Quick answer: Treatment for achilles tendon rupture treatment michigan follows a stepwise approach: 1) conservative care first (rest, ice, supportive footwear, OTC anti-inflammatories), 2) physical therapy and targeted exercises, 3) in-office treatments (injections, custom orthotics) if conservative fails at 4-6 weeks, 4) surgery for refractory cases. Most patients resolve at step 1 or 2. Call (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
The most important clinical decision with Achilles Tendon Rupture Treatment Michigan isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.
Quick Answer
Achilles Tendon Rupture: Surgery vs. Boot Treatment Michigan relates to Achilles tendonitis — typically caused by sudden activity increase. Most patients improve in 8-12 weeks with conservative care. Same-week appointments in Howell + Bloomfield Hills: (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.
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An Achilles tendon rupture is one of the most feared sports injuries — a sudden, complete tear of the largest and strongest tendon in the body, occurring most commonly during explosive push-off movements like sprinting, jumping, or pivoting. The “pop” and immediate inability to push off are classic. The decision between surgical repair and non-surgical boot treatment is nuanced and has evolved significantly in recent years, with high-quality evidence showing functional bracing can match surgical outcomes in selected patients. At Balance Foot & Ankle in Howell and Bloomfield Hills, Michigan, Dr. Tom Biernacki, DPM provides comprehensive Achilles tendon rupture evaluation and management.
Quick Answer: Achilles Tendon Rupture
An Achilles tendon rupture causes a sudden pop, immediate severe pain at the back of the heel, and inability to push off or stand on tiptoe. The Thompson test (squeezing the calf produces no foot plantarflexion) confirms complete rupture. Treatment is either surgical repair (reattaching the tendon ends) or accelerated functional rehabilitation in a boot with early weight-bearing. Evidence shows similar re-rupture rates with either approach when accelerated rehabilitation protocols are used. Active athletes and younger patients often choose surgery for potentially faster return to sport; older less-active patients often achieve equivalent outcomes non-surgically. Go to the ER or call a podiatrist same-day — this is an acute surgical decision.
How Achilles Ruptures Happen
The classic mechanism is sudden eccentric loading of the calf — pushing off explosively while the knee is extended (basketball jump, sprint start, hill running). The rupture most commonly occurs 2–6 cm above the calcaneal insertion (the “watershed zone” where blood supply is poorest). The classic demographic is the “weekend warrior” — a 35–50 year old male who plays recreational sports after periods of relative inactivity, with pre-existing degenerative tendinopathy creating a weak point. However, ruptures occur at all ages and activity levels.
Warning: fluoroquinolone antibiotics (ciprofloxacin, levofloxacin) are associated with significantly increased tendon rupture risk — the Achilles is the most commonly affected tendon. If you’ve been on these antibiotics recently and experience Achilles pain, evaluation is urgent.
Diagnosis: Thompson Test and Ultrasound/MRI
The Thompson test (or Simmonds test) is highly accurate: with the patient prone and knee bent 90°, the examiner squeezes the calf. Normal: foot plantarflexes. Ruptured Achilles: no foot movement. Sensitivity and specificity >95%. Ultrasound is the preferred imaging study — it directly visualizes the rupture site, gap size (important for treatment planning), and can distinguish complete from partial rupture. MRI provides superior detail for complex presentations but is typically not required for straightforward complete rupture diagnosis.
Treatment Decision: Surgery vs. Accelerated Functional Rehabilitation
The treatment decision has evolved significantly since landmark randomized controlled trials (Willits et al. 2010, Twaddle & Poon 2007) showed that accelerated functional rehabilitation (early weight-bearing in a boot with progressive range of motion) achieves similar re-rupture rates and functional outcomes compared to surgical repair, while avoiding surgical complications.
Factors favoring surgical repair: Age <40, competitive athlete, elite or professional sport requirements, large tendon gap on ultrasound (>10mm), patient willing to accept surgical risks for potentially faster return to sport.
Factors favoring accelerated non-surgical rehabilitation: Age >55, sedentary or low-demand lifestyle, medical comorbidities that increase surgical risk (diabetes, peripheral artery disease, immunosuppression), patient preference to avoid surgery, small or reducible gap on ultrasound.
Key: the non-surgical protocol must be accelerated — immediate weight-bearing in a boot with heel raises (not strict non-weight-bearing), with progressive range of motion starting within days. The old “cast and wait” non-surgical approach had poor results; it is the accelerated early-mobilization protocol that matches surgical outcomes.
