What does a podiatrist treat?

Podiatrists specialize in the foot, ankle, and lower leg. They diagnose and treat heel pain, bunions and hammertoes, tendon injuries, nerve conditions (Morton's neuroma, neuropathy), toenail disorders, skin conditions (warts, calluses, ulcers), fractures, sports injuries, diabetic foot complications, ankle instability, and perform foot and ankle surgery. At Balance Foot & Ankle, Dr. Tom Biernacki DPM, Dr. Carl Jay DPM, and Dr. Daria Gutkin DPM AACFAS serve Howell, Bloomfield Hills, and surrounding Michigan communities.

How often should a healthy person see a podiatrist?

Annual foot exams are beneficial if you are over 60, are an active runner or athlete, have diabetes, have a family history of foot problems, or notice any changes in foot shape, nail appearance, or skin texture. Preventive visits catch problems early — before bunions require surgery or a small nail issue becomes an infection.

Can foot problems cause knee, hip, or back pain?

Yes — the foot is the foundation of the kinetic chain. Overpronation causes the tibia to internally rotate, increasing stress on the knee and altering hip alignment. High arches transmit shock poorly, overloading the ankle and knee. Custom orthotics that correct foot mechanics frequently improve knee, hip, and back symptoms — one of the most underappreciated benefits of podiatric care.

When should I see a podiatrist versus an orthopedic surgeon?

Podiatrists specialize exclusively in the foot, ankle, and lower leg — making them the most experienced providers for most foot and ankle conditions. For foot and ankle surgery, a DPM with high case volume is appropriate. Dr. Tom Biernacki at Balance Foot & Ankle has performed over 3,000 foot and ankle procedures. Call (810) 206-1402.

Lateral Ankle Reconstruction: Brostrom Procedure 2026

Procedure	Technique	Indication	Success Rate	Return to Sport
Modified Brostrom	Direct anatomic ATFL repair to fibula with suture anchors	First-time surgery; adequate native tissue	85–90%	4–5 months
Brostrom-Gould	Brostrom + IER augmentation to fibula	Severe laxity; hypermobility; high-demand athletes	90–95%	4–6 months
Brostrom + CFL Repair	ATFL + CFL simultaneous repair	Combined ATFL + CFL laxity on stress X-ray	90–95%	5–6 months
Allograft Reconstruction (Chrisman-Snook)	Split peroneus brevis or allograft threaded through bone tunnels	Revision; failed Brostrom; insufficient tissue; hypermobility syndrome	75–85%	6–9 months
InternalBrace Augmentation	Brostrom + synthetic ligament tape (FiberTape) between fibula and talus	High-demand; revision augmentation; faster return desired	90–95%	3–4 months (faster protocol possible)

Phase	Timeline	Goal	Milestones
Phase 1: Protection	0–2 weeks	Wound healing; swelling control	NWB in cast or boot; elevation; ice
Phase 2: Early Motion	2–6 weeks	ROM restoration; gentle strengthening	PWB in boot; active ROM exercises; scar massage
Phase 3: Strengthening	6–12 weeks	Peroneal strength; proprioception	Full WB; resistance band eversion; balance board
Phase 4: Functional Training	3–5 months	Sport-specific movements; jogging	Running mechanics; lateral agility drills; cutting
Phase 5: Return to Sport	4–6 months	Full competitive return	Strength >90% contralateral; hop test; ankle stability

Medically Reviewed | Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle, Michigan

https://www.youtube.com/watch?v=8opvH3qxkW4

Dr. Biernacki explains the Broström procedure — the surgical fix for chronic ankle instability that has failed physical therapy — and what Michigan patients can expect from surgery to return to sport.

Podiatrist explaining Brostrom lateral ankle ligament reconstruction to a patient in Michigan

Chronic lateral ankle instability is one of the most common sequelae of ankle sprains — and one of the most undertreated. When the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) are repeatedly sprained without adequate healing, they become permanently elongated and lose their ability to prevent ankle rolling. Patients develop a chronic giving-way sensation, recurrent sprains with trivial trauma, and ongoing apprehension with athletic activity. For patients who have failed adequate physical therapy and bracing, the Broström procedure offers a definitive, anatomic repair of the lateral ankle ligament complex.

Watch: Ankle conditions & surgical options

MICHIGAN PODIATRIST INSIGHT

The most important clinical decision with Lateral Ankle Ligament Reconstruction Brostrom Procedure isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.

Who Is a Candidate for the Broström Procedure?

The ideal Broström candidate has documented chronic lateral ankle instability with recurrent giving-way, has completed at least 3–6 months of structured physical therapy (peroneal strengthening, proprioception, neuromuscular training) without adequate improvement, and demonstrates objective instability on examination or stress X-rays. MRI is performed to confirm ATFL and CFL status and rule out concurrent pathology (osteochondral lesions, peroneal tendon tears) that may require simultaneous treatment. Patients with severe hyperlaxity (generalized joint hypermobility) or revision cases may require a tenodesis augmentation rather than the anatomic repair.

