(262) 544-0700

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David Guhl, DPM
Amy Miller-Guhl, DPM
20700 Watertown Rd
Ste 200
Waukesha, WI 53186



 


 


  

 

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Whether you're a committed athlete who hits your favorite routes several times a week, or a casual runner who joins in events like September's Procrastination Run, there's one thing that will always ring true: you never want something to get in the way of your running!

Sometimes that means fudging your schedule to get a run in. Other times that means donning whatever lucky charm you have to avoid hitting that one long stop at a crosswalk.

But when the hindrance comes from your own body, such as from heel pain, it can be one of the most frustrating problems you'll face!

What's responsible for a runner's heel pain and, even better, what can be done about it? Let's not keep you waiting.

Person with an ankle sprain holding their foot

What Can Cause Heel Pain in Runners?

While heel pain is a rather simple symptom, its causes can be many. Whne it comes to runners and other athletes who are quick on their feet, however, there tend to be a few prime suspects.

Perhaps the most common cause of heel pain in runners is plantar fasciitis. This is irritation and injury to the thick band of tissue (the plantar fascia) that runs along the underside of each foot. This band connects the heel bone to the base of the toes, and faces a lot of forces in its supportive and functional role.

Another potential cause of heel pain is stress fractures. These are tiny surface cracks that develop along the surface of the bone. In this case, it may likely be the heel bone itself.

Yet another possible cause of heel pain is Achilles tendinitis, irritation or injury to the tendon that connects the heel bone to the calf muscle.

These are three different sources of heel pain, targeting three different parts of the foot. However, when it comes to runners and other athletes, they do tend to have one thing in common.

Many times, an athlete will develop plantar fasciitis, stress fractures, or Achilles tendinitis as a result of overuse. In other words, the body is being pushed farther or harder than from which it can recover.

This can be a problem for those who are trying to hit their goals as fast as possible, or trying to hit personal bests before a race. In the effort to push oneself, and not listening to the needs of the body to recover, they ultimately end up delaying their progress with an injury.

It can be a tough, frustrating line to walk between excellence and injury prevention, but a planned steady increase in intensity of no more than 10% per week, combined with proper, supportive equipment and a cross-training plan that switches up focus on different muscles go a long way toward keeping a runner off the sidelines.

But What If It Happens Anyways?

Even with the best laid plans, heel pain can still strike. There may be additional factors outside of one’s control, such as an abnormal foot shape or gait that places excess stress on the heel. Or, sometimes, things simply line up in just the wrong way.

If and when that happens, your response can go a long way toward both the speed of your recovery and your risks of developing more chronic problems down the road.

In many cases, the best immediate reaction to heel pain in athletes is to employ the RICE method:

  • REST – Especially if your heel pain has suddenly developed during activity. Do not try to "push through it."
  • ICE – Apply for no more than 20 minutes at a time; otherwise you risk harm to your skin and your recovery time.
  • COMPRESSION – Wrap the area site with an ACE bandage for support, but not tight enough to restrict blood flow.
  • ELEVATE – Raise your foot above the level of your heat, propping it on pillows or furniture to reduce pain and swelling.

Now, this is good general first response advice, but it may not be the most effective overall heel pain treatment for your case. Ultimately, the cause of the heel pain should be identified so the most direct and effective steps can be taken for its care.

In some cases, heel pain treatment may involve addressing imbalances with the use of orthotics. In others, recommendations may include stretches, medications, or injections. It will all depend on the cause of one's problem, as well as individual needs and lifestyle.

Person putting ice on their ankle in pain

OK, we know what you really want to know: how long do you have to stay away from running or whatever else you like to do? Depending on the case, that may be up to weeks!

We know, we’re sorry—but it’s not as bad as you might think! Even if you might have to hang up running as much as you want to for a bit, there are still other ways to work out that can keep you moving in the interim—and not risk your injury worsening. Swimming, cycling, and walking may be useful, low-impact alternatives, as is weight training!

We can help you figure out the best uses of your time as you recover, but one thing you should never do is try to push back to a normal routine before you’re ready. You’re only delaying your return to 100% efficiency this way. Not only that, but you risk making repeat injuries more likely!

