Advanced Foot and Ankle Center Blog
January 22, 2018
Category: Uncategorized
Tags: Untagged

Stress fractures are a common overuse injury in athletes and weekend warriors of all ages. Stress fractures occur due to fatigue from repeated stress such as running or jumping over time. This is in contrast to “normal” fractures from a sudden severe impact or twisting motion.

Where and why do they occur?

Stress fractures most commonly occur in the tibia (shin bone), fibula (ankle bone), navicular (foot bone), and metatarsal (bones behind the toes). The pain is typically brought on by a rapid increase in exercise such as sports, running, or jumping. In the early stages, pain is present during activity but subsides with rest. In later stages or more severe stress fractures, pain may be present with any weight bearing activity. If left untreated the stress fracture may even displace, similar to a “normal” fracture, and require surgery.


Your foot and ankle specialist at Advanced Foot and Ankle Center in Mckinney and Prosper will perform a thorough history and physical exam. X-rays during the early stage may show a faint line or “hairline fracture”. After 3 weeks from onset of pain, x-rays may show bone remodeling and healing with what is called callous formation.


Stress fractures are typically treated by immobilization, partial weight bearing, and modification of activity. Your foot and ankle specialist may order a pneumatic cam boot to immobilize the foot, protect the stress fracture, thereby allow healing. For more severe and rare cases, complete non weight bearing may be necessary.

If you or a family member show the signs and symptoms of a stress fracture, call Advanced Foot and Ankle Center of Mckinney and Prosper to schedule your appointment!

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

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
January 17, 2018
Category: Foot Care
Tags: Foot Stretches  

The feet bear a lot of stress from day to day. That’s why podiatrists recommend stretching as a great way to revitalize and strengthen the feet. Simple stretches can be performed at home as a part of your morning routine, or even at work while you’re sitting at your desk. Improving your flexibility through stretching can help prevent foot injuries, increase your mobility, improve performance and posture, and relieve stress.

When Should I Stretch?

It is especially important to stretch properly before starting any exercise routine. When muscles are warmed up prior to a workout, the strain on muscles, tendons and joints can be reduced and injuries avoided.  

Simple stretches include flexing your feet repeatedly while pointing your toes to help build strength in the foot muscles or rotating your foot from side to side while you point your toes. Massaging the muscles in your feet with your hands is another helpful way to promote circulation and relaxation.

Always allow at least 5-10 minutes to fully stretch your muscles, which should include a stretch/hold/relax pattern, without any pulling or bouncing. Before beginning any new type of stretch, visit your podiatrist first to ensure it will be safe for your particular foot pain.

What Kind of Stretches Should I Do?

Here are just a few helpful stretches you can do at home to help lessen foot pain and improve foot health:

  • Stretch for Calf Muscles: Excessive tightness of the calf muscle can cause many foot problems. To stretch this muscle, face a wall from approximately 2-3 feet away. Lean into the wall, keeping heels on the floor and knees extended. Hold for 10 seconds as the calf muscle stretches, then relax. Do not bounce. Repeat five times.

  • Stretch for Hamstring: Put your foot with knee straight on a chair or table. Keep the other leg on the floor straight with knee locked. Lower your head toward the knee on the chair or table until the muscles are tight. Hold to a count of 10 then relax. Repeat five times, and then switch to the other leg.

  • Stretch for Plantar Fascia: This stretch for heel pain can be performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and slowly pull them toward you. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 10 seconds. Repeat it 20 times for each foot. This exercise is most effective when you first wake up, before standing or walking.

Stretching in combination with supportive footwear will help you keep your feet healthy and fit. Whether you’re gearing up to train for a marathon, or simply looking to revitalize your feet after a long day at work, talk to your podiatrist at about the best foot stretches for your individual needs.

January 10, 2018
Category: Foot Care
Tags: ankle sprain  

Are your ankles in pain?ankle sprain

If you are having trouble with your ankle(s), your McKinney and Prosper, TX, podiatrists can help.

Ankle Injuries:

There are common ankle injuries people experience. People visit their podiatrist when they twist their ankle inward, underneath their leg, which may occur while playing sports, stepping off of a curb, missing a stair or walking on uneven surface.

Twisting or rolling your ankle can lead to sprains and fractures in the foot and ankle.

An ankle sprain occurs when one or more of your ligaments get stretched or torn. The most common ligaments that get injured are your lateral collateral ligaments.The deltoid ligaments (the inside of your ankle) or your syndesmosis (the ligament that connects the two bones of your leg just above your ankle) are less likely to be sprained.

When these ligaments are injured, you will usually develop:

  • swelling
  • bruising
  • pain

What to do if you injure your foot according to your McKinney and Prosper Podiatrists:

  • If you sprain your ankle and there are visible deformities to your leg, ankle or foot, you need to go to an emergency room immediately. If, however, there's no serious damage, then you should begin home therapy with PRICE treatment (Protection, Rest, Ice, Compression and Elevation).
  • Fractures can develop at the ankle and foot. If you aren't able to put weight on the injured ankle or foot the next day, you will need to seek medical attention to make sure you aren't suffering from fractures in your foot or ankle.
  • The doctors will perform a physical exam and take X-rays to evaluate the severity of your injury.
  • If your podiatrist confirms there is no fracture but there's a sprain, they may supply you with a brace or walking boot to help and protect your ankle.

If you have any questions or concerns, call the podiatrists of Advanced Foot and Ankle Center in McKinney and Prosper, TX.

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