Surgical Repair: What to Expect
Open repair involves suturing the two tendon ends together through a longitudinal incision behind the ankle. Minimally invasive (percutaneous) techniques reduce wound complication risk while maintaining repair strength. Surgery is performed within 3–10 days of injury ideally; beyond 2 weeks the tendon ends begin to retract and gap, making repair more technically challenging. Post-surgical protocol: boot for 8–10 weeks with progressive weight-bearing; physical therapy for 3–6 months; return to sport 5–9 months.
Rehabilitation Timeline (Accelerated Protocol)
- Week 0–2: Boot with 3–4 heel raises (20–30mm); partial weight-bearing with crutches
- Week 2–4: Progressive weight-bearing; begin controlled dorsiflexion within boot
- Week 4–8: Full weight-bearing; begin calf strengthening; remove heel raises progressively
- Week 8–12: Transition from boot to shoe; begin eccentric calf training
- Month 3–5: Running progression on treadmill/soft surface
- Month 5–9: Return to sport (sport-specific testing required)
Warning Signs
- Pop during activity + inability to push off = ruptured Achilles until proven otherwise; seek same-day evaluation
- Swelling and bruising at the back of the heel (can be absent in complete rupture paradoxically)
- False reassurance from ability to plantarflex (partial toe flexor strength remains after complete Achilles rupture — the foot can still point down; the inability to push off body weight is the key test)
Achilles Rupture Evaluation in Michigan
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Dr. Tom Biernacki, DPM at Balance Foot & Ankle provides same-day Achilles tendon rupture evaluation with Thompson test, diagnostic ultrasound, and surgical/non-surgical treatment pathway guidance at both our Howell and Bloomfield Hills locations. This is a time-sensitive injury. Call (810) 206-1402 or book online.
Related Guides
- Achilles Tendonitis Non-Surgical Treatment
- Shockwave Therapy for Achilles
- PRP Injections for Foot & Ankle
- Haglund’s Deformity Guide
- Ankle Brace Types Guide
Dr. Tom’s Recommended Products for Achilles Tendon Pain
📍 Located in Michigan?
Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
These are products I personally use and recommend to my patients at Balance Foot & Ankle.
- Aircast AirHeel Ankle Brace — Pneumatic cells pulse with each step to reduce Achilles tendon load and promote blood flow for healing
- Doctor Hoy’s Natural Pain Relief Gel 3oz — Arnica + camphor formula — apply 3-4x daily to the painful area for natural topical relief
- PowerStep Pinnacle Plus Insoles (Heel Lift) — Elevated heel reduces Achilles tensile load with each step — immediate pain reduction for insertional tendonitis
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we trust for our own patients.
Dr. Tom’s Recommended: Natural Topical Pain Relief
This is what I actually use in our clinic at Balance Foot & Ankle.
- Doctor Hoy’s Natural Pain Relief Gel — Natural topical pain relief I use in our clinic. Arnica + camphor formula. Apply directly to the painful area 3-4x daily for fast-acting relief without NSAIDs.
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we trust for our own patients.
👟 Dr. Tom’s Pick: CURREX RunPro Insoles for Runners
CURREX RunPro are biomechanically tuned running insoles with 3 arch profiles (low, medium, high) to match your foot type. Unlike generic insoles, they’re engineered specifically for the high-impact demands of running — reducing pronation stress and metatarsal loading.
View CURREX RunPro on Amazon →Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases.
Join 950,000+ Learning About Foot Health
Dr. Tom shares honest medical advice, supplement reviews, and treatment guides you won’t find anywhere else.
Subscribe on YouTube →Recommended Products for Achilles Tendonitis
- Strassburg Sock Night Splint — Overnight Achilles Stretch
- Heel Lift Wedge Inserts — Reduce Achilles Tension
- Percussion Massager — Calf & Achilles Recovery
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Howell Office
4330 E Grand River Ave
Howell, MI 48843
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Bloomfield Hills Office
43494 Woodward Ave, #208
Bloomfield Hills, MI 48302
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Most Achilles tendonitis patients we see at Balance Foot & Ankle are recreational runners in their 40s or 50s who ramped up mileage too quickly, plus a second cohort of middle-aged women who recently switched from heels to flat shoes. The first question we ask is whether the pain is at the insertion on the heel bone versus 2–6 cm up the mid-substance — the treatment ladder is genuinely different. Eccentric heel-drops, heel lifts, and a soft-strike gait retraining pass resolve ~80 % of cases. The ones who aren’t improving by week 8 usually have an unrecognized Haglund’s deformity or insertional calcific tendinosis that needs imaging.
