Medically Reviewed by Dr. Jeffery Agnoli, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Running-related foot and lower extremity injuries — the most common injuries in recreational and competitive runners — are predominantly caused by biomechanical factors that produce repetitive loading at specific anatomical sites. A systematic podiatric biomechanical assessment, including static foot posture evaluation, dynamic gait analysis, and footwear assessment, identifies the specific mechanical factors contributing to each runner’s injury pattern and guides targeted treatment — orthotic correction, footwear modification, running technique adjustment, and targeted strengthening.
Biomechanical Assessment Components
Static foot posture: foot posture index (FPI-6) — a validated 6-component clinical assessment producing a score from -12 (highly supinated) to +12 (highly pronated); neutral is 0–5; >6 indicates pronated foot; <0 indicates supinated foot. Subtalar neutral position: the subtalar joint in neutral (neither pronated nor supinated) is the reference position for assessing forefoot varus/valgus — a forefoot varus deformity (forefoot inverted relative to the rearfoot in subtalar neutral) drives rearfoot eversion (pronation) during contact loading. Ankle dorsiflexion: Silfverskiöld test — gastrocnemius equinus drives premature heel rise during running, increasing forefoot loading and Achilles-plantar fascia complex stress. Leg length discrepancy: even 5–8mm discrepancy significantly increases loading asymmetry and injury risk on the long-leg side. Dynamic video gait analysis: treadmill video at 240fps in the coronal and sagittal planes — excessive dynamic valgus collapse (foot and knee converging during stance phase), vertical oscillation, cross-over gait pattern (foot striking across the midline).
Common Running Injury Patterns and Biomechanical Correlates
Plantar fasciitis: excessive pronation, equinus, increased cadence (training error). Medial tibial stress syndrome: overpronation, increased training volume. Achilles tendinopathy: equinus, rapid heel-to-toe drop reduction (switching from cushioned to minimalist footwear). Iliotibial band syndrome: hip abductor weakness, cross-over gait. Patellofemoral pain: dynamic valgus collapse (foot, knee, hip alignment). Orthotic prescription based on gait analysis: custom orthotics for forefoot varus and significant pronation; lateral heel wedge for supination; metatarsal pad for metatarsalgia. Dr. Biernacki at Balance Foot & Ankle performs comprehensive biomechanical gait assessment for runners and prescribes custom orthotics and footwear guidance to address running injury patterns. Call (810) 206-1402 at our Bloomfield Hills or Howell office.
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Frequently Asked Questions
When should I see a podiatrist?
See a podiatrist for any foot or ankle pain that persists more than 2 weeks, doesn’t improve with rest, limits your daily activities, or is accompanied by swelling, numbness, or skin changes. People with diabetes or circulation problems should see a podiatrist regularly even without symptoms.
What does a podiatrist treat?
Podiatrists diagnose and treat all conditions of the foot, ankle, and lower leg including plantar fasciitis, bunions, hammertoes, toenail problems, heel pain, nerve pain, diabetic foot care, sports injuries, fractures, and foot deformities — both surgically and non-surgically.
What can I expect at my first podiatry visit?
Your first visit includes a full medical history, physical examination of your feet and gait, and in-office diagnostic imaging if needed (X-rays, ultrasound). We’ll discuss your diagnosis and create a personalized treatment plan. Most visits take 30–45 minutes.
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
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.
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