Same-Week Appointments at Balance Foot & Ankle
Three board-certified podiatric surgeons. 950K+ YouTube subscribers. 1,123+ five-star reviews. Howell & Bloomfield Hills, Michigan.
Medically reviewed by Dr. Tom Biernacki, DPM · Board-certified podiatrist · Balance Foot & Ankle, Howell & Bloomfield Hills, MI · Updated April 2026
Quick Answer
Balance Foot & Ankle combines fellowship-trained surgical expertise (over 3,000 surgeries), a 4.9-star rating across 1,123 reviews, same-day appointments, advanced technology (3D scanning, laser therapy, shockwave), and a patient education platform reaching 950,000+ YouTube subscribers. Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin provide comprehensive podiatric care at two Michigan locations — Howell and Bloomfield Hills.
Table of Contents
- Fellowship-Trained Surgical Expertise
- Meet Our Doctors
- Patient Reviews and Reputation
- Advanced Technology and Treatments
- Same-Day Appointments for Urgent Care
- YouTube and Patient Education
- Comprehensive Foot and Ankle Services
- Two Convenient Michigan Locations
- Insurance and Medicare Accepted
- Our Patient-Centered Philosophy
- Conservative-First Treatment Approach
- Frequently Asked Questions
- Book Your Appointment
Choosing a podiatrist is a decision that affects your mobility, comfort, and quality of life. You want a doctor who combines surgical skill with conservative wisdom, who explains your condition clearly, and who treats you as a person — not a chart number. At Balance Foot & Ankle, we’ve built our practice around one principle: every patient deserves the same thorough, evidence-based care we’d want for our own families.
Fellowship-Trained Surgical Expertise
Dr. Tom Biernacki completed two surgical fellowships — a level of training that fewer than 10% of podiatrists pursue. This double-fellowship background means expertise in both reconstructive foot surgery and advanced ankle procedures, providing patients access to techniques that many podiatric practices can’t offer. With over 3,000 surgeries performed, the surgical volume at Balance Foot & Ankle translates directly into better outcomes — research consistently shows that surgical volume correlates with complication rates.
But surgical expertise matters most when it helps you avoid surgery. Understanding what surgery can and can’t accomplish makes our conservative treatment recommendations more precise — we know exactly which conditions will respond to orthotics, physical therapy, and lifestyle changes, and which truly need surgical intervention. Most of our patients never need surgery.
Meet Our Doctors
Dr. Tom Biernacki, DPM — Founder of Balance Foot & Ankle. Double fellowship-trained in foot and ankle surgery. Over 3,000 surgeries. Creator of the Michigan Foot Doctors YouTube channel (950K+++ subscribers). Specializes in bunion surgery, plantar fasciitis, sports injuries, and complex reconstructive procedures. Board-certified by the American Board of Foot and Ankle Surgery.
Dr. Carl Jay, DPM — Specializes in surgical reconstruction, wound care, and diabetic limb salvage. Extensive experience in complex cases requiring multi-stage surgical planning. Known for meticulous surgical technique and comprehensive post-operative protocols.
Dr. Daria Gutkin, DPM, AACFAS — Cleveland Clinic-trained. Associate of the American College of Foot and Ankle Surgeons. Specializes in bunion correction, custom orthotics, and laser therapy. Brings a patient-first approach with particular expertise in women’s foot health and minimally invasive surgical techniques.
Patient Reviews and Reputation
1,123 reviews at 4.9 stars — this isn’t a number we take for granted. Every review represents a patient who trusted us with their foot health and felt compelled to share their experience. Our reviews consistently highlight three themes: thorough explanations of diagnosis and treatment options, minimal wait times, and genuine care from the entire team — front desk through recovery.
We read every review. Positive feedback tells us what we’re doing right. The occasional constructive criticism helps us improve. This feedback loop is why our patient satisfaction has remained above 4.9 stars across more than a thousand reviews — we treat every interaction as an opportunity to earn the trust patients place in us.
