Haglund’s deformity is a bony enlargement of the back of the heel bone and usually referred to as a “pump bump” since it’s common among patients who wears heels. The primary symptoms of this deformity… More
At Associated Podiatrists P.C., we are committed to using the most advanced technology and therapies available to treat our patients’ injuries and disorders of the foot and ankle. Platelet rich plasma (PRP) offers patients a non-surgical method for treating injuries and other common foot problems such as plantar fasciitis or tendonitis.
What are PRP Injections?
For humans, blood is composed of red blood cells, white blood cells, plasma, and platelets. Plasma is the liquid portion of blood that transports cells and contains a protein that catches platelets at the site of a wound or injury to begin clotting. Platelets are responsible for maintaining stability within the body by restoring the blood supply to an area after an injury and constructing new connective tissue. Normal blood contains 93% red blood cells, 6% platelets, and 1% white blood cells. In contrast, PRP contains 94% platelets, 5% red blood cells. Thus, by injecting a concentrated solution of PRP, it can help spur the body’s natural healing process.
Are they safe?
PRP injections are very safe as they use the patient’s own blood, so the risk of immune reactions or disease transfer are eliminated.
What are they used for?
PRP has been used for over 20 years to help treat acute and chronic conditions including:
- Peroneal tendonitis
- Posterior tibial tendonitis
- Plantar fasciitis
- Achilles tendinitis
- Ankle ligament sprains
When platelets are placed into areas of the foot and ankle, they release factors necessary for growth and healing, thus resulting in a decrease in pain, improved function, an increase in activity and decrease in recovery time.
What type of procedure is involved?
The process involves drawing the patient’s blood, placing the blood in a centrifuge and then drawing off the platelet concentration. The platelet concentration is then injected in and around the affected area.
To learn more about PRP injections or to schedule an appointment with one of our podiatrists, Marc A. Borovoy, DPM, and John D. Miller, DPM, feel free to contact our office at (248)348-5300 or schedule an appointment online!
In a human foot, there are 26 different bones that are held together by 33 joints and over 100 muscles, tendons and ligaments. The arches, which are formed by the tendons that attach at the heel and foot bones, pull together to form a moderate, normal arch. When the tendons do not pull together properly, there is little or no arch, which is referred to as a flat foot.
The purpose of an arch is to help distribute your body weight evenly across your feet and legs, which determines how a person walks. When a person has little or no arch, the arch of their foot is depressed, and the sole of the foot is almost completely in contact with the ground.
In infants and toddlers, prior to walking, the arch has not developed yet and flat feet are considered normal. Arches will appear when children begin standing on their toes and will continue to develop throughout childhood. By adulthood most people have developed normal arches.
Many people with flat feet do not experience pain or other problems. When pain in the foot, ankle, or lower leg does occur, especially in children, your feet should be evaluated by a podiatrist. If left untreated, it may lead to severe disability and chronic pain.
Anti-inflammatory medications, physical therapy, icing, supportive taping, orthotics, and bracing are the most common treatments for flat feet. In some cases, surgery may be performed to repair a torn or damaged tendon and restore normal function.
If you or someone you know is experiencing problems associated with flat feet, please feel free to contact our office at (248)348-5300 or request an appointment online. Our podiatrists, Marc A. Borovoy, DPM, and John D. Miller, DPM, are experts in all areas of foot and ankle care and will be happy to assist you with any problems you may be experiencing.
It’s no surprise that high heels aren’t good for your feet, but what exactly happens to your feet after wearing heels for hours on end? When you’re in any kind of shoe that has elevation or a heel, your weight gets shifted forward to the ball of the foot and therefore, the higher the heel, the more weight and pressure gets applied. Ultimately, it throws off your body’s alignment and causes damage to other parts of the body such as your feet, ankles, lower leg, hip, and spine.
Foot Problems that Develop from Wearing High Heels:
- Metatarsalgia – Overuse of the fat pad in your forefoot causes it to gradually become thinner over time, causing severe pain.
- Stress Fractures – Strain on the bones over time puts you at a higher risk of fractures/breaks.
- Bunions – The swollen, bony protrusion that forms on the side of the big toe becomes aggravated due to the narrow toe box often found in heels and other poorly fitting shoes.
- Morton’s Neuroma – A thickening of nerve tissue that frequently develops between the metatarsals as a result of compression and irritation of the nerve.
- Sprains – The higher the heel, the more your body is thrown off balance, putting you at a higher risk of twisting your foot or ankle.
- Hammertoes – A contracture deformity which causes the middle joint to bend and become stuck in a curled position, frequently caused by a narrow toe box.
- Plantar Fasciitis – High heels leave you with a weakened arch, so when you suddenly switch to more supportive shoes, it leaves you with an arch that can’t effectively absorb impact or support your weight.
