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Team physicians for Iowa Western Reivers
Wed, 29 Jan 2020

If the Shoe Doesn’t Fit, Don’t Wear It

foot and ankle center in Omaha, NE and Council Bluffs
A person is barefoot and is experiencing pain in the ankle, heel, and toes.

Some people choose their shoes because they like the style or color. Other people choose their shoes because they fit the requirements by their job. Then, there are the people that choose shoes based on the comfort and support provided. A combination of these things can often contribute to the choice of shoes. However, many people do not realize the importance of properly fitting footwear.

When choosing shoes is it important to look for a few things. Some people do not know why the fit of a shoe really matters. Improperly fitting footwear is a common cause of foot and ankle injuries. They can also further exacerbate other health conditions that are common. Seeing a podiatrist to assist in the process of choosing properly fitting footwear is also a great idea. It will help eliminate some of the guesswork for what kind of shoes to get.

Proper Shape

First, it is important to choose shoes that take the natural shape of the foot. The heel should not be slipping around and the ball of the foot should fit into the widest part of the shoe. Pointed toes often cause the foot to be squished into the shape of the shoe, which is not good.

Signs Your Shoes Don’t Fit

  • Pain and discomfort
  • Callouses
  • Blisters
  • Bruising on toenails
  • Skin irritation (especially around toenails)
  • Bruising on the tips of toes

Here are some tips when going to the store to buy footwear:


  • Keep heels less than 2 ¼ inches tall. Too high of a heel can put unnecessary pressure on the ankle and balls of the feet which can cause injuries over time.
  • Consider shopping at the end of the day after walking around. This means your feet are more swollen than usual, and thus it is easier to be sure the shoes still fit, even with swollen feet.
  • Make sure the shoes are not ones that have to be broken in later. Walk around in them to make sure they are comfortable both walking and standing.
  • Remember that not all shoes fit the same way, so do not rely solely on size, and be sure to try on both shoes to ensure they do not only fit one foot properly.

Another thing to consider if foot pain persists no matter what type of shoe, is a custom orthotic. Many people think it is only important to get orthotics if they have a specific condition such as plantar fasciitis, arthritis or diabetes. However, custom orthotics are a good idea for most people. A custom orthotic will help provide the kind of comfort needed for the individual. A certified podiatrist would be best suited to help each individual find the orthotic that works best for each individual’s feet.

Shoes and orthotics cannot solve everyone’s foot problems. They can help reduce some of the pain, but it is important to see a podiatrist to understand what things are causing the issues. Podiatrists can help devise a diagnosis and treatment plan to help reduce foot pain or injuries. Dr. Panesar is a Board Certified Podiatric Surgeon who can provide advice on what kind of shoes or orthotics would work best for each individual, and he can determine whether the problem goes deeper than just improperly fitting shoes.  Even if a custom orthotic or shoe is not ordered, a podiatrist can help provide recommendations for things to avoid or to purchase in order to help avoid any further foot problems that might occur from improperly fitting shoes.


Do you have pain in your feet? Our foot and ankle specialists are here for you. Click here to contact Miller Orthopedic today for a consultation. 


Wed, 18 Sep 2019

Don’t Live with the Pain of Shin Splints!

If you have shin splints, see an orthopedic sports medicine doctor

Shin Splints are things that many people will have to deal with at some point in their life. If you have pain in your shins when you run, then then this might be what you are facing. Whether you often run or just occasionally jog to get to the door more quickly that someone is holding open for you, if you have a throbbing pain in your shins when you go faster than walking pace, then it might be time to get it checked out.  

What are shin splints?

Shin splints or medial tibial stress syndrome is when the connective tissue on your shins have too much stress on them and they become inflamed. This inflammation can cause a lot of pain. The more you run, the more stress is on them and thus the pain continues or worsens.

How do you get shin splints?

You do not have to be an athlete to get shin splints. They often arise from poorly supported shoes or flat feet. Some people simply have weak ankles, muscles or hips, and that can cause shin splints as well.

Then, of course there are also those people who have overworked their legs or who did not allow enough time for a proper warm-up or cool-down for their workout.

If you have shin splints, then you might be wondering when that pain will go away. Many times, the pain can subside on its own. However, it is still good to see a doctor if you suspect you might have this condition.

