Bunion Treatment in Frisco

What are bunions?

Bunions are bumps or prominences on the inside of the foot near the great toe joint.  Although we just think of a bunion as the bump on the side of the foot, there is more occurring than just that.  When a bunion develops, the big toe starts to angle or lean towards the second toe.  The large toe joint becomes out of alignment leading to the visible bump.  The medical term for this condition is Hallux Valgus.  Bunions start small and gradually progress with time.  Bunions are not always painful, however, the larger they become the more likely they are to become painful especially with wearing shoes.  Since the big toe drifts over towards the second toe, bunions (hallux valgus) can often lead to the development of hammertoes and calluses.

What are the symptoms of bunions?

  • Pain at big toe joint
  • Redness noted at the site of the bunion
  • Pain with snug shoes/ high heels
  • Numbness or burning pain as nerves can become entrapped between the bone and skin
  • Stiffness

What causes bunions?

Bunions are typically a result of a person’s foot structure, which is hereditary.  Although genetics are the cause of bunion (hallux valgus), certain risk factors such as wearing ill-fitting, unsupportive shoes may lead to progression and worsening of the deformity.  Bunion deformities are more common in women and over the age of 60.


What are treatment options for bunions?

Nonsurgical options will not fix the bunion but will alleviate symptoms and slow progression.  These include:

  • Orthotics to provide proper arch support and promote a better gait pattern. These will help slow down the progression of the bunion.
  • Supportive shoes with a wider toe box to accommodate the bunion
  • Bunion padding/shields/taping
  • NSAIDs for acute pain
  • Toe separators to take pressure off of the second toe
  • Cortisone injections are an option to alleviate acute pain and nerve irritation

If conservative treatment options fail, surgical intervention is the next step.  There are many different types of surgical procedures depending on the severity of the bunion.   Prior to surgery, we will need to take x-rays to help in surgical planning.  Often these surgeries, called bunionectomies, require cutting the bone and realigning it as well as shaving off any prominent bunion.  At Star Foot & Ankle Specialists, we also offer minimally invasive surgery.  Minimally invasive surgery results in minimal scarring and often leads to a quicker recovery.

If you are suffering from bunions click HERE to make an appointment to come see us and find the best treatment plan for you!

Fixing Flatfeet in Frisco, TX

Flatfeet is a condition of the foot where the arch appears to collapse.  In medical terminology, we refer to this as pes planus or as an overpronated foot type.  There are two main types of flatfeet: flexible and rigid.  Flexible flatfeet typically present in childhood and progress with age and can become rigid.  When a foot is described as a flexible flatfoot this means that the arch flattens when a person is standing and bearing weight but the curvature of the arch returns at rest.  When a flatfoot is described as rigid, this means the arch is collapsed with weight bearing and at rest.


  • Visible flattening/collapsing of the arch
  • Pain in the arches of the feet especially with extended walking or standing
  • Feet feeling overall tired/fatigued
  • Inability to walk or run long distances
  • Heel pain with extended weight bearing
  • Possible knee/hip/lower back pain
  • Possible development of other deformities such as hammertoes and bunions
  • Shin splints
  • Increased wear noted to the inside of your shoes

Causes/Risk Factors

  • Many children are born with flatfeet, but they outgrow this as the foot continues to develop. However, sometimes the flatfeet continue to progress due to foot structure.
  • Hereditary
  • Arthritis
  • Obesity
  • Tendon weakness/imbalance



We always start with nonsurgical treatment options whether child or adult.  Typically, symptoms can be managed and improved with conservative treatment.  This includes:

  • Orthotics (custom arch inserts) to provide support to your arches
  • Possible bracing if the ankle is affected
  • If weight plays a role then weight loss/diet modifications may be necessary
  • Recommend supportive shoes for your foot type
  • Physical therapy is sometimes necessary to help strengthen tendons/musculature
  • Possible medication for pain relief
  • Activity modifications


If conservative treatment fails for severe deformities, then surgical intervention may be necessary.  There are a variety of surgical techniques depending on the anatomy of your foot, age, and activity levels.   For adults this may involve surgery on the bones of the foot and possibly the tendons.  For children, we typically use an implant to raise the arch to avoid any bone work as children develop.

If you are having foot pain and think it may be due to flatfeet, click HERE to schedule your appointment at Star Foot and Ankle Specialists.

Ingrown Toenails in Frisco, Texas

Ingrown toenails are one of the most common conditions we see in our office at Star Foot and Ankle Specialists.  Ingrown toenails can be extremely painful and can lead to infection.  We most commonly see ingrown toenails on the big toes, but they can happen to the nails on the remaining toes as well.

