(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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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

By contactus@waukeshafootspecialists.com
June 01, 2018
Category: Summer Foot Care
Tags: Untagged

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.

By contactus@waukeshafootspecialists.com
April 30, 2018
Category: Foot Care

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.

By Dr. David Guhl
March 01, 2018
Category: Running
Tags: train for a run  

Whether you’re gearing up for your first ever 5K, or even pushing toward a half marathon or marathon this summer, running and racing is a great way to improve your fitness—and your outlook on life. For most of us, to train for a run isn’t about competing against others. It’s about setting and completing a personal goal, crossing that finish line, and doing your best—whatever your best may be.

Running Tips

But it can also be really hard to get started running, and common training mistakes can have you sore, swollen, injured, and wishing you never started in the first place. We don’t want that! Here are some tips to help you train as comfortably and safely as possible:

  • Get a good pair of running shoes, matched with your foot shape and pronation style. If you have no idea what that means or how to find one, relax! Most specialty running stores can help you make a good choice. We can help too, and on top of that, assess whether you might benefit even further from orthotics.
  • Don’t try to do too much, too soon! If you’re really starting from zero, don’t try to work yourself up to race length and intensity right away—you’ll only burn yourself out, and quite possibly injure yourself. (It’s the main reason most would-be runners quit.) Start with a sustainable mix of jogging and walking, at a level that provides moderate intensity but not pain. (Try talking during your run—if you’re gasping for air, you’re going too hard.) Then, ramp up the difficultly and mileage slowly—no more than 15 percent per week.
  • Always warm up and cool down. We recommend a good five minutes of walking before starting that jog. Do the same at the end to let your heart rate descend slowly and bloodstream flush toxins out of the system.
  • Resting is an important part of the training cycle. Don’t run every day, as this simply adds more pressure and stress on the feet without giving them a chance to heal and get stronger. Listen to your body.
  • Cross train in other fitness disciplines. Strength training not only protects muscles and joints from injury, but helps them use oxygen more efficiently. You can do additional cardio if it’s low impact—for example, riding your bicycle.

We hope you find these tips helpful as you prepare for your big race! If foot pain or injury ever starts to creep into your training regimen, slow down and give the Waukesha Foot Specialists a call. We’re here not only to provide effective treatment, but also help you prevent future problems. You can reach us at (262) 544-0700.





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Call Today 262-544-0700

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