TREATMENTS

We offer both conservative and surgical treatment of the foot and ankle. We strive to meet our patient’s expectations with a good outcome. Our patients are fully education on their treatment options.
We then work with our patients to come up with a treatment option for the best outcome.

Associates in Podiatry of Michigan are equipped to handle all your foot and ankle needs.  Our doctors specialize in sports medicine, ankle and foot injuries/trauma, pediatric foot and ankle problems, all facets of reconstructive foot and ankle surgery, arthroscopic foot and ankle procedures and orthotic therapy. 

All foot and ankle surgery performed by our doctors emphasizes cosmetic outcomes. 
 
We regularly work with athletes, and as competitive athletes ourselves, we understand your desire to get better and return to your sport.

We provide a variety of custom orthotics and braces, and will work to ensure that we provide the right orthotics for your condition and lifestyle. 

We’ve included information on the most common conditions that we treat; if your condition is not listed, please contact our office with questions (734-414-0874). 

 

Foot/Ankle Fractures
See a foot and ankle specialist right away for appropriate treatment of injuries/fractures. Prompt treatment will minimize future arthritis associated with the injury/fracture.


Achilles Tendon Trauma

Achilles Tendon Ruptures require immobilization for several weeks at minimum. Surgical reapproximation of the ruptured ends provides the most optimal long-term result and is strongly recommended for younger patients active patients and athletes.

Achilles Tendonitis may be treated with heel lifts, orthotics or immobilization, depending on the severity and duration of the symptoms. Anti-inflammatory medications and ice are often used to reduce any swelling and to aid in healing the injured tendon. Achilles tendonitis that has been present for some time or recurs following conservative treatment can be successfully treated with minimal incision radioablation therapy (TOPAZ). This outpatient procedure stimulates healing in the tendon and requires minimal downtime.  The benefit of this procedure is that the tendon is left entirely intact, as is the blood supply.


Ankle Sprains
Ankle sprains are typically treated with rest and immobilization of the ankle. Ankle sprains may require surgical repair depending on the degree of damage to the ankle ligaments and ankle joint. Early treatment is key to prevent further sprains, painful ankle arthritis or fractures in the future.


Tendon and Muscle Injuries
Tenon and muscle injuries are treated with ice and anti-inflammatory medications.  Braces, orthotics and immobilization may be used to offload excess pressure on the injured tissues. Physical therapy may be used to rehabilitate the affected structures. Tendon ruptures may require surgical repair to regain full function of the injured limb.


Motor Vehicle Injuries
Motor vehicle injuries may require a visit to the emergency department if chest or head trauma is suspected. If the motor vehicle injury only affects the legs/feet, a visit to a foot and ankle specialist allows for immediate and appropriate management of any lower extremity trauma.

 
Crush Injuries
Crush injuries often require surgical intervention to relieve any excess pressure and prevent necrosis of tissues. Multiple fractures may be associated with crush fractures — they may also require surgical intervention. Prompt evaluation and management by a foot and ankle specialist will minimize long-term sequelae of the injury. 


Achilles Tendonitis
Achilles tendonitis is often treated initially by PRICE therapy, anti-inflammatory medication and orthotics. Prompt treatment of this condition is key to prevent the weakened and inflamed tendon from progressing to a full Achilles tendon rupture. Achilles tendonitis that has been present for some time or recurs following conservative treatment can be successfully treated with minimal incision radioablation therapy (TOPAZ). This outpatient procedure stimulates healing in the tendon and requires minimal downtime. The benefit of this procedure is that the tendon is left entirely intact, as is the blood supply.

 

Ankle Instability
Depending on the severity of the instability, treatment ranges from bracing or orthotics, to immobilization/rest of the ankle, to surgical repair of stretched or ruptured ankle joint ligaments. Failure to obtain appropriate medical care of the injured ankle may result in long-term ankle arthritis, chronic pain and continued instability. 


Ankle and Foot Arthritis
Treatment differs depending on the type of arthritis. Rheumatoid arthritis is a progressive type of arthritis and requires more permanent procedures than gouty arthritis or osteoarthritis (degenerative arthritis). Early or mild arthritis can often be treated with orthotics and steroid injections or anti-inflammatory medications for flare-ups; end stage arthritis or arthritis that fails to respond to conservative treatments may require surgery to relieve pain. Surgical intervention for arthritis ranges from joint cleanup to joint decompression to joint implants (joint replacement) to joint fusion.

 
Arch Pain
Arch pain due to plantar fasciitis is often treated with steroid injections and orthotics. Arch pain due to tendon imbalances or overuse injuries may be treated with rest, anti-inflammatory medications, orthotics and/or immobilization. Arch pain due to flat feet is treated with a combination of the above therapies; severe flat feet associated with arch pain that is not relieved by conservative methods may require more sophisticated braces or eventual surgical reconstruction of the dysfunctional foot to reestablish an arch and avoid chronic pain and limitation of activity.

   
Athlete’s Foot
Athlete's foot can be treated most effectively with prescription medications. Over the counter sprays and powders may help in minor cases. Prescription medications typically treat and cure the condition in a much shorter period of time.

 
Ball of Foot pain (Metatarsalgia)
Treatment varies depending on the cause. Your podiatrist may obtain x-rays to evaluate for underlying fractures/stress fractures, bone abnormalities or abnormal bone position to better determine your treatment plan.


Bunions
Change in shoe gear/wider shoes and orthotic therapy can slow progression of the deformity and may provide pain relief. Orthotics will support the arch and encourage the foot to function in a more appropriate position while using the orthotic. The only way to correct a bunion is through surgical cutting and shifting of the bone. The type of bunion and rate of progression determines each patient’s treatment plan and surgical options.

