Quick answer: Stage 4 Inside Of The Ankle Pain Posterior Tibial Tendonitis has multiple potential causes including mechanical, neurological, vascular, and inflammatory. The patterns we see most often are overuse, poorly-fitted shoes, and biomechanical imbalance. Red flags requiring urgent evaluation: warmth/redness (infection), inability to bear weight (fracture), and unilateral swelling without injury (DVT). Call (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
In This Article
The most important clinical decision with Stage 4 Inside Of The Ankle Pain Posterior Tibial Tendonitis isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.
Related Conditions
Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle
Last reviewed: May 2026
Quick Answer
STAGE 4 Inside of the Ankle Pain [ Posterior Tibial Tendoni relates to tendon injury — typically caused by overuse or sudden strain. Most patients improve in 6-12 weeks with conservative care. Same-week appointments in Howell + Bloomfield Hills: (810) 206-1402.
✅ Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026
STAGE 4 Inside of the Ankle Pain [ Posterior Tibial Tendonitis ]
STAGE 4 Inside of the Ankle Pain [ Posterior Tibial Tendonitis ]
🦶Do you have Posterior Tibial Tendonitis? AKA Inside of the Ankle Pain or Pain on Inside of the Foot? We go over the 4 stages of posterior tibial tendonitis pain! These are The BEST & Most PROVEN Treatment Options! Full Video: https://youtu.be/X1mtD7XUIsc 🦶
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DISCLAIMER:
Dr. Tomasz Biernacki received his Doctor of Podiatric Medicine degree from Kent State College of Podiatric Medicine in 2013; he completed his Surgical Reconstructive Foot Surgery & Podiatric Medicine Residency in 2017; he completed 2x traveling Fellowships in Diabetic Surgery, Skin Grafting & Nerve Surgery. He is double board certified in Podiatric Medicine and Foot & Ankle Surgery. Dr. Biernacki is a licensed podiatrist & surgeon in Michigan. This video should not be used to self-diagnose and is not a substitute for a medical exam, cure, treatment, diagnosis, prescription, or recommendation. It does not create a doctor-patient relationship between Dr. Biernacki and you. It would be best to not change your health regimen or diet before consulting a physician and obtaining a medical exam & diagnosis. Always seek the advice of a physician or other qualified health provider with any questions regarding a medical condition.
At Balance Foot & Ankle, every Michigan patient receives expert podiatric care delivered with genuine attention to their individual needs and goals. Our podiatrists take time to explain diagnoses clearly, discuss all treatment options honestly, and follow up to ensure treatments are working effectively. We serve patients from Livingston and Oakland counties and the broader Southeast Michigan region from our Howell office at 4330 E Grand River and our Bloomfield Hills office at 43494 Woodward Ave #208. New patients are always welcome — call (810) 206-1402 to schedule today.
Michigan patients can count on Balance Foot & Ankle for the full range of podiatric services delivered with clinical excellence and genuine patient care. Whether your concern is a common foot condition that has been bothering you for years or an acute injury that needs prompt attention, our team in Howell and Bloomfield Hills is ready to help. We offer in-office diagnostics, evidence-based conservative treatment, and surgical correction when needed — all within a practice that values your time, respects your preferences, and communicates clearly throughout the care process. Call us at (810) 206-1402 to take the first step toward better foot health.
Our podiatric team brings decades of combined clinical experience to every patient encounter. We stay current with the latest evidence in podiatric medicine and surgery, applying emerging treatments — including EPAT shockwave therapy, MLS laser, PRP injection, and minimally invasive surgical techniques — where the evidence supports their use for specific conditions. Michigan patients can trust that the treatment recommendations they receive at Balance Foot & Ankle reflect the current standard of care, not outdated approaches. Call (810) 206-1402 to schedule at our Howell or Bloomfield Hills office.
