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
Most foot and ankle problems respond to conservative care — proper footwear, supportive inserts, activity modification, and targeted stretching — within 4-8 weeks. Persistent pain beyond that window, or any symptom that prevents walking, warrants a podiatric evaluation to rule out fracture, tendon tear, or systemic cause.
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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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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Platelet-rich plasma (PRP) — a concentration of autologous growth factors derived from the patient’s own blood — has become one of the most widely used biological treatments in musculoskeletal medicine, with applications in foot and ankle care for plantar fasciitis, Achilles tendinopathy, and chronic ligament injuries. Understanding the science behind PRP, the quality of the evidence supporting its use, and the specific protocols that maximize benefit helps patients make informed decisions about PRP treatment.
Mechanism of Action
PRP preparation: a small volume of the patient’s blood (15–60mL) is centrifuged using a double-spin or single-spin protocol to concentrate platelets 3–5× above baseline. The concentrated platelet layer is then activated or injected unactivated — platelets release growth factors from their alpha granules that stimulate tissue repair: PDGF (platelet-derived growth factor — stimulates fibroblast proliferation), TGF-β (transforming growth factor beta — promotes collagen synthesis), VEGF (vascular endothelial growth factor — stimulates neovascularization), IGF-1 (insulin-like growth factor — increases cell proliferation), and EGF (epidermal growth factor). In tendinopathy specifically, PRP is hypothesized to restart the healing cascade in stalled chronic degeneration by reintroducing growth factors that have become depleted in chronically degenerated tissue.
Evidence and Clinical Applications
Plantar fasciitis: Level I evidence from multiple randomized controlled trials — PRP produces superior long-term pain reduction compared to cortisone injection at 3, 6, and 12 months; cortisone has superior short-term (1–4 weeks) pain relief. PRP is the preferred injection treatment for plantar fasciitis when long-term outcomes are prioritized. Achilles tendinopathy (mid-portion): Level II evidence — peritendinous PRP injections combined with eccentric loading show benefit for mid-portion tendinopathy that has not responded to eccentric loading alone; evidence for insertional Achilles tendinopathy is less robust. Lateral ankle ligament injuries: emerging evidence for PRP in Grade II–III lateral ankle sprains and chronic ligament insufficiency, though not yet standard of care. Protocol considerations: leukocyte-rich vs. leukocyte-poor PRP formulations; the optimal centrifugation protocol varies by condition — leukocyte-poor PRP is preferred for joint injections; leukocyte-rich PRP for tendon and fascia. Dr. Biernacki at Balance Foot & Ankle offers ultrasound-guided PRP injections for plantar fasciitis and Achilles tendinopathy. Call (810) 206-1402 at our Bloomfield Hills or Howell office to discuss whether PRP is appropriate for your condition.
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Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
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.
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
PRP Therapy for Foot & Ankle Conditions in Michigan
Platelet-rich plasma (PRP) injections harness your body’s own healing factors to accelerate tissue repair. Our podiatrists offer PRP therapy for plantar fasciitis, Achilles tendinopathy, ankle sprains, and other chronic foot and ankle conditions.
Explore Advanced Treatment Options | Book Your Appointment | Call (810) 206-1402
Clinical References
- Peerbooms JC, van Laar W, Faber F, et al. Use of platelet rich plasma to treat plantar fasciitis: design of a multi centre randomized controlled trial. BMC Musculoskelet Disord. 2010;11:69.
- de Vos RJ, Weir A, van Schie HT, et al. Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA. 2010;303(2):144-149.
- Monto RR. Platelet-rich plasma efficacy versus corticosteroid injection treatment for chronic severe plantar fasciitis. Foot Ankle Int. 2014;35(4):313-318.
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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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Same-week appointments available at both locations.
Book Your AppointmentMost Common Mistake We See
The most common mistake we see is: Waiting too long before seeking care. Fix: any foot pain lasting more than 4 weeks, or any sudden severe symptom, deserves a professional evaluation rather than more rest.
Warning Signs That Need Same-Day Care
Seek immediate evaluation at Balance Foot & Ankle if you experience any of the following:
- Unable to bear weight
- Severe swelling with skin colour change
- Fever with foot pain (possible infection)
- Diabetes plus any new foot symptom
Call (810) 206-1402 — same-day and next-day appointments at our Howell and Bloomfield Hills offices.
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)