September 22, 2018, marks the 10th annual National Falls Prevention Awareness Day!

Among aging adults, falls are the leading cause of injury related emergency visits, the major cause of hip fractures, and responsible for more than half of fatal head injuries. Educating yourself about the risks is the first step in preventing falls, and this September, we dedicate the entire month to Fall Prevention.


Here are some of Associated Podiatrists, P.C.’s suggestions for fall-prevention:

  • Keep pathways clear by removing objects that you could trip over.
  • Be aware of uneven surfaces, such as in doorways or in between carpeting and tile.
  • Remove throw rugs or use a rug gripper underneath to secure them to the floor.
  • Install bright lights to light your pathways/hallways.
  • In the evenings, walk where there is plenty of light to help you see where you are going and watch out for cracks in sidewalks, holes, and changes in sidewalk levels.
  • Be extra careful during and after stormy weather. Rain, snow, and ice can make any surface slippery.
  • Walk in pairs or groups so you can alert each other of potential hazards.
  • Wear shoes with firm soles and low heels.
  • Hold hand rails and move slowly when climbing outdoor stairs
  • Always take your time – hurrying across streets puts you at risk of falling.

If you or someone you know feels unsteady while walking, it’s important to make an appointment with your podiatrist, a trained specialist in fall prevention, who can discuss your potential risk factors for falling and develop a plan to help prevent them.

To schedule an appointment, please contact our office today at (248)348-5300 or schedule an online using our patient portal appointment scheduler.

How to Treat Haglund’s Deformity


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 are a bony prominence on the back of the heel, which may lead to heel pain and/or blisters as a result of your shoes rubbing against the bump.

While many place the blame on the type of shoe you’re wearing, Haglund’s deformity can also develop if you have high arches, a tight Achilles tendon, or a tendency to walk on the outside of your feet.

Heel pads placed in the backs of your shoes may relieve and redistribute some of the pressure and applying ice to the area after removing your shoes may also ease some of the pain and discomfort. If the pain persists, however, or if the bump continues to enlarge, it’s time to see a podiatrist. A podiatrist can carefully evaluate your feet and create a treatment plan tailored to you, including:

  • Shoe modifications
  • Heel pads/lifts
  • Custom orthotics
  • Anti-inflammatories
  • Surgery (If none of the non-surgical methods provide adequate relief, your podiatrist may recommend surgery to correct the deformity)

To learn more about Haglund’s deformity or to schedule an appointment with one of our podiatrists, please feel free to contact our office at (248)348-5300 or schedule an appointment online!

Tony Finau Played Masters with Dislocated Ankle

Photo by Andrew Redington/Getty Images

During last week’s Par 3 Contest, golfer Tony Finau suffered a painful ankle injury, dislocating it while celebrating a hole-in-one on the 7th. As he made his way down the fairway backwards, his left ankle buckled, causing him to land on it awkwardly. The player was able to pop it back into place himself before being taken to the clubhouse for an x-ray.

Fortunately, the initial x-rays came back negative and as reported later in the week, so did his MRI, which confirmed no break. As long as the player was able to keep the swelling under control, he was given clearance to play in the season’s first major at Augusta National.

Typically, ankle dislocations are a direct result of a trauma when forces are placed on the ankle that cause the bones to fracture or the ligaments to tear. In this case, Finau was lucky to not have sustained enough damage to prevent him from playing, but it’s likely there may have been some ligament tearing [based on the photo that surfaced this past Monday] that the player will need to address in the future to prevent ankle instability.

If you or someone you know experiences problems with a ligamentous ankle injury, it’s important to consult a podiatrist as soon as the injury occurs. Dr. Marc A. Borovoy, DPM, and Dr. John D. Miller, DPM, are experts in all areas of the foot and ankle and can diagnose ligament ankle issues through radiological testing in-office, and based on the severity of their findings, suggest physical therapy or surgery to correct the torn ligaments and/or fractures.

For more information regarding ankle injuries, please feel free to visit our website, where you can also request an appointment.


According to the American Podiatric Medical Association, the average person takes 10,000 steps each day, which adds up to more than three million steps per year.  With that in mind, it’s important to appreciate the value of our feet and remember to examine, maintain, and protect them on a daily basis!

In honor of April’s National Foot Health Awareness Month, our podiatrists at Associated Podiatrists P.C. have put together several tips for keeping your feet happy and healthy!

  • Keep your feet clean and dry – While bathing, thoroughly clean your feet and toes with soapy water, and be sure to fully dry them afterwards, as fungal organisms love moisture.
  • Inspect your feet daily – Be sure to check the bottom of your feet for injuries, cracks, peeling, or dry skin, especially if you’re diabetic, since cracks in the skin provide a breeding ground for bacteria or fungus.
  • Stop going places barefoot – Floors at home and public places are filled with bacteria and foreign bodies, making you susceptible to fungal infections, plantar warts, or stepping on something.
  • Wear proper footwear – No two feet are identical (even on the same person), therefore, it can be difficult to find proper fitting shoes. Since one foot is always slightly larger, Dr. Borovoy suggests shopping for shoes that fit the larger foot, as well as purchasing them at the end of the day, to compensate for any swelling that occurred during the day.
  • Replace your walking or exercise shoes – Shoes should be replaced every six months or 500 miles in order to avoid foot and heel pain when the inside of the shoe begins to wear and lose support.
  • Polish Change – Don’t leave nail polish on 24/7, as it may lead to brittle nails, making you prone to fungus. 
  • Maintain a healthy weight – Keeping up with a healthy diet and regular exercise is the key to keeping your feet in top form! Added weight puts pressure on the feet and leads to many common complaints such as foot or ankle pain.
  • Stretch – In addition to maintaining a healthy weight, it’s important to stretch your feet, ankles, and lower legs before exercising to prevent injury.
  • Don’t keep putting it off – If you’re suffering from any kind of foot or ankle injury, don’t hold off on seeing a podiatrist. Injuries left untreated can lead to poor healing, recurring pain, limited mobility, and development of other serious issues.

So, this April, remember the importance of good foot health and make sure to schedule an appointment with one of our podiatrists! A visit to a podiatrist for a general foot exam will help treat any existing problems, and help to prevent any future ones.

Platelet Rich Plasma (PRP) Injections

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
  • Osteoarthritis

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!

Are Flat Feet Bringing You Down?

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.



How High Heels Affect Your Feet


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.

Pistons’ Jon Leuer Scheduled to Undergo Season-Ending Surgery on Friday


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.

Mayo Clinic

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 TherapyMLS 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.

Sesamoid Injuries of the Foot


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.