How can an orthopedist help?

Doctors can do a physical examination and take x-rays to look for possible fractures that might have occurred, which could be leading to your pain. Doctors can also provide some advice on ways to help your pain if you do have this condition.

Orthopedic surgeons who are specialty trained in orthopedic sports medicine would be recommended to check out your condition if you think you have shin splints. Our orthopedic surgeons are specifically trained to treat this kind of injury.

How do you relieve the pain from shin splints?

Some ways to help relieve some of the pain is to relieve some of the stress being put on your muscles. Working out on hard surfaces (concrete, gyms, etc.) all can lead to shin splints, so working out on softer surfaces whilst recovering can help relieve some of that stress and pain. This is if you do not choose the more effective treatment of rest.

Resting is one of the best ways to help relieve shin splint pain. Ice can also help ease the pain and swelling, but it is recommended to do this for multiple days to have the best result. If your condition was caused by flat feet or poorly supported shoes, then insoles or orthotics can be highly beneficial. This can help prevent your shin splints from returning as well. Finally, anti-inflammatory medicine can be good to help with pain and swelling as well.

“Will I ever be pain free again?”

Once you have taken proper care of your shin splints and seen a doctor to make sure there is not any underlying condition, then you should start to see positive results. You will be back to jogging, running and jumping in no time. Everyone heals at different speeds though, so it is important to continue to take care of your condition to help promote your healing.

How Miller Orthopedic Sports Medicine Specialists Can Help

Miller Orthopedic Specialists offers a *FREE sports injury clinic at both locations. Council Bluffs has a walk-in clinic from 10-11am every weekday, and the Omaha office has a free sports injury clinic by appointment weekdays. We offer same and next day appointments for sports injuries. Call 402-991-9958 for an appointment. Closed on holidays.

Initial consultation is free, but charges may occur for x-rays, supplies or follow-up visits. Come into our Council Bluffs office for the walk-in clinic and ask our front desk about your free T-shirt!

We have 2 fellowship-trained, Board Certified, Sports Medicine Physicians, Dr. Larose and Dr. Atteberry. They can treat patients of all ages, from children to the weekend warrior. Miller Orthopedic Specialists are proud to be the team physicians for the Iowa Western Reivers, UNO Mavericks, and College of Saint Mary Flames.

Contact us or visit us today!  Get back to living your life pain free.

Tue, 11 Jun 2019

Tarsal Tunnel Syndrome

Miller Orthopedic foot and ankle specialists show where tarsal tunnel syndrome pain is.

You have probably heard of carpal tunnel syndrome, but did you know that tarsal tunnel syndrome is also a common condition? This is a condition in the feet that is similar to carpal tunnel syndrome except instead of taking place in the wrist it is in the ankle.

The tarsal tunnel is a small tunnel-like space that lies on the inside of the ankle, next to the bone. The “tunnel” is covered with the flexor retinaculum (a thick ligament). This ligament protects and maintains the structures within said tunnel, such as arteries, veins, tendons and nerves.

When one has tarsal tunnel syndrome it means that there is a squeezing on one of the nerves within that tunnel (posterior tibial nerve). This causes symptoms that shoot throughout the trail of the nerve runs from the inside of the ankle into the foot. The compression can cause tingling, numbness and aching in your foot that is sometimes very piercing.

Tarsal tunnel syndrome can be caused by anything that produces compression on the nerve. There are several different things that can increase your chances for this.

  • Injuries, such as ankle sprains can produce inflammation and swelling can cause the nerve compression.
  • People with flat feet are at a higher risk of developing this due to the way the fallen arches cause outward titling of the heel, leaving potential for muscle strain and nerve compression.
  • Diabetes, arthritis and other systemic diseases cause swelling and therefore also increasing potential for nerve compression.
  • Finally, one other thing that is likely to increase your chance of tarsal tunnel syndrome is an abnormal or enlarged structure, such as a varicose vein, bone spur, swollen tendon or ganglion cyst, that forms within the “tunnel” of space.

