts transcapillary exchange of nutrients.

2. Involuntary Exercise: Retrains and rebuilds muscle, aids in restoring flexion, range of motion and strength. Elevates metabolism and production of local metabolites.

3. Lymphatic Drainage: Boosts lymphatic drainage from 10- fold to 30-fold, which relieves swelling and inflammation, decompresses nerves in constricted spaces and boosts the body's immune responses.

4. Pain Management: Palliative effects of MicroVas therapy include the blocking of neurological transmission of pain signals and stimulation of endorphins


What type of conditions does MicroVas Therapy help with?

* Healing of fractures of the foot and ankle

* Complex Regional Pain Syndrome of the foot and ankle

* Tarsal Tunnel Syndrome

* Charcot Arthropathy

* Rheumatoid Arthritis

* Osteoarthritis

* Edema

* Achilles Tendonitis

* Plantar fasciitis

* Neuropathy

* Sprain of foot or ankle

* Chronic Pain in the foot and ankle


What are the contraindications of MicroVas Therapy?

1. Implanted cardiac pacemaker

2. Implanted cardiac defibrillator

3. Recent unstable or untreated stroke

4. History of melanoma

5. Active bleeding disorders

6. Deep venous thrombosis

7. Currently pregnant 


How is MicroVas Therapy Administered?

Each MicroVas treatment lasts 45 minutes and is administered twice weekly in 4 week intervals. After each 4 week interval, the Doctor will evaluate your response to therapy.


What is Neuropathy?

There are many causes of peripheral neuropathy, the most common being: diabetes, alcoholism, radiation and chemical treatment for cancer. The most common cause that is seen by Dr. Silvers, Dr. Lloyd and Dr. Witt at Advanced Foot and Ankle in McKinney and Prosper, Texas is Diabetic Peripheral neuropathy which is caused by the gradual destruction of the nerves in the feet due to high glucose levels. At Advanced Foot and Ankle Center our providers use a combination of treatments for their patients. One of these treatments is MicroVas, which is a unit that stimulates microcirculation and blood flow to the nerve which allows the nerves to regenerate. The patient needs to be aware that improvement will be gradual and may take several months, although some patients do feel a difference quickly. The treatments duration is 45 minutes and is recommended 3 times a week initially. The patient essentially just sits and relaxes while the unit is attached to the patient’s leg and gradually increased in intensity to their level of tolerance. This therapy in combination with Neur-Rx, a vitamin especially designed for diabetic neuropathy is very effective. The Microvas encourages blood flow to the nerve and the Neur-Rx nourishes the nerve and encourages re-growth. At times, our providers may recommend an epidermal nerve density test to measure the amount of nerve fibers in the skin and to obtain a baseline prior to initiating treatment. Another skin biopsy can be obtained to monitor the efficacy of treatment and evaluate for new nerve growth and the density of the nerve re-growth. MicroVas is usually covered with private insurances; however, Medicare does not pay for this treatment as they consider it “experimental” Therefore, payment plans are offered for these