What is Haglund’s Deformity? Does Heel Pain Go Away?

Picture of heel with Haglund's Deformity. What is Haglund's Deformity, Does Haglund's Deformity Go Away?

Haglund’s Deformity, What Is It and Does Heel Pain Go Away?

Haglund’s deformity is a bony enlargement on the back of the heel where the achilles tendon attaches to 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 fluid-filled sac between the tendon and the bone. When the heel becomes inflamed, calcium can build up in the heel bone. This makes the bump larger and increases the pain over time.
Haglund’s deformity Achilles Tendon insertion on the Calcaneal bone. Retrocalcaneal bursa and subcutaneous bursa

In 1927, Patrick Haglund named this condition Haglund’s deformity. It is also referred to as Haglund’s syndrome or “pump bump” by some people. The term “pump bump” followed doctors observing that women who wore high-heeled pump shoes had the condition.

Haglund’s Deformity Heel Pain

Causes

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.

Doctors have linked some features to Haglund’s deformity, including:

  • A prominent heel bone that slopes outward, making the heel more likely to rub on the backs of shoes.
  • Feet that roll outward when walking, known as supination.
  • Tight Achilles tendons, which may put pressure on the heel bone.
  • High arches, which can force the heel slightly backward during walking and rub the Achilles tendon.
  • Wearing certain types of shoes may cause Haglund’s deformity, or some shoes may aggravate the condition and bring on symptoms such as pain.

Shoes or boots with rigid backs can cause friction that aggravates a foot structure that is prone to Haglund’s deformity.

People with the foot types listed above may wish to avoid shoes with rigid backs and ensure their footwear fits properly.

The shoes most often linked to Haglund’s deformity symptoms include:

  • Ice skates and roller skates
  • Dress shoes, including men’s dress shoes, women’s dress shoes, and high-heeled pumps
  • Steel-toed work boots
  • Stiff winter boots or rain boots

Haglund’s Deformity Heel Pain

Symptoms

Haglund’s deformity can occur in one or both feet. The symptoms may include:

  • A bony bump on the back of your heel
  • Severe pain in the area where your Achilles tendon attaches to your heel
  • Swelling in the bursa, which is the fluid-filled sac at the back of your heel
  • Redness near the inflamed tissue

 

Diagnosis

Haglund’s deformity can sometimes be easily diagnosed by your doctor by simply doing a foot physical examination.

Diagnostic tests, such as an X-ray or MRI, may be used to evaluate the shape of the heel bone and to determine the severity of the condition. An X-ray or other tests can help a doctor decide which treatment options may be best.

Haglund’s Deformity Heel Pain

Treatment

>> Non-surgical treatments for Haglund’s deformity are commonly used first.

Although none of these treatments can alter the bone or the foot structure, they may provide pain relief for some people and may improve quality of life.

Some non-surgical treatment choices include:

  • Changing the type of shoes worn, especially avoiding rigid-backed shoes and pumps.
  • Placing heel lifts in shoes to help bring the heel up and avoid friction.
  • Using heel pads inside the backs of shoes to help reduce irritation and friction on the heel.


  • Inserting footwear arch supports for people with high arches.
  • Taking anti-inflammatory drugs, such as ibuprofen, to ease pain from an inflamed bursa or Achilles tendon.
  • Icing the bump for 20 to 40 minutes per day to reduce swelling
  • Doing Achilles tendon eccentric stretch exercises to alleviate a tendon tightness.
  • Avoiding exercises that aggravate the condition, especially running and running uphill.
  • Using a soft cast or walking boot to help keep the heel bone from rubbing on the bursa or Achilles tendon.
  • Trying physical therapy to bring relief.
  • Getting ultrasound treatments



>> Surgical treatment may be needed when non-surgical treatments do not relieve symptoms. Surgery aims to remove the part of the heel bone that is sticking out. Surgery may also be used to repair the Achilles tendon if it is damaged.

Podiatrists and foot and ankle surgeons can perform different types of surgery to correct Haglund’s deformity. The type of procedure depends on how severe the Haglund’s deformity is, the person’s health history, and their lifestyle.

Endoscopic surgery is less invasive than traditional surgery. Because it uses smaller incisions than traditional surgery, the recovery is often shorter. According to 2018 research, it results in good to excellent outcomes in the short and medium-term.

Conventional surgery, however, also appears to have successful outcomes. One study found that the majority of those who had traditional surgery had relief of their pain at their one-year follow-up. But, the authors noted that doctors should tell people that the recovery from surgery can be several months.

Haglund’s Deformity Heel Pain

Prevention:

Unfortunately you cannot avoid Haglund’s deformity in every case. However, you may be able to reduce the risk of it developing by taking the following steps:

  • Wearing shoes that have open backs. The American Podiatric Medical Association caution against open-backed shoes if a person has tendinitis, bunions, or other foot problems.
  • Wearing shoes with soft, flexible backs to prevent pressure on the heel.
  • Stretching correctly before and after exercise, especially the calves, Achilles tendon, and feet.
  • Wearing shoes that have proper arch support for people with high arches.
  • Taking a gradual approach to strenuous exercises, such as running, to avoid overuse injuries.
  • Seeing a medical professional right away for heel pain. Haglund’s deformity may get worse over time if it is left untreated.

Haglund’s Deformity Heel Pain

What is the long-term outlook?

With proper treatment, pain should go away. While some people may see their symptoms reappear, taking the precautions listed above will help reduce your chances of getting Haglund’s deformity again.

 

 

Source: [1],[2],[3],[4],[5] Haglund’s Deformity Heel Pain

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