When it comes to athletes, trust us when we say we want to get you back to form as quickly as possible—but also as safely, as well. Keeping the long game in mind is the key to an optimal recovery.

If you need help with heel pain issues—whether training for a marathon or just enjoying walks around the block—come see the experts at Waukesha Foot Specialists. Call us at (262) 544-0700 or fill out our online contact form to schedule an appointment.

Perhaps citizens down in Florida, Texas, and Arizona cities might take warm weather for granted, but in Southeastern Wisconsin we only get a couple months of warmth every year. 

And for our summer months, it’s only natural you want to enjoy everything the season has to offer!

Of course, “everything the season has to offer” can mean anything from catching a ballgame at Miller Park to watching your kids swim at Buchner Pool or the Horeb Springs Aquatic Center here in town to having a picnic with loved ones at any of our city’s award-winning parks.

Summer Fun

No matter which summertime activities are your favorites, one of the best parts of the season is being able to air out our feet – especially after keeping them encased in socks, shoes, and winter boots for so many months of the year!

Sure, it simply just feels good to let your feet breathe, but it’s also worth noting the fact that those other months contribute to increased frequency of fungal toenail infections and athlete’s foot (which is also caused by fungus). 

The increased risk comes from the fact fungus thrives in warm, damp environments and—even when the air outside is cold-to-downright-frigid—this is the exact condition you find with feet that are covered.

Now, there are certainly ways to reduce fungal infection risk even in our colder months, but they cannot compare to avoiding the problem by sporting sandals and open-toed shoes during the summer.

Appropriately, you don’t want issues keeping you from wearing your favorite seasonal footwear – and this can be the situation when ingrown toenails are in the picture!

When it comes to ingrown toenails, the simple fact is that you can potentially develop them no matter who you are.

See, certain demographics have a greater predisposition for some foot issues. If someone is going to get a bunion, that person is most likely to be female. (And same with osteoarthritis and elderly people.)

That is not the case for this condition.

As long as you have toenails, there’s a chance one of them—usually the nails found on big and small toes—could become ingrown.

When this happens, it can be quite painful. And beyond any pain or discomfort, the soft tissue flanking the nail can become irritated, reddened, and inflamed as the skin is pressed (and eventually pierced).

Along with the other symptoms, an ingrown nail also increases your risk for various bacterial and fungal infections. In fact, a significant number of fungal toenail cases actually begin this way.

Essentially, microorganisms have an easy path into the body when skin is pierced. And if they do find their way inside, the infection can potentially lead to the development of pockets of pus – which causes even more pressure and pain for the infected toe.

Fortunately, severe infections tend to be rare.

Summer Feet

The reason for that is because most people will feel the pain and then take appropriate measures, including applying antibacterial cream or ointment.

Not everyone has the ability to feel physical sensations in their feet, however. Such is the case with diabetic neuropathy.

Diabetes is a very serious medical condition, one which causes systemic damage in the body. This can impair normal function for several of the body systems, including the nervous system.

If elevated blood sugar levels have started to damage your nerves, you will likely start with neuropathic pain (which includes sharp, burning, and tingling sensations). When enough time has lapsed—with continued heightened glucose levels and no measures to properly address the disease—those sensations cease and areas become numb.

It might sound better not to have pain, but this isn’t the case at all!

A diabetic individual cannot rely on the sense of touch to know when problems exist, which means he or she is probably not going to take measures to resolve the problem.

Left untreated, wounds—including ingrown toenails—can break down and become dangerous diabetic foot ulcers. This is particularly concerning because these ulcers have a 5-year mortality rate that is worse than the ones you can find for several prominent types of cancer, including colon, breast, and prostate cancers.

(And that illustrates a major reason why responsible diabetic foot care—such as having our office perform nail trimming services for you—is so important!)

Even if you don’t have diabetes, you still will want to have the problem resolved if you have a toenail that has become ingrown.

For cases that are mild-to-moderate and aren’t recurring, we will probably be able to handle this for you in a very conservative manner. In that best-case scenario, we may simply need to take measures to soften the nail, gently lift it over the skin, and then provide instructions for how to prevent it from becoming ingrown again. Further, these initial steps are typically followed by applying topical ointment or cream (to reduce infection risk).

