Podiatry

What conditions do podiatrists treat?

Podiatrists treat a variety of foot & ankle conditions for people of all ages. Some of the most common foot problems – arthritis, bunions, hammertoes, diabetes, heel or achilles pain and more.

Foot & ankle procedures

Achilles Tendon Pain
Ankle Pain & Instability
Ankle Sprains
Arthritis
Athletes Foot
Bunions
Children’s Foot Care
Corns & Calluses
Crush Injuries
Diabetic Foot Care
Flat Feet
Fractures
Fungus Toenails

Geriatric Foot Care
Hammertoes
Heel Pain
Heel Spurs
Ingrown Toenails
Injuries
Joint Replacement
Neuromas (Pinched Nerve)
Orthotics
Plantar Fasciitis/Heel Pain Treatment
Reconstructive Surgery
Sports Podiatry – Injury treatment
Warts

PODIATRISTS

Dr. Timothy W. Bush, DPM

Foot & Ankle Specialists
4230 Harding Pike | Suite 202
Nashville, TN 37205

TEL: 615.662.6676 FAX: 615.662.8371

Mon – Thur 8AM – 5PM
Fri 8AM – 12PM

Dr. Tod Bushman, DPM

Lebanon Clinic
920 S. Hartmann Rd. | Suite 340
Hermitage, TN 37090
TEL: 615.784.4039 FAX: 615.871.9682

Mon – Fri 7:30AM – 4:30PM

Summit Clinic
660 S. Mt. Juliet Rd. | Suite 230
Mt. Juliet, TN 37122
TEL: 615-874-9667 FAX: 615.871.9682

Mon – Fri 7:30AM – 4:30PM

Podiatry Specialties at TSC

Achilles Surgery

Surgery to repair a torn (ruptured) Achilles tendon is conducted on an outpatient basis using a local anesthetic. It involves making an incision or cut in the back of the leg above the heel to access the torn tendon. The tendon is then sewn back together. Surgery may be delayed for about one week after the rupture to let the swelling go down.

After surgery, a cast or walking boot is usually worn for six to 12 weeks. At first, the cast or boot is positioned to keep the foot pointed downward as the tendon heals. The cast or boot is then adjusted gradually to put the foot in a neutral position (not pointing up or down).

Specific gentle exercises (restricted motion) after surgery can shorten the time needed in rehabilitation.

Ankle Surgery

Ankle surgery may be required to correct a serious deformity of the ankle and its bone structure. Injury (such as a fracture), birth defects, or changes throughout the course of life are the usual culprits. Diseases, such as diabetes, rheumatoid arthritis, and neuromuscular conditions, may cause severe foot and ankle deformities that, over time, cause pain and difficulty in walking.

Ankle surgeries emphasize the realignment of the structure either around or after removal of the deformity. Various kinds of internal and external fixation devices—some temporary, others permanent—are often required to maintain the appropriate alignment during, and beyond, the healing process.

Ankle surgeries vary in complexity, length, and severity, yet many of them today are conducted on a same-day, outpatient basis. Patients need to arrange for another person to take them home afterwards and stay with them for the first 24 hours following the surgery. Post-operative instructions, provided by your surgeon, will give you the information needed to care for your recovering ankle following surgery.

Arthritis Surgery

Patients who undergo surgery to correct arthritis in the foot are often diabetics with a type of arthritis known as Charcot Foot. The average age of patients developing a Charcot foot is 40 years. About one-third of patients develop a Charcot foot in both feet and/or ankles. This form of arthritis can develop suddenly and without pain. Quite suddenly, the bones in the foot and/or ankle can spontaneously fracture and fragment, often causing a severe deformity.

The arch of the foot often collapses, and pressure areas develop on the bottom of the foot, leading to open sores or ulcers.

While many of these deformities can be treated with nonsurgical care, surgery may be required. Such instances may include:

  • Chronic deformity with increased plantar pressures and risk of ulcers.
  • Chronic deformity with significant instability that cannot be corrected by braces.
  • Significant deformity that may include ulcers that don’t heal or respond to therapy.

Surgical procedures used to treat arthritis include:

  • Hindfoot and ankle realignment. This kind of procedure is usually prescribed when there is significant instability resulting in a patient being unable to walk. Various types of internal fixation are placed within the foot during this kind of procedures.
  • Midfoot realignment. This kind of procedure is usually prescribed when there is significant instability of the middle portion of the foot. During a midfoot realignment, various types of internal fixation are placed within the foot.
  • Ostectomy. In this procedure, a portion of bone is removed from the bottom of the foot. It is usually performed for a wound on the bottom of the foot that is secondary to pressure from a bony prominence.
Bunions

 

Bunions

bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe (known as Hallux Valgus). The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe.Bunion Treatment

Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.

Heredity is the leading cause of bunions, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.  Wearing tight fitting shoes can aggravate the deformity but do not cause bunions.