More Podiatrist-Recommended Achilles Essentials
Achilles Night Splint
United Ortho dorsiflexion splint — reduces morning Achilles tendon stiffness.
Cushioned Running Shoe
Watch: Torn Achilles Tendon Rupture — MichiganFootDoctors YouTube
Hoka Clifton 10 — max-heel-cushion offloads the Achilles with every step.
Calf Foam Roller
TriggerPoint foam roller — releases calf tension that upstream-drives Achilles inflammation.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
Achilles tendonitis that lasts more than 3 months has usually caused structural tendon changes that heating and stretching can’t reverse. Balance Foot & Ankle offers shockwave therapy and ultrasound-guided PRP for chronic Achilles pain — both treatments rebuild tendon tissue without surgery. If you’ve been icing, stretching, and modifying activity without improvement, it’s time for an in-office evaluation.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Pros & Cons of Conservative Care for Achilles tendonitis
Advantages
- ✓ Eccentric heel drops 80%+ effective
- ✓ Conservative treatment first
- ✓ Strong recovery prognosis
Considerations
- ✗ Recovery 8-12 weeks typical
- ✗ Risk of rupture if ignored
- ✗ Surgery required if rupture
Dr. Tom’s Recommended Products for Achilles tendonitis
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we use with patients.
TriggerPoint Footballer Dr. Tom’s Pick
Best for: Calf release + plantar release
Ready to Get Back on Your Feet?
Same-day appointments in Howell + Bloomfield Hills. Most insurance accepted. Dr. Tom Biernacki, DPM & team.
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Call Now: (810) 206-1402
About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Hills, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
Dr. Hoy’s Complete Pain Relief Line — Dr. Tom’s Picks (2026)
Dr. Hoy’s Natural Pain Relief is Dr. Tom Biernacki, DPM’s #1 prescription topical pain relief for plantar fasciitis, Achilles tendonitis, foot pain, knee pain, and back pain. Cleaner formula than Voltaren or Biofreeze — safe for diabetics + daily long-term use without 30-day limits. Below is the complete Dr. Hoy’s product line, organized by use case.
Dr. Hoy’s Natural Pain Relief Gel (4oz Tube)Dr. Tom’s #1 Brand
The flagship Dr. Hoy’s — menthol-based natural pain relief gel. The bottle Dr. Tom hands every plantar fasciitis patient on visit one. Cleaner formula than Voltaren or Biofreeze.
- Menthol-based natural formula
- No greasy residue
- Safe for diabetics
- Fast cooling relief 5-10 min
- Daily long-term use safe
- Pricier than Biofreeze
- Strong menthol scent at first
Dr. Hoy’s Natural Pain Relief Gel (8oz Pump Bottle)Dr. Tom’s #1 Brand
8oz pump bottle — same formula as the 4oz tube but 2x the value. Best for athletes, families, or chronic pain patients who use it daily.
- 8oz pump bottle
- 2x value of 4oz
- Same clean formula
- Easy pump dispensing
- Larger size
- Pricier upfront
Dr. Hoy’s Arnica Boost Pain ReliefDr. Tom’s #1 Brand
Dr. Hoy’s + arnica boost — for bruising, swelling, post-injury inflammation. Adds arnica’s anti-inflammatory power to the standard menthol formula.
- Added arnica for bruising
- Reduces post-injury swelling
- Fast topical relief
- Safe for athletes
- Specialty use
- Pricier than standard
Dr. Hoy’s Natural Pain Relief Roll-OnDr. Tom’s #1 Brand
Same Dr. Hoy’s formula in a roll-on stick — no greasy hands, no mess, perfect for gym bags and travel. TSA-friendly.
- No greasy hands
- TSA-friendly
- Travel-sized
- Same Dr. Hoy’s formula
- Less product per use
- Pricier per oz
Dr. Hoy’s Pain Relief Gel — 3-Pack BundleDr. Tom’s #1 Brand
3-pack of Dr. Hoy’s 4oz tubes — best per-tube price for chronic pain patients, families, or anyone who uses it daily.