Regarding pain management, you may find benefit by taking recommended or prescribed pain relievers, and potentially with over-the-counter options you can pick up at the store.

That’s the basics of conservative treatment, but—as with just about anything in life—“best case” scenarios obviously don’t always happen. (After all, there would be no need for the “best case” label if they did!)

In some cases, more aggressive treatment is needed.

Usually, we reserve surgery (nail removal – either partial or complete) for ingrown toenails that are either causing severe pain and/or recurrent.

Between the two situations—which are not mutually-exclusive—it is more likely we need to recommend surgical intervention to address a recurrent ingrown nail. This is simply because the core issue typically is an unusually-curved nail structure that will cause it to continually become ingrown.

We understand that it might seem as though removing a toenail, or part of one, would be painful, but this is not the case. Prior to the procedure, we use anesthesia to numb the area (provided there are no issues preventing us from doing so).

In the case of complete nail removal, we may perform another procedure to keep the toenail from growing back. The reason for this is because we’ve determined the same problem will keep arising over and over again, and we don’t want you to keep dealing with pain and discomfort continually.

The second procedure is one which renders the nail matrix—which generates your new nail tissue—inoperable on a permanent basis.

Naturally, the affected nail will be covered with antibacterial ointment and gauze following the surgery.

For optimal healing and reduced infection risk, it is imperative you follow all postop instructions, including measures for keeping the area clean.

Patients typically want to know what they can expect from the procedure and we normally start by noting that it is done on an outpatient basis – which means you will leave the same day. Since anesthesia is used, plan on having someone drive you to and from the appointment. And during the recovery period, you will probably have a bit of discomfort for the first couple of days, but this will start to fade in time.

Choose Properly-Fitting Shoes

Unless you have an inherited nail structure making you susceptible to this condition, there are some measures you can take to reduce your risk. These include things like:

  • Keep your toenails at a proper length. Ideally, you should keep your nails roughly even with the edge of their respective toes. If you trim them too short, it can potentially result in pressure from footwear – and this can direct a nail to start growing into surrounding tissue.
  • Clip the nails straight across.Whereas people usually round fingernails when trimming them, toenails should be clipped with a straight cut. Doing so reduces the risk they will dig into the sides as they grow.
  • Choose properly-fitting shoes.Though not as common a root cause as people may think, tight-fitting shoes can possibly lead to the condition. This is particularly true when toes are pinched by footwear that does not have enough room in the toe box. To avoid this—and other foot issues—always opt for comfortable shoes that fit well.
  • Protect your feet at work (and at home).Some cases of ingrown toenails develop on account of physical trauma, often by dropping something heavy on the toes. If your job requires you to move heavy items, make sure you wear steel-toed shoes or boots. And if you are moving something heavy at home, ask a family member, friend, or neighbor to help. (Not only does that lower your risk of dropping the object on your foot, it can also potentially save your back!)

Hopefully you are able to prevent a case of ingrown toenails from happening in the first place, but if you do find yourself with this common condition and want to enjoy the couple months of summer we actually get, contact our team at Waukesha Foot Specialists and request an appointment for professional treatment!

You can connect with us by calling (262) 544-0700 and one of our team members will be happy to answer any questions or assist you in scheduling an appointment

There are plenty of opportunities to have fun in town this summer, but today let’s focus on some Milwaukee activities you might want to participate in or check out with friends and family.

Naturally, any conversation about summer fun in Milwaukee has to start with “The World’s Largest Music Festival” – Summerfest.

This year, the “Big Gig” kicks off on June 27th and runs through July 8th. You know you can catch some big acts on the main stage, but don’t forget to check out the action on the secondary stages. (After all, there are over 800 bands performing at the festival.) (According to Summerfest; we didn’t actually count them all!)

If we’re talking about big events, we’d be remiss not to include the Wisconsin State Fair, which takes place from August 2nd through August 12th this year.

Young child eating a donut at the Wisconsin State FairSure, the Waukesha County Fair (the oldest county fair in the state!) is a great place for food, entertainment, and fun right here in town, but it does pale in comparison to the State Fair. (That said, be sure to keep your calendar open for July 18th through July 22nd so you can stop by the county fairgrounds!)