Symptoms of an Ingrown Toenail

  • Pain near the toenail
  • Redness
  • Swelling
  • Drainage from the side of the nail that is ingrown. This drainage can be clear, bloody, or have pus.  There may also be an associated odor.

Causes of an Ingrown Toenail

  • Genetics
  • Trauma (dropping something that damages the toenail/repeatedly stubbing the toe)
  • Nails being trimmed incorrectly (digging into corners)
  • Too narrow of shoes causing pressure to the nails

Treatment of Ingrown Toenails

If you notice signs/symptoms of an ingrown toenail you can ease the symptoms at home by soaking the affected toenail in warm water and Epsom salts.  Please avoid attempting “bathroom surgery” and attempting to dig it out yourself.  This often will make the condition worse.  It is important to make an appointment as soon as you can with a podiatrist to treat the ingrown toenail so it does not become infected.  Although sometimes the nail can be trimmed at the tip to provide relief, most often the ingrown nail border will need to be removed.  This can be done the same day in office in a relatively quick procedure.  We start by cleaning and numbing the toe with local anesthesia.  Once the toe is numb, we use sterile instruments to remove the affected angry nail border.  We apply topical antibiotic ointment and bandage the toe following the procedure.  There is sometimes mild discomfort/aching to the toe for a few days following.  If the nail is infected, topical or oral antibiotics may be prescribed.

There is a possibility that the ingrowing toenail can return in the future.  We also present the option to permanently remove the ingrown toenail border.  This procedure is the same with the exception of the application of a chemical to destroy the nail root and prevent regrowth.  This procedure tends to cause discomfort for a little longer, usually about a week or so.

Prevention of Ingrown Toenails

  • When cutting nails, trim them straight across. Avoid digging into the corners.
  • Avoid cutting toenails too short.
  • Wear shoes that are not too narrow and cause pressure to the sides of the toes.

If you are experiencing any symptoms of an ingrown toenail, click HERE to schedule an appointment at Star Foot and Ankle Specialists!

22 Podiatry Facts for Twosday in Frisco, Texas

In honor of 2/22/22, here are 22 facts regarding podiatry and your feet:

  1. Both feet contain a combined total of 52 bones: 26 in each foot!
  2. Archeologists have found evidence of foot doctors in ancient Egyptian tombs and Greek ruins.
  3. APMA (The American Podiatric Medical Association) estimates that everyone will walk close to or more than 100,000 miles in their lifetime.
  4. Standing in one spot puts more strain on your feet than walking does.
  5. The first shoes were said to be made out of animal skin about  5 million years ago.
  6. The health of your feet can be an indication of your overall health and illnesses such as diabetes, cardiovascular disease, and arthritis.
  7. Toe to thumb transplants have been performed in cases where thumbs have undergone traumatic amputation.
  8. Those who wear heels periodically are more likely to have foot pain and seek treatment later in life.
  9. Skin cancer can develop on the feet.  It is important to check the skin on the feet, especially the bottoms, for new moles.
  10. Lower back pain can actually be worsened or even caused by poor foot support.  Custom orthotics can help with low back pain, hip pain, and last for 2-3 years on average.
  11. Abraham Lincoln, along with other significant historical figures have written about the care they received from podiatrists (at the time called chiropodists).
  12. Ankle injuries should be treated promptly to prevent further injury and prevent chronic ankle pain/instability later in life.
  13. Heel numbness can be caused by possible neuropathy (damage to nerves) or nerve compression.
  14. Toenails grow very slowly. It takes 5-6 months to grow an entirely new toenail, which is slower than fingernails.
  15. Foot sizes have been increasing over the last few decades.
  16. Our feet are at their biggest in the afternoon/evening.
  17. Heel pain is very common: 6 in 10 Americans have experienced pain in the past year.
  18. Shoe shopping is best done in the afternoon due to swelling and should be properly measured while standing.
  19. More often than not, people have two different sized feet.
  20. There are about 250,000 sweat glands in a single pair of feet and can produce almost half a pint of moisture daily.
  21. If your second toe is longer than your first toe this can be a sign for increased risk of bunions, hammers toes (toes that point down), and even back problems.
  22. Your feet can continue growing even as an adult. Feet become wider and longer as you age because your tendons and ligaments lose elasticity


To schedule an appointment to learn even more about your feet click here

Treating Toenail Fungus in Frisco, Texas


Toenail fungus, which medically is termed onychomycosis, is a common condition that can cause changes to the thickness and color of a nail.  Fungus, in general, is an organism that likes moist and dark environments, just like how we can find in our shoes!  Wearing shoes, especially when snug, can cause repeated friction and microtrauma which can cause nails to lift up. This lifting of the nail allows fungus to enter and infect the nail.