Advanced Technology and Treatments
Investing in technology isn’t about having the newest gadgets — it’s about giving patients access to treatments that produce better outcomes with less downtime. Balance Foot & Ankle offers:
- 3D Foot Scanning: Digital impressions for custom orthotics — more accurate than traditional casting, with faster fabrication
- MLS Laser Therapy: FDA-cleared dual-wavelength laser that reduces inflammation and accelerates healing for plantar fasciitis, neuropathy, and post-surgical recovery
- Shockwave Therapy (EPAT): Non-invasive treatment for chronic heel pain and Achilles tendonitis when conservative measures plateau
- Digital X-Ray: On-site imaging with results in minutes — no separate imaging appointments needed
- Toenail Fungus Laser: Pain-free laser treatment for nail fungus that doesn’t require oral medications
- Biomechanical Gait Analysis: Pressure mapping and gait assessment for sports injuries and orthotic prescriptions
Same-Day Appointments for Urgent Care
Foot emergencies don’t schedule themselves. We reserve same-day appointment slots at both locations specifically for acute injuries, diabetic foot concerns, infections, and severe pain. When you call with an urgent problem, our goal is to see you that day — not send you to an ER where podiatric expertise may not be available.
This same-day commitment matters most for diabetic patients, where a 24-hour delay in wound treatment can mean the difference between a simple dressing change and a hospital admission. If you’re diabetic and notice anything unusual on your feet, call us before going to urgent care — we have the specialized equipment and training to manage diabetic foot emergencies effectively.
YouTube and Patient Education
950,000+ subscribers trust our YouTube channel for honest, evidence-based foot health education. Dr. Tom started the Michigan Foot Doctors channel because he saw patients making avoidable mistakes based on misinformation — applying Vicks VapoRub to toenail fungus, using corn removers on diabetic feet, stretching cold plantar fascia. Every video reflects what we teach patients in clinic visits, available to anyone with an internet connection.
The YouTube channel isn’t a marketing strategy — it’s an extension of our clinical philosophy. An educated patient makes better decisions about their foot health, follows treatment plans more consistently, and recognizes warning signs earlier. Watch our videos, then bring your questions to your appointment. We love patients who come prepared.
Comprehensive Foot and Ankle Services
From preventive care through complex surgery, Balance Foot & Ankle handles the full spectrum of foot and ankle conditions in-house. You won’t be referred elsewhere for imaging, orthotics, or procedures that we can perform on-site. Our comprehensive service range includes:
- Conditions: Plantar fasciitis, bunions, toenail fungus, neuropathy, ingrown toenails, hammertoes, flat feet, heel spurs, ankle sprains, stress fractures, gout, diabetic foot complications
- Treatments: Custom orthotics, laser therapy, shockwave therapy, injection therapy, wound care, diabetic shoe fitting, sports rehabilitation
- Surgery: Bunion correction, hammertoe surgery, heel spur surgery, ankle stabilization, fracture repair, tendon repair
Two Convenient Michigan Locations
Howell (4330 E Grand River Ave, MI 48843) serves Livingston County — Brighton (~10 min), Hartland (~10 min), Fenton (~20 min), Fowlerville (~15 min). Ground-floor entry, free parking, full diagnostic and treatment capability.
Bloomfield Hills (43494 Woodward Ave #208, MI 48302) serves Oakland County — Troy (~10 min), Farmington Hills (~15 min), Novi (~15 min), Auburn Hills (~10 min), Birmingham (~5 min). Elevator access, covered parking, full diagnostic and treatment capability.
All three doctors practice at both locations. See our detailed directions page for turn-by-turn driving instructions from your city.
Insurance and Medicare Accepted
We accept most major insurance plans including Blue Cross Blue Shield, Aetna, Cigna, UnitedHealthcare, Medicare, HAP, Priority Health, and McLaren. Medicare patients receive full coverage for diabetic foot exams, therapeutic shoes, custom inserts, and routine foot care for qualifying conditions — we handle all documentation and bill directly. Most Medicare patients pay $0 for covered services.
Our insurance team verifies your benefits before your visit so you know your costs upfront. No surprises at checkout. Call (810) 206-1402 to verify your specific plan.
Our Patient-Centered Philosophy
We believe in informed patients. Every appointment includes a clear explanation of your diagnosis, all available treatment options (including doing nothing), expected timelines, and honest answers about what we can and can’t guarantee. We don’t rush appointments. We don’t use scare tactics to push surgery. We don’t recommend treatments we wouldn’t choose for ourselves.
This philosophy extends to our online presence. Our YouTube videos, blog articles, and product recommendations all follow the same principle: honest, evidence-based information that empowers you to make good decisions about your foot health — whether you become our patient or not.
