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.

What causes foot drop?

Foot drop is caused by weakness of the muscles that lift the foot. Common causes include peroneal nerve injury (from knee surgery, crossing legs, or trauma), lumbar disc herniation, stroke, multiple sclerosis, and Charcot-Marie-Tooth disease.

Can foot drop be cured?

Recovery depends on the cause. Peroneal nerve compression often recovers with time and physical therapy. If nerve recovery doesn't occur within 6-12 months, tendon transfer surgery (posterior tibial tendon to dorsum of foot) can restore active dorsiflexion.

What is an AFO for foot drop?

An ankle-foot orthosis (AFO) is a brace that holds the foot in a neutral position to prevent tripping and allow normal walking. Custom AFOs are fitted by your podiatrist and are the primary treatment while awaiting nerve recovery or as a permanent solution.

Foot Drop: Peroneal Nerve Injury & Treatment

Name: Foot Drop: Peroneal Nerve Injury & Treatment | Podiatrist
Creator: Dr. Tom Biernacki, DPM
Published: 2026-03-22T11:30:56-04:00

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. Jeffery Agnoli, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.

Foot drop — inability to dorsiflex the foot from peroneal nerve dysfunction — is a functionally disabling condition that forces a high-stepping gait pattern, increases fall risk, and produces a slapping foot strike from loss of the anterior compartment muscles. Accurate anatomical localization of the nerve injury (common peroneal at the fibular neck vs. deep peroneal at the anterior ankle vs. lumbar radiculopathy at L4–L5) determines whether the prognosis for recovery is favorable and guides the selection between conservative management with ankle-foot orthosis (AFO), nerve repair or decompression, and tendon transfer for permanent foot drop.

Anatomy, Causes, and Electrodiagnostic Assessment

Peroneal nerve anatomy: the common peroneal nerve divides at the fibular neck into the superficial peroneal (eversion, sensation over the dorsal foot) and deep peroneal (ankle dorsiflexion and EHL — sensation first web space); the fibular neck is the most vulnerable point — compression from leg crossing, plaster cast pressure, prolonged squatting, knee dislocation, or proximal fibular fracture. Causes of foot drop: common peroneal nerve palsy at the fibular neck (most common compressive neuropathy of the lower extremity — 87% of peroneal palsies); deep peroneal nerve entrapment; L4–L5 radiculopathy (distinguishable by preserved eversion and inversion); sciatic nerve injury; central (stroke, MS, spinal cord lesion). Electrodiagnostic testing (EMG/NCS): essential for localization — nerve conduction studies show reduced CMAP amplitude and conduction velocity across the fibular neck; EMG denervation potentials in the tibialis anterior and peronei; the EDB is an accessible distal muscle for prognosis assessment. Prognosis: compressive neuropathies at the fibular neck with axonotmesis (preserved endoneurial tubes) — 70–80% spontaneous recovery over 3–6 months; neurotmesis (complete disruption) — poor spontaneous recovery, surgical repair or reconstruction required.

Management: AFO vs. Surgery

AFO (ankle-foot orthosis): indicated for all patients during the observation period for spontaneous recovery; carbon fiber posterior leaf spring AFO for mild foot drop; solid ankle AFO for complete palsy; maintains dorsiflexion for safe ambulation; does not preclude surgical intervention if recovery is incomplete. Peroneal nerve decompression: surgical decompression at the fibular neck for compressive neuropathy with electrophysiological evidence of incomplete injury — 70–80% functional improvement when performed within 6 months of onset; fibular neck osteomalacia correction and scar tissue release. Tendon transfer for permanent foot drop (>12–18 months without recovery): posterior tibial tendon transfer through the interosseous membrane (Bridle procedure) — PTT rerouted anteriorly to insert on the dorsal midfoot; provides active dorsiflexion from a normally innervated tendon; 75–85% functional improvement with AFO requirements significantly reduced; requires intact tibialis posterior strength preoperatively. Dr. Biernacki at Balance Foot & Ankle evaluates and manages foot drop with AFO prescription and surgical tendon transfer at our Bloomfield Hills and Howell offices. Call (810) 206-1402.

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Frequently Asked Questions

What is the best treatment for peripheral neuropathy in the feet?

Treatment depends on the cause. For diabetic neuropathy, blood sugar control is most important. Other options include B12 supplementation, MLS laser therapy, topical creams (capsaicin, lidocaine), and prescription medications like gabapentin or duloxetine. Our podiatrists tailor treatment to each patient’s specific type and severity.

Can neuropathy be reversed?

In some cases — particularly when caused by vitamin deficiencies or early-stage diabetes with good glucose control. However, long-standing nerve damage is often permanent. Treatment focuses on slowing progression, managing symptoms, and preventing dangerous foot complications like ulcers.

How often should I see a podiatrist if I have neuropathy?

Patients with peripheral neuropathy should have comprehensive foot exams every 3–6 months, or more frequently if they have diabetes, poor circulation, or a history of foot ulcers.

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

Foot Drop Treatment in Michigan

Balance Foot & Ankle diagnoses and treats foot drop from peroneal nerve injury, spinal conditions, and neurological disorders. Our podiatrists provide AFO bracing and surgical tendon transfer options.

Explore Our Nerve & Tendon Treatments → | Book Your Appointment | Call (810) 206-1402

Clinical References

Stewart JD. Foot drop: where, why and what to do? Pract Neurol. 2008;8(3):158-169.
Vigasio A, et al. New tendon transfer for correction of drop-foot in common peroneal nerve palsy. Clin Orthop Relat Res. 2008;466(6):1454-1466.
Sackley C, et al. An approach to the management of foot drop. BMJ. 2009;338:b1735.

Dr. Tom Biernacki, DPM

Affiliate Disclosure: This page contains affiliate links to products we recommend. If you purchase through these links, Balance Foot & Ankle may earn a small commission at no additional cost to you. We only recommend products we use with our patients.

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.