Now, if you’re going to the State Fair, make sure you wear some comfortable shoes—more on this shortly!—since checking out all the events, displays, and demonstrations will put a lot of steps into your Fitbit (or other activity logging device).

At present, the Brewer season is going pretty well and we certainly don’t want to jinx that. Still, another great option for enjoying the summer is to head to Miller Park and watch the Brewers as they look to improve on last year’s results and qualify for the playoffs for the first time since 2011. If the bullpen holds up and the team stays healthy, there’s a good chance they can make it happen!

For a more active experience, you may want to take advantage of any of the walking or running trails found throughout the city, or load up your bike and spend a day cycling around town. Activities like these are great ways to keep your feet—and the rest of you!—healthy and in shape.

Perhaps one of the best ways to have fun this summer is to stop out at the Milwaukee County Zoo with any younger family members (sons, daughters, grandkids, nieces, nephews, etc.). Sure, you could enjoy viewing and learning about the animals yourself, but it is so much better when children get excited seeing the over 3,100 different mammals, fish, birds, reptiles, and amphibians.

At Waukesha Foot Specialists, we want you to have every opportunity possible. We’ve only barely scratched the surface on ways to have fun in the “Great City on a Great Lake,” but you might have to pass on these extracurriculars if you have foot pain or dysfunction.

To keep your feet healthy and safe this summer—so you can enjoy those outstanding activities throughout the entire season—here are some tips to help:

  • Wear comfortable shoes. If you are attending Summerfest or any of the other Milwaukee festivals this year, you are probably going to spend a lot of time on your feet. When you do, you want to make sure you are wearing shoes that are comfortable, supportive, and functional.
  • Wear activity-appropriate footwear. Sure, if you’re watching the Brew Crew at Miller Park, you don’t need to sport baseball cleats, but if you participate in any of our local softball leagues make sure you do! Even if you play more for fun—or beverages with the team afterwards—and aren’t super competitive, you still want to protect yourself from injury.

That example is certainly applicable, but keep in mind this tip pertains to any kind of physical activity you might do. So if you enjoy going for a run here in town or driving out to the lakefront and training there, make sure you are wearing running shoes that fit appropriately and work with your particular pronation pattern. And if you head to any of the basketball or tennis courts for some competitive summer fun, wear basketball or tennis shoes (respectively) to lower your injury risk.

  • Wear moisture-wicking socks and shoes made from breathable materials. We don’t have to tell you that our summer months can bring more heat than a Josh Hader fastball. When temperatures start rising (like the Brewers’ playoff chances this year!), your feet start to produce more sweat to stay cool. This is natural, but there’s a slight problem – fungi and bacteria love damp, warm, and dark environments.

Reduce your risk of fungal and bacterial infection—and keep your feet and footwear from smelling outright funky—by choosing footwear that wicks away moisture and allows feet to actually breathe.

  • Ease into new activities. Hey, we know it can be exciting to participate in fun, summer activities or take advantage of the nice weather to start a running program, but always take the time to ease into new physical activities. Remember, trying to do “too much, too soon” is almost always a recipe for injury!
  • Warm up and stretch. Before you head out for a run or take to the court for the game of pickup or rec league basketball, spend a good 10-15 minutes warming up and stretching first. For your warmup, brisk walking or light jogging will start get your cardiovascular system ready for action. When it comes to stretching, perform dynamic stretches—not static ones (where you hold a stretching position for 30 seconds)—to prepare your musculoskeletal system and reduce your risk for orthopedic injuries.
  • Stay hydrated. One potential problem that can develop during summertime activities is cramping in legs and feet. A smart way to avoid this is to make sure you are drinking plenty of water during hot days, and especially if you are staying active.
  • Eat well. When you think about the benefits of healthy eating, you probably don’t consider foot and ankle health. Well, the fact of the matter is that a nutritious, healthy diet keeps your lower limbs healthy and strong. This is absolutely essential if you have diabetes and strongly recommended if you suffer from gout. At the same time, every person on this planet benefits when he or she makes smart dietary choices.

