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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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
When Ankle Reconstruction Becomes the Answer
Chronic lateral ankle instability — the persistent sensation of the ankle “giving way” — affects millions of Americans, particularly those with prior ankle sprains who never fully rehabilitated. For most patients, a structured rehabilitation program restores sufficient stability for daily activities and sport. But for a significant minority whose instability persists despite adequate conservative management, ankle ligament reconstruction offers a reliable surgical solution.
Confirming the Diagnosis Before Surgery
Surgical candidacy for ankle reconstruction requires confirming that mechanical instability is present (not purely functional instability from muscle weakness), that adequate conservative rehabilitation has been attempted (typically 6 months of structured peroneal strengthening and proprioceptive training), that the instability is causing significant functional limitations despite bracing, and that the patient understands and accepts the surgical process and recovery demands. Stress X-rays or MRI may confirm ligamentous laxity, though clinical examination by an experienced surgeon is often the most informative assessment.
The Broström-Gould Procedure
The most commonly performed ankle reconstruction for chronic lateral instability is the modified Broström-Gould procedure — an anatomic repair that uses the patient’s own attenuated ATFL and CFL tissue, reinforced with the inferior extensor retinaculum, to reconstruct stable ligaments in their native positions. This anatomic approach preserves normal ankle motion and biomechanics, unlike non-anatomic tenodesis procedures that sacrifice normal joint mechanics to achieve stability. The Broström-Gould has an extensive evidence base with excellent long-term outcomes — 90%+ satisfaction rates and return to prior activity levels in most patients.
Who Is NOT a Candidate for Standard Reconstruction
Patients with generalized ligamentous laxity syndromes (Ehlers-Danlos syndrome), prior failed reconstruction with inadequate native tissue remaining, revision situations requiring grafting, or significant associated pathology (osteochondral lesions, peroneal tendon tears) may require modifications of the standard procedure or alternative approaches. These patients benefit from surgeons with extensive ankle reconstruction experience and access to allograft tissue when needed.
Recovery and Return to Sport
Ankle reconstruction recovery requires patience and commitment. Non-weight-bearing or protected weight-bearing for 2-4 weeks is followed by progressive weight-bearing in a boot. Physical therapy begins at 4-6 weeks, focusing on range of motion, peroneal strengthening, and proprioceptive training. Return to cutting sports and full athletic activity typically occurs at 4-6 months. Most patients find that their ankle feels more stable immediately after surgery than it has since before their original ankle sprains — a gratifying outcome for patients who have been managing instability for years.
Foot or Ankle Pain? We Can Help.
Balance Foot & Ankle — Howell & Bloomfield Township, MI
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📞 (810) 206-1402
Need Ankle Reconstruction? Expert Surgical Care Available
Ankle reconstruction surgery restores stability and function to severely damaged ankles. Dr. Tom Biernacki performs advanced ligament reconstruction, tendon repair, and joint restoration procedures with proven outcomes and comprehensive post-operative care.
Learn About Ankle Reconstruction | Book Your Appointment | Call (810) 206-1402
Clinical References
- Krips R, et al. Anatomical reconstruction and Evans tenodesis of the lateral ligaments of the ankle. Foot and Ankle International. 2002;23(8):743-745.
- Bell SJ, et al. Anatomic reconstruction of the lateral ankle ligaments using the Brostrom-Gould technique. Foot and Ankle International. 2006;27(11):913-917.
- Petrera M, et al. Surgical management of chronic ankle instability. Foot and Ankle Clinics. 2013;18(2):241-260.
Insurance Accepted
BCBS · Medicare · Aetna · Cigna · United Healthcare · HAP · Priority Health · Humana · View All →
Howell Office
3980 E Grand River Ave, Suite 140
Howell, MI 48843
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Bloomfield Hills Office
43700 Woodward Ave, Suite 207
Bloomfield Hills, MI 48302
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Your Board-Certified Podiatrists
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Same-week appointments available at both locations.
Book Your AppointmentMore Podiatrist-Recommended Surgery Essentials
OOFOS Recovery Slide
- The Original Recovery Footwear.
- Finding Your Size - For your perfect fit, consult the “size chart” link above. Wear a half size? In general, we recommend that women who wear a ½ size size UP, and men who wear a ½ size size DOWN
- OOahh - An evolution of the OOriginal, the OOahh slide features our proven foundation of OOfoam technology + patented footbed design with a slide-style strap that has become a best-seller in the OOFOS line
- OOfoam Technology - Our revolutionary OOfoam technology absorbs 37% more impact than traditional footwear foams to reduce the stress on your feet, joints & back. Plus, the closed-cell foam is machine washable and designed to minimize odor
- Patented Footbed - Our patented footbed cradles and supports arches to reduce energy exertion in the ankles by up to 47% compared to competitors’ footwear. So walking is easier. Recovery is faster. And yOO feel better
Post-op approved — impact-absorbing slide for early recovery.
HOKA Ora 3 Recovery Slide
- Model ID: 1135061-BTRT
Max-cushion recovery sandal — comfort for post-surgical swelling.
Hoka Bondi 9
Max-cushion walking shoe — ease into return-to-walking post-surgery.
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
Foot and ankle surgery in 2026 is dramatically different than a decade ago — most procedures are now minimally-invasive, outpatient, and allow weight-bearing within days. Balance Foot & Ankle surgeons have performed 3,000+ foot/ankle surgeries with modern techniques. If another surgeon has recommended a traditional open procedure, a second opinion may reveal a faster, less-invasive option.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Watch: Dr. Tom explains
Podiatrist-recommended products
As an Amazon Associate, Dr. Tom earns from qualifying purchases.
Post-op immobilization for ankle reconstruction.
View on Amazon →Post-surgical cold therapy.
View on Amazon →Long-term arch support post-reconstruction.
View on Amazon →Menthol topical for post-surgical pain.
View on Amazon →Related resources
Ready to solve this? Book today.
Same-week appointments · Howell & Bloomfield Hills · 4.9★ (1,123+ reviews)
☎ (810) 206-1402Book Online →PowerStep Dynamic Ankle Stability Sock (DASS)
Best for: Chronic ankle instability · Repeat ankle sprains · Proprioception training · Athletes returning to play
A revolutionary alternative to bulky ankle braces. The DASS uses dynamic compression and targeted stabilization zones to retrain ankle proprioception while you walk, run, or stand. Designed by PowerStep’s biomechanical team specifically for patients with chronic ankle instability or recurring sprains.
- Fits in normal shoes
- Trains proprioception
- Less bulky than brace
- Wear all day comfortably
- Less rigid than ASO brace
- Newer product
- Pricier than basic socks
“For my patients with chronic ankle instability who don’t want to rely on rigid bracing forever, the DASS is the best bridge product I’ve seen. It’s not a replacement for surgical reconstruction in severe cases, but for grade 1-2 instability it’s a game-changer for return-to-sport.”
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
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- 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
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- Fast cooling relief — 5-10 minutes
- Cleaner ingredient list than Biofreeze
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- Strong menthol scent at first
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.
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)