When should I see a podiatrist?

You should see a podiatrist for any persistent foot or ankle pain lasting more than a few days, difficulty walking, numbness or tingling, wounds that won't heal, changes in skin color or temperature, or structural deformities. Dr. Tom Biernacki, DPM is a board-certified podiatrist serving SE Michigan with same-day appointments available. Call 810-206-1402.

Does Dr. Biernacki accept insurance?

Balance Foot & Ankle accepts most major insurance plans including Blue Cross Blue Shield, Aetna, United Healthcare, Cigna, Medicare, and many others. Contact our office at 810-206-1402 to verify your specific coverage. We also offer affordable self-pay options.

What should I expect at my first podiatry appointment?

Your first visit includes a comprehensive evaluation with Dr. Biernacki including medical history review, physical examination, biomechanical assessment, and any necessary diagnostic imaging (X-rays are available in-office). You'll receive a diagnosis, treatment plan, and same-day treatment when possible. Most initial visits take approximately 30-45 minutes.

Ankle & Foot Tendon Injuries | Complete Guide to Tendons at Risk

Name: Ankle & Foot Tendon Injuries | Complete Guide to Tendons at Risk
Creator: Dr. Tom Biernacki, DPM
Published: 2026-03-23T13:05:05-04:00

Medically Reviewed by Dr. Jeffery Agnoli, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.

Foot and Ankle Tendons: The Moving Parts That Fail

The foot and ankle depend on a complex network of tendons — the cable-like structures connecting muscles to bones — to produce and control movement. Understanding which tendons are injured in specific clinical presentations directs appropriate diagnosis and treatment. At Balance Foot and Ankle in Howell and Bloomfield Township, Michigan, we evaluate and treat the full spectrum of foot and ankle tendon pathology.

Achilles Tendon

The Achilles — the largest and strongest tendon in the body — connects the gastrocnemius and soleus calf muscles to the calcaneus. It is subject to two distinct injury patterns: mid-substance tendinopathy (pain 2-6 cm above the heel insertion, from repetitive overload) and insertional tendinopathy (pain directly at the heel bone attachment, often with Haglund’s spur). Both respond to eccentric loading exercise programs. Complete Achilles rupture — an acute, often painless pop with complete loss of plantarflexion power — requires surgical or conservative management with extended immobilization.

Posterior Tibial Tendon

The posterior tibial tendon is the primary dynamic arch support and most commonly injured through progressive overuse in the middle-aged and older population, particularly women. Tendinopathy causes inner ankle pain and progressive arch collapse — left untreated, PTTD advances to flexible then rigid flatfoot requiring complex surgical reconstruction. Early orthotic support and strengthening exercises arrest progression.

Peroneal Tendons

The peroneal longus and brevis tendons run behind the lateral malleolus and evert the foot. They are injured in ankle sprains, from repetitive inversion stress, and from anatomic anomalies (a shallow fibular groove that allows tendon subluxation — snapping sensation at the outer ankle). Longitudinal splits in the peroneal brevis are common in athletes with chronic ankle instability. Surgical repair addresses persistent tendon tears and subluxation.

Flexor Hallucis Longus

The FHL runs through a fibrous tunnel behind the medial ankle and under the arch to insert on the base of the great toe. It is the “push-off” tendon for the great toe — essential for running and ballet. Tendinopathy causes posterior ankle or arch pain with great toe flexion and is particularly common in dancers. Tenosynovitis and nodule formation can cause triggering (stenosing tenosynovitis of the great toe).

Extensor Tendons

The extensor digitorum longus and extensor hallucis longus run across the top of the foot. They are more commonly injured by direct trauma (lacerations, contusions) than by overuse. Extensor tendinitis from tight shoelaces or footwear pressing on the dorsum of the foot is treated by footwear modification and anti-inflammatory measures.

When Tendons Need Surgery

Tendon surgery is indicated for complete ruptures requiring repair, longitudinal tears causing persistent pain despite conservative care, tendon subluxation, and chronic tendinopathy with failed conservative management. Contact Balance Foot and Ankle at (810) 206-1402 for evaluation of any tendon injury — early diagnosis and appropriate treatment prevents progression to conditions requiring surgical intervention.

Foot or Ankle Pain? We Can Help.

Balance Foot & Ankle — Howell & Bloomfield Township, MI

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Dr. Tom Biernacki, DPM

Affiliate Disclosure: This page contains affiliate links to products we recommend. If you purchase through these links, Balance Foot & Ankle may earn a small commission at no additional cost to you. We only recommend products we use with our patients.

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon 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 reached over one million views.