Treatment for Bunions

Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain cause by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:

  • The use of protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
  • Removal of corns and calluses on the foot.
  • Changing to carefully-fitted footwear designed to accommodate the bunion and not contribute toward its growth.
  • Orthotic devices—both over-the-counter and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.
  • Exercises to maintain joint mobility and prevent stiffness or arthritis.
  • Splints for nighttime wear to help the toes and joint align properly. This is often recommended for adolescents with bunions, because their bone development may still be adaptable.

Surgical BunionTreatment

Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe.

Cyst Removal

Ganglion masses, or cysts, are normally removed through surgery. Most cyst removal surgeries are performed on an outpatient basis. Contact our office to have this procedure performed.

During the procedure, the cyst is dissected from the surrounding soft tissues and removed. The recovery period depends on the location of the ganglion and the amount of dissection required during surgery. In many cases, patients receive a splint or below-the-knee cast. The surgeon may require the patient to use crutches for several days to up to three weeks. This level of protection may be necessary if the ganglion is near the ankle joint.

Possible complications from cyst removal surgery include infection, excessive swelling, and nerve damage.

Flatfoot correction

Adult-acquired flatfoot or posterior tibial tendon dysfunction usually leads to a gradual loss of the arch. The posterior tibial muscle is a deep muscle in the back of the calf and has a long tendon that extends from above the ankle and attaches into several sites around the arch of the foot. The muscle acts like a stirrup on the inside of the foot to help support the arch. The posterior tibial muscle stabilizes the arch and creates a rigid platform for walking and running. If the posterior tibial tendon becomes damaged or tears, the arch loses its stability and as a result, collapses, causing a flatfoot.

Surgery is often performed to give the patient a more functional and stable foot. Several procedures may be required to correct a flatfoot deformity, depending on the severity of the problem. These may include:

  • Tenosynovectomy—a procedure to clean away (debridement) and remove any of the inflamed tissue around the tendon.
  • Osteotomy—removal of a portion of the heel bone (calcaneus) to move the foot structure back into alignment.
  • Tendon Transfer—in which replacement fibers from another tendon are inserted to help repair damage.
  • Lateral Column Lengthening—A procedure that implants a small piece of bone, usually removed from the hip, outside of the heel bone to create the proper bone alignment and rebuild the arch.
  • Arthrodesis—Fusing of one or more bones together to eliminate any joint movement, which stabilizes the foot and prevents any further deterioration or damage.
Hammertoe Surgery

Hammertoe is a deformity of the second, third, or fourth toes. In this condition, the toe is bent at the middle joint, causing it to resemble a hammer. Left untreated, hammertoes can become inflexible and painful, requiring surgery.

Hammertoe surgery can be done on an outpatient basis in the doctor’s office or a surgery center using a local anesthetic, sometimes combined with sedation. The surgery takes about 15 minutes to perform. Up to four small incisions are made and the tendons are rebalanced around the toe so that it no longer curls. Patients usually can walk immediately after the surgery wearing a special surgical shoe. Minimal or no pain medication is needed following the surgery.

Icing and elevation of the foot is recommended during the first week following the procedure to prevent excessive swelling and promote healing. It is also important that the dressing be kept clean and dry to prevent infection. Two weeks after the surgery, the sutures are removed and a wide athletic shoe can replace the post-operative surgical shoe. Patients can then gradually increase their walking and other physical activities.

Heel pain

Heel Pain Treatment in Nashville

Plantar fasciitis is the term commonly used to refer to arch and heel pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation. Heel Pain Treatment

Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy. Note: Please consult your physician before taking any medications.

Ingrown Toenails
What to do when you have an Ingrown Toenail?

Ingrown toenails, also known as onychocryptosis, is usually caused by trimming toenails too short, particularly on the sides of the big toes. They may also be caused by shoe pressure (from shoes that are too tight or short), injury, fungus infection, heredity, or poor foot structure. Ingrown toenails occur when the corners or sides of the toenail dig into the skin, often causing infection. A common ailment, ingrown toenails can be painful. Ingrown toenails start out hard, swollen, and tender. Left untreated, they may become sore, red, and infected and the skin may start to grow over the ingrown toenail.

In most cases, treating ingrown toenails is simple: soak the foot in warm, soapy water several times each day. Avoid wearing tight shoes or socks. Antibiotics are sometimes prescribed if an infection is present. Note: Please consult your physician before taking any medications. In severe cases, if an acute infection occurs, surgical removal of part of the ingrown toenail may be needed. Known as partial nail plate avulsion, the procedure involves injecting the toe with an anesthetic and cutting out the ingrown part of the toenail.

Ingrown toenails can be prevented by:

  • Trimming toenails straight across with no rounded corners.
  • Ensuring that shoes and socks are not too tight.
  • Keeping feet clean at all times.