Foot And Ankle Specialist

A foot and ankle surgeon or a podiatrist, such as Dr. Inderjit Panesar, is best suited to do the examination if you think you might have this problem. The specialist will work with you for a treatment plan after a thorough examination. Sometimes surgery is required, but other cases of tarsal tunnel syndrome can be treated with local steroid injections and weight loss.

Rest, ice and anti-inflammatory medication can also be very beneficial in reducing the swelling and potentially boosting healing. There are several different things that can be done to help reduce pain and the compression of the posterior tibial nerve, but the first step is getting the proper diagnosis to get the best treatment plan.

Be sure to call our Council Bluffs office at 712-323-5333 or our Omaha office at 402-991-9958 to schedule an appointment with foot and ankle specialist Dr. Panesar to see how he can help relieve your foot pain!

Fri, 23 Nov 2018

Foot Pain? Plantar Fasciitis May Be To Blame

A person experiences foot and ankle pain.

If the first few steps you take in the morning are painful, you might be experiencing plantar fasciitis. It’s one of the most common causes of foot pain, with over two million people seeking medical treatment each year. Many people typically seek treatment after having months or years of heel pain.

The stabbing pain that is felt is caused by inflammation of a band of tissue known as the plantar fascia that connects the heel bone to the toes.  The pain is normally localized near the heel but can be felt anywhere along the plantar fascia ligament.  The pain tends to be worse first thing in the morning and after long periods of sitting or standing. When there is no weight put on the foot, the ligament shortens and tightens,

There are many reasons why one might develop plantar fasciitis. Some of these factors include being overweight, being on your feet for extended periods and wearing shoes with inadequate support and high impact sporting activities. Also, flat feet or high arches, excessive pronation (when the foot rolls severely inward when walking) or wearing high heels regularly can be aggravating factors.

To diagnose plantar fasciitis, a physician will examine the foot, including looking for areas of tenderness, the height of the arch and ankle mobility.  Imaging tests such as X-rays or MRIs may also be used to rule out other potential causes of foot pain, such as fractures or arthritis.

There are three main ways to treat plantar fasciitis:

  • Stretching the plantar fascia and the muscle group in the back of the leg,
  • Wearing good quality and supportive shoes or orthotics,
  • Reducing inflammation.

If plantar fasciitis remains untreated, chronic heel pain can develop with irreversible consequences including scarring and thickening of the plantar fascia at its origin in the heel.  The ligament could also become partially or completely ruptured if a person with plantar fasciitis continues their high-impact activities.

Stretching is the single most important thing to do to eliminate and prevent pain.  Physicians also recommend taking a break from high-impact exercises like running and switching to low-impact exercises like swimming or yoga.  Over-the-counter anti-inflammatory medications such as ibuprofen and the use of ice and massage can be used to reduce inflammation and pain.  If pain continues it is important to see your physician for a more extensive treatment plan that could include steroid injections and sometimes surgery.  More than 90 percent of people with plantar fasciitis experience a significant reduction in pain after less than a year of treatment

The feet are relatively small body parts that experience significant pressure and stress daily.  For that reason, it’s important to make sure your feet stay healthy and be aware of the symptoms of foot conditions such as plantar fasciitis.

If you are experiencing pain in your feet please call Miller Orthopedic Specialists at 712-323-5333 (Council Bluffs Office) or 402-991-9958 (Omaha Office) to schedule an appointment to evaluate, diagnose and develop a treatment plan that is both beneficial and appropriate for you.

Wed, 25 Apr 2018

Suffering from a Sprained Ankle? Here’s What to Do:

sprained ankle


An ankle sprain can happen to anyone at any age.  Walking on an uneven surface or even wearing inappropriate foot wear can cause this type of injury.  Many times a sprain occurs when the foot suddenly twists or rolls, forcing the ankle joint out of its normal position. This movement can stretch or tear the ligaments that hold the ankle bones and joints together.

If you have recently injured your ankle and are noticing the following symptoms you may have a sprained ankle:

The ankle can sustain many different types of injuries. It’s important to see your doctor when you’re experiencing problems with your ankle as they can determine whether the injury is a sprain or something more severe.  Your physician will perform a physical exam to determine if ligaments have been torn. During the exam, your doctor may move your ankle joint in various ways to check your range of motion.