Conservative-First Treatment Approach
Surgery is a last resort at Balance Foot & Ankle — not a first option. Despite Dr. Tom’s extensive surgical experience (3,000+ procedures), the vast majority of our patients are treated conservatively with orthotics, footwear modifications, physical therapy, injection therapy, and lifestyle changes. We pursue surgery only when conservative treatment has been given adequate time and the patient’s quality of life isn’t improving.
When surgery is necessary, our surgical volume means we perform procedures frequently enough to maintain peak proficiency. High-volume surgeons consistently demonstrate lower complication rates, shorter operative times, and better outcomes — this is well-established in orthopedic literature. You get the best of both worlds: a team that exhausts conservative options first, and the surgical expertise to handle complex cases when needed.
More Podiatrist-Recommended Foot Health Essentials
Hoka Clifton 10
Max-cushion everyday shoe — podiatrist favorite for walking and running.
PowerStep Pinnacle Insole
- The Pinnacle Full length insoles for men & women provide maximum cushioning, from high activity to moderate support. The PowerStep arch support shape provides stability to the foot and ankle, helping to relieve foot pain.
- When you spend all day on your feet, every step counts. PowerStep insoles are a podiatrist-recommended orthotic to help relieve & prevent foot pain related to athletes, runners, Plantar Fasciitis, heel spurs & other common foot, ankle & knee injuries
- The Pinnacle plantar fasciitis insoles offer superior heel cushioning and arch support. The dual-layer cushioning is designed to reduce stress and fatigue, while PowerStep premium arch support is designed for plantar fasciitis relief.
- The PowerStep Pinnacle arch support inserts for men & women can be worn in a variety of shoe types such as; athletic, walking, running, work & some casual shoes. Orthotic Inserts are ordered by shoe size, no trimming required.
- Made in the USA & backed by a 30-day money-back guarantee. PowerStep orthotic inserts for men & women are designed for shoes where the factory insole can be removed. HSA & FSA Eligible
The podiatrist-recommended over-the-counter orthotic.
OOFOS Recovery Slide
- The Original Recovery Footwear.
- Finding Your Size - For your perfect fit, consult the “size chart” link above. Wear a half size? In general, we recommend that women who wear a ½ size size UP, and men who wear a ½ size size DOWN
- OOahh - An evolution of the OOriginal, the OOahh slide features our proven foundation of OOfoam technology + patented footbed design with a slide-style strap that has become a best-seller in the OOFOS line
- OOfoam Technology - Our revolutionary OOfoam technology absorbs 37% more impact than traditional footwear foams to reduce the stress on your feet, joints & back. Plus, the closed-cell foam is machine washable and designed to minimize odor
- Patented Footbed - Our patented footbed cradles and supports arches to reduce energy exertion in the ankles by up to 47% compared to competitors’ footwear. So walking is easier. Recovery is faster. And yOO feel better
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
Frequently Asked Questions
What makes Balance Foot & Ankle different from other podiatrists?
Three things set us apart: surgical volume and training (3,000+ surgeries, double fellowship), our education-first philosophy (950K++ YouTube subscribers built on transparent patient education), and our conservative-first approach (most patients never need surgery despite our surgical expertise). We combine high-end technology with genuine patient relationships.
How many surgeries has Dr. Tom performed?
Over 3,000 foot and ankle surgeries across his career, including bunion corrections, hammertoe repairs, heel spur removals, ankle stabilizations, and complex reconstructive procedures. This surgical volume, combined with two fellowship trainings, provides a depth of experience that directly benefits patient outcomes — including for patients who don’t need surgery.
Do you treat children?
Yes. We treat pediatric patients of all ages for conditions including flat feet, in-toeing, heel pain (Sever’s disease), ingrown toenails, warts, and sports injuries. Dr. Gutkin has particular expertise in pediatric foot conditions. We create a comfortable, non-intimidating environment for young patients.
Can I see Dr. Tom specifically?
Yes — you can request any of our three doctors when scheduling. Dr. Tom, Dr. Carl, and Dr. Daria each have their own scheduling availability at both locations. If your preferred doctor’s next opening doesn’t work for you and your condition is urgent, another doctor can see you sooner with full access to your records. Call (810) 206-1402 to schedule.
What is your cancellation policy?
We ask for 24 hours notice for cancellations so we can offer your slot to another patient. We understand emergencies happen — if you need to cancel same-day, just call as soon as possible. We don’t charge cancellation fees for the first occurrence. Our goal is to make scheduling as stress-free as possible.