One way to do so is to practice “clean eating.” This is simply a matter of eating food as close to its natural form and state as possible. If this is something you are interested in practicing—and we certainly recommend doing so—you might want to consider shopping at the Waukesha Farmers Market for the best fresh produce around. The market is open now through October 27th on Saturdays from 8 AM – noon.

  • Don’t push through pain. We hope you are able to stay safe, healthy, and injury-free this summer (and the rest of the year, too!). Of course, we also know that injuries happen. That is simply a risk that’s always present when our bodies are in motion. If you do feel pain in a foot or ankle—or anything doesn’t seem right as you move—contact our Waukesha office for professional diagnosis and treatment.

Pain is your body’s way of letting you know there’s a problem, so let us provide the treatment you need to resolve the problem.

In the event you do have an issue that develops in your lower limbs and you need expert care and treatment for a foot or ankle, contact Waukesha Foot Specialists at the earliest opportunity. Let us help you find relief from pain and restored functionality!

Contact us today by calling (262) 544-07000 for more information or to request your appointment.

At Waukesha Foot Specialists, we provide treatment for many different kinds of foot and ankle conditions. These conditions cause an array of issues ranging from embarrassment (fungal toenails) to sharp, stabbing pain (plantar fasciitis).

One of the most serious conditions we treat—nerve damage in feet—can lead to severe issues and medical emergencies.

If your feet are tingling—and especially if this is a chronic condition—there is a good chance it's an indication of nerve damage in your lower limbs. More specifically, the damaged nerve tissues are most likely sensory peripheral nerves.

Your body uses several different kinds of nerves. In this case, the ones we are discussing run throughout your entire body and are responsible for collecting sensory information, and then communciating it back to the central nervous system (your spinal column and brain).Cartoon ants crawling over a foot to represent tingling feet

Tingling is one of the symptoms of nerve damage, but others include burning, prickling, throbbing, and painful sensations. In some cases, neuropathy causes hypersensitivty (extreme sensitivity to touch) – which can make something like a light bedsheet or the water coming down in the shower rather painful.

Symptoms like those are definitely bad news, but even more concerning, however, is when nerve damage leaves you unable to feel physical sensations.

When nerve damage is responsible for numbness, issues like tiny cuts and sores can potentially break down over time and become ulcers. There is an especially high risk of this for those who have diabetes (and this highlights the importance of diabetic foot care). The main concern with this situation is when an untreated ulcer leads to gangrene – tissue death that can only be "treated" by amputation of an affected limb (so the gangrene doesn't spread).

Nerve damage is certainly concerning no matter where you experience it in your body, but neuropathy in the feet is especially concerning for a couple of reasons.

First, your feet endure tremendous physical stress on a daily basis—even if all you do is stand and walk around a bit—which can place them at heightened risk for various injuries and medical problems.

Second, your feet aren't particularly visible, even when not covered by socks and shoes. They are, after all the farthest points on the body from your eyes. This means you need to be vigilant and catch the issues (that can become medical emergencies when left unattended) early!

When everything goes as it should, the transfer of information is smooth. This isn't always the case, however, and neuropathy is often to blame.

When this occurs, you will likely experience sensations that shouldn't exist—pain, tingling, burning—or, even worse, no sensation at all. Numbness can be particularly concerning for individuals who have autoimmune disorders and conditions like diabetes.

The causes of nerve damage are quite varied. They include such factors as:

  • Diabetes. Over half of those affected by this disease experience some form of neuropathy.
  • Infections. Various bacterial or viral infections—Epstein-Barr virus, HIV, Lyme disease, hepatitis C—can affect the nervous system.
  • Trauma. Accidents and injuries can damage or severe peripheral nerves and create disconnect in the system or result in fault messages being sent.
  • Tumors. Whether cancerous or benign, a tumor that grows on a nerve or presses against one can lead to peripheral neuropathy issues.
  • Poor nutrition. A lack of B vitamins, vitamin E, and niacin can impair nerve health.

Other diseases, medications, and inherited disorders also can cause peripheral neuropathy.

When neuropathy accompanies diabetes, it can be a dangerous combination. Unfortunately, the high blood sugar levels created by the disease injures nerve fibers, so this is particularly common.

The primary cocnern in this case is that injuries or conditions can develop without the diabetic individual being aware. This presents the opportunity for otherwise minor issues to develop into serious problems that could potentially necessitate in an amputation or even be life-threatening.

