1150 Professional Court Suite C, Hagerstown, MD 21740, (301) 797-8554   
2100 Old Farm Drive Suite D, Frederick, MD 21702, By Appointment Only

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We encourage you to contact us whenever you have an interest or concern about our services.




By contactus@rfainstitute.com
June 01, 2016
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What is a Foot or Ankle Sprain or Fracture?

The feet and ankles work together to provide support and mobility to the body. A foot or ankle sprain is a soft tissue injury. Most often, a sprain occurs when an injury pulls, stretches, or tears the ligaments that connect bone to bone. A fracture is actually a break in the bone.


Injuries are the most common causes of foot and ankle sprains and fractures. Many fractures and sprains occur during sports. Football players are particularly vulnerable to foot and ankle sprains and fractures. Basketball players are prone to ankle sprains, and runners may develop stress fractures of the ankle or foot. Gymnasts and dancers may also develop stress fractures.

Tripping or stumbling on uneven ground is another common cause of foot and ankle sprains and fractures.


Pain, swelling, bruising, and difficulty walking on the affected foot or ankle are the most common symptoms of a sprained or fractured foot or ankle.

Home Care 

If you've hurt your foot or ankle, it's best to err on the side of caution. The acronym RICE can help you remember what to do:
Rest—Rest the affected area. Stay off the injured foot or ankle until it can be fully evaluated. Walking, running, or playing sports on an injured foot or ankle may make the injury worse.
Ice—Apply ice to the affected area as soon as possible, and reapply it for 15–20 minutes every three or four hours for the first 48 hours after injury. Ice can decrease inflammation.
Compression—Wrap an elastic bandage (such as an Ace® wrap) around the affected foot or ankle. The wrapping should be snug, but not so tight as to cut off circulation.
Elevation—Elevate the affected extremity on a couple of pillows; ideally, your foot or ankle should be higher than your heart. Keeping your foot or ankle elevated also decreases swelling.

When to Visit Dr. Michaels

Dr. Michaels specialize in the care and treatment of the lower extremities. If you've injured your foot or ankle, see a podiatrist. He or she can determine the extent of the injury and develop a plan of care to get you back in the game (or back to your everyday life) as soon as possible.

Increased pain, swelling, bruising, redness, or difficulty walking after an injury are definite signs that it's time to see Dr. Michaels

Diagnosis and Treatment

Dr. Michaels  will carefully examine your feet and ankles and take a complete medical history. He or she will also order tests, including an X-ray, ultrasound, or MRI, to determine the extent of your injury. If you have a fracture that's clearly visible on X-ray, you may not need additional testing. Ultrasounds and MRIs are useful for finding soft issue injuries (including torn ligaments) and stress fractures.

Treatment will depend on your injury. If you have a broken bone, your podiatrist may attempt to “reduce” the fracture, which means lining up the ends of the bones so they can heal properly. (You'll be given a local anesthetic to numb the area first.) If the fracture is “unstable,” meaning that the ends of the bone do not stay in place after a reduction, surgery may be needed. Podiatrists can use metal plates and screws to fix broken bones.
Stress fractures are treated with rest and immobilization. You will be instructed to stay off the affected area until healing is complete. Crutches and/or a special “boot” or cast may be used to immobilize the area.

Sprains are also treated with a period of immobilization. Depending on the extent of your sprain, you may be able to resume activity fairly quickly, or you may need to wear a soft cast or special “boot” and use crutches for a period of weeks.

Professional athletes may undergo surgery to repair torn ligaments.
Oral anti-inflammatory medication, such as ibuprofen, can be used to decrease pain, swelling, and inflammation.


Warming up prior to physical activity can prevent ankle sprains and fractures. So can wearing proper shoes. If you're an athlete, talk to your podiatrist to determine which shoes are best for your sport, and read APMA's footwear selection tips on our Tips for Healthy Feet page for more information. Athletic shoes should be replaced yearly; running shoes should be replaced every 300–400 miles or so.

Avoid running or walking on uneven surfaces

For further information about foot or ankle conditions, contact one of our foot and ankle surgeons at the Reconstructive Foot & Ankle Institute, LLC.  Visit us on the web at www.rfainstitute.com or make an appointment with one of our state of the art offices in Maryland:

Hagerstown 301.797.8554, 1150 Professional Court, Suite C, 21740

Frederick 301.418.6014, 2100 Old Farm Drive, Suite D, 21702

To make an appointment at our Frederick office, please call 301.797.8554.  2100 Old Farm Drive Ste. D, Frederick, MD 21702

To make an appointment at our Hagerstown office, please call 301.797.8554.  1150 Professional Court, Suite C, Hagerstown, MD 21740

Most insurance accepted but not required.

We look forward to solving your foot and ankle problems with Comprehensive Foot and Ankle Care® and treating you like a member of the family.

Very truly yours,

Daniel D. Michaels, DPM, MS & Associates


By contactus@rfainstitute.com
May 23, 2016
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What is Peripheral Neuropathy?