Book Your Appointment at Balance Foot & Ankle
Experience the Balance Foot & Ankle Difference
Dr. Tom Biernacki, DPM · Dr. Carl Jay, DPM · Dr. Daria Gutkin, DPM AACFAS
Over 3,000 surgeries · 1,123 five-star reviews · 950K+ YouTube subscribers
Same-day appointments · Conservative-first approach · Advanced technology
Howell: 4330 E Grand River Ave, Howell MI 48843
Bloomfield Hills: 43494 Woodward Ave #208, Bloomfield Hills MI 48302
Explore our resources: Plantar Fasciitis Guide · Bunion Guide · Toenail Fungus Guide · Neuropathy Guide · Custom Orthotics · Diabetic Foot Care · Recommended Shoes · Shop Products
Watch Dr. Tom explain common foot conditions:
Insurance Accepted
BCBS · Medicare · Aetna · Cigna · United Healthcare · HAP · Priority Health · Humana · View All →
Howell Office
3980 E Grand River Ave, Suite 140
Howell, MI 48843
Get Directions →
Bloomfield Hills Office
43700 Woodward Ave, Suite 207
Bloomfield Hills, MI 48302
Get Directions →
Your Board-Certified Podiatrists
Ready to Get Back on Your Feet?
Same-week appointments available at both locations.
Book Your AppointmentWhen Shoes Aren’t Enough — Dr. Tom’s Top 9 Orthotics
About 30% of patients I see for foot pain need MORE than a great shoe — they need a structured insole. Below: my complete 2026 orthotic ranking with pros, cons, and the specific patient I’d give each one to.
★ DR. TOM’S COMPLETE 2026 ORTHOTIC RANKING
9 Best Prefab Orthotics by Use Case
PowerStep, Currex, Spenco, Vionic, and PowerStep Pinnacle — every orthotic I’ve fitted to thousands of patients across both Michigan offices. Each card includes pros, cons, and the specific patient I’d give it to. Real Amazon ratings, review counts, and prices below.
Best All-Purpose Orthotic for Most Patients
Semi-rigid arch shell + dual-layer cushion + deep heel cup. The orthotic I’ve fitted to more patients than any other for 15 years. APMA-accepted. Trim-to-fit design works in athletic shoes, casual shoes, and most work boots.
- The Pinnacle Full length insoles for men & women provide maximum cushioning, from high activity to moderate support. The PowerStep arch support shape provides stability to the foot and ankle, helping to relieve foot pain.
- When you spend all day on your feet, every step counts. PowerStep insoles are a podiatrist-recommended orthotic to help relieve & prevent foot pain related to athletes, runners, Plantar Fasciitis, heel spurs & other common foot, ankle & knee injuries
- The Pinnacle plantar fasciitis insoles offer superior heel cushioning and arch support. The dual-layer cushioning is designed to reduce stress and fatigue, while PowerStep premium arch support is designed for plantar fasciitis relief.
- The PowerStep Pinnacle arch support inserts for men & women can be worn in a variety of shoe types such as; athletic, walking, running, work & some casual shoes. Orthotic Inserts are ordered by shoe size, no trimming required.
- Made in the USA & backed by a 30-day money-back guarantee. PowerStep orthotic inserts for men & women are designed for shoes where the factory insole can be removed. HSA & FSA Eligible
✓ Pros
- Semi-rigid arch shell provides true biomechanical correction
- Deep heel cup centers the heel and reduces lateral instability
- Dual-layer cushion (top + bottom) lasts 9-12 months daily wear
- Available in 8 sizes for precise fit
- APMA-accepted and clinically validated
- Lower price than PowerStep Pinnacle for equivalent function
✗ Cons
- Too thick for most dress shoes (use ProTech Slim instead)
- Some break-in period required (3-7 days for arch tolerance)
- Not enough correction for severe pes planus or rigid pes cavus
Dr. Tom’s Recommendation: If a patient has run-of-the-mill plantar fasciitis, mild flat feet, or arch fatigue, this is the first orthotic I try. Better value than PowerStep Pinnacle for 90% of patients, which is why I swapped it into our clinic kits three years ago. Sub-$50 typically.
Maximum Motion Control · Flat Feet & Severe Over-Pronation
PowerStep’s most aggressive stability orthotic. Adds a 2°-7° medial heel post on top of the standard PowerStep platform — designed specifically for flat-footed patients and severe pronators who need real corrective force.
