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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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Foot Care After Spinal Cord Injury
Spinal cord injury (SCI) dramatically alters foot health through multiple mechanisms: loss of protective sensation below the injury level removes the warning system that normally prevents foot damage, paralysis eliminates the normal muscular support and movement that prevents deformity, autonomic dysfunction affects circulation and skin health, and the mechanical demands of wheelchair use, bracing, and transfers create unique pressure and friction patterns. At Balance Foot & Ankle in Howell and Bloomfield Township, Michigan, we provide specialized podiatric care for SCI patients throughout their recovery and long-term management.
Insensate Foot: The Core Challenge
The complete or partial loss of protective sensation below the injury level means that pressure, friction, temperature extremes, and wounds go undetected. This creates catastrophic potential for injury accumulation — what would be painful and immediately corrected in a sensate person becomes a chronic, progressive wound in an insensate patient. Daily foot inspection — by the patient when upper extremity function permits, or by a caregiver — is the most important preventive measure. Mirror inspection of the sole, systematic checking of all pressure-bearing surfaces including heel and malleoli, and immediate attention to any area of skin breakdown are non-negotiable.
Pressure Injuries: Prevention and Management
Pressure injuries (formerly called pressure ulcers or decubitus ulcers) develop over bony prominences where tissue is compressed between skin and hard surfaces — the heel is particularly vulnerable in bedridden or wheelchair-bound SCI patients. Prevention: heel-offloading boots for at-risk patients in bed, pressure-redistributing mattresses and seat cushions, regular repositioning, and meticulous skin inspection. Any heel or foot pressure injury in an SCI patient requires immediate offloading and professional wound care — insensate tissue heals poorly and infection can spread rapidly without the warning of pain.
Spasticity and Foot Deformity
Spasticity — the hyperreflexive muscle activity below the injury level — creates powerful and persistent forces that deform the foot over time. Equinus (plantarflexed foot position) from calf spasticity, inversion from tibialis anterior and posterior spasticity, and toe deformity from intrinsic imbalance all develop without appropriate management. Ankle-foot orthoses (AFOs) worn consistently prevent equinus contracture. Intramuscular botulinum toxin injection reduces spasticity in specific muscle groups. Surgical tendon lengthening addresses fixed contractures that AFOs cannot manage.
Coordinated Care
SCI foot care is best delivered as part of a coordinated team including physiatry, physical and occupational therapy, and podiatry. Regular podiatric visits — more frequent than the annual exam recommended for the general population — monitor developing pressure areas, manage nail care safely, and provide ongoing assessment of deformity and circulation status. Contact Balance Foot & Ankle at (810) 206-1402 to establish podiatric care after spinal cord injury.
Foot or Ankle Pain? We Can Help.
Balance Foot & Ankle — Howell & Bloomfield Township, MI
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When to See a Podiatrist After Spinal Cord Injury
Spinal cord injury creates unique foot care challenges including sensory loss, muscle imbalance, spasticity, and skin breakdown risk. At Balance Foot & Ankle, Dr. Tom Biernacki provides specialized foot care for SCI patients including pressure-relieving orthotics, spasticity management, wound prevention, and deformity correction.
Learn About Our Specialized Foot Care Options | Book Your Appointment | Call (810) 206-1402
Clinical References
- McKinley WO, Jackson AB, Cardenas DD, et al. Long-term medical complications after traumatic spinal cord injury: a regional model systems analysis. Arch Phys Med Rehabil. 1999;80(11):1402-1410.
- Garber SL, Rintala DH. Pressure ulcers in veterans with spinal cord injury: a retrospective study. J Rehabil Res Dev. 2003;40(5):433-441.
- Betz RD, Mulcahey MJ, D’Andrea LP, et al. Orthopaedic issues in spinal cord injury. In: Vaccaro AR, et al, eds. Spine surgery: techniques, complication avoidance, and management. Philadelphia: Churchill Livingstone; 2005.
Insurance Accepted
BCBS · Medicare · Aetna · Cigna · United Healthcare · HAP · Priority Health · Humana · View All →
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
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Same-week appointments available at both locations.
Book Your AppointmentMore Podiatrist-Recommended Foot Health Essentials
Hoka Clifton 10
Max-cushion everyday shoe — podiatrist favorite for walking and running.
