About Next Step Foot & Ankle Clinic

Why Patients Choose Next Step.

Foot pain is not normal. If you’re living with it, something is wrong. Our goal is to find out what, fix it, and get you back on your feet as quickly as possible.

The Next Step Difference

We Hear It All the Time.

“I’ve been to doctor after doctor. They took a quick look at my feet, gave me a diagnosis, and offered treatments that didn’t work. Nobody helped me.”

We take the time to listen carefully to your complaint and history. Then we provide a thorough, multi-step, symptom-directed physical exam to look at all the possible causes of the pain you’re experiencing. Our goal is to give you the most complete exam in South Texas so that we are confident about your diagnosis.

Because one of the worst things that can happen in a doctor’s office is being treated for something you don’t have.

That’s why Next Step Foot and Ankle Clinic is different.

Why Choose Next Step

“No one has ever examined my foot so carefully before.”

“I finally found someone who listened, understood the pain I was going through, and offered various treatments to help me.”

“10 out of 10 for Dr. Larsen and this office. I’m not quite sure where I would be on my healing journey without them.”



The Next Step Difference

Four Reasons Patients Choose Next Step

We’ve built this practice around a simple idea: get the diagnosis right, explore every option, and get you back on your feet as fast as possible.

1

We Take the Time to Get the Diagnosis Right

Foot pain can be caused by several things, and often by more than one thing at once. That’s why treatment fails. We use careful clinical exams, diagnostic injections, mechanical testing, and in-house ultrasound imaging that many clinics don’t even have, so we can make a more accurate diagnosis.

2

Conservative Care Usually Works

Most patients don’t need surgery. We offer comprehensive conservative options on your first visit: injections, orthotics, taping, medication, and more. It’s rare that a patient doesn’t get significant relief from the very first visit. Our goal is to get you feeling significantly better as quickly as possible.

3

Advanced Technology You Won’t Find Elsewhere

We’ve invested in advanced equipment that gives you more options when traditional treatment isn’t enough: shockwave therapy, Class IV Laser, red light therapy, EST Neuropathy Treatment, PRP, and more. Our investment in technology means you have alternatives that most podiatry practices simply can’t offer.

4

Expert Surgery When Needed

Our doctors have years of experience performing simple and complex procedures, including minimally invasive surgery through incisions the width of a pencil eraser. Sometimes surgery is the first and only option, and we know how to tell when that’s the case. When it is, you’re in expert hands.

60+
Years Combined Experience
4
Board-Certified Specialists
9/10
Neuropathy Patients Find Relief
2
Locations in South Texas
About Our Team

Your Doctors

Every doctor at Next Step sees general podiatry patients. For complex nerve cases, Dr. Silvester and Dr. Larsen provide specialized care.

Dr. Darren Silvester
Dr. Darren Silvester
General Podiatry
Board-Certified Surgeon
AENS-Certified Nerve Specialist
DPM, FACFAS, FABFAS, FAENS
Dr. Silvester is a Fellow of the Association of Extremity Nerve Surgeons (AENS), with specialized training in the diagnosis and treatment of complex nerve conditions. He is also the author of a patient guide on managing diabetic foot ulcers. He founded Next Step Foot & Ankle Clinic with a mission to provide the most thorough diagnostic and treatment experience in South Texas. Patients know him for one thing above all: he is always seeking out better ways to treat their foot pain.
Dr. Gregory Larsen
Dr. Gregory Larsen
General Podiatry
Nerve Surgery
DPM, AENS
Dr. Larsen holds advanced certification in nerve surgery through the Association of Extremity Nerve Surgeons. He works alongside Dr. Silvester to provide comprehensive nerve care for patients throughout South Texas. Known for his thorough diagnostic approach and caring bedside manner.
Dr. Sara Grzywa
Dr. Sara Grzywa
General Podiatry
Board-Certified Surgeon
Reconstructive Foot & Ankle Surgery
DPM, FACFAS
Dr. Grzywa graduated summa cum laude from the University of Texas at San Antonio and earned her medical degree from Des Moines University, where she graduated second in her class. She completed her surgical residency at Detroit Medical Center, a level one trauma hospital, and one of the most coveted surgical fellowships in the country at the American Foundation of Lower Extremity Surgery and Research. She recently completed the first Total Talus surgery in South Texas. She treats all foot and ankle ailments and develops tailored treatment plans utilizing the latest technology and procedures.
Dr. Bryan Sagray
Dr. Bryan Sagray
General Podiatry
Board-Certified Surgeon
Reconstructive Rear Foot/Ankle Surgery
DPM, FACFAS
Dr. Sagray is board certified in foot and reconstructive rear foot/ankle surgery. He completed his undergraduate studies at Texas A&M University, earned his medical degree from Midwestern University, and served as chief resident at INOVA/Georgetown University focusing on trauma, reconstruction, and sports injuries. He chose his specialty after experiencing foot and ankle injuries himself, fueling his dedication to helping patients resume the activities they love.
Not Getting Answers?

Have You Been Told There’s Nothing More That Can Be Done?

If you’ve been living with foot or ankle pain and haven’t found answers, we can offer a fresh perspective. Our advanced diagnostics and specialized training let us find what others miss.

Our Technology

Options You Won’t Find at Every Clinic

We’ve invested in advanced diagnostic and treatment technology that most podiatry practices don’t have. This means more accurate diagnoses, more treatment options, and better outcomes for you.

Plus the things you’d expect from any podiatry office: ingrown nail treatment, diabetic foot care, injections, and more. But our advanced capabilities are what set us apart.

Comprehensive Neuropathy Programs
3D Printed Custom Orthotics
In-House Ultrasound
Shockwave Therapy
Class IV Laser
Red Light Therapy
Sudo Scan Nerve Testing
EST
PRP

Ready to Experience the Difference?

Whether it’s your first visit or you’re coming to us after seeing other doctors, our goal is the same: get the diagnosis right and get you back on your feet.

Universal City Office Pleasanton Office Appointments

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