Toenail fungus symptoms include discoloration and thickening of the nail.  The affected nail may become brittle and separate from the nail bed.  You may notice debris (buildup) underneath the nail.  Sometimes the nail can even have an odor.  The nail may become painful as it continues to thicken, which can be worsened with certain shoes.  Often, we see toenail fungus in combination with Athlete’s Foot (a fungal infection of the skin).

Although anyone can contract toenail fungus, there are certain groups that are more at risk than others including those who are immunocompromised, have diabetes, and are elderly.  People with poor circulation are also more prone to a fungal infection of the toenails.  We also see toenail infections more commonly in those with excessive sweating of the feet and Athlete’s Foot infections.

Without treatment, the toenail fungus will likely spread to other toenails.  There are multiple types of treatment options:

  • Oral medications, depending on the medication, offer success rates of up to 76%. These antifungal pills often have predictable and successful results.  Typically, these require about a 12 week course of treatment and improvement to the nail is noticed as it grows out.  As with any oral medication, although uncommon there are risks.  We require routine bloodwork to be done to ensure that there are no side effects particularly on the liver or blood cell count.
  • Topical medication includes creams and medicated nail lacquers. Overall, these are not quite as effective as oral medication but are an option if there are contraindications or hesitancy to taking antifungal pills.  Topical medications tend to work better on more mild nail infections.  With use of topical medication, we recommend regular nail trimming.
  • Laser therapy is another option for treating toenail fungus. Laser therapy typically involves 4 weekly sessions of 12 minutes of laser exposure, which is relatively painless.  Research has shown to have approximately 67% efficacy rate, with some sources even higher than this.
  • Nail Removal is a last choice option for severe nail thickness. This involves a minor procedure in the office where the affected toe is numbed with anesthesia and the nail is removed.  Regardless of the treatment option there is always a chance of recurrence.

There are certain steps that can be taken to help prevent toenail fungus.  These include:

  • Changing socks regularly, especially throughout the day if you have sweaty feet
  • Avoiding being barefoot in public areas, especially damp areas like showers/saunas/etc
  • Ensuring that clean instrumentation is used when cutting nails/getting a pedicure
  • If noticing any signs of Athlete’s Foot (fungal skin infection) seek prompt treatment
  • Wearing shoes that fit your feet well
  • Wearing shoes with material like mesh that breathes well
  • Wearing moisture wicking socks
  • Having toenails well trimmed
  • Seeing a podiatrist in a timely manner when noticing changes in nail color or thickness

If you have any concerns about possible toenail fungus, make an appointment with Star Foot & Ankle Specialists and have Dr. Heredia and Dr. Zellers find the best treatment for you!

Schedule an appointment by clicking here


How to Treat Heel Pain in Frisco, Texas

Heel pain is often caused by a very common condition called plantar fasciitis, which is inflammation of the plantar fascia.  The plantar fascia is a ligament that starts on the heel bone, runs across the bottom of the foot, and ends near the base of the toes.  This means that the plantar fascia acts as an arch support.

Heel pain caused by plantar fasciitis often presents as pain with first step in the morning when getting out of bed or when getting up from resting or extended sitting.  This is because at rest the plantar fascia shortens and with that first step the plantar fascia stretches out.  Plantar fasciitis pain can also be felt when standing for extended periods or when exercising.

There are multiple possible causes of plantar fasciitis including overpronation (rolling inwards of the foot and ankle), ill-fitting shoegear, obesity, tight calf muscles/Achilles tendons, and standing on hard surfaces for extended periods.

We start with conservative (non-surgical) treatment for patients with plantar fasciitis.  This may include rest, NSAIDs, or steroids.  We also recommend calf stretches and icing the heel.  We also recommend changing shoes to a more supportive pair as well as orthotics to help provide arch support and take pressure off of the heel.  If these treatments do not provide complete relief, we can also consider stretching devices such as a night splint, physical therapy, and cortisone injections.  In severe and chronic cases, surgical intervention is an option.

The podiatrists at Star Foot & Ankle Specialists will provide a thorough explanation and tailor treatment to each individual patient.  If surgical intervention is necessary, they offer minimally invasive techniques

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