Haglund’s Deformity

Definition 

Haglund’s deformity is a bony enlargement on the back of the heel.  Usually, the enlarged bone causes increased pressure on the soft tissue of the posterior heel leading to bursitis or an inflammation of a fluid-filled sac between the tendon and bone.  Often described as a ‘pump bump’, the bursa sac become irritated when the bony enlargement rubs against the hard heel counter of ‘pump’ type shoes, mens dress shoes or ice skates.  It most often develops in women but does present in men.

Symptoms 
Symptoms include a prominent bump on the outside or inside of the heel at the attachment of the Achilles tendon to the heel bone.  Other signs include pain, redness and swelling (usually associated with an inflamed bursa sac).

Causes 
Foot structure is the leading cause of a symptomatic Haglund’s deformity.  A high arched foot causes increased pressure on the insertion of the Achilles tendon to the heel bone; squeezing of the bursa that lies between the tendon and the bone.  Consistent irritation at this site can lead to an inflamed bursa and bony prominence.

Diagnosis 
Your Podiatric Foot and Ankle Surgeon will examine the foot and ankle and evaluate the extent to which the Achilles tendon and bone are involved.  Often, x-rays will be ordered to visualize the extent of the bony prominence.  Sometimes bony in-growth may occur within the Achilles tendon (enthesis).

Treatment

Non-surgical Approaches
Non-surgical treatment of Haglund’s deformity include:

  • Heel lifts
  • Ice
  • Physical Therapy
  • Nonsteroidal anti-inflammatory medication (NSAIDs

Surgical Treatment  
Surgical intervention may be needed if conservative treatment fails to provide adequate pain relief.  Several procedures can be recommended by your Podiatric Foot and Ankle Surgeon depending on the severity of the condition.