Haglund's Deformity

Overview and Facts about Haglund’s Deformity

Haglund’s deformity is an orthopaedic condition in which an abnormality of the bone and soft tissues in the foot results in a bony bump on the back of the heel.

The soft tissue near the back of the heel can become irritated when the large, bony bump rubs against rigid shoes. This often leads to bursitis, the inflammation of the bursae, which are the fluid-filled sacs between the joints that provide cushioning and reduce friction between moving parts in the body's joints.

Signs and Symptoms of Haglund’s Deformity

Also known as “pump bump,” the main sign of Haglund’s deformity is a noticeable bump on the back of the heel that can occur in one or both feet. Other symptoms can include:

• Pain in the area where the Achilles tendon meets the heel
• Swelling in the back of the heel
• Redness in the affected area

Causes and Risk Factors of Haglund’s Deformity

There are several causes for Haglund's deformity, including:

• A high foot arch
• A tight Achilles tendon
• Walking on the outside of the heel
• Wearing shoes with a firm, rigid back (women’s pumps or men’s dress shoes)
• Inherited foot structures

Tests and Diagnosis of Haglund’s Deformity

To diagnose Haglund’s deformity, a podiatrist will perform an examination of your foot and order X-rays to get a better look at the bone structure of your feet.

An MRI may be useful to evaluate any bursitis and the associated degenerative changes in the Achilles tendon. An ultrasound may also be used to find the exact location of the deformity.

Treatment and Care for Haglund’s Deformity

Haglund’s deformity is typically treated conservatively to help reduce pain and the inflammation of the bursa. Such treatments include:

• Oral nonsteroidal anti-inflammatory drugs, such as ibuprofen.
• Applying ice to the inflamed area.
• Shoe modification, such as wearing backless or soft-backed shoes to minimize irritation.
• Orthotic devices, which stabilize and control the motion of the foot to avoid aggravating symptoms.
• Using heel pads to reduce irritation when walking.
• Stretching exercises, which help relieve tension in the Achilles tendon.
• Physical therapy, such as ultrasound therapy, to help reduce inflammation.
• Immobilization, such as casting.

If none of these treatments provide relief, surgery may be recommended to correct the deformity. Surgery may include removing the part of the heel bone that is sticking out. Surgery may also be used to repair a damaged Achilles tendon.