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 common are blood clots after foot surgery?

DVT occurs in approximately 2-6% of patients after foot and ankle surgery, though rates can be higher with prolonged immobilization, major reconstructive procedures, or additional risk factors. Pulmonary embolism (PE) is less common but potentially life-threatening, occurring in less than 1% of cases.

What are risk factors for DVT after foot surgery?

Major risk factors include prolonged non-weight-bearing immobilization, history of blood clots, obesity (BMI >30), smoking, oral contraceptive or hormone use, cancer, clotting disorders, age over 40, and varicose veins. Combined risk factors significantly increase DVT likelihood.

How is DVT prevented after foot and ankle surgery?

Prevention strategies include early ankle pumping exercises, mechanical compression devices during and after surgery, aspirin for low-risk patients, and prescription blood thinners (low-molecular-weight heparin or oral anticoagulants) for high-risk patients. Risk assessment determines the appropriate level of prophylaxis.

DVT Prevention After Foot & Ankle Surgery Guide

Name: DVT Prevention After Foot & Ankle Surgery Guide
Creator: Dr. Tom Biernacki, DPM
Published: 2026-03-22T09:32:18-04:00

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.

Deep vein thrombosis (DVT) — blood clot formation in the deep veins of the lower leg — is a recognized complication of foot and ankle surgery, particularly procedures requiring non-weight-bearing immobilization. While the absolute incidence of symptomatic DVT after foot and ankle surgery is lower than after hip and knee arthroplasty (1–3% vs. 10–15%), pulmonary embolism (PE) from DVT is potentially life-threatening, and understanding DVT prevention strategies helps patients and their care teams minimize this risk.

Risk Stratification

High-risk procedures and patient factors for foot/ankle surgical DVT: hindfoot and ankle procedures with prolonged non-weight-bearing (calcaneal osteotomy, triple arthrodesis, Achilles repair, ankle ORIF) — more risky than forefoot procedures where early weight-bearing is possible; patient risk factors: prior DVT or PE (highest risk — anticoagulation is mandatory), active malignancy, inflammatory bowel disease, thrombophilia (factor V Leiden, prothrombin gene mutation), obesity (BMI >35), age >60, combined oral contraceptive use, prolonged air travel within 2 weeks of surgery, and venous insufficiency. Low-risk patients undergoing forefoot procedures with early protected weight-bearing: mechanical prophylaxis only (ankle pump exercises, early mobilization).

Prevention Strategies

Mechanical prophylaxis: ankle dorsiflexion-plantarflexion ‘pump’ exercises begin immediately post-operatively (20 repetitions every hour while awake) — the calf muscle pump is the primary driver of deep venous return; sequential compression devices (SCDs) applied to the non-operative extremity during surgery and the first 24–48 hours post-operatively. Pharmacological prophylaxis: aspirin 81–325mg daily for low-to-moderate risk patients undergoing non-weight-bearing hindfoot surgery — emerging evidence supports aspirin efficacy with lower bleeding risk than anticoagulants; low-molecular-weight heparin (LMWH — enoxaparin) or direct oral anticoagulants (DOACs — rivaroxaban, apixaban) for high-risk patients or those with prior VTE history. Warning signs requiring immediate evaluation: unilateral calf swelling, warmth, and erythema (DVT); sudden dyspnea, chest pain, or hypoxia (PE). Dr. Biernacki at Balance Foot & Ankle stratifies DVT risk before all foot and ankle surgical procedures and prescribes individualized prophylaxis protocols. Call (810) 206-1402 at our Bloomfield Hills or Howell office.

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When to See a Podiatrist

Many foot conditions can be managed conservatively at home, but some require professional evaluation. See a podiatrist promptly if you experience:

Pain that persists for more than 2 weeks despite rest
Swelling, redness, or warmth that isn’t improving
Numbness, tingling, or burning in the feet
A wound or sore that is not healing within 2 weeks
Any foot concern if you have diabetes or poor circulation
Nail changes that suggest fungal infection or other problems

At Balance Foot & Ankle, our three board-certified podiatrists — Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin — provide comprehensive foot and ankle care at our Howell and Bloomfield Township offices. Most insurance plans are accepted.

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Board-certified podiatrists Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients daily at our Howell and Bloomfield Township, MI offices.

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Frequently Asked Questions

How do I know if I sprained or broke my ankle?

Both cause pain, swelling, and difficulty walking. Key differences: fractures often cause more immediate severe pain, tenderness directly over bone (not just ligament), and inability to bear any weight. X-rays and the Ottawa Ankle Rules help determine if imaging is needed.

How long does an ankle sprain take to heal?

Grade I (mild): 1–2 weeks. Grade II (moderate): 3–6 weeks. Grade III (complete tear): 2–3 months. Chronic instability from improperly treated sprains can persist and may require surgery.

What is the best treatment for a sprained ankle?

RICE protocol (Rest, Ice, Compression, Elevation) for the first 48–72 hours, followed by protected weight-bearing as tolerated. Physical therapy rehabilitation is critical for high-grade sprains to restore strength and proprioception and prevent chronic instability.

Need Treatment at Balance Foot & Ankle?

Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients at our Howell and Bloomfield Township offices.

Book Online or call (810) 206-1402

Blood Clot Prevention After Foot & Ankle Surgery

Deep vein thrombosis (DVT) is a serious risk after foot and ankle surgery, especially during non-weight-bearing recovery. Our surgeons implement evidence-based DVT prevention protocols tailored to each patient’s risk factors to ensure safe surgical recovery.

Learn About Our Surgical Care | Book Your Appointment | Call (810) 206-1402

Clinical References

Fleischer AE, Abicht BP, Baker JR, et al. American College of Foot and Ankle Surgeons clinical consensus statement: risk, prevention, and diagnosis of venous thromboembolism disease in foot and ankle surgery. J Foot Ankle Surg. 2015;54(3):497-507.
Calder JDF, Freeman R, Domeij-Arverud E, et al. Meta-analysis and suggested guidelines for prevention of venous thromboembolism in foot and ankle surgery. Knee Surg Sports Traumatol Arthrosc. 2016;24(4):1409-1420.
Saragas NP, Ferrao PNF, Saragas E, Jacobson BF. The impact of risk assessment on the implementation of venous thromboembolism prophylaxis in foot and ankle surgery. Foot Ankle Surg. 2014;20(2):85-89.

Dr. Tom Biernacki, DPM

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.

Medical References

Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
Plantar Fasciitis (APMA)
Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
Heel Pain (APMA)

This article has been reviewed for medical accuracy by Dr. Tom Biernacki, DPM. References are provided for informational purposes.