- Full Length Support - Our ProTech orthotic insoles support pronation, arch pain, heel pain, plantar fasciitis, and heel spurs.
- Your Go To Inserts - These orthotics for plantar fasciitis provide full length, total contact support for a number of common foot issues
- Easily Fix Your Arches - Standard, semi-rigid arch support that fits most shoes including, work boots, dress shoes and sneakers.
- Enhanced Comfort - Our ProTech orthotic inserts have maximum cushioning featuring ShockAbsorb Premium Foam heel support cushion to increased protection.
- Support + Comfort - PowerStep ProTech orthotic insoles are designed with built-in arch support, heel cradle, and a perfect balance of support and comfort. Legitimate PowerStep product packaging is marked with a unique US quality control code. If you are concerned that a PowerStep item is not legitimate, please contact PowerStep customer service.
✓ Pros
- 2°-7° medial heel post adds aggressive pronation control
- Same trusted PowerStep arch shell, more correction
- Built specifically for flat-foot biomechanics
- Excellent for posterior tibial tendon dysfunction (PTTD)
- Removable top cover for cleaning
✗ Cons
- Too aggressive for neutral-arch patients
- Needs longer break-in (10-14 days) due to stronger correction
- Adds 2-3 mm of stack height — won’t fit slim dress shoes
Dr. Tom’s Recommendation: When a patient comes in with significant flat feet AND symptoms (heel pain, arch pain, knee pain), the Original PowerStep isn’t aggressive enough. The Maxx is what gets prescribed. About 25% of my flat-footed patients end up here.
Low-Profile · Fits Dress Shoes & Narrow Casuals
3 mm slim profile with podiatrist-designed tri-planar arch technology. Engineered specifically to fit inside dress shoes, oxfords, loafers, and women’s flats without crowding the toe box. Vionic was founded by an Australian podiatrist.
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✓ Pros
- 3 mm slim profile (vs 7-10 mm for standard orthotics)
- Tri-planar arch technology adds support without bulk
- Built-in deep heel cup despite slim design
- Fits dress shoes WITHOUT having to remove the factory insole
- Trim-to-fit · APMA-accepted
✗ Cons
- Less arch support than full-volume orthotics
- Top cover wears faster than thicker alternatives
- Not enough correction for severe foot deformities
Dr. Tom’s Recommendation: My default when a patient says ‘I need orthotics but I have to wear dress shoes for work.’ Slim enough to fit in oxfords and pumps without the heel sliding out. The single highest-impact change you can make for office workers with foot pain.
Built-In Metatarsal Pad · Morton’s Neuroma · Ball-of-Foot Pain
Standard Pinnacle orthotic with a built-in metatarsal pad positioned proximal to the metatarsal heads — the exact location that offloads neuromas and metatarsalgia. No need for separate met pads or pad placement guesswork.
- PODIATRIST DESIGNED! An effective alternative to expensive custom-made orthotics. Innovative biomechanical THREE-ZONE COMFORT technology delivers deep heel cup stability, forefoot cushioning, and ultimate arch support to prevent excessive pronation caused by flat feet. These essential contact points help to realign positioning of feet, aiding to re-establish your body's natural alignment, from the ground up.
- VIONIC ORTHOTIC INSOLES! These women's and men's shoe inserts offer a convenient, pain-free natural healing solution for many of the common aches and pains associated with poor lower-limb alignment, plantar fasciitis, and arch pain. EVA orthotic with re-enforced, hardened plastic (PE) shell for added motion control and stability. Cushioned shock dot in the heel for added shock absorption. Can be trimmed in forefoot if necessary.
- DESIGNED FOR EVERYDAY USE! Designed to provide greater control in faster paced activities such as running and fast walking. 4 degree rear foot wedge to provide support and control which helps prevent excess pronation. Odor absorbing cover. Contoured around the heel and arch areas to achieve 100% foot contact. Podiatrist Designed, APMA Seal of Acceptance.
- COMFORTABLE TO WEAR! Shoe inserts for women and men contoured around the heel and arch areas to achieve perfect foot contact.
