Custom Orthotics Michigan 2026 | Balance Foot & Ankle

What Conditions Do Custom Orthotics Treat?

Custom orthotics are evidence-supported for a wide range of lower extremity conditions — the common thread is that biomechanical dysfunction (abnormal foot mechanics during standing, walking, or running) is either causing or significantly contributing to the pain. Dr. Biernacki prescribes custom orthotics for:

Condition	How Orthotics Help	Evidence Level
Plantar Fasciitis	Reduce strain on plantar fascia by correcting overpronation and supporting the arch	Strong — multiple RCTs
Flat Feet (Pes Planus)	Medial arch support prevents arch collapse and redistributes pressure	Strong
Heel Pain / Heel Spurs	Heel cup and cushioning reduce impact at the heel; correct pronation	Strong
Bunions	Slow progression by correcting foot pronation that drives 1st MTP deformity	Moderate
Morton’s Neuroma	Metatarsal pad reduces nerve compression in the forefoot	Moderate
Knee Pain (Patellofemoral)	Foot pronation correction reduces tibial rotation that causes knee tracking problems	Moderate
Diabetic Foot Care	Pressure redistribution protects high-risk areas from ulceration	Strong — ADA guideline
Posterior Tibial Tendon Dysfunction	Medial arch support reduces tendon strain and prevents progressive flat foot	Strong
Achilles Tendinopathy	Heel lift reduces Achilles tension; controls over-pronation that strains medial Achilles	Moderate

Custom Orthotics vs. Store-Bought Insoles: The Real Difference

The fundamental difference is that custom orthotics are prescribed and cast for your specific foot — the structural problem driving your pain is identified first, then the device is designed to correct it. Store-bought insoles provide standardized cushioning based on generic arch height categories (low/medium/high) — they cannot address the specific biomechanical dysfunction that causes your particular condition.

Feature	Custom Orthotic (Dr. Biernacki)	OTC Insole
Foot casting	3D mold of your exact foot	Generic sizing
Biomechanical exam	Gait analysis + clinical assessment	None
Prescription	Tailored to your diagnosis	Not prescribed
Materials	Medical-grade polypropylene, carbon fiber, EVA	Foam, gel (softer, less durable)
Durability	3-5 years typical	3-6 months typical
Insurance coverage	Yes — most PPO plans cover when medically indicated	No
Adjustable	Yes — Dr. Biernacki adjusts fit at follow-up	No

The Balance Foot & Ankle complete custom orthotics guide Process

Step 1: Biomechanical Evaluation

Dr. Biernacki begins with a comprehensive biomechanical assessment: static stance evaluation (how your arches and ankles look bearing weight), gait analysis (how your foot moves through the walking cycle), range of motion testing (ankle dorsiflexion, subtalar joint mobility, forefoot alignment), and neurovascular assessment. For diabetic patients, a pressure mapping study identifies high-risk plantar areas requiring offloading.

Step 2: Foot Casting

Dr. Biernacki casts the foot in the subtalar neutral position — the anatomically correct alignment where the foot is neither pronated nor supinated. This is the critical step where expertise matters most: casting in the wrong position produces an orthotic that corrects to the wrong position, causing discomfort and failure. Casting methods at Balance Foot & Ankle include plaster slipper cast, foam box casting, or digital 3D scanning — the method chosen based on foot complexity and clinical requirements.

Step 3: Orthotic Prescription & Fabrication

The cast is sent to a certified orthotic laboratory with Dr. Biernacki’s written prescription specifying: shell material (polypropylene thickness, carbon fiber), intrinsic or extrinsic posting (wedge angles to correct rearfoot or forefoot varus/valgus), topcover material (leather, EVA, Poron for diabetic patients), and any additions (heel lift, metatarsal pad, Morton’s extension, toe filler). Fabrication takes 2-3 weeks.