The Broström Procedure: What Happens

The procedure is typically performed as an outpatient surgery under general or regional anesthesia. A 4–5cm incision is made along the anterior lateral ankle. The ATFL (and CFL if needed) are identified and released from their fibular origin. The ligaments are imbricated (tightened and overlapped) and reattached to the fibula with suture anchors — restoring their anatomic tension and length. The Gould modification — augmenting the repair with a flap of the inferior extensor retinaculum sutured over the repaired ligaments — provides additional strength and is used in most cases. If concurrent pathology is present (osteochondral lesion, loose bodies), it is addressed arthroscopically at the same setting.

Recovery Timeline

Recovery from the Broström procedure follows a structured progression. Weeks 1–2: non-weight-bearing in a splint/cast, elevation. Weeks 3–6: progressive weight bearing in a boot. Weeks 6–10: walking shoe, begin physical therapy (ROM, gentle strengthening). Weeks 10–16: progressive strengthening, proprioception, jogging. Months 4–6: sport-specific training, return to full sport with ankle brace. Most recreational athletes return to sport at 4–5 months; high-level athletes may require 5–6 months for complete recovery and confidence in the repaired ankle.

Outcomes and Long-Term Results

The Broström-Gould procedure has excellent long-term outcomes in the literature. Systematic reviews report good-to-excellent results in 85–95% of patients. Recurrence rates for instability are low — particularly in normal body weight patients without hyperlaxity. Most patients report significant improvement in subjective instability, confidence during athletic activity, and ankle-related quality of life. The anatomic repair preserves the natural ligament biology, unlike tenodesis procedures that sacrifice normal anatomy.

Dr. Tom's Product Recommendations

Ossur Formfit Ankle Walker Boot

⭐ Highly Rated

Walking boot for early post-Broström procedure recovery — provides immobilization during the critical initial ligament healing phase.

Dr. Tom says: “After Broström surgery, patients transition from a splint to a walking boot around weeks 3–4. A comfortable, well-fitting walking boot that can be adjusted as swelling decreases makes the recovery phase significantly more manageable.”

✅ Best for
Post-Broström procedure recovery, ligament repair immobilization phase

⚠️ Not ideal for
Return to sport phase (ankle brace worn instead)

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Med Spec ASO Ankle Stabilizer

⭐ Highly Rated

Lace-up ankle brace for the return-to-sport phase after Broström procedure — provides external lateral support while the repaired ligaments reach full strength.

Dr. Tom says: “I recommend all Broström patients wear an ankle brace during athletic activity for at least the first year after surgery. The Med Spec ASO is low-profile, fits in athletic footwear, and provides the right amount of lateral support to protect the repaired ligament.”

✅ Best for
Post-Broström return to sport, ankle protection during athletics, ongoing instability prevention

⚠️ Not ideal for
Very early post-operative phase (walking boot required instead)

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Disclosure: We earn a commission at no extra cost to you.

✅ Pros / Benefits

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❌ Cons / Risks

Dr. Tom Biernacki’s Recommendation

The Broström procedure is one of my favorite surgeries because it works so well and the patients come back transformed. Someone who’s been rolling their ankle six times a year, avoiding hiking and basketball and volleyball — after recovery they’re back to everything and feel completely confident in their ankle. The key is selecting the right patient: adequate physical therapy tried first, documented instability, no severe hyperlaxity. When those boxes are checked, the Broström rarely disappoints.

— Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle

Frequently Asked Questions

How do I know if I need the Broström procedure?

If you’ve had recurrent ankle sprains, a giving-way sensation with normal activities, and you’ve completed 3–6 months of physical therapy without adequate improvement, you may be a Broström candidate. A foot and ankle specialist evaluation including stress X-rays and MRI confirms the diagnosis.

Is the Broström procedure the same as ankle ligament repair?

Yes — the Broström procedure is the anatomic lateral ankle ligament repair, the most commonly performed ankle stabilization surgery. The Gould modification adds extensor retinaculum augmentation.

How long is recovery from Broström surgery?

Most patients return to sport at 4–6 months. Walking independently starts around 3–4 weeks post-op. Physical therapy begins at 6 weeks and runs for 3–4 months.

Can the Broström procedure fail?

Recurrence rates are low (approximately 5–10%). Risk factors for failure include severe generalized hyperlaxity, high BMI, and return to high-demand sport too early without adequate rehabilitation.

Is Broström surgery done arthroscopically?

Traditionally, the Broström is an open procedure. Arthroscopic-assisted techniques exist and are growing in use, but the open Gould-modified Broström remains the gold standard at most centers.

Michigan Foot Pain? See Dr. Biernacki In Person

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Same-week appointments · Howell & Bloomfield Hills

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In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your lateral ankle ligament reconstruction brostrom procedure, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

Same-day appointments available. (810) 206-1402

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Dr. Tom Biernacki, DPM

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.