Medically reviewed by Dr. Tom Biernacki, DPM — Board-certified foot & ankle surgeon, 3,000+ surgeries performed. Updated April 2026 with current clinical evidence. This article reflects real practice experience from Balance Foot & Ankle Specialists in Howell and Bloomfield Hills, Michigan.
Quick Answer
Custom orthotics are prescription inserts made from a 3D scan of your foot. They address the structural cause of plantar fasciitis, flat feet, or metatarsalgia rather than just cushioning symptoms. Most patients feel improvement within 2-4 weeks. Covered by most PPO plans and Medicare when medically indicated.
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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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Podiatrist Recommended Orthotics 2026: Dr. Tom’s Top 10 Insoles & Arch Supports
A podiatrist’s complete clinical guide to the best insoles — custom orthotics, OTC picks, and what actually works for plantar fasciitis, flat feet, neuropathy & more.
Read the Full Guide →Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Insurance Accepted
BCBS · Medicare · Aetna · Cigna · United Healthcare · HAP · Priority Health · Humana · View All →
Howell Office
4330 E Grand River Ave
Howell, MI 48843
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Bloomfield Hills Office
43494 Woodward Ave, Suite 208
Bloomfield Hills, MI 48302
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Your Board-Certified Podiatrists
Ready to Get Back on Your Feet?
Same-week appointments available at both locations.
Book Your AppointmentWatch: Custom vs Store Orthotics
Dr. Tom explains the real difference between custom orthotics and store-bought insoles — materials, design, and outcomes.
Quality OTC Insole Options
While custom orthotics are the gold standard, these OTC options bridge the gap:
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Best OTC for most foot types — our #1 recommendation.
Sport-specific support for runners and athletes.
Budget pick for mild overpronation.
Cushioning focus — good for metatarsal pain.
Related: Custom Orthotics · Gait Analysis · Book Orthotic Consult
👟 Dr. Tom’s Complete Footwear Library
Podiatrist-Approved Guides for Every Foot Type & Condition
Clinically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist
All guides are written and reviewed by licensed podiatrists. Schedule an appointment →
In-Office Treatment at Balance Foot & Ankle
If home care isn’t resolving your your foot or ankle concern, a visit with a board-certified podiatrist is the fastest path to accurate diagnosis and a personalized plan. At Balance Foot & Ankle Specialists, Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin offer same-day and next-day appointments at both our Howell and Bloomfield Hills offices. We perform on-site diagnostic ultrasound, digital X-ray, conservative care, advanced regenerative treatments, and minimally invasive surgery when indicated.
Call (810) 206-1402 or request an appointment online. Most insurance plans accepted, including Medicare, Blue Cross Blue Shield, Aetna, Cigna, and United Healthcare.
In Our Clinic
The patients we see for custom orthotic consultations usually fall into two groups. First are athletes — runners, hikers, basketball players — looking to correct a biomechanical asymmetry they’ve identified themselves or their coach has flagged. Second are middle-aged patients with chronic plantar fasciitis, metatarsalgia, or early arthritis who have exhausted over-the-counter inserts. Our process begins with a 3D foot scan plus a gait-video analysis on our in-office treadmill. We select materials based on activity — a stiffer carbon composite for performance running, a softer plastazote top cover for diabetic patients, a semi-rigid polypropylene for everyday wear. Most patients adapt in 2–4 weeks.
Most Common Mistake We See
The most common mistake we see is: Wearing new orthotics all day from day one. Fix: break-in schedule of 2 hours on day one, adding 2 hours per day until full-day tolerance.
Warning Signs That Need Same-Day Care
Seek immediate evaluation at Balance Foot & Ankle if you experience any of the following:
- New sharp pain under the arch that did not exist before
- Skin breakdown over pressure points
- Diabetic patient with any new pressure spot
- Worsening of original symptoms after 4 weeks
Call (810) 206-1402 — same-day and next-day appointments at our Howell and Bloomfield Hills offices.
More Podiatrist-Recommended Orthotics Essentials
PowerStep Pinnacle

Watch: Best Insoles & Orthotics 2026 [Flat Feet, Plantar Fasciitis, Bunions] — MichiganFootDoctors YouTube
The podiatrist-recommended OTC orthotic — arch support + heel cup.
CURREX RunPro Insole
Performance insole for runners — reduces fatigue and prevents injuries.
Tuli’s Heel Cups
Shock-absorbing heel cushion — adds lift and relief under painful heels.
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
Off-the-shelf inserts help 70% of patients — but if you’ve tried several without relief, custom orthotics molded to your specific foot mechanics are usually the next step. Balance Foot & Ankle makes custom orthotics in-office and most major insurance plans cover them. We’ll cast or scan your feet and have them ready in about 2 weeks.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
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
Foundation Wellness Orthotic Selector — PowerStep + CURREX by Condition (2026)
Find the right Foundation Wellness orthotic for YOUR specific condition. Dr. Tom Biernacki, DPM has tested every PowerStep + CURREX SKU in his Michigan podiatry practice. Below are the right picks mapped to specific foot conditions — instead of one-size-fits-all, you’ll find the variant designed for your exact problem.
PowerStep Pinnacle MaxxDr. Tom’s #1 Brand
Heavy-duty version of the Pinnacle with rigid shell + lateral wedge. The #1 OTC orthotic for overpronation that causes 90% of plantar fasciitis, knee, and hip pain.
