Quick answer: Tendon Transfer Surgery Foot Michigan is a common foot/ankle topic that affects many patients. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Hills practices. Call (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
The most important clinical decision with Tendon Transfer Surgery Foot Michigan isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.
Quick Answer
Tendon Transfer Surgery for the Foot & Ankle in Michiga 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 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.
Tendon transfer surgery — in which a functioning tendon is rerouted from its original attachment point to a new insertion to compensate for the loss of a paralyzed or absent muscle — is an important but underappreciated reconstructive tool in foot and ankle surgery. It addresses the root cause of foot deformities that result from muscle imbalance: when one muscle group is absent or weakened (from neurological injury, trauma, or congenital condition), the antagonist pulls unchecked, causing progressive deformity. At Balance Foot & Ankle in Southeast Michigan, Dr. Tom Biernacki performs tendon transfer procedures in the context of comprehensive foot and ankle reconstruction.
Common Tendon Transfer Procedures
Posterior tibial tendon (PTT) transfer for drop foot: in patients with drop foot (weakness of dorsiflexion from peroneal nerve injury or CMT disease), the posterior tibial tendon is rerouted through the interosseous membrane from the medial to the anterior compartment and attached to the dorsum of the foot — converting a plantarflexor/invertor into a dorsiflexor. This restores active clearance of the foot during gait, eliminating the need for an AFO in appropriate patients. FHL (flexor hallucis longus) transfer for Achilles insufficiency: used in insertional Achilles pathology with tendon degeneration or for late-presenting ruptures with tendon deficit. The FHL passes behind the medial malleolus to the posterior calcaneus — its power and direction closely mimic the Achilles. Most patients have minimal FHL loss as the FHL flexion arc is replaced by FDL. PTT transfer for lateral instability: used in neurological conditions (CMT, post-polio) where chronic inversion deformity has caused recurrent lateral ankle sprains uncontrollable with bracing. Flexor-to-extensor tendon transfer for hammertoe: the FDL (long flexor) of an affected toe is divided and rerouted over the top of the toe to the extensor apparatus — corrects a flexible hammertoe by converting the deforming force into a correcting force (Girdlestone-Taylor transfer).
Patient Selection and Outcomes
Tendon transfer success depends critically on: the donor tendon having sufficient excursion and strength (typically grade 4–5 MRC) to perform its new function; the deformity being correctable or corrected simultaneously (a tendon transfer into a rigid deformity doesn’t work); the absence of significant spasticity (spastic muscles don’t respond predictably to transfer); and appropriate rehabilitation to teach the patient the new motor pattern (the brain must re-learn to activate a muscle in its new role). Most tendon transfers in appropriately selected patients produce excellent, durable results — but the rehabilitation phase of learning to use the transferred tendon in its new role is essential and takes 6–12 months.
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When to See a Podiatrist
Foot and ankle surgery in 2026 is dramatically different than a decade ago — most procedures are now minimally-invasive, outpatient, and allow weight-bearing within days. Balance Foot & Ankle surgeons have performed 3,000+ foot/ankle surgeries with modern techniques. If another surgeon has recommended a traditional open procedure, a second opinion may reveal a faster, less-invasive option.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Frequently Asked Questions
What conditions benefit from tendon transfer surgery in the foot?
Tendon transfers benefit patients with: drop foot (from peroneal nerve injury, CMT, or other neurological cause) who want to reduce or eliminate AFO dependence; PTTD failure where the posterior tibial tendon cannot be reconstructed and FHL or FDL transfer is needed to restore arch support; chronic Achilles deficiency after failed repair or degenerative rupture; progressive foot deformity from Charcot-Marie-Tooth disease or post-polio syndrome; and flexible hammertoe (Girdlestone-Taylor flexor-to-extensor transfer). Consultation determines whether transfer is appropriate for each individual’s specific muscle strength pattern and deformity.
How long is recovery from tendon transfer surgery?