- SIZES AVAILABLE: XS: Women's 4.5 – 6 / Men's 3.5 – 5 S: Women's 6.5 – 8 / Men's 5.5 – 7 M: Women's 8.5 – 10 / Men's 7.5 – 9 L: Women's 10.5 – 12 / Men's 9.5 – 11 XL: Men's 11.5 – 13
✓ Pros
- Built-in met pad eliminates DIY pad placement errors
- Specifically designed for Morton’s neuroma + metatarsalgia
- Same trusted PowerStep arch + heel cup platform
- Top cover protects sensitive forefoot skin
- Faster relief than orthotics + add-on met pads
✗ Cons
- Met pad position is fixed (can’t fine-tune individual placement)
- Some patients with very small or very large feet need custom
- Slightly thicker than the standard Pinnacle
Dr. Tom’s Recommendation: If a patient has Morton’s neuroma, sesamoiditis, or generalized ball-of-foot pain (metatarsalgia), this saves a clinic visit and a prescription. The built-in pad placement is anatomically correct for 80% of feet. Way better than DIY met pads.
Adaptive Dynamic Arch · Athletic & Daily Wear
Currex’s flagship adaptive arch technology — the orthotic flexes with your gait instead of fighting it. Different stiffness zones along the length give you targeted support at the heel, midfoot, and forefoot. Available in three arch heights (low/medium/high).
- Signature waffle-inspired rubber outsole for traction and flexibility
✓ Pros
- Dynamic flex zones adapt to natural gait cycle
- Three arch heights ensure precise fit
- Lighter than rigid orthotics (no ‘heavy foot’ feel)
- Excellent for runners and athletic walkers
- European podiatric design (German engineering)
✗ Cons
- More expensive than PowerStep Original ($55-65 typically)
- Less aggressive correction than Pinnacle Maxx for severe cases
- Three arch heights means you must self-select correctly
Dr. Tom’s Recommendation: I started recommending Currex three years ago for runners who said PowerStep felt ‘too rigid.’ The dynamic flex zones respect natural gait. Best for active patients who walk 8K+ steps daily and don’t need maximum motion control.
Running-Specific · Heel Strike + Forefoot Strike Compatible
Currex’s purpose-built running orthotic. The midfoot flex zone is positioned for runner’s gait mechanics, with a flared heel cushion for heel strikers and a forefoot rocker for midfoot/forefoot strikers. Tested on 1000+ runners during product development.
- Provides continuous support of the Plantar Fascia by gently stretching the fascia tissue.
- Compression zones promote circulation, reduce impact vibration, boost recovery and strengthen feet.
- Lightweight, seamless design with extra cushioning provides support while still being comfortable.
- Supports the heel/arch and overall foot structure while stabilizing the tendon for better performance
- Made from high quality materials, the socks are moisture wicking and breathable.
✓ Pros
- Designed by German biomechanics lab specifically for runners
- Dynamic arch flexes with running gait (not static like PowerStep)
- Three arch heights (low/medium/high)
- Reduces overuse injury risk in mid-distance runners
- Lightweight (no impact on cadence)
✗ Cons
- Premium price ($60-75)
- Not aggressive enough for severe over-pronators (use Pinnacle Maxx)
- Runner-specific design = less ideal for daily walking shoes
Dr. Tom’s Recommendation: If a patient runs 20+ miles per week and has plantar fasciitis or shin splints, this is the orthotic I prescribe. The dynamic flex zones respect running biomechanics in a way that no rigid PowerStep can match. Pricier but worth it for serious runners.
Cavus Foot & High-Arch Patients
Polyurethane base with a deeper heel cup and higher arch profile than PowerStep — built for cavus (high-arched) feet that need maximum cushion and support. The 5-zone cushioning system addresses the unique pressure points of high-arch feet.
- The first generation of Protalus's M-100 Insole
- Patented Alignment Technology: The M-100 features a deep heel cup and contoured arch to correct overpronation and promote better posture, stability, and joint health throughout your body.
- Comfortable Insoles: The patented stress relief replacement shoe insoles increase comfort and relieve plantar fasciitis and anti-fatigue.
- Improves Alignment: The shoe insoles help improve alignment and reduce pain in the feet, ideal for low and high arches.
✓ Pros
- Deeper heel cup centers the heel for cavus foot stability
- Higher arch profile fills the void under high arches
- 5-zone cushioning addresses cavus foot pressure points
- Polyurethane base lasts 12+ months
- Available in Wide width
✗ Cons
- Too tall/aggressive for normal or low arches
- Won’t fit slim dress shoes
- Pricier than PowerStep Original
- Some patients find the arch height uncomfortable initially
Dr. Tom’s Recommendation: Cavus foot patients are often misdiagnosed and given low-arch orthotics — that makes everything worse. Spenco’s Total Support has the arch profile that high-arch feet actually need. About 15% of my patients have cavus feet; this is what they wear.