Overall, the best thing to do is to not wear heels, but if you do, the American Podiatric Medical Association offers some basic guidelines for choosing better-for-you heels:
- Avoid heels higher than two inches.
- A high stiletto with a pointy, closed toe is the worst type of shoe for your feet. Instead, choose heels with a generous toe box area and extra cushioning at the front of the shoe.
- Consider wearing supportive shoes during your commute and changing into high heels after you arrive at the office. This simple step will help minimize the time your feet spend in heels.
- Kitten heels are a foot-friendly option for heel wearers. With a heel height typically less than one inch, kitten heels deliver a bit of height without the pressure that higher heels can cause.
- Be extra careful when wearing platforms or wedges, as these styles can compromise your balance and stability. Very high shoes may lead to ankle rolls and falls. Choose lower platforms and wedges that secure with ankle straps.
If you start to notice any type of foot pain or problem, our podiatrists, Marc A. Borovoy, DPM, and John D. Miller, DPM, are experts in all areas of foot and ankle care, and will be happy to assist you with any problems you may be experiencing. Feel free to contact our office at (248)348-5300 or request an appointment on our website.
It was revealed earlier last week that Detroit Pistons forward Jon Leuer would be heading towards a season-ending ankle surgery this coming Friday.
After seeking the advice from a specialist, the injury that was originally diagnosed as an ankle sprain, also revealed bone fragments and several other issues during the exam. The initial recommendation was for Leuer to have a series of injections, but after weeks of little progress, it was decided surgery would be the only option.
“I knew even a month and a half ago when I saw the specialist that he kind of suggested [surgery] right away,” Leuer told The Detroit News. “But we wanted to see if we could try to manage the pain and hopefully get through the season.”
According to Dr. Marc Borovoy, a podiatric physician, “The ligaments that surround and connect the bones in the ankle have a specific range of motion and boundaries that allow them to keep the joints stabilized. When the ligaments surrounding the ankle are pushed past those boundaries, it causes a sprain.”
“We usually recommend surgery when the damage to the ligaments is severe or the injury doesn’t improve with nonsurgical treatments such as physical therapy. In this particular case, for someone with a torn ankle ligament, I would recommend an internal brace ligament augmentation, which is a surgical procedure used to strengthen the lateral ankle ligament and rebuild the ligaments that are torn or ruptured.”
From all of us at Associated Podiatrists P.C., we wish Jon all the best with his upcoming surgery and recovery.
If you or someone you know believes they may have a sprained ankle or torn ligament, it’s important to see a podiatrist immediately in order to promote recovery and help prevent secondary injuries. Our podiatrists, Marc A. Borovoy, DPM, and John D. Miller, DPM, are experts in all areas of foot and ankle care, and will be happy to assist you with any problems you may be experiencing. Feel free to contact our office at (248)348-5300 or request an appointment on our website.
Did you know that approximately 10% of people will suffer from a painful condition known as plantar fasciitis during their lifetime? This common ailment occurs when the shock-absorbing band of tissue that runs along the bottom of your foot becomes irritated and inflamed, causing mild to severe heel pain. While the exact cause may be difficult to determine, it is frequently a development of ill-fitting footwear, excessive physical activity, age, tight tendons, and/or improper foot mechanics.
One of the most common symptoms of plantar fasciitis is a stabbing pain in the bottom of your foot that tends to be most noticeable first thing in the morning. The sudden over-extension of the foot upon getting out of bed stretches the ligament, and with repeated stress to the plantar fascia, small tears are likely to develop.
Our office offers several different treatment options for plantar fasciitis, both conservative, and surgical, as a last result. In the beginning stages, plantar fasciitis can be treated with icing, anti-inflammatories, exercise(s)/physical therapy, or custom-molded orthotics. However, if the issue persists, we also have the latest cutting-edge treatments available including Radial Shockwave Therapy, MLS Laser Therapy, and Amniotic Fluid Injections.
If you’re experiencing heel pain, it’s important to see your podiatrist and discuss all your possible options to determine the best course of treatment for you. Please feel free to contact our office at (248)348-5300 or request an appointment on our website. Our podiatrists, Marc A. Borovoy, DPM, and John D. Miller, DPM, are experts in all areas of foot and ankle care, and will be happy to assist you with any problems you may be experiencing.
While most bones in the body are connected to each other, there are several that are embedded within a tendon or a muscle called sesamoids. In your foot, these small, pea-shaped bones are found in the underside of the forefoot, just beneath the big toe joint.
The purpose of the sesamoids is to act like a pulley—providing a smooth surface to allow the tendons to slide and help the big toe move normally. By doing this, it helps provide leverage when the big toe pushes off during walking and running, while also assisting as a weightbearing surface for the first metatarsal bone.