 
Circulatory Disorders
Because peripheral arterial disease can lead to ulcerations, and even limb loss in advanced cases that go untreated, it is essential that you see your doctor if you are experiencing any of these problems. If your doctor finds any signs of peripheral vascular disease you will likely undergo tests to determine your level of disease; if there are any significant findings, you will be referred to a vascular surgeon who will work with your podiatrist.

 
Corns and Calluses
Corns and calluses should not be treated with over the counter corn/callus removers as these preparations often contain strong acids which are not tissue specific, meaning they eat up callused as well as healthy skin. Overuse of these acids can cause ulcers in severe cases. Podiatrists can safely treat these lesions for you and will often recommend special pads for cushioning. Discomfort associated with corns and calluses that is not relieved by periodic professional debridement and padding may be removed surgically. Often, surgical remodeling of the underlying bony problem will also permanently rid patients of these painful lesions.

  
Diabetic Foot
The key to amputation prevention in diabetic patients is early recognition and regular foot screenings two times a year (or more) by a foot and ankle specialist. Diabetic custom shoes and custom molded insoles are strongly recommended for all diabetics, especially those with decreased sensation, peripheral vascular disease or recurring foot ulcerations. Diabetic shoes/insoles help prevent many of the foot and ankle problems and complications associated with diabetes. Diabetic patients should allow a foot and ankle specialist to provide nail care if they have decreased sensation or advanced diabetes which may limit their ability to appropriately care for their feet. Foot and ankle ulcers should be treated and followed closely by a foot and ankle specialist to minimize complications. Ulcers can progress to infection if left untreated; this may require hospitalization and surgical intervention. This can be avoided/minimized by timely presentation to a foot and ankle specialist at the first sign of a problem.


Flatfoot
Pain associated with flat feet should be evaluated by your podiatrist. Depending on your age, activity level, and type of flatfoot, a variety of treatment options will be made available to you following your initial work-up and exam. Some types of flat feet can be managed with orthotics or braces; others require surgical intervention to relieve pain and symptoms.


Fungal Nail Infections
Treatment for fungal nails includes oral medications, topical medications and periodic debridement by a foot and ankle specialist. In most cases medication is advised to limit the spread to other nails or the skin. Medications will typically cure the fungal infection in healthy patients.


Geriatric Foot Care
Elderly patients who have trouble caring for their own feet, especially those suffering from diabetes or vascular disease, should present to their podiatrist regularly for care of their feet and to avoid potential problems associated with inappropriate home/self nail care.

 
Hammertoes
Patients can benefit from padding and custom orthotics. Advanced or progressing hammertoes often require surgery to alleviate pain and correct the deformity.


Heel Spurs
Heel spurs associated with plantar fasciitis are often not removed as removal can destabilize the plantar fascia, resulting in continued pain and instability. These types of heel spurs are generally not painful; the pain is associated with plantar fasciitis. Plantar fasciitis can be effectively treated by your podiatrist. Heel spurs on the back of the heel can often be relieved with anti-inflammatory medication, shoe gear modification and, occasionally, rest/immobilization of the area. Severe cases may require removal of the prominent bone on the back of the heel to minimize continued pain and swelling associated with irritation of the area. 


Ingrown Toenails
Ingrown toenails are typically treated with removal of the offending nail border. Infected ingrown toenails may require a topical or oral antibiotic in addition to removal of the ingrown portion of the nail. Repeated ingrown toenails may require surgery to reshape the nail plate and destroy part of the nail matrix so that ingrown nails do not continue to form. 


Neuromas
Temporary relief may be obtained by removing shoes and massaging the affected area. If you present to a podiatrist in the early stages, a steroid injection may soothe the irritated nerve and provide relief. Certain patients may be candidates for sclerosing injections; a chemical is injected into the nerve to destroy the neuroma. Persistent and larger neuromas usually require removal to provide relief of pain and associated symptoms.

   
Plantar Fasciitis (or Heel Spur Syndrome)
Plantar fasciitis is most often successfully treated with conservative measures such as use of corticosteroid injections, anti-inflammatory medications, RICE therapy, stretching exercises and orthotics devices. Patients who present promptly following initial onset of symptoms have the greatest success with treatment. Most patients respond to conservative measures; those who fail conservative treatment may require surgical release of part of the plantar fascia to resolve their symptoms. Another option to treat plantar fasciitis is minimal incision radioablation therapy (TOPAZ). This is an outpatient procedure requiring minimal downtime.


Pediatric Foot and Ankle Problems
Pediatric foot and ankle problems are best managed by a foot and ankle specialist. Care may be coordinated with your pediatrician, depending on the presenting problem and your child’s medical history.  Pediatric orthotics are helpful for flat feet, in-toeing gait and following surgical treatment of such conditions as clubfoot. Prompt evaluation by a foot and ankle specialist once a problem is noted will minimize long-term sequelae. Pediatric foot problems left untreated often result in pain and limitation of activity throughout the patient’s life. 


Peripheral Neuropathy (numbness from Diabetes or other conditions)
If you are experiencing numbness, tingling or strange sensations in your feet, especially if you are a diabetic, see a podiatrist as soon as possible.

 
Warts
A variety of treatments exist for warts. Over the counter treatments are often damaging to healthy skin and should be used with extreme caution. If you believe you have a wart, visit your podiatrist for treatment to minimize spreading the wart to other areas of your feet/hands, or to your family members.


Wounds/Ulcers
If you experience sores or blisters on the foot or lower leg, fever, skin redness or swelling or other signs of infection, see a podiatrist immediately.