Peripheral neuropathy is damage of the peripheral nerves. Your peripheral nerves—the nerves in your toes and fingertips—are the ones on the periphery of your body. When the nerves are damaged, they don't function properly. People with peripheral neuropathy have decreased or abnormal sensation in their toes and fingers. Sometimes, they develop problems moving these parts of the body as well.


In the United States, the most common cause of peripheral neuropathy is diabetes. According to the American Diabetes Association, 60 to 70 percent of people with diabetes will develop neuropathy within their lifetime.
Other causes of peripheral neuropathy include:
• Certain medications, including some chemotherapy drugs.
• Heredity. Some people have a family history of peripheral neuropathy.
• Advanced age. Peripheral neuropathy is more common as people age.
• Arthritis. Certain type of arthritis can cause peripheral neuropathy.
• Alcoholism. According to the US National Library of Medicine, up to half of all long-term heavy alcohol users develop peripheral neuropathy.
• Neurological disorders. Certain neurological disorders, including spina bifida and fibromyalgia, are associated with peripheral neuropathy.
• Injury. Acute injury to the peripheral nerves may also cause peripheral neuropathy. 


The most common symptoms of peripheral neuropathy include burning, numbness, tingling, or shooting or stabbing pain in the toes and/or fingertips. Any change in sensation in the fingers or toes may be a symptom of peripheral neuropathy. Be sure to report any abnormal sensations to your doctor. Those sensations may be the first sign of another problem, such as diabetes.

Home Care

If you have peripheral neuropathy, it is important to inspect your feet regularly. Because decreased sensation may develop eventually, you might not notice an injury or infection. Someone who has diabetes and peripheral neuropathy with loss of protective sensation, for instance, could step on a tack without noticing it. Regularly inspect your feet so you can note any injuries or infections and seek appropriate medical attention as needed.
If you're unable to properly inspect your own feet, enlist a family member or friend to help you. It's absolutely essential that any injuries are caught and treated promptly. Otherwise, an infection can develop and progress.

People with peripheral neuropathy should wear properly fitted shoes and avoid walking barefoot to prevent injury. If you have diabetes, it's important to control your blood sugar as well, because out-of-control blood sugar leads to increased nerve damage. Take your insulin or medication as prescribed and follow the recommended diet.

When to Visit Dr. Michaels

Everyone with peripheral neuropathy of the feet should see Dr. Michaels.  He is specially trained to preserve the health of the feet.

Diagnosis and Treatment

Dr. Michaels, family physician, internist, or physician who specializes in diabetes can diagnose peripheral neuropathy. The diagnosis is made on the basis of a physical exam, health history, and your reporting of symptoms. The doctor may order a blood test to check your blood sugar level because high blood sugar levels and diabetes are an important cause of peripheral neuropathy.

There is no known cure for peripheral neuropathy. The goal of treatments are to slow the progression of the disease, to maintain foot health, and to decrease pain (if present) and improve the quality of life.

Dr. Michaels may prescribe oral medication to help with pain. He or she will also perform a thorough foot check to look for any injuries or infections and will teach you how to do the same. Your podiatrist will also show you how to take care of your feet at home. People who have peripheral neuropathy should have their feet examined by a podiatrist at least once per year.

If you also have diabetes, the podiatrist will work closely with you and other health-care professionals. Controlling the patient's blood sugar levels with diet, exercise, and medication (if needed) can slow the progression of peripheral neuropathy and maintain foot health.

The best thing you can do to prevent peripheral neuropathy is to keep your blood sugar levels under control. Peripheral neuropathy is common in people with diabetes, but the degree of neuropathy generally corresponds to the degree of blood sugar control. Someone whose blood sugar is kept under tight control will usually have much better sensation in their fingers and toes than someone with poorly controlled diabetes.


By contactus@rfainstitute.net
March 06, 2015
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One of the most common ailments that people complain of are bunions. A #bunion is a bump that forms on the base of the joint of the big toe. This bump is irritated by shoes rubbing against the affected area. This inflammation can become painful and cause the toe to stiffen and swell. If you fear that you are affected by bunions, please contact one of our convenient locations for an appointment with Dr. Michaels, 301-797-8554 for #hagerstown or 301-418-6014 for#frederick.


By contactus@rfainstitute.net
February 18, 2015
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#February is National Heart Healthy Month so today we have dedicated our#wackyshoewednesday to some pretty crazy heart heels! Keep in mind that we offer vascular testing to detect and diagnose poor blood flow. It is not uncommon that if you have poor vascular health in your feet you may also have it in your heart. Make sure to call our office if you are experiencing any symptoms (cold/bluish feet, swelling, ect.) to schedule an appointment with Dr. Michaels 301-797-8554 #hagerstown.

By contactus@rfainstitute.net
February 12, 2015
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With #Valentine'sDay quickly approaching, don't forget you can always give the gift of a gift certificate to our Safe Spa! Treat your loved one to a relaxing, safe #mani or #pedi! Call our office, 301-797-8554, to schedule a service or stop in to our #hagerstownlocation to pick up a gift certificate, 1150 Professional Court, Suite C, Hagerstown, MD!

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