Haglund’s Deformity

Haglund’s Deformity is a bony enlargement on the back of the heel. The soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes. This often leads to painful bursitis, which is an inflammation of the bursa (a fluid-filled sac between the tendon and bone).

Haglund’s deformity is often called “pump bump” because the rigid backs of pump-style shoes can create pressure that aggravates the enlargement when walking. In fact, any shoes with a rigid back, such as ice skates, men’s dress shoes, or women’s pumps, can cause this irritation.

To some extent, heredity plays a role in Haglund’s deformity. Inherited foot structures that can make one prone to developing this condition include:

A high-arched foot.
A tight Achilles tendon.
A tendency to walk on the outside of the heel.

Symptoms

This deformity can occur in one or both feet. The symptoms can often be overlooked if the deformity isn’t severe enough to be painful or problematic.

A noticeable bump on the back of the heel.
Swelling in the back of the heel.
Redness near inflamed tissue.
Pain in the area where the Achilles tendon attaches to the heel.
Blisters on the back of their heel.

Prevention

Wearing appropriate shoes, that do not have a rigid heel back.
Using arch supports or orthotic devices.
Continuously practicing the stretching exercises given to you by your specialist.

Treatment

Typically x-rays are ordered to allow the surgeon to evaluate the structure of the heel bone. After that is completed and reviewed, your doctor will discuss the best treatment options for you.

Nonsurgical Treatment:

Nonsurgical measures are aimed at reducing the inflammation of the bursa. While these approaches can resolve the pain and inflammation, they will not shrink the bony protrusion. Non-surgical treatment can include one or more of the following:

Medication- oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.
Ice- apply for 20 minutes, using a towel between the skin and ice pack. Wait 40 minutes before repeating the process.
Exercises- stretching is crucial to relieving tension in the Achilles tendon.
Heel Pads- this helps to elevate the heel with the hopes of preventing blisters.
Shoe Modification- backless or soft backed shoes tend to be more comfortable, allowing more space in the back of the shoe for the deformity.
Physical Therapy- stretching exercises and modalities, such as ultrasound, can help to reduce inflammation and manage pain.
Orthotic Devices- custom molded orthotics can help to adjust the position of the foot within a shoe, making it more comfortable.
Immobilization- In some cases, a walking boot may be necessary.

Surgical Treatment:

Surgery may be necessary if the pain becomes unmanageable. Your specialist will discuss and determine which procedure is best suited for your case. Some cases require a removal and reattachment of the Achilles tendon, while other cases only require an exostectomy, where the surgeon will simply shave down the bone growth.

It is crucial to the healing process that you follow your surgeon’s post-operative instructions diligently.

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