- Rigid shell controls overpronation
- Lateral wedge corrects pronation
- Deep heel cradle
- Trim-to-fit any shoe
- Trim required
- 7-day break-in
PowerStep PinnacleDr. Tom’s #1 Brand
Flagship PowerStep — semi-rigid arch with deep heel cradle. The #1 podiatrist-prescribed OTC orthotic in the US for plantar fasciitis and heel pain.
- Semi-rigid medical-grade arch
- Deep heel cradle
- Dual-density EVA
- APMA-accepted
- 30-day guarantee
- Trim required
- Less aggressive than Maxx
PowerStep Pinnacle High ArchDr. Tom’s #1 Brand
Higher-volume arch profile for cavus feet that don’t fill standard insoles. Prevents the lateral roll that causes ankle sprains in supinators.
- High-arch profile
- Deep heel cradle
- Prevents lateral roll
- Only for high arches
- Wrong choice for flat feet
PowerStep Pinnacle Plus (with Built-In Met Pad)Dr. Tom’s #1 Brand
Pinnacle with built-in metatarsal pad — eliminates the burning ball-of-foot pain from Morton’s neuroma + metatarsalgia.
- Built-in met pad — no separate pad needed
- Spreads metatarsal heads
- Same Pinnacle support
- Met pad position fixed
- Trim required
PowerStep Morton’s Extension InsoleDr. Tom’s #1 Brand
Stiffener under the 1st MTP joint — limits big toe extension. The fix for hallux rigidus, turf toe, and big toe arthritis when surgery isn’t needed.
- Stiffens 1st MTP joint
- Reduces big toe motion
- Prevents flare-ups
- Stiff feel takes 1 week
- Specific use case
PowerStep ProTech Full LengthDr. Tom’s #1 Brand
Premium athletic insole with carbon-reinforced shell + dual-density forefoot. Best PowerStep for serious athletes.
- Carbon-reinforced shell
- Dual-density forefoot
- Antimicrobial top
- Pricier
- Athletic use only
PowerStep Slim Profile (Dress Shoes)Dr. Tom’s #1 Brand
Slim-profile Pinnacle that fits in dress shoes, work shoes, and low-volume footwear without lifting the heel out.
- Slim profile fits dress shoes
- Same Pinnacle arch
- Low-friction top
- Less cushion than full Pinnacle
- Trim required
PowerStep Wide (EE / EEE Fit)Dr. Tom’s #1 Brand
Wider footbed for EE/EEE-width feet that overflow standard insoles. Same Pinnacle support, wider sole.
- Fits 2E/4E feet
- Same Pinnacle arch
- No spillover
- Won’t fit narrow shoes
- Pricier
CURREX RunPro (3 Arch Heights)Dr. Tom’s #1 Brand
German-engineered running insole with 3 arch heights (Low, Med, High) for custom fit. Carbon-reinforced heel — closest OTC orthotic to a $500 custom orthotic.
- 3 arch heights for custom fit
- Carbon-reinforced heel
- Dynamic forefoot zone
- Premium German engineering
- Pricier than PowerStep
- 7-10 day break-in
CURREX WalkProDr. Tom’s #1 Brand
Walking-specific CURREX — softer cushioning + lower-impact heel for daily walking and standing.
- Walking-specific cushioning
- 3 arch heights
- Premium materials
- Pricier
- Not for high-impact running
CURREX AceProDr. Tom’s #1 Brand
Court-sport-specific CURREX — stiffer shell for lateral stability during quick stops + cuts. Pickleball + tennis + basketball.
- Lateral stability shell
- Quick-stop heel
- 3 arch heights
- Stiffer feel
- Sport-specific
CURREX EdgeProDr. Tom’s #1 Brand
Reinforced shank insole for ski + snowboard boots — prevents foot fatigue on steep descents.
- Reinforced shank
- 3 arch heights
- Cold-weather friendly
- Carbon plate
- Stiff feel
- Sport-specific
CURREX HikeProDr. Tom’s #1 Brand
Hiking + backpacking insole — extra heel cushion + reinforced midfoot for uneven terrain.
- Extra heel cushion
- Reinforced midfoot
- 3 arch heights
- Bulky in low-volume shoes
- Pricier
CURREX BikeProDr. Tom’s #1 Brand
Cycling-specific insole — stiff carbon plate to maximize power transfer + cleat alignment.
- Stiff carbon plate
- Cleat-compatible
- Lightweight
- Cycling-only
- Pricier
Doctor Hoy’s Natural Pain Relief Gel
Natural topical pain relief I use in our clinic. Arnica + camphor formula — apply directly to the area 3–4x daily. ($20–25)
Shop Doctor Hoy’s →Frequently Asked Questions
Which is better for plantar fasciitis?
The shoe with more cushioning and a stronger rocker typically wins for plantar fasciitis. See full comparison for our specific verdict.
Which lasts longer?
Both options typically last 300-500 miles for runners or 9-12 months for daily walkers. Material durability varies; check our detailed comparison.
Which is better for flat feet?
Flat feet need stability or motion control. The neutral option is not ideal unless paired with a custom orthotic.
Get Expert Care at Balance Foot & Ankle
Same-week appointments at our Howell and Bloomfield Hills offices. Board-certified podiatric surgeons. Most insurance accepted.
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.