Step 4: Fitting & Adjustment

At the fitting appointment, Dr. Biernacki evaluates the orthotic in your shoe, watches you walk, and makes real-time adjustments using a grinder and heat gun if needed. Minor modifications — edge grinding, heat-molding, adding padding — fine-tune the fit. A follow-up visit at 4-6 weeks confirms clinical improvement and addresses any pressure points or accommodation issues. Orthotics are covered by a satisfaction guarantee — adjustments are made until the fit is correct.

Watch: The Future of Custom Orthotics at Balance Foot & Ankle Michigan

See the custom orthotic process at Balance Foot & Ankle — from foot casting to gait analysis to final fitting — and learn how Dr. Biernacki personalizes each device to the patient’s specific biomechanical dysfunction:

Insurance Coverage for Custom Orthotics in Michigan

Most PPO health insurance plans cover custom orthotics when they are medically necessary — meaning a documented foot condition is causing functional limitation. Coverage requires a written prescription from a physician and documentation of the clinical diagnosis. Medicare Part B covers custom diabetic shoes and inserts for qualifying diabetic patients under the Therapeutic Shoes for Persons with Diabetes benefit. Balance Foot & Ankle verifies your orthotic coverage before your appointment — call (810) 206-1402 and we will check benefits at no charge.

Common insurances accepted at Balance Foot & Ankle that cover orthotics: Blue Cross Blue Shield of Michigan, United Healthcare, Cigna, Aetna, Priority Health, HAP, Meridian, McLaren, Molina, and most other Michigan PPO plans. We verify benefits before your appointment so there are no billing surprises.

Frequently Asked Questions: Custom Orthotics Michigan

How long do custom orthotics last?

Custom orthotics typically last 3-5 years for adults with stable foot structure. The hard shell (polypropylene or carbon fiber) is durable and rarely needs replacement; the topcover (the cushioning layer you stand on) typically wears out in 1-2 years and can be replaced at lower cost. Children need new orthotics every 12-18 months as their feet grow. Athletes who train daily may need shell replacement in 2-3 years due to higher mechanical stress.

Are custom orthotics worth the cost over OTC insoles?

For biomechanical conditions (plantar fasciitis, flat feet, heel pain, knee pain from foot mechanics), custom orthotics produce significantly better outcomes than OTC insoles. A 2022 systematic review found custom orthotics reduced pain scores 40-60% more than OTC insoles for plantar fasciitis. When the orthotic cost is divided over 3-5 years of use, the per-day cost is typically less than a quality OTC insole replaced every 3-6 months. For patients with insurance coverage, the cost difference is even smaller.

Can I put custom orthotics in any shoe?

Custom orthotics work best in shoes with removable insoles and adequate depth in the toe box. Athletic shoes, walking shoes, work boots, and most casual lace-up shoes accommodate orthotics well. Dress shoes and high heels have limited depth and may not accommodate a full-length orthotic — Dr. Biernacki can prescribe a 3/4-length or heel-and-arch style orthotic for dress shoe use. Sandals and flip-flops cannot accommodate standard orthotics, though custom orthotic sandals are available.

Do custom orthotics hurt at first?

A break-in period of 1-2 weeks is normal — the foot and lower leg muscles adapt to the new position. Dr. Biernacki recommends starting with 2-3 hours of wear daily and increasing by 1-2 hours per day until full-time use is comfortable. Mild arch or leg fatigue during break-in is normal; sharp pain, pressure points, or worsening of the original condition is not normal and should prompt a return visit for adjustment.

Schedule Your Orthotic Consultation

Balance Foot & Ankle offers custom orthotic consultations at both Michigan locations. Most patients are assessed and cast in one appointment — orthotics ready in 2-3 weeks. We verify insurance benefits before your visit so you know your cost upfront.

• Howell: 4330 E Grand River Ave, Howell MI 48843
• Bloomfield Hills: 43494 Woodward Ave #208, Bloomfield Hills MI 48302
• Phone: (810) 206-1402

Related Services

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• Diabetic Foot Care
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