PowerStep Pinnacle Insole
- The Pinnacle Full length insoles for men & women provide maximum cushioning, from high activity to moderate support. The PowerStep arch support shape provides stability to the foot and ankle, helping to relieve foot pain.
- When you spend all day on your feet, every step counts. PowerStep insoles are a podiatrist-recommended orthotic to help relieve & prevent foot pain related to athletes, runners, Plantar Fasciitis, heel spurs & other common foot, ankle & knee injuries
- The Pinnacle plantar fasciitis insoles offer superior heel cushioning and arch support. The dual-layer cushioning is designed to reduce stress and fatigue, while PowerStep premium arch support is designed for plantar fasciitis relief.
- The PowerStep Pinnacle arch support inserts for men & women can be worn in a variety of shoe types such as; athletic, walking, running, work & some casual shoes. Orthotic Inserts are ordered by shoe size, no trimming required.
- Made in the USA & backed by a 30-day money-back guarantee. PowerStep orthotic inserts for men & women are designed for shoes where the factory insole can be removed. HSA & FSA Eligible
The podiatrist-recommended over-the-counter orthotic.
OOFOS Recovery Slide
- The Original Recovery Footwear.
- Finding Your Size - For your perfect fit, consult the “size chart” link above. Wear a half size? In general, we recommend that women who wear a ½ size size UP, and men who wear a ½ size size DOWN
- OOahh - An evolution of the OOriginal, the OOahh slide features our proven foundation of OOfoam technology + patented footbed design with a slide-style strap that has become a best-seller in the OOFOS line
- OOfoam Technology - Our revolutionary OOfoam technology absorbs 37% more impact than traditional footwear foams to reduce the stress on your feet, joints & back. Plus, the closed-cell foam is machine washable and designed to minimize odor
- Patented Footbed - Our patented footbed cradles and supports arches to reduce energy exertion in the ankles by up to 47% compared to competitors’ footwear. So walking is easier. Recovery is faster. And yOO feel better
Impact-absorbing recovery sandal — wear after long days on your feet.
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
If foot or ankle pain has been bothering you for more than a few weeks, home care alone may not be enough. Balance Foot & Ankle offers same-week appointments at our Howell and Bloomfield Hills clinics — no referral needed in most cases. Bring your current shoes and a short list of symptoms and we’ll build you a treatment plan in one visit.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Dr. Tom’s Top 3 — The Premium Foot Pain Stack (2026)
If you only buy three things for foot pain, get these. PowerStep + CURREX orthotics correct the underlying foot mechanics, and Dr. Hoy’s pain gel delivers fast topical relief. This is the exact stack Dr. Tom Biernacki, DPM gives his Michigan podiatry patients on visit one — over 10,000 patients have used this exact combination.
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 for 30+ days minimum. Last verified: April 28, 2026.
PowerStep Pinnacle MaxxDr. Tom’s #1 Brand
Dr. Tom’s most-prescribed OTC orthotic. Lateral wedge corrects overpronation that causes 90% of foot pain. Deep heel cradle stabilizes the ankle. Built by podiatrists, used by patients worldwide.
- Lateral wedge corrects pronation
- Deep heel cradle stabilizes ankle
- Dual-density EVA — comfort + support
- Trim-to-fit any shoe
- Used by 10,000+ podiatrists
- Trim-to-size required
- 5-7 day break-in for some
CURREX RunProDr. Tom’s #1 Brand
3 arch heights for custom fit (Low/Med/High). Carbon-reinforced heel + dynamic forefoot — the closest OTC orthotic to a $500 custom orthotic. Engineered in Germany.
- 3 arch heights for custom fit
- Carbon-reinforced heel cup
- Dynamic forefoot zone
- Premium German engineering
- Sport-specific support
- Pricier than PowerStep
- 7-10 day break-in
Dr. Hoy’s Natural Pain Relief GelDr. Tom’s #1 Brand
Menthol-based natural pain relief — Dr. Tom’s #1 brand for fast relief without greasy residue. Safe for diabetics + daily use. Cleaner formula than Voltaren or Biofreeze.
- Menthol-based natural formula
- No greasy residue
- Safe for diabetics
- Fast cooling relief — 5-10 minutes
- Cleaner ingredient list than Biofreeze
- Pricier than Biofreeze
- Strong menthol scent at first
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.
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)