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Universal City 210-375-3318
Pleasanton 830-569-FEET (3338)
Toll-Free: 855-972-9512
Next Step Foot & Ankle Clinic

Frequent Foot Questions: What You Want to Know About Ankle and Foot Health

Exploring medical options to cope with pain can be very overwhelming, and it can be hard to know where to start. Here, we share our most commonly asked questions from people just like you. Whether you are wondering what is causing your pain or trying to find out what treatment options are available to you, find answers here in our frequently asked questions section.

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  • What foot conditions are associated with diabetes?

    People with diabetes can develop many different foot problems. Even ordinary problems can get worse and lead to serious complications.

    Seniors gardening


    Although it can hurt, diabetic nerve damage can also lessen your ability to feel pain, heat, and cold. Loss of feeling often means you may not feel a foot injury. You could have a tack or stone in your shoe and walk on it all day without knowing. You could get a blister and not feel it. You might not notice a foot injury until the skin breaks down and becomes infected.

    Skin Changes

    Diabetes can cause changes in the skin of your foot. At times your foot may become very dry. The skin may peel and crack. The problem is that the nerves that control the oil and moisture in your foot no longer work.


    Calluses occur more often and build up faster on the feet of people with diabetes. This is because there are high-pressure areas under the foot. Too much callus may mean that you will need therapeutic shoes and inserts.

    Foot Ulcers

    Ulcers occur most often on the ball of the foot or on the bottom of the big toe. Ulcers on the sides of the foot are usually due to poorly fitting shoes. Remember, even though some ulcers do not hurt, every ulcer should be seen by your health care provider right away. Neglecting ulcers can result in infections, which in turn can lead to loss of a limb.

    Poor Circulation

    Poor circulation (blood flow) can make your foot less able to fight infection and to heal. Diabetes causes blood vessels of the foot and leg to narrow and harden. You can control some of the things that cause poor blood flow. Don't smoke; smoking makes arteries harden faster. 


    People with diabetes are far more likely to have a foot or leg amputated than other people. The problem? Many people with diabetes have peripheral arterial disease (PAD), which reduces blood flow to the feet. Also, many people with diabetes have nerve disease, which reduces sensation. Together, these problems make it easy to get ulcers and infections that may lead to amputation. Most amputations are preventable with regular care and proper footwear.

    Dr. Darren Silvester and the staff at Next Step Foot & Ankle Clinic are dedicated to treating your diabetic feet and finding you the relief you need. Contact our office in Universal City, Texas today by calling 210-375-3318 or our Pleasanton, TX office at 830-569-3338 to start effectively managing your diabetes and foot health.

  • What is the benefit of diabetic shoes?

    Trying on shoesShoes for people with diabetes have a higher, wider toe box, giving your toes extra wiggle room. Toes that rub against each other or against a shoe get hot spots and blisters. Those do not heal as fast as they did before diabetes.

    Nerve damage caused by diabetes can make your toes feel numb. If this is the case, they cannot warn you when they are rubbing and blistering. The extra room in diabetes shoes protects your toes while you stand and walk.

    Now that you have diabetes, you need shoes that support your arches, ankles, and heels. Going barefoot is out. Flip-flops are out.

    Some people may overpronate (roll the feet too far inward) or underpronate (not roll the feet inward enough) when walking, which can also cause hot spots that may develop into blisters and sores. So the soles of shoes for people with diabetes have special stabilizers to keep feet level.

    You will notice that the soles are thick and wide. Thicker soles cushion your feet from wear and tear, and that little bit of extra width helps your feet to avoid those hot spots.

    Shoes made for people with diabetes also tend to be deeper than other shoes to make room for orthotics — the inserts that correct an uneven stride, cushion the heel, or support arches. Many patients with Type 2 diabetes use these inserts, so we need the extra depth.

    We are pleased to offer DJO (formerly Dr. Comfort) and SafeStep Shoes. Fitting is done in our office by our trained medical assistants, and shoes typically arrive in two weeks. Dr. Silvester and Dr. Danial will provide any needed follow-up and can modify insoles to ensure a proper and safe fit.  Next Step Foot & Ankle Clinic offers Diabetic Shoes on a self-pay basis.  We do not participate in any insurance carrier's diabetic shoe program.  This includes the Medicare Therapeutic Shoe Program.  