There are three types of sesamoid injuries in the foot, which can involve the bones, tendons and/or surrounding tissue in the joint.
- Turf toe – An injury of the soft tissue surrounding the big toe joint.
- Fracture – A direct result from trauma (acute) or a longstanding injury (chronic).
- Sesamoiditis – An overuse injury involving chronic inflammation of the sesamoid bones and tendons.
Common Symptoms of Sesamoid Injuries:
- Pain in the ball of the foot under the big toe
- Pain when trying to bend or straighten the big toe
- Swelling and bruising
- Immediate onset of pain indicates a fracture, whereas sesamoiditis develops more gradually
In diagnosing a sesamoid injury, your podiatrist will perform a physical examination of the foot, focusing on the big toe joint to see if you can move it up and down without an increase in pain. In many cases, x-rays will be ordered to rule out a possible fracture.
Treatment for sesamoid injuries is usually non-invasive and includes:
- Resting and ice.
- Oral medications to reduce pain and inflammation.
- Padding in the shoe to cushion the inflamed area.
- Taping the big toe to limit movement and relieve that area of tension.
- A steroid injection to reduce pain and inflammation.
- Orthotic inserts to help balance the pressure placed on the ball of the foot.
If conservative measures fail, however, your podiatrist may recommend surgery to remove the sesamoid bone.
If you or someone you know believes they may have a sesamoid injury, it’s important to see a podiatrist as soon as possible. Our podiatrists, Marc A. Borovoy, DPM, and John D. Miller, DPM, are experts in all areas of foot and ankle care, and will be happy to assist you with any problems you may be experiencing. Feel free to contact our office at (248)348-5300 or request an appointment on our website.
A diabetic foot ulcer is the result of skin tissue breaking down from constant pressure and forming an open sore or wound, typically on the bottom of your foot. People with chronic conditions, such as diabetes, are particularly susceptible to foot ulcers. In fact, about 15 percent of all people with diabetes will develop a foot ulcer at some point in their lives.
In most cases, one of the first signs a patient notices with a foot ulcer is drainage from their foot, but it’s also common to notice swelling, irritation, and/or odor from one or both feet. If you start to notice any of these symptoms, it’s important to consult a podiatrist immediately, as not all signs of foot ulcers are obvious; some may initially resemble a callous or blister with fluid underneath, with red or yellow tissue at the base. If an infection has already set in, it’s common for a toe or part of the foot to turn black due to the absence of healthy blood flow.
Common causes of diabetic ulcers:
- Poor Circulation
- Nerve Damage
- Irritated or Wounded Feet
- History of Smoking
- Peripheral Neuropathy
During an initial evaluation, your podiatrist will assess the wound and your circulation, in order to determine the best course of action. Depending on the severity, there are several treatment options including debridement, which is the removal of dead or infected tissue from the ulcer, dressings, which are the application of special materials, solutions, or ointments to the wound, and off-loading, which is the use of casts or boots to help decrease pressure at the ulcer site.
The best way to prevent an ulcer on the foot from forming, however, is to treat the underlying health problem, have routine visits with your podiatrists, and follow these important steps:
- Inspect your feet daily. Holding a mirror up to the soles of your feet will make this easier, but if you’re unable to, ask someone to check your feet for you and ask yourself these questions:
- Is there any new pain or throbbing?
- Does your feet feel hotter than usual?
- Are there any new areas of redness, inflammation or swelling?
- Is there any discharge?
- Is there a new smell from your foot?
- Do you have any flu-like symptoms?
- Keep your feet clean. Wash your feet every day in warm water and dry them well.
- Keep your feet soft. Put a thin layer of lotion on the tops and bottoms of your feet (not between your toes). Dry skin can easily crack and peel, making it a target for infection.
- Nail Maintenance. If you’re diabetic, it’s important to have your nails cut properly by a podiatrist every 2-3 months.
- Don’t go barefoot. Always wear socks and shoes to avoid the risk of stepping on something and make sure your shoes fit perfectly to avoid blisters.
- Stop smoking. Smoking decreases blood flow to your feet, which delays wound healing.
“It’s important to seek care as soon as possible for any cut or wound on the foot,” Dr. Marc Borovoy, a podiatric physician at Associated Podiatrists PC, recommends. “Most wounds have the ability to heal with proper treatment, but a small problem can quickly escalate into a major one if left untreated.”
If you or someone you know is diabetic and/or believes they may have an ulcer, it’s important to have frequent visits with your podiatrist. Our podiatrists, Marc A. Borovoy, DPM, and John D. Miller, DPM, are experts in all areas of foot and ankle care, and will be happy to assist you with any problems you may be experiencing. Feel free to contact our office at (248)348-5300 or request an appointment on our website.
