Dr. Waldman performing a diagnostic ultrasound at a recent large factory health fair

Did you know that employers can save $1.65 on health care expenses for every $1 spent on health and wellness in the work place? What a worthwhile investment! Are you looking for vendors for your Milwaukee area employee health fair? Contact us today! We can offer great advice and advanced treatment options on site, including the diagnostic ultrasound pictured above. We can also offer a work site assesment, and offer suggestions and environmental modification that will help to prevent workplace injuries. Don't let your employees suffer injuries, miss work, or simply be less productive due to foot and ankle pain.

There are many causes of Achilles tendinitis but the most common are training errors, calf muscles inflexibility and bio-mechanical abnormalities. Training errors include increasing your workout intensity too suddenly or changing your running terrain too abruptly. Inflexibility of the calf muscles can result from improper or inadequate stretching. This inflexibility can also be due to wearing high-heeled shoes that tend to shorten the tendon.

The Achilles tendon has a relatively poor blood supply and this accounts for the longer time these injuries often take to heal. Early treatment is necessary to prevent chronic injury. Initially, you should reduce or stop your sports activities for a period of time, and ice the back of the Achilles three times a day for 15 minutes. Using heel cups can help take the stress off the tendon, but be sure to place them in both shoes or you may develop an imbalance that can lead to other injuries.

While Achilles tendinitis can be slow to heal, if your pain lingers for more than two weeks, seek the care of a podiatric physician for a more thorough evaluation.

There is a lot you can do throughout your life to prevent osteoporosis, slow its progression and protect yourself from fractures.

Include Adequate Amounts of Calcium & Vitamin D in Your Diet

During the growing years, your body needs calcium to build strong bones and to create a supply of calcium reserves. Building bone mass when you are young is a good investment for your future. Inadequate calcium during growth can contribute to the development of osteoporosis later in life. Whatever your age or health status, you need calcium to keep your bones healthy. Calcium continues to be an essential nutrient after growth because the body loses calcium every day. Although calcium can't prevent gradual bone loss after menopause, it continues to play an essential role in maintaining bone quality. Even if you have gone through menopause or already have osteoporosis, increasing your intake of calcium and vitamin D can decrease your risk of fracture. How much calcium you need will vary depending on your age and other factors. The National Academy of Sciences make the following recommendations regarding daily intake of calcium:

• Males & Females 9 to 18 years : 1,300 mg per day
• Women & Men 19 to 50 years: 1,000 mg per day
• Pregnant/Nursing women up to age 18: 1,300 mg per day
• Pregnant/Nursing women 19-50 years: 1,000 mg per day
• Women & Men over 50: 1,200 mg per day

Daily products, including yogurt and cheese are excellent sources of calcium. An 8-ounce glass of milk contains about 300 mg of calcium. Other calcium-rich foods include sardines with bones and green leafy vegetables, including broccoli and collard greens.

If your diet doesn't contain enough calcium, dietary supplements can help. Talk to your doctor before taking a calcium supplement.

Vitamin D helps your body absorb calcium. The recommendation for vitamin D is 200-600 iu daily. Supplemented dairy products are an excellent source of vitamin D. (A cup of milk contains 100 iu. A multi-vitamin contains 400 iu of vitamin D.) Vitamin supplements can be taken if your diet doesn't contain enough of this nutrient. Again consult with your doctor before taking a vitamin supplement. Too much vitamin D can be toxic.

Exercise Regularly

Like muscles, bones need exercise to stay strong. No matter what your age, exercise can help you minimize bone loss while providing many additional health benefits. Doctors believe that a program of moderate, regular exercise (3 to 4 times a week) is effective for the prevention and management of osteoporosis. Weight bearing exercises such as walking, jogging, hiking, climbing stairs, dancing, treadmill exercises, and weight lifting are probably best. Falls account for 50% of fractures, therefore, even if you have low bone density, you can prevent fractures if you avoid falls. Programs that emphasize balance training, especially Tai Chi, should be emphasized. Consult your doctor before beginning any exercise program.

Causes of Ingrown Toenails?

• Heredity
• Improper nail trimming
• Trauma
• Shoe Pressure
• Poor foot structure

What Can You Do?

• Trim toenails straight across as a preventative measure.
• Select the proper shoe style and size.

What will a Podiatric Physician do for you?

