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.

How does Charcot-Marie-Tooth disease affect the feet?

CMT causes progressive weakness of the foot and leg muscles, leading to high arches (pes cavus), hammertoes, foot drop, ankle instability, and difficulty walking. The peroneal muscles weaken first, causing the foot to turn inward. Over time, the foot deformities become rigid and painful, increasing the risk of calluses, ulcers, and ankle sprains.

What treatments are available for CMT foot problems?

Treatment is stage-dependent. Early stages benefit from custom orthotics to support the arch and redistribute pressure, ankle-foot orthoses (AFOs) for foot drop, physical therapy to maintain strength and flexibility, and properly fitted shoes. Advanced deformities may require surgical correction including tendon transfers, osteotomies, and joint fusions to restore a stable, plantigrade foot.

Should CMT patients see a podiatrist regularly?

Yes, regular podiatric care is essential for CMT patients. A podiatrist monitors deformity progression, adjusts orthotics and bracing as the condition changes, manages calluses and skin breakdown, provides nail care for thickened nails, and determines the optimal timing for surgical intervention if needed. Visits every 3-6 months are typical.

Charcot-Marie-Tooth Disease & Foot Problems

Name: Charcot-Marie-Tooth Disease & Foot Problems
Creator: Dr. Tom Biernacki, DPM
Published: 2026-03-23T12:30:33-04:00

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

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

Charcot-Marie-Tooth Disease: A Genetic Neuropathy

Charcot-Marie-Tooth (CMT) disease is the most common inherited peripheral neuropathy, affecting approximately 1 in 2,500 people. Named after the three physicians who described it in 1886, CMT causes progressive deterioration of the peripheral nerves, leading to characteristic foot deformities, weakness, and sensory loss that worsen gradually over decades.

How CMT Affects the Foot

CMT causes distal muscle wasting — weakness and atrophy preferentially affecting the intrinsic foot muscles and the muscles of the lower leg. The imbalance between stronger and weaker muscles creates progressive deformities: pes cavus (high arch) from intrinsic weakness with intact flexors, hammer or claw toes from intrinsic-minus foot mechanics, foot drop from peroneal and anterior tibial weakness (causing a steppage gait), and ankle instability from peroneal weakness. The sensory loss accompanying CMT reduces protective sensation, increasing injury risk.

Conservative Management

Conservative care focuses on accommodating deformities, preventing progression where possible, and maintaining function. Custom orthoses — often ankle-foot orthoses (AFOs) for foot drop or severe cavovarus deformity — are the cornerstone of CMT foot management. Orthotics and AFOs must be carefully designed to accommodate rigid deformities, protect insensate skin, and provide sufficient stability for safe ambulation. Sturdy footwear with good ankle support complements orthotic management. Physical therapy maintains flexibility and prevents contracture development.

Surgical Options

When deformities are rigid, painful, or beyond orthotic accommodation, surgery addresses specific structural problems. Plantar fascia release and tendon transfers correct cavus deformity. Calcaneal osteotomy corrects varus (inward tilting) of the heel. Toe corrections address claw and hammertoe deformities. Ankle fusion may be needed for end-stage equinovarus deformity. CMT surgical planning requires careful assessment of which muscle groups retain function to ensure transferred tendons have adequate power. The podiatric surgeons at Balance Foot & Ankle in Howell and Bloomfield Township have experience with CMT foot reconstruction.

Monitoring and Long-Term Care

CMT is a lifelong condition requiring regular monitoring of deformity progression, neurological status, and skin/nail integrity. Annual podiatric evaluations allow proactive orthotic adjustment and early identification of surgical candidates before deformities become fixed and more complex to correct. Genetic counseling and neurology co-management are integral to comprehensive CMT care.

Foot or Ankle Pain? We Can Help.

Balance Foot & Ankle — Howell & Bloomfield Township, MI

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Charcot-Marie-Tooth Disease? Specialized Foot Care Available

CMT causes progressive muscle weakness and foot deformities that require expert podiatric management. Dr. Tom Biernacki provides custom bracing, orthotics, and surgical correction tailored to the unique challenges of Charcot-Marie-Tooth patients.

Learn About Neuromuscular Foot Care | Book Your Appointment | Call (810) 206-1402

Clinical References

Burns J, et al. Interventions for the prevention and treatment of pes cavus. Cochrane Database of Systematic Reviews. 2007;(4):CD006154.
Pareyson D, Marchesi C. Diagnosis, natural history, and management of Charcot-Marie-Tooth disease. Lancet Neurology. 2009;8(7):654-667.
Reilly MM, et al. Charcot-Marie-Tooth disease. Journal of the Peripheral Nervous System. 2011;16(1):1-14.

Insurance Accepted

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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

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

Board-Certified Podiatrist

Dr. Daria Gutkin, DPM

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Dr. Tom Biernacki, DPM

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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.