  • What are diabetic compression stockings?

    Putting on compression socksCompression Stockings are used not only to help decrease swelling in your legs, but to also help prevent the formation of blood clots in the lower legs, as well as aiding in the treatment of ulcers of the lower legs. The majority of venous ulcers heal with compression bandages, however ulcers frequently recur. Clinical guidelines therefore recommend that people continue to wear compression, usually in the form of hosiery (tights, stockings, socks) after their ulcer heals, to prevent recurrence.

  • Why do I need diabetic socks?

    Taking a step Diabetes causes nerve damage and reduced circulation that can be hazardous to your feet. Deterioration of your peripheral nerves reduces sensation in your extremities, so you may not feel it when you hurt your feet.  Poor blood circulation can also make it difficult for foot injuries and infections to heal. That’s why even a small bump or cut can result in serious consequences if it goes without timely medical attention.

    If you have diabetes, the right socks can be one of your best protectors from painful foot problems, like those associated with diabetic neuropathy (nerve damage). Learn what to look for when you stock up on socks.

    Most diabetic socks are seam-free to prevent irritation on your toes, stretchy and non-binding to help promote circulation and cushioned to protect feet from shock and pressure.

  • What should I do if my child has an ingrown toenail?

    Child with ingrown toenailSome home remedies may be successful in the early stages of an ingrown toenail. You can try soaking your child’s feet in warm salt water for 10-15 minutes at a time, 2-3 times a day, then dry and apply a dab of antibiotic ointment. If possible, you may also try to gently lift the corner of the nail and place a sterile piece of cotton underneath.

    However, we generally recommend you bring your child in for a check-up if they have an ingrown nail, especially one that is painful or hasn’t improved after about a week of home treatment. Ingrown nails may seem minor, but they can be painful and easily become infected, resulting in swelling, discharge, and other problems. Professional treatment is usually a relatively simple affair, with the podiatrist removing a small portion of the nail and draining any built-up liquid that may remain.

    To schedule an appointment for your child with Dr. Darren Silvester at Next Step Foot and Ankle, give us a call at 855-972-9512.

  • Do children’s flat feet need treatment?

    Children's feet hanging off ledgeA child’s flat feet only need treatment if the child is experiencing pain, discomfort, or difficulty walking and running due to the condition. If your child is free from painful symptoms, you should have nothing to worry about.

    Young children especially often have no arches, or arches that disappear when the child is standing—a condition known as flexible flatfoot. It’s very normal—kids’ bones are still very soft and flexible at this stage; it may not be until age 6 or older when tissues finally tighten and become more rigid, forming a distinctive arch shape. Early fatigue, difficulty keeping up with other kids, and avoiding activity are all warning signs. Most kids rarely complain of pain—they just stop doing things that hurt.

    However, if your child is having difficulty with foot pain, bring him or her in to see Dr. Darren SIlvester at Next Step Foot & Ankle. There may be an underlying condition that requires more attention. Request an appointment online, or call us at 855-972-9512 to see us in Pleasanton or Universal City, TX.

  • How can you tell what type of foot arch you have?

    Knowing your arch type can save you a lot of trouble when it comes to buying shoes.The easiest way to identify your arch type is to take the “wet test.” Wet the bottom of your foot in a shallow pan or bucket of water, then set your sole down on a piece of paper. Once you’ve made a footprint on the paper, remove your foot and examine the print’s shape.

    If you have a moderate curve between the ball of the foot and the heel, you have a normal arch height. If the print appears to have very little or no curve on the inside—so it’s just one oblong mark—you probably have low or flat arches. If you have a significant curve in the middle of the print, so the ball of the foot and the heel are only connected by a small area, you have high arches.

    No one arch type is “bad” or necessarily a problem; however, low and high arches may be more prone to pain and overuse issues. If you’re concerned about your feet, or you’re already experiencing discomfort, don’t wait. Contact Dr. Darren Silvester and the Next Step Foot & Ankle Clinic staff for help. Call (830) 569-3338 or use the website to contact us.