- 3-pack bulk pricing
- Same flagship formula
- Stockpile value
- Family-sized
- Larger upfront cost
- Need storage space
Top 10 Premade Orthotics — Dr. Tom’s Picks (2026)
Dr. Tom Biernacki, DPM has tested 60+ over-the-counter orthotic insoles in his Michigan podiatry practice over the past 15 years. Below are the top 10 he prescribes most often — ranked by clinical results, build quality, and patient feedback. PowerStep + CURREX brands are Dr. Tom’s #1 prescription brands — built by podiatrists, with biomechanical features (lateral wedge, deep heel cradle, dual-density EVA) that 90% of OTC insoles lack.
Dr. Tom Biernacki, DPM is a board-certified podiatrist + Amazon Associate. Picks shown are products he prescribes to patients at Balance Foot & Ankle Specialists. We earn a commission on qualifying purchases at no extra cost to you. All products independently tested + reviewed. Last verified: April 28, 2026.
PowerStep Pinnacle MaxxDr. Tom’s #1 Brand
The most prescribed OTC orthotic in podiatry. Lateral wedge corrects overpronation that causes 90% of plantar fasciitis. Deep heel cradle stabilizes the ankle.
- Lateral wedge corrects pronation
- Deep heel cradle
- Dual-density EVA
- Trim-to-fit
- Used by 10,000+ podiatrists
- Trim required
- 5-7 day break-in
PowerStep Original Full LengthDr. Tom’s #1 Brand
The original PowerStep — flexible semi-rigid arch with deep heel cradle. The right choice for neutral feet that need everyday support without the lateral wedge.
- Flexible semi-rigid arch
- Deep heel cradle
- Fits dress shoes
- 30-day guarantee
- APMA-accepted
- Less aggressive than Pinnacle
- No lateral wedge for overpronation
PowerStep Pulse MaxxDr. Tom’s #1 Brand
Built for runners + athletes who need maximum support during high-impact activity. Engineered for forefoot strike + lateral motion.
- Sport-specific cushioning
- Lateral wedge for runners
- Antimicrobial top cover
- Shock-absorbing forefoot
- Pricier than Pinnacle
- Best for athletes only
CURREX RunProDr. Tom’s #1 Brand
German-engineered insole with 3 arch heights (Low, Med, High) for custom fit. Carbon-reinforced heel + dynamic forefoot.
- 3 arch heights for custom fit
- Carbon-reinforced heel
- Sport-specific zones
- Premium materials
- Pricier than PowerStep
- 7-10 day break-in
CURREX EdgeProDr. Tom’s #1 Brand
For hikers, skiers, and high-impact athletes — reinforced shank prevents foot fatigue on steep descents + uneven terrain.
- Reinforced shank
- 3 arch heights
- Cold-weather friendly
- Carbon plate
- Stiff feel — not for casual
- Pricier
CURREX SupportSTPDr. Tom’s #1 Brand
For nurses, retail, and standing professions — the most supportive CURREX with deep heel cup + maximum medial support.
- Maximum medial support
- Deep heel cup
- 12-hour shift tested
- Slip-proof
- Stiffest CURREX option
- Pricier
Superfeet Green
Firm, structured arch support — the right choice ONLY for high-arched (cavus) feet. Wrong choice for flat feet.
- Strong structured arch
- Deep heel cup
- Long-lasting (5+ years)
- Firm — not for flat feet
- No lateral wedge
Vionic OrthoHeel Active Insole
APMA-accepted, podiatrist-designed casual insole. Best for adding mild arch support to dress shoes + walking shoes.
- APMA-accepted
- Slim profile
- Antimicrobial top
- Less support than PowerStep
- No lateral wedge
Sof Sole Athlete
Budget athletic insole with neutral arch + gel forefoot. Decent value if you need a quick replacement.
- Affordable
- Gel forefoot
- Antimicrobial
- Wears out in 6 months
- No structured arch
Spenco Polysorb Total Support
Mid-range insole with 5-zone polysorb cushioning. Decent support for standing professions.
- 5-zone cushioning
- Trim-to-fit
- Mid-price point
- Less stable than PowerStep
- No lateral wedge
Dr. Tom’s Top 3 — The Premium Foot Pain Stack (2026)
If you only buy three things for foot pain, get these. PowerStep + CURREX orthotics correct the underlying foot mechanics, and Dr. Hoy’s pain gel delivers fast topical relief. This is the exact stack Dr. Tom Biernacki, DPM gives his Michigan podiatry patients on visit one — over 10,000 patients have used this exact combination.
Dr. Tom Biernacki, DPM is a board-certified podiatrist + Amazon Associate. Picks shown are products he prescribes to patients at Balance Foot & Ankle Specialists. We earn a commission on qualifying purchases at no extra cost to you. All products independently tested + reviewed for 30+ days minimum. Last verified: April 28, 2026.