Last week, Seattle Seahawks cornerback, Richard Sherman, was forced to exit the game after suffering a season-ending Achilles tendon rupture during the third quarter.
“I’ve put a lot of stress on it,” Sherman said during a post-game conference, revealing that his Achilles had been bothering him all season. “Think it would have gone eventually.”
The Achilles tendon—a tendon that connects the lower leg and calf to the heel of the foot—is the strongest tendon in the body and essential for making movement possible. The most common types of injuries are Achilles tendinitis and ruptured tendons, which often result in inflammation, severe pain, swelling, and in certain cases, complete immobility.
Through a physical evaluation, your podiatrist will be able to confirm the diagnosis through radiological testing and develop a plan of treatment. Depending on the severity of the injury, there are surgical and non-surgical options (such as Zimmer/Radial Shockwave Therapy, which is available in our office for tendinitis/tendonosis), but for athletes such as Sherman, surgery is usually the first choice of treatment. The advantage of a surgical approach includes a decreased risk of re-rupture and a higher likelihood of return to physical activities.
If you or someone you know is dealing with an Achilles tendon issue, it’s important to see your podiatrist immediately. Our podiatrists, Marc A. Borovoy, DPM, and John D. Miller, DPM, are experts in all areas of foot and ankle care, and will be happy to assist you with any problems you may be experiencing. Feel free to contact our office at (248)348-5300 or request an appointment on our website.
If you’ve ever felt like you were walking around with a rock in your shoe, then you might be familiar with the symptoms of one of the most common types of neuromas—a Morton’s neuroma.
A neuroma is a thickening of nerve tissue that frequently develops between the metatarsals as a result of compression and irritation of the nerve. Symptoms tend to build up gradually, and may even go away temporarily if certain activities are avoided, but over time, the symptoms are likely to become more intense as the neuroma enlarges and becomes permanent.
While the exact cause of a neuroma’s development is unclear, there are several different factors that can contribute to their formation such as:
- Wearing shoes with a tapered toe box or high-heeled shoes
- Certain foot deformities such as bunions, hammertoes, high arches or flatfeet
- Activities that involve repetitive irritation to the ball of the foot, such as running or sports
- An injury or other type of trauma to the foot
Common symptoms of neuromas include pain in the forefoot and between the toes, tingling/numbness, and swelling. “If you start to notice any of these symptoms, it’s important to see a podiatrist as soon as possible,” Dr. Marc Borovoy says. “If you’re able to catch it early in its development, you’re more likely to treat it with conservative treatments and avoid surgical intervention.”
Treatment options will vary based on the severity of each neuroma, but the primary goal is to relieve the pressure on the areas where the neuroma has developed. The most common types of treatments include:
- Laser – A non-operative technique
- Padding and Taping – Provides support to help lessen the pressure on the nerve and decrease compression
- Medications/Injections – Used to reduce pain and inflammation
- Orthotics – Custom inserts to help reduce pressure
- Surgery – An option for patients who have not responded to nonsurgical treatments
If you or someone you know believes they may have a neuroma, feel free to contact our office at (248)348-5300 or request an appointment on our website. Our podiatrists, Marc A. Borovoy, DPM, and John D. Miller, DPM, are experts in all areas of foot and ankle care, and will be happy to assist you with any problems you may be experiencing.
A hammertoe is a contracture deformity caused by a muscle and tendon imbalance of the joints in the 2nd-5th toe(s), which causes the middle joint to bend and become stuck in a curled position. There are two types of hammertoes: flexible, which means they are still movable at the joint, and rigid, which means the tendons have become tight, making surgery the usual course of treatment.
Common causes of hammertoes:
- Inherited genes
- Injury to the toe(s)
- Ill-fitting shoes
Common symptoms of hammertoes:
- Pain/irritation when wearing shoes.
- Corns and calluses.
- Inflammation, redness or a burning sensation.
- Contracture of the toe.
- In more severe cases of hammertoe, open sores may form.
Although hammertoes are readily apparent, they’re also progressive, too, which means they will not go away by themselves and usually get worse over time.
- Trimming/padding corns and calluses.
- Changes in shoewear.
- Orthotic devices.
- Injections/medications to reduce pain and inflammation.
If you have a hammertoe, it’s important to seek medical attention from a podiatrist quickly. Depending on the severity of your hammertoe(s), conservative treatments or a surgical route will be suggested in order to help relieve the pain and discomfort that has developed.
To learn more about hammertoes or to make an appointment with one of our podiatrists, please feel free to contact our office at (248)348-5300 or request an appointment on our website. Our physicians, Marc A. Borovoy, DPM, and John D. Miller, DPM, are experts in all areas of foot and ankle care, and will be happy to assist you with any problems you may be experiencing.