  • How do I know if my Achilles is ruptured?

    You'll know an Achilles tear when you have one.

    An Achilles rupture is a serious injury that generally creates a lot of discomfort. Often you feel intense pain around your heel. Normally the discomfort is sudden and sharp; some people even hear a popping or snapping sound when it happens. The area around the torn tendon swells and might bruise. Your foot will feel weak and possibly loose. Typically you lose your ability to push off the ground effectively, making walking more difficult. You probably won’t be able to rise up on your toes at all, though you may still be able to point your digits somewhat.

    If you’re at all concerned that you may have ruptured your Achilles, don’t wait to find out or hope it will get better on its own. You risk trouble healing and chronic pain when you don’t take care of the problem right away. Dr. Darren Silvester and our team at Next Step Foot & Ankle Clinic will help you diagnose the condition. Use our website or call our Pleasanton, TX, office at (830) 569-3338 to schedule a consultation.


  • Can you get a bone spur on the top of your foot?

    Bone spurs can occur on the tops of feet, too -- not just the heelsYes, you most certainly can get a bone spur on the top of your foot. Although somewhat less common than heel spurs or pump bumps, bony bumps on the top of the foot may or may not cause pain. Typically they’re uncomfortable if shoes squeeze or press against them, or if they’re blocking a joint. They might be more trouble if they press on a nerve, contribute to corns, or cause ulcers.

    You develop top of the foot bumps for multiple reasons. It could be excess tissue growth from arthritis in your big toe or another joint. It could be that your foot didn’t heal well after a fracture or a dislocation. As you get older, little spots of extra bone can simply pop up. Serious diseases like bone infections or tumors could be behind the lump as well, though this is uncommon. Let Dr. Darren Silvester and the Next Step Foot & Ankle Clinic team in Pleasanton, TX, help you deal with any foot bumps. Call (830) 569-3338 or use our online request tools to contact us.

  • Will physical therapy speed up my recovery?

    Physical therapy on kneePhysical therapy absolutely speeds up and improves your recovery. You see this clearly in the difference between professional and recreational athletes. Injuries that might sideline a weekend warrior for weeks while recovering may only take half the time with a professional athlete. This is largely because they get immediate medical treatment, including thorough physical therapy.

    You see faster recoveries with physical therapy in many situations. The treatment rehabilitates your limbs over time so that they build up strength, improve their range of motion, and generally restore their function. The sooner this happens, the more effective and quickly it works. Otherwise you’re left waiting for the injury to heal as best it can on its own, and then trying to rebuild the muscle strength you need to walk or move around correctly. If you’re struggling with a lower limb injury, don’t just wait for it to get better. Take an active role in healing it through physical therapy. Dr. Darren Silvester and our team at Next Step Foot & Ankle Clinic will help. Just call (830) 569-3338 to make an appointment.

  • Can orthotics help with flat feet?

    For many people, orthotics can definitely make a different for flatfoot pain. The support lifts the arch and helps your foot distribute pressure more evenly. It can also cushion the feet to absorb shock better. Custom orthotics can actually control your biomechanics as well. These specially-prescribed inserts take into account the specific shape of your foot and your gait to help your feet where you need it most.

    Custom orthotic impression

    On the other hand, not everyone who has flat feet needs orthotic inserts. Some people have low arches and do not experience any pain or problems with their walking or their sports. If you think your arches are low but they aren’t causing trouble, you may not need to wear inserts in your shoes at all. If you are concerned about foot pain, however, don’t be afraid to try orthotics for your flat feet. Dr. Darren Silvester and the Next Step Foot & Ankle Clinic staff are happy to help you determine if you need them and get you the right kind. Make an appointment online, or call (830) 569-3338 to reach our Pleasanton, TX, office.


  • How does pregnancy affect your feet?

    Pregnant bellyPregnancy has a huge effect on your feet, sometimes in surprising ways. One of the most common issues with pregnancy and your feet is edema, or swelling. Extra weight and pressure from a weight-bearing stance that accommodates your growing belly can contribute to swelling in your feet and ankles. Cramping feet and spider veins are common consequences of weight gain as well. Many women develop a problem with overpronation, which can lead to arch, heel, and even ball of the foot pain. Plantar fasciitis is, unfortunately, a possible side effect of all this, too.