Podiatrist in Nashville, Mt. Juliet & Lebanon, TN

podiatry in nashville dr timothy bush podiatrist TSC foot and ankle surgeon in nashville podiatry nashville tennessee

Dr. TImothy Bush
Podiatrist
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podiatry in mt juliet and hermitage nashville tn dr tod bushman podiatrist at the surgical clinic in lebanon tn

Dr. Tod Bushman
Podiatrist
VIEW PROFILE

Board certified podiatrists

The Podiatry Division at The Surgical Clinic is your answer to any and all podiatry/foot and ankle related questions and needs. Whether you sprained your ankle, have a pinched nerve, or you’re looking for expert diabetic foot care, our podiatrists are ready to help.

The Surgical Clinic in Tennessee has teamed up with Dr. Tod Bushman (in Mt. Juliet and Lebanon, TN) with over 20 years of experience in podiatric care and Dr. Timothy Bush from Foot and Ankle Specialists of Nashville to bring you the best, board certified podiatrists.

Both Drs. Bush and Bushman are long standing members of the American Podiatric Medical Association and board certified podiatrists.

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When to call a foot doctor

People call a foot and ankle doctor/podiatrist for help diagnosing and treating a wide array of foot and ankle problems including:

  • Persistent pain in your feet or ankles.
  • Changes in the nails or skin on your foot.
  • Severe cracking, scaling, or peeling on the heel or foot.
  • Increased pain, swelling, redness, tenderness, or heat.
  • Red streaks extending from the affected area.
  • Diabetics with poor circulation who develop Athlete’s Foot.

Podiatry in Nashville

Our board certified podiatrists, who specialize in foot and ankle surgery, strive to offer the best podiatry treatments and procedures to our patients in Nashville, Mt. Juliet, Lebanon and throughout Middle Tennessee.

With over 40 surgeons in our network at The Surgical Clinic, we are confident that our team is able to care for each patient with compassion and advanced care.

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Common foot & ankle problems in podiatry

Bunions

Bunions

Bunions—misaligned big toe joints that swell and become tender, causing the first joint of the big toe to slant outward and the second joint to angle toward the other toes. Bunions tend to be hereditary, but can be aggravated by shoes that are too narrow in the forefoot and toe. Surgery is frequently performed to correct the problem.

Hammertoes

Hammertoes

Hammertoes usually stemming from muscle imbalance, this condition occurs when the toe is bent into a claw-like position. Hammertoe can affect any toe, but most frequently occurs to the second toe, when a bunion slants the big toe toward and under it. Selecting shoes and socks that do not cramp the toes may help alleviate any aggravation of pain or discomfort.

Heel Spurs

Heel Spurs

Heel Spurs—growths of bone on the underside, forepart of the heel bone. Heel spurs occur when the plantar tendon pulls at its attachment to the heel bone. This area of the heel later calcifies to form a spur. Proper warm-up and the use of appropriate athletic shoes can reduce the strain to the ligament and prevent the formation of heel spurs.

Ingrown Toenails

Ingrown Toenails

Ingrown Toenails—toenails with corners or sides that dig painfully into the skin. Ingrown toenails are usually caused by improper nail trimming, but can also result from shoe pressure, injury, fungus infection, heredity, and poor foot structure. Women are more likely to have ingrown toenails than men. The problem can be prevented by trimming toenails straight across, selecting proper shoe styles and sizes, and responding to foot pain in a timely manner.

Neuromas

Neuromas

Neuromas—enlarged benign growths of nerves, most commonly between the third and fourth toes. Neuromas are caused by tissue rubbing against and irritating the nerves. Pressure from ill-fitting shoes or abnormal bone structure can also lead to this condition. Depending on the severity, treatments may include orthotics (shoe inserts), cortisone injections, and, in extreme cases, surgical removal of the growth.

Plantar Fasciitis

Plantar Fasciitis

Plantar Fasciitis—an inflammation on the bottom of the foot that leads to heel and/or arch pain. A variety of foot injuries or improper foot mechanics can lead to plantar fasciitis. Treatments range from icing and foot exercises to the prescription of custom orthotics to correct the foot position and help alleviate pain.

Sesamoiditis

Sesamoiditis

Sesamoiditis—an inflammation or rupture of the two small bones (known as sesamoids) under the first metatarsal bone. Proper shoe selection and orthotics can help.

Shin Splints

Shin Splints

Shin Splints—pain on either side of the leg bone caused by muscle or tendon inflammation. Shin splints are related to excessive foot pronation, but also may be related to a muscle imbalance between opposing muscle groups in the leg. Proper stretching before and after exercise and corrective orthotics for pronation can help prevent shin splints.

Stress Fractures

Stress Fractures

Stress Fractures—incomplete cracks in bone caused by overuse. With complete rest, stress fractures in toes or any bones of the foot heal quickly. Extra padding in shoes can help prevent the condition. Left untreated, stress fractures may become complete bone fractures, which require casting and immobilization.

See a Podiatrist in TN for foot problems

Medical professionals known as podiatrists are trained to deal with health issues concerning your feet and lower legs. Podiatrists can treat injuries, diagnose diseases, and help patients manage ongoing foot, ankle, and leg issues resulting from complications of other diseases.

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