Haglunds deformity, also called a “pump bump”, is a bony protrusion on the back of the heel bone that irritates the Achilles tendon and causes pain. This is a condition that can be treated with medications, ice, change of footwear, heel pads, and exercise to strengthen the muscles in the foot and ankle.
Symptoms
Haglund’s deformity is a bony enlargement of the back of your heel bone that creates pressure on the Achilles tendon and can cause pain. Also known as “pump bump,” it most commonly develops from wearing shoes with rigid backs, like pumps or men’s dress shoes. This pressure irritates the Achilles tendon and a fluid-filled sac in the heel called the retrocalcaneal bursa, which can become swollen and painful as well.
Haglunds deformity often gets worse over time if you keep wearing the kinds of shoes that cause it. If you have pain, talk to your provider about changing the types of shoes you wear. You may be able to get pain relief by using pads or inserts to ease the pressure on your heel. Physical therapy and stretches to strengthen your legs and feet can also help.
If conservative treatments don’t ease your symptoms, your doctor may recommend surgery to remove the bump. Your doctor will use general or local anesthesia to numb the area around your heel. Then, they will cut into the bone and remove the protruding bump or smooth it away. Your doctor may also remove a portion of your Achilles tendon, especially if it’s degenerative or if you’re experiencing other problems with it.
Foot and ankle surgeons (also known as podiatric surgeons) have more education and training than other healthcare providers to treat conditions of the foot and ankle. They can diagnose and treat the many conditions that affect your heels, including Haglund’s deformity.
Diagnosis
Haglund’s deformity is a symptomatic enlarged osseous prominence of the back of the heel bone (calcaneus) resulting in pain and inflammation at the site of the Achilles tendon insertion. It may be aggravated by shoes that put excessive pressure on the heels, cavo varus deformities, and hereditary traits. Signs of inflammation like swelling, warmth, redness, and tenderness over the posterior heel may be present.
Your doctor will evaluate your symptoms and foot history to diagnose Haglund’s deformity. He or she may recommend x-rays to evaluate the front and rear of your ankle and the back of the heel for signs of calcification and deformity.
Medications like nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce the swelling and inflammation in the area. Ice application to the affected area can help decrease the pain and inflammation as well. Changing the type of shoe wear, heel pads and stretching exercises can also be beneficial. If these conservative treatments are not helpful, surgery may be recommended to remove the enlarged bony projection and reduce pressure on the Achilles tendon. At Resurgens, our foot and ankle surgeons are experts in diagnosing and treating Haglund’s deformity. Contact us to schedule an appointment at one of our Metro Atlanta locations. We are dedicated to providing clear answers, advanced treatment options and personalized solutions for all of your foot and ankle needs.
Treatment
Haglund’s deformity causes a bump to form on the back of your heel bone, where the Achilles tendon is attached. This enlargement of the bone section triggers soft tissue irritation (retrocalcaneal bursitis, insertional Achilles tendinitis) and thickening of the calcaneus tendon. The exact cause of this condition is not fully understood. It has been suggested that tight Achilles tendons, high arch of the foot, and heredity may contribute to this condition.
Your doctor will diagnose Haglunds deformity based on a physical exam and your symptoms. Your doctor will feel the enlarged area on the back of your heel, and may recommend X-rays to get a better view of the enlargement of the bone and the extent of inflammation in the retrocalcaneal bursa or calcaneus tendon. Your doctor may also use magnetic resonance imaging (MRI) to better evaluate your condition, particularly if you have severe symptoms or other underlying conditions that could be contributing to your pain.
Conservative treatment options include changing shoes to ones that have a wide toe box, using heel pads, applying ice, stretching, and physical therapy. When these options do not provide relief, surgery can help. During surgery, your surgeon will remove the bony enlargement and may trim or transfer the calcaneus tendon to relieve pressure on it. Surgery is generally performed outpatient, and your doctor will either use local anesthesia or a nerve block to numb the leg that will be operated on.
Prevention
Since experts aren’t sure what causes Haglunds deformity to begin with, it may never be possible to prevent it entirely. However, there are things you can do to decrease your risk. For example, wear comfortable shoes that don’t press against the back of your