    Changes in hormones, along with added weight gain, can cause your feet to widen and flatten. This can actually increase your shoe size. Many women need to change their footwear to avoid pain from pinched feet. The right foot care can help you adjust to all these changes and take steps to alleviate any discomfort that may arise. Dr. Darren Silvester and our team at Next Step Foot & Ankle Clinic is more than happy to help you. Just make an appointment at our Pleasanton office through our website, or by calling (830) 569-3338.

  • What kinds of foot conditions are considered rare?

    Rubber boots on a dirt trailRare foot conditions are any sort of disease, disorder, deformity, or even injury that only affects a few people. This range from cancer to forms of arthritis to unusual infections. Three specific rare foot disorders are Kohler’s disease, Maffucci syndrome, and Freiberg’s disease. All three involve damage or deterioration to the bones in the feet.

    Kohler’s disease is an arch problem. Something limits the blood flow to a midfoot bone called the tarsal navicular bone, causing it to break down and start to crumble. This creates pain and swelling in the arch. Maffucci syndrome involves benign bone tumors growing near the ends of long bones in your feet. These can deform your lower limbs, impair joint function, and increase your fracture risk. Freiberg’s disease flattens the head of a metatarsal bone. This causes a forefoot ache that worsens with activity and stiffens the affected toe.

    The sooner you seek a diagnosis for any of these conditions, the better it is for the affected feet. Let Dr. Darren and our team at Next Step Foot & Ankle Clinic help you diagnose and manage any rare foot disorders. Contact our Pleasanton, TX, office through our website or by calling (830) 569-3338.

  • Do you need to treat black toenails?

    Shoe pain that causes black toenailsWhether or not your black toenails need treatment largely depends on why they are black, and whether or not they are painful. Nails that are black because of a type of fungus or some melanoma underneath the hard keratin will definitely need treatment. If your nails are dark because you’ve bruised them—whether by running, stubbing a toe, or dropping something heavy on your foot—you might not need extra care.

    Bruised nails are dark because small amounts of blood leak under your keratin and stain it black. The discoloration will grow out as your nail does. Too much blood pooled under the nail, however, can cause painful pressure. This does need treatment to alleviate your discomfort. Dr. Darren Silvester and our team at Next Step Foot & Ankle Clinic can help with this by draining the pooled blood, or even by removing the damaged nail. Don’t wait until you can’t stand it anymore to get help. Call our Pleasanton, TX, office at (830) 569-3338 to get an appointment.

  • Will I feel the HyproCure implant in my foot?

    Feet in the airAs long as the implant does not displace, you should not be able to feel HyProCure after the procedure. Sometimes for the first few months a hard substance may be felt in the area of the surgery. This is scar tissue and should dissipate after several months, if present at all.

  • Will there be a visible scar after HyproCure?

    Holding feetThe incision is less than an inch long and slender and this part of the skin heals remarkably well. With time, the scar should become virtually invisible, in most cases.

  • If HyproCure is performed on a child, does it have to be replaced later in life?

    Pointing to child's footThe short answer is likely no, but this is not a guarantee. Normally, once the stent is inserted into the foot it never has to be changed. The bones will continue to grow peripherally around HyProCure

  • Can I still get MRIs, CT scans, etc. with HyProCure in my foot?

    Ultrasound machineHyProCure stents are made from medical grade titanium which is not reactive to imaging modalities. However, as with any procedural implant, you should inform your doctor of the implant and follow their recommendation.

  • Are there any limitations, as far as sports go, after this procedure?

    Running on streetOnce the tissues surrounding the stent are healed, there should be no limitation. The abnormal motion is no longer present and normal motion will occur. Usually, there is a significant improvement in running, jumping -– any activity involving propulsion from the foot.

  • Is there drilling or screwing involved in the procedure?

    Surgeon pointing at footThere is no drilling or screwing involved with the HyProCure procedure. A small incision is made in the skin above the sinus tarsi and the stent simply slides into the natural space inside the foot. The threads on the stent are only to allow for the scar tissue to form around the grooves and lock the device in place during the normal healing process.