• Perform a physical exam.
• Perfom x-ray evaluation when necessary.
• Remove the ingrown portion of the nail.
• Culture the nail.
• Perform surgical correction of the nail when indicated.
• Prescribe an antibiotic (when an infection is present).

Cold weather and lower humidity as a result of indoor heating can strip away the skin's natural protective layer and wreak havoc with our skin's abilitiy to stay moisturized. In extreme cases, if not treated, some of these dry areas can deteriorate into painful cracked and bleeding skin, particularily around the feet and ankles. A quick trip to your local drug store will, however, prove that there is no limit to the number of products that are designed to alleviate dry skin.

If your skin is excessively dry and certainly if you have any cracking on your feet or heels, you should visit with your podiatric physician. Your doctor will diagnose and help you treat your feet so that you can get these conditions under control. Many podiatrists can dispense creams and lotions right in the office or make recommendaitons for the best products for your particular condition.

Every pair of feet is different, and boot manufacturers design ski boots to fit a variety of feet. When choosing ski boots for either buying or renting, it is important to remember that the boots need to be comfortable. It is best to have a professional work with you to fit your boots. Try to find a technician who is familiar with foot types and boot lasts. This will ensure that you choose the right boot for your foot and for your ability.

Since ski boots do not allow normal gait and limit the flexion at the ankle, the orthotics that you wear every day are not appropriate for insertion into your ski boots. Special orthotics for skiing can be designed and developed by a podiatric physician when necessary. When purchasing new boots, you will need to bring those to your Doctor of Podiatric Medicine (DPM) so that your foot can be evaluated with the boot.

If you want to ensure that your feet stay comfortable and warm as you manage the moguls, consider purchasing toe heaters. The heaters have a small disk that can be placed in the sock or under an orthotic. combined with a rechargeable battery pack, these heaters can provide a heat source throughout the day.

Finally, the socks you choose can make the difference in how long you are able to tolerate the temperatures. When your feet are dry, they feel warmer. Look for socks with wicking ability.

Tips for Snowboarding:

Since boots for snowboarding differ from ski boots, here are a few tips to keep in mind when purchasing or renting snowboard boots:

* In snowboarding, the heel drives everything. So a snug, firm fit is important. A boot that is too loose is a safety hazard. The heel should be stable in all directions in order to ensure maximum performance.

* To determine a proper fit when trying on a snowboard boot, you must completely lace the boot and stand up in it. This will allow the heel to settle back into the boot.

* Try on your boots while wearing a thin synthetic sock. Wearing a sock that is too heavy will prevent a proper fit. Synthetic socks are preferred to control moisture as well as prevent friction.

According to your podiatric physician, the most effective way of dealing with frostbite is to prevent it from occurring in the first place. If you know you will be exposed to the cold weather, following these tips can literally save your toes:

* Drink plenty of water, avoid alcohol, and dress appropriately.

* If you begin to feel pain, numbness or tingling in your feet, get out of the cold as soon as possible.

* Seek professional help as soon as possible from your podiatric physician for any foot or ankle related concerns.

Prolonged exposure to extremely cold temperatures can lead to severe injury if proper treatment is not provided in a timely manner. Signs and symptoms of frostbite include:

* Pain or prickling progressing to numbness.

* Pale, hard, and cold skin with waxy appearance.

* Flushing due to blood rushing to area after it is re-warned.

* Burning sensation and swelling from collected fluid that may last for weeks.

* Blisters.

* Black scab-like crust, which may develop several weeks later.

Mild frostbite is treated by re-warming that affected are, washing it with an antiseptic, and applying a sterile dressing. If medical care is not available immediately, seek shelter and re-warm a mildly frostbitten area in a warm water (101-104 degrees F) or by repeatedly applying warm cloths to the area for 30 minutes. Never use hot water, fire, a heating pad, or other dry heat because these methods may burn the skin before the feeling returns.

Frostbite is a very serious injury that can involve significant damage to the feet. In severe cases, surgery may even be necessary, depending on the depth and extent of tissue damage. Therefore, prompt diagnosis and proper treatment by a podiatric physician is essential.

The shockwave was performed by Dr. Steven Waldman, and after just six short weeks, most of his heel pain was gone.