If you have diabetic neuropathy, it is essential that you have a diabetic foot care plan in place that contains a daily inspection of your feet. Doing so will enable you to recognize issues at the earliest possible stages and prevent them fom becoming critical situations.

Further, if you are experiencing tingling—or any other neuropathy symptoms—in your lower limbs, contact Waukesha Foot Specialists as soon as possible. We'll examine you to discover the reason why your nerves are malfunctioning, and then create an effective treatment plan for you.

When treatment is started early, you will find relief from any painful sensations and your nerves can start to recover, so don't delay—call (262) 544-0700 to connect with our Waukesha, WI office.

By David Guhl, DPM
March 29, 2018
Category: Footwear
Tags: Untagged

How many pairs of shoes do you own?

new sneaker display

Some people could fill a couple of closets just with footwear. Pumps in every color of the rainbow. At least a couple of pairs of trainers. Ankle, calf, and knee-high boots in both black and brown. And so on.

On the other hand, your hardcore minimalist might strip it all down to the “bare essentials.” One pair of sneakers that they wear almost every day, and one pair each of dress shoes, boots, and sandals—used rarely, and haven’t been replaced in a decade.

So how many shoes are enough? What’s the right number of pairs? Obviously, taste matters here. If you’re a shoe lover and ultimate fashionista, having multiple looks and styles is going to be important for you.

But even if you aren’t that hung up on fashion, it’s still important to have appropriate footwear for any task or situation you might face. Remember, shoes aren’t just for style. They’re also to protect your feet from pain and injury, and the wrong pair of shoes in the wrong situation isn’t going to do a very good job of that!

Here are some basics—and remember, these are coming from a podiatrist, not a fashion designer!

  • At least two pairs of comfortable, casual shoes for everyday wear. Why two pairs? Simple. Feet get sweaty, stinky, and gross. They attract bacteria and fungi and allow them to proliferate. If you’re wearing the same pair of shoes every single day, they never fully dry out, and that can lead to infections like athlete’s foot. So get at least two and rotate them.
  • Probably two pairs of good weatherproof boots, minimum. This is Wisconsin after all. One pair of winter boots might be enough if you’re only wearing them for short periods of time outside and then changing back. But if your boots become your “everyday shoes” in wintertime, you’ll want at least two pairs for rotation, for the same reason as the everyday shoes.
  • Sport-specific athletic shoes. Even if you don’t play any specific sports, you’re definitely going to want at least one pair of general-purpose athletic shoes for walking around the neighborhood, or playing with the kids. If you do participate in a specific athletic activity regularly—running, basketball, tennis, hiking, soccer, etc.—you should have a pair of footwear designed specifically for that activity. A general purpose (or wrong sport) shoe may not provide the right support, flexibility, or protection in the right places that a sport-specific shoe can provide.
  • Shoes specific to your occupation of hobbies. Obviously, if your work requires you to wear steel-toed work boots, or you’re a ballet dancer, you’ll need appropriate footgear for those activities.
  • Your dress and fashion shoes. Some people might be able to get away with a single pair of dress shoes. For others, this category is wide open, with accent and practical flats, heels, and knee highs in multiple color and styling options. Your only limitations on quantity are your budget, storage space, and your sense of style. Quality is a different matter, however. Even “occasional” shoes should fit properly and comfortably, and you should keep the heels below 2” (and as chunky as possible). Never buy shoes that are too tight or uncomfortable for your feet just because they’re cute. They will hurt your feet. Find something that satisfies both your sense of taste and give your feet what they need.

With these as your guidelines, you shouldn’t have any problems finding a suitable set of footwear for any situation! And if you’ve made good choices in terms of the fit, cushioning, and support those shoes provide, you’ll not only look good, but your feet will feel good, too!

Of course, if your feet aren’t feeling so good, we can definitely help. Just give our office in Waukesha, WI a call today at (262) 544-0700.





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20700 Watertown Rd.
Waukesha, WI 53186

Foot Specialists - Waukesha, David Guhl, DPM, Amy Miller-Guhl, DPM, 20700 Watertown Rd, Waukesha WI, 53186 262-544-0700