Cushion Layer · Standing All Day · Gel Pressure Relief
NOT a true biomechanical orthotic — this is a cushion insole. But for patients who want gel pressure relief instead of arch correction (or to add ON TOP of factory insoles in work boots), this is the best gel option on Amazon.
- ✶ALLEVIATES HEEL PAIN – Tuli’s Heavy Duty Heel Cups provide heel pain relief caused by plantar fasciitis, Sever’s disease, excessive pronation, Achilles tendonitis, etc. Ideal for those on their feet for most of the day or those looking for added comfort.
- ✶PODIATRIST PREFERRED – In an independent study conducted by M3 Global Research, podiatrists chose Tuli’s as the clear winner of recommended heel cup brands.
- ✶SHOCK-ABSORBING DESIGN – The multi-cell, multi-layer design absorbs shock and impact energy, mimicking the natural shock-absorbing system of your feet. As you walk or run, the design reduces the stress on your feet.
- ✶DOCTOR RECOMMENDED & APMA ACCEPTED – Tuli’s Heel Cups were designed by a leading podiatrist and have the honor of being accepted by the American Podiatric Medical Association.
- ✶FITS MOST LACE-UP SHOES – Best used in spacious lace-up shoes like athletic shoes / sneakers.
✓ Pros
- Genuine gel cushioning (not foam pretending to be gel)
- Targeted gel waves under heel and ball of foot
- Trim-to-fit · works in most shoe types
- Sub-$15 price (most affordable option in this list)
- Massaging texture is genuinely soothing
✗ Cons
- ZERO arch support — this is cushion only
- Won’t fix plantar fasciitis or flat-foot issues
- Compresses faster than PowerStep (4-6 months)
- Top cover wears through in high-mileage applications
Dr. Tom’s Recommendation: I recommend these to patients who tell me ‘I just want my feet to stop hurting at the end of my shift’ and who don’t have a biomechanical issue. Construction workers, factory workers, retail. Pure cushion does the job for them.
Tight-Fitting Shoes · Cycling Shoes · Hockey Skates
PowerStep Pinnacle’s slim version of their famous Green insole. The trademark stabilizer cap is preserved but the overall thickness is reduced — works in cycling shoes, hockey skates, ski boots, and other tight-fitting footwear that the standard PowerStep Pinnacle can’t fit into.
- Plantar Fasciitis Relief, Every Step – Firm arch support helps relieve heel and arch pain from plantar fasciitis and supports flat feet and overpronation for better alignment and all-day comfort.
- Clinical-Grade Biomechanics – Tread Labs 26-33 ARCHitecture delivers orthotic-level stability—custom-orthotic feel without the prescription.
- Dialed Fit for Any Shoe – Four arch heights (low, medium, high, extra-high) and an easy 3-step sizing guide make selection simple for work boots, sneakers, and everyday shoes—great for standing all day.
- Built to Last a Million Miles – Durable, recyclable arch supports with our Million-Mile Guarantee; replaceable top covers keep insoles fresh and cost-effective. Unlike foam that flattens, Pace is engineered to last.
- Trusted Expertise – Designed by Mark Paigen (founder of Chaco). Premium arch support inserts for men and women backed by decades of footwear innovation.
✓ Pros
- Stabilizer cap centers the heel (PowerStep Pinnacle’s signature feature)
- Slim profile fits tight athletic footwear
- Lasts 12+ months daily wear
- Excellent for cycling shoes specifically
- Built-in odor-control treatment
✗ Cons
- Premium price ($45-55)
- Less cushion than PowerStep equivalents
- Not as aggressive correction as Pinnacle Maxx for flat feet
- The signature ‘heel cup feel’ takes 1-2 weeks to adapt to
Dr. Tom’s Recommendation: If you’re a cyclist with foot numbness, hot spots, or knee pain — this is the orthotic. The stabilizer cap solves cycling-specific biomechanical issues that no other orthotic addresses. Worth the premium for athletes.
None of these solving your foot pain?
Some patients (about 30%) need custom-molded prescription orthotics. We make 3D-scanned custom orthotics in our Howell and Bloomfield Hills offices — specifically built for your foot mechanics.
Schedule a Custom Orthotic Fitting →FSA/HSA eligible · Most insurance accepted · (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.
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)