PowerStep Pinnacle MaxxDr. Tom’s #1 Brand
Dr. Tom’s most-prescribed OTC orthotic. Lateral wedge corrects overpronation that causes 90% of foot pain. Deep heel cradle stabilizes the ankle. Built by podiatrists, used by patients worldwide.
- Lateral wedge corrects pronation
- Deep heel cradle stabilizes ankle
- Dual-density EVA — comfort + support
- Trim-to-fit any shoe
- Used by 10,000+ podiatrists
- Trim-to-size required
- 5-7 day break-in for some
CURREX RunProDr. Tom’s #1 Brand
3 arch heights for custom fit (Low/Med/High). Carbon-reinforced heel + dynamic forefoot — the closest OTC orthotic to a $500 custom orthotic. Engineered in Germany.
- 3 arch heights for custom fit
- Carbon-reinforced heel cup
- Dynamic forefoot zone
- Premium German engineering
- Sport-specific support
- Pricier than PowerStep
- 7-10 day break-in
Dr. Hoy’s Natural Pain Relief GelDr. Tom’s #1 Brand
Menthol-based natural pain relief — Dr. Tom’s #1 brand for fast relief without greasy residue. Safe for diabetics + daily use. Cleaner formula than Voltaren or Biofreeze.
- Menthol-based natural formula
- No greasy residue
- Safe for diabetics
- Fast cooling relief — 5-10 minutes
- Cleaner ingredient list than Biofreeze
- Pricier than Biofreeze
- Strong menthol scent at first
In-Office Treatment at Balance Foot & Ankle
If home treatment isn’t providing relief for your Achilles tendon conditions, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.
Same-day appointments available. (810) 206-1402
Frequently Asked Questions
How long does treatment take to work?
Most patients see improvement in 4-8 weeks with consistent conservative care. Persistent symptoms after 8 weeks need imaging and escalation.
When is surgery needed?
Surgery is reserved for cases that fail 3-6 months of conservative care, structural deformities, or fractures requiring stabilization.
Is this covered by insurance?
Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Custom orthotics often require diabetic or post-surgical justification.
What is Achilles tendon?
Achilles tendon is a common foot/ankle condition that affects mobility and quality of life. Understanding the underlying cause is the first step in successful treatment. Our podiatrists at Balance Foot & Ankle perform a hands-on biomechanical exam, review your activity history, and use diagnostic imaging when appropriate to identify the root cause—not just treat the symptom. Many patients have been told to “rest and ice” without a deeper diagnostic workup; our approach is different.
Symptoms and warning signs
Common signs of Achilles tendon include pain that worsens with activity, morning stiffness, swelling, tenderness when palpated, and difficulty bearing weight. If you experience sudden severe pain, inability to walk, visible deformity, numbness or color change, contact our office the same day or visit urgent care—these can signal a more serious injury such as a fracture, tendon rupture, or vascular compromise. Diabetics with any foot wound should seek same-day care.
Conservative treatment options
Most cases of Achilles tendon respond to non-surgical care: structured rest, supportive footwear changes, custom orthotics, targeted stretching and strengthening protocols, anti-inflammatory medications when medically appropriate, and in-office procedures such as ultrasound-guided injections. We also offer advanced therapies including MLS laser therapy, EPAT/shockwave, regenerative injections, and image-guided procedures. Treatment is sequenced from least invasive to most invasive, and we explain the rationale at every step.
When is surgery considered?
Surgery is reserved for cases that fail 3-6 months of well-structured conservative care, when there is structural pathology (severe deformity, complete tear, advanced arthritis), or when imaging shows damage that will not heal without intervention. Our surgeons have performed 3,000+ foot and ankle procedures and prioritize minimally-invasive techniques whenever appropriate. We discuss recovery timelines, return-to-activity milestones, and realistic outcome expectations before any procedure is scheduled.
Recovery timeline and prevention
Recovery from Achilles tendon varies based on severity and chosen treatment path. Conservative cases often improve within 4-8 weeks with consistent adherence to the protocol. Post-procedural recovery may range from a few days (in-office procedures) to several months (reconstructive surgery). Long-term prevention involves footwear assessment, activity modification, structured strengthening, and regular check-ins with your podiatrist if you have a history of recurrence. We provide written home-exercise plans and digital follow-up support.
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Same-week appointments available in Howell and Bloomfield Hills, Michigan.
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Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.