Imaging tests, such as X-rays, may also be ordered to rule out a bone fracture. An MRI may be done if your doctor suspects a fracture, a serious injury to the ligaments, or damage to the surface of the ankle joint allowing your physician to make the proper diagnosis.

Your doctor may tell you to stay off of your injured ankle until the pain subsides. For mild sprains, this may take a week to 10 days, while more severe sprains may take up to several weeks to heal

Treating a sprained ankle promotes recovery and prevents further discomfort.  You may be able to treat mild sprains at home.

 Recommended home care treatments include:

  • using elastic bandages (such as an ACE bandage) to wrap your ankle, but not too tightly
  • wearing a brace to support your ankle
  • using crutches, if needed
  • elevating your foot with pillows as necessary to reduce swelling
  • taking ibuprofen (such as Advil) or acetaminophen (such as Tylenol) to manage pain
  • getting plenty of rest and not putting weight on your ankle

It’s also helpful to apply ice to the injured area as soon as you can to reduce swelling. On the first day, you should apply ice every 20 to 30 minutes, three to four times per day. Afterward, apply ice every three to four hours for the next two days.

Surgery for a sprained ankle is rare. It may be performed when the damage to the ligaments is severe and there is evidence of instability, or when the injury doesn’t improve with nonsurgical treatment.

In most cases, an ankle sprain isn’t very serious and will completely heal with proper treatment. The amount of time required for a full recovery will depend on the severity of the sprain. Most ankle sprains take a few weeks to fully heal. A more severe sprain may take months.

Although pain and swelling will eventually go away, your injured ankle may not be as stable as your unaffected ankle. Your doctor may suggest certain exercises to help strengthen the muscle about the ankle. However, you shouldn’t proceed with exercises until your doctor has told you to do so.

If you have recently sustained an injury to your ankle, contact Miller Orthopedic Specialists for more information or to set up an appointment.

Tue, 24 Jan 2017

Diabetes and Feet: Why a Podiatrist is Essential to People with Diabetes

Diabetes is a growing epidemic in the United States. According to the American Diabetes Association there are 26 million adults and children living with disease and an additional 7 million who have prediabetes. Diabetes complications in the feet can be dangerous and is the leading cause of non-traumatic lower limb amputation.  These complications and amputations can be prevented with proper foot care from a podiatrist.

The connection between a podiatrist and diabetes is an important one as proper foot care can help avoid serious limb injury or loss.  Podiatrists specialize in caring for feet so they can offer the best possible treatment and recommendations to their patients. This care improves patients’ outcomes by catching problems at an early stage and providing access to appropriate treatment.  A podiatrist will complete a full examination looking for signs and symptoms representative of potential diabetic foot problems.  Some examples to look for on your feet and ankles include:

  • numbness
  • redness
  • swelling
  • ulcers or non-healing wounds

If you have diabetes you are more vulnerable to foot problems because of possible nerve damage and poor circulation to your leg and foot.  This can lead to loss of sensation in the feet, meaning that the damage is more likely to go unnoticed.  In addition, high blood glucose leads to dry skin, making your feet more prone to cuts and tears.  You are also more susceptible to foot infections, toenail fungus and athlete’s foot.

It’s important to educate yourself and your family on your condition.  They can play a vital role in helping you control your diabetes.   If your family has a history of diabetes, the chance of you developing diabetes also increases.

Your podiatrist will instruct you on proper self-exam and care for your feet.  This could include how to properly wash and dry your feet, why it is important to keep your feet moisturized, what to look for when examining your feet, taking care of your toenails and exercising tips.  They may also recommend special footwear, such as socks that pull moisture away from your feet or shoes specifically designed for people with diabetes.  Educated patients with the right tools can prevent foot and lower extremity problems by controlling their diabetes effectively and taking some simple steps to care for their feet.

A podiatrist can perform vascular, neurological and functional tests which will tell you your foot health status.  It is important to have your feet checked regularly, and you should be checking your own feet daily if you are diabetic. A podiatrist’s education, training, and experience qualify them to diagnose and treat conditions of the foot, ankle and related structures of the leg as well as perform surgery if needed.

If you have diabetes and would like to start a relationship with a podiatrist to ensure the health of your feet, make an appointment to see one of our physicians today.


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