Related Treatment Guides
- Achilles Tendinopathy Treatment
- Peroneal Tendon Disorders Treatment
- Posterior Tibial Tendon Dysfunction Treatment
Insurance questions are easy to address before you schedule — call Balance Foot & Ankle at (810) 206-1402 and our insurance team will verify your specific plan’s coverage for the services you need. We accept Blue Cross Blue Shield, Aetna, UnitedHealthcare, Cigna, Priority Health, HAP, and Medicare and Medicare Advantage plans. Our verification process identifies your copay, deductible status, and any prior authorization requirements in advance, so you can make an informed scheduling decision. Both our Howell and Bloomfield Hills locations offer convenient daytime and early morning appointment times to fit busy schedules.
Related Patient Guides
- PTTD Treatment Michigan
- Flat Feet Pain: Causes & Treatment
- The Complete Guide to Custom Orthotics
- Ankle Sprain Recovery Guide
- ankle instability treatment at Balance Foot & Ankle.michiganfootdoctors.com/when-to-see-a-podiatrist/”>12 Signs You Need to See a Podiatrist
Insurance Accepted
BCBS · Medicare · Aetna · Cigna · United Healthcare · HAP · Priority Health · Humana · View All →
Howell Office
4330 E Grand River Ave
Howell, MI 48843
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Bloomfield Hills Office
43494 Woodward Ave, #208
Bloomfield Township, MI 48302
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Your Board-Certified Podiatrists
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Same-week appointments available at both locations.
More Podiatrist-Recommended Foot Health Essentials
Hoka Clifton 10
Max-cushion everyday shoe — podiatrist favorite for walking and running.
OOFOS Recovery Slide
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
In-Office Treatment at Balance Foot & Ankle
When conservative care isn’t enough, Dr. Tom Biernacki and the team at Balance Foot & Ankle offer advanced, same-day options — including Flat Feet Treatment Michigan at our Howell and Bloomfield Hills clinics.
Same-day appointments available. Call (810) 206-1402 or book online.
Pros & Cons of Conservative Care for foot care
Advantages
- ✓ Conservative care first
- ✓ Same-week appointments
- ✓ Multiple insurance accepted
Considerations
- ✗ Self-treatment can mask issues
- ✗ See a podiatrist if pain >2 weeks
Dr. Tom’s Recommended Products for foot care
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we use with patients.
Footnanny Heel Cream Dr. Tom’s Pick
Best for: Daily moisturizer for cracked heels
Ready to Get Back on Your Feet?
Same-day appointments in Howell + Bloomfield Hills. Most insurance accepted. Dr. Tom Biernacki, DPM & team.
Book Today — Same-Day Appointments Available
Call Now: (810) 206-1402
About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Township, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
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
4.5
(28,341+ reviews)
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
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- Trim-to-fit any shoe
- Used by 10,000+ podiatrists
- Trim-to-size required
- 5-7 day break-in for some
This single insole eliminates plantar fasciitis pain in 60% of patients within 2 weeks. The lateral wedge is the active ingredient — it stops the overpronation that causes the fascia to overstretch with every step. Pair with a max-cushion shoe for compound effect.
CURREX RunProDr. Tom’s #1 Brand
4.4
(4,000+ reviews)
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.
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Choose your arch height from a wet-foot test (low/med/high). Wrong arch = re-injury. For runners, athletes, or anyone who failed standard insoles — this is the closest you can get to custom orthotics without paying $500. The carbon heel is what professional athletes use.
Dr. Hoy’s Natural Pain Relief GelDr. Tom’s #1 Brand
4.6
(5,500+ reviews)
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
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- Cleaner ingredient list than Biofreeze
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- Strong menthol scent at first
Apply to plantar fascia + calves before bed. Combined with stretching, eliminates morning fascia pain. The clean formula means you can use it daily long-term — Voltaren has 30-day limits, Dr. Hoy’s doesn’t.
Ready for Expert Care?
Same-day appointments in Howell & Bloomfield Hills, MI.
4.9★ | 1,123 Reviews | 3,000+ Surgeries
Or call: (810) 206-1402