Shockwave therapy is a non invasive therapy performed in the office. It is 85% effective and has no potential for serious side effects. Dr. Waldman states, "This FDA approved procedure is one of the most significant advances in the treatment of plantar fasciitis."

Come and see Dr. Nute on November 13th, 2010. From 10:00am-Noon he will be giving a free lecture at our Milwaukee Foot location, which is located on the 5th floor at St. Joe's Outpatient center. The focus of this lecture will be: Innovative ways to end ankle pain & maintain an active lifestyle. Don't miss this chance to hear one of Wisconsin's leading foot surgeon's speak and answer your questions! Refreshments will be available and a door prize will be awarded! If you have any questions or need further details, please call our office at 262.821.1588. We hope to see you there!

Tingling or burning in the arms and legs may be an early sign of nerve damage. These feelings often start in your toes and feet. You may also have deep pain that often happens in the feet and legs. The symptoms related to neuropathy can also include a loss of sensation in the hands, feet, and legs, as well as burning, or itching pain. People who suffer from neuropathy can also experience cold feet/hands or hot feet. Some feel a full sensation and make statements like; "my feet don’t feel attached," or "they feel full" or swollen. These symptoms can also be associated with a condition known as Restless leg syndrome. The symptoms of neuropathy are often worse at night and can make staying asleep impossible.

The problem for many patients with neuropathic pain is that there is no cure – only treatment. This does not mean that you should give up on seeking treatment. Take control of your health and seek treatment promptly. An integrated treatment approach to neuropathy is usually required for a successful result. The newest treatments and therapies that are being used successfully to reduce nerve damage, limit symptoms, and reduce prolonged use of side-effect heavy medications. Health care providers well versed in neuropathy management employ combinations of medical, surgical, rehabilitative, and physical therapies. These treatments are designed to keep you healthy and pain free, and seek - where possible - to restore function.

The easiest and most cost-effective way to diabetic amputation prevention is an annual diabetic foot exam performed by a podiatrist. Preventative podiatric visits can reduce diabetic foot complications - including amputation! Just ONE visit to a podiatrist reduces the risk of lower limb amputation, but yearly exams are best.

Did you know that white tail season is not over in our great state of Wisconsin? CDW zones in Racine and Kenosha county offer hunting through the end of March 2012.  Even though most deer are herded up, great hunting is still available.  All you need to do is purchase a two dollar CDW tag and get written permission from your local land owner!

Whether you are hunting exotic game in the bush, pursuing the elusive white tail deer during Wisconsin's week-long rifle season, or stalking North America's big game high up in the Rockies, your feet are an indispensable commodity.  A small amount of planning and effort can keep you moving without pain or injuries. As an avid hunter, fisherman, and outdoorsman, I wish you good luck! 

Over time, a painful bump develops at the side of the joint. The big toe moves at an angle toward the second toe. Lesser toes can become bent, or hammertoes. Bone growth can occur in response to the inflammatory process, and a hard bone spur can develop. Bunions can be very painful - making walking and other activities very difficult.

There are many non-surgical treatment options. However, the bunion is a structural problem; conservative treatment will probably not reduce the size of the bunion but may help to reduce associated pain.

Things you can do:

1.      Wear appropriate fitting shoes that do not crowd your toes

2.      Avoid high heel shoes

3.      Use a bunion pad to prevent the bunion from rubbing on the shoe

4.      Calf stretches

5.      Ice the area (Avoid if you have circulation or sensation problems)

6.      Do not use spacers between the toes

Things your doctor can do:

1. Use Anti-inflammatories to help reduce inflammation
2. Create a custom insole (orthotics) for your shoe
3. Cortisone injection(s)

• Pain
• Difficulty walking
• Difficulty fitting shoes
• Worsening bunion
• Pain at the ball of the foot
• Big toe is causing lesser toes to drift or sit on top of the big toe
• Failed conservative measures.

An important factor in deciding whether to have bunion surgery is a full understanding of what the procedure can and can not do. The vast majority of patients who have bunion surgery feel a dramatic reduction of foot pain after surgery, and a significant improvement in the alignment of their big toe. Often, with bunion surgery, you get more for less when you correct the deformity sooner rather than later. Conventional wisdom suggests that you leave the bunion until you can’t stand it any more. This just leads to greater deformity, which is harder to correct. Please consider earlier intervention for a better result.