Tendon transfer recovery involves two phases: structural healing (6–8 weeks non-weight-bearing in a cast for most transfers), and functional re-education (3–12 months of rehabilitation to retrain the brain to activate the transferred tendon in its new role). Most patients are in a walking boot by 8 weeks and normal footwear or AFO by 3–4 months. The functional re-education phase is the limiting step — patients who complete intensive physical therapy achieve significantly better outcomes than those who don’t.
Is tendon transfer the same as tendon repair?
No — tendon repair restores a torn or ruptured tendon to its original attachment point (like Achilles rupture repair). Tendon transfer moves a working tendon to a completely different location to compensate for a missing or non-functional muscle. The two procedures address different problems: repair restores function of a damaged but originally functional tendon; transfer compensates for permanent or irreversible muscle/tendon loss by repurposing a functional tendon from a different muscle group.
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Complex foot deformity from muscle imbalance or nerve injury may benefit from tendon transfer. Contact Balance Foot & Ankle in Southeast Michigan for hands-on exam plus imaging when needed with Dr. Biernacki.
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Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
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Considerations
- ✗ Self-treatment can mask issues
- ✗ See a podiatrist if pain >2 weeks
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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 Hills, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
Visit Balance Foot & Ankle — Same-Day Appointments Available
Our podiatry team serves patients throughout Michigan including Howell, Brighton, and Bloomfield Hills. If you’re dealing with heel pain, ingrown toenails, or a foot injury, we have same-day appointment availability.
Same-day appointments available. (810) 206-1402
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When should I see a podiatrist?
If symptoms persist past 2 weeks, affect your normal activity, or are accompanied by red-flag symptoms (warmth, redness, swelling, inability to bear weight).
What does treatment cost?
Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Out-of-pocket costs vary by your specific plan.
How quickly can I get an appointment?
Most non-urgent cases see us within 5 business days. Urgent cases (sudden pain, possible fracture) typically same or next business day.
What is Foot pain?
Foot pain is a common foot/ankle condition that affects mobility and quality of life. Understanding the underlying cause is the first step in successful treatment. Our podiatrists at Balance Foot & Ankle perform a hands-on biomechanical exam, review your activity history, and use diagnostic imaging when appropriate to identify the root cause—not just treat the symptom. Many patients have been told to “rest and ice” without a deeper diagnostic workup; our approach is different.
Symptoms and warning signs
Common signs of foot pain include pain that worsens with activity, morning stiffness, swelling, tenderness when palpated, and difficulty bearing weight. If you experience sudden severe pain, inability to walk, visible deformity, numbness or color change, contact our office the same day or visit urgent care—these can signal a more serious injury such as a fracture, tendon rupture, or vascular compromise. Diabetics with any foot wound should seek same-day care.
Conservative treatment options
Most cases of foot pain respond to non-surgical care: structured rest, supportive footwear changes, custom orthotics, targeted stretching and strengthening protocols, anti-inflammatory medications when medically appropriate, and in-office procedures such as ultrasound-guided injections. We also offer advanced therapies including MLS laser therapy, EPAT/shockwave, regenerative injections, and image-guided procedures. Treatment is sequenced from least invasive to most invasive, and we explain the rationale at every step.
When is surgery considered?
Surgery is reserved for cases that fail 3-6 months of well-structured conservative care, when there is structural pathology (severe deformity, complete tear, advanced arthritis), or when imaging shows damage that will not heal without intervention. Our surgeons have performed 3,000+ foot and ankle procedures and prioritize minimally-invasive techniques whenever appropriate. We discuss recovery timelines, return-to-activity milestones, and realistic outcome expectations before any procedure is scheduled.
Recovery timeline and prevention
Recovery from foot pain varies based on severity and chosen treatment path. Conservative cases often improve within 4-8 weeks with consistent adherence to the protocol. Post-procedural recovery may range from a few days (in-office procedures) to several months (reconstructive surgery). Long-term prevention involves footwear assessment, activity modification, structured strengthening, and regular check-ins with your podiatrist if you have a history of recurrence. We provide written home-exercise plans and digital follow-up support.
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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.