Haglund’s Deformity
Foot & Ankle Care of Colorado
Haglund’s deformity is characterized by a bony enlargement on the back of the heel. When this enlargement rubs against shoes, it irritates the soft tissue near the Achilles tendon, often causing painful bursitis. Bursitis refers to inflammation of the bursa, a fluid-filled sac located between the tendon and bone.
Causes of Haglund’s Deformity
Haglund’s deformity is commonly referred to as “pump bump” due to the pressure created by the rigid backs of pump-style shoes, which can aggravate the bony enlargement when walking. This irritation can also be caused by other types of shoes with rigid backs, such as ice skates, men’s dress shoes, or women’s pumps.
Heredity plays a role in Haglund’s deformity to some extent. Inherited foot structures that can predispose someone to developing this condition include:
- A high-arched foot
- A tight Achilles tendon
- A tendency to walk on the outside of the heel.
Haglund’s Deformity Symptoms
Haglund’s deformity can occur in one or both feet. The symptoms include:
- A noticeable bump on the back of the heel
- Pain in the area where the Achilles tendon attaches to the heel
- Swelling in the back of the heel
- Redness near the inflamed tissue
Haglund’s Deformity Diagnoses
After evaluating the patient’s symptoms, the foot and ankle surgeon will examine the foot. In addition, x-rays will be ordered to help the surgeon evaluate the structure of the heel bone.
Nonsurgical Treatments
Nonsurgical treatment of Haglund’s deformity is aimed at reducing the inflammation of the bursa. While these approaches can resolve the pain and inflammation, they will not shrink the bony protrusion. Nonsurgical treatment can include one or more of the following:
- Medication. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce the pain and inflammation. Ice. To reduce swelling, apply an ice pack to the inflamed area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
- Exercises. Stretching exercises help relieve tension from the Achilles tendon. These exercises are especially important for the patient who has a tight heel cord.
- Heel lifts. Patients with high arches may find that heel lifts placed inside the shoe decrease the pressure on the heel.
- Heel pads. Pads placed inside the shoe cushion the heel and may help reduce irritation when walking.
- Shoe modification. Backless or soft backed shoes help avoid or minimize irritation.
- Physical therapy. Physical therapy modalities, such as ultrasound, can help to reduce inflammation.
- Orthotic devices. Custom arch supports control the motion in the foot.
- Immobilization. In some cases, casting may be necessary.
When Is Surgery Needed?
If nonsurgical treatment fails to provide adequate pain relief, surgery may be needed. The foot and ankle surgeon will determine the procedure that is best suited to your case. It is important to follow the surgeon’s instructions for postsurgical care.
