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.
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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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Your Board-Certified Podiatrists
Ready to Get Back on Your Feet?
Same-week appointments available at both locations.
Book Your AppointmentDifferential Diagnosis: What Else Could It Be?
Not every case of turf toe / first mtp sprain is straightforward. In our clinic we routinely rule out three look-alike conditions before confirming the diagnosis. If your symptoms don’t match the classic presentation, one of these may explain the pain — which is why physical exam matters more than self-diagnosis.
| Condition | How It Differs |
|---|---|
| Hallux rigidus | Chronic progressive stiffness, not a single hyperextension event; dorsal osteophyte on X-ray. |
| Sesamoiditis | Pain under the joint (at the sesamoid bones), not on top; worse with push-off. |
| Gout | Warm, erythematous, crystal-driven flare; elevated uric acid and crystal arthrocentesis. |
Red Flags — When to See a Podiatrist Now
Seek same-day evaluation at Balance Foot & Ankle if you notice any of the following:
- Inability to push off big toe
- Swelling and bruising across entire joint
- Grade 3 injury on MRI (complete plantar plate tear)
- Progressive hallux valgus after injury
Call (810) 206-1402 or request an appointment. Our Howell and Bloomfield Hills offices reserve same-day slots for urgent foot and ankle issues.
In Our Clinic: What We See
Clinical perspective from Dr. Tom Biernacki, DPM — Balance Foot & Ankle, Howell & Bloomfield Hills, MI:
Turf toe is the injury everyone remembers — a football cleat stuck in the turf, a yoga pose that forced the toe too far back, or a misstep off a curb. In our clinic we grade 1, 2, or 3. Grade 1 is taping, a stiff-soled shoe, and return to play in a week. Grade 2 frequently takes 4-6 weeks and may need a carbon-fiber plate inside the shoe. Grade 3 plantar-plate tears need imaging and often surgical repair. We have patients keep a photo of the toe in neutral so we can track swelling and bruising across follow-ups. Return-to-sport is earned, not timed.
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.
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)
- Hallux Valgus (Bunions): Evaluation and Management (PubMed)
- Bunions (Mayo Clinic)
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