Haglund’s deformity is a bony protrusion (enlargement) on the back of the heel. Irritation occurs in the soft tissue near the Achilles tendon when this bony protrusion rubs against the backs of shoes. This friction usually results in painful bursitis – an inflammation of the bursa. A bursa is a fluid-filled sac between the tendon and bone.
Haglund’s deformity is sometimes called “pump bump” because the rigidity in the back of pump-style shoes causes pressure that aggravates the protrusion when walking. As a matter of fact, all shoes with a rigid back including ice skates, men’s dress shoes or women’s pumps may cause irritation.
Genetics contributes to Haglund’s deformity to a certain extent. These hereditary foot structures play a role in the development of Haglund’s deformity:
Haglund’s deformity may occur in one or both feet with symptoms such as:
When diagnosing Haglund’s deformity, Dr. Radovic will assess your symptoms and examine your foot. Dr. Radovic will order x-rays to supplement his evaluation of the structure of the heel bone.
The goal of non-surgical treatment for Haglund’s deformity is to reduce the inflammation of the bursa. These treatments are often successful at resolving pain and inflammation, but will not reduce the bony protrusion.
Non-surgical options may include one or more of the following:
Ibuprofen, aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) might be recommended to reduce pain and inflammation.
Ice may be applied to reduce swelling. Apply a bag of ice covered with a thin towel to the affected area. Leave ice on the area for 20 minutes, then wait at least 40 minutes before icing again.
Stretching exercises help reduce tension in the Achilles tendon, and can be beneficial especially for patients with a tight heel cord.
Patients with high arches can wear heel lifts inside the shoe to reduce pressure on the heel.
Heel pads worn inside the shoe cushion the heel to help reduce irritation when walking.
Modifying shoe gear by wearing backless or soft backed shoes can help minimize or relieve irritation.
Physical therapy exercises or ultrasound may help to decrease inflammation.
Custom orthotic devices provide arch support and help control foot motion.
Immobilization, sometimes including casting, may be necessary.
Surgery may be required for patients who feel inadequate pain relief from non-surgical treatments. Dr. Radovic will determine the most suitable surgical treatment for each individual case. Patients should make sure to follow post-operative care as instructed by Dr. Radovic.
Patients may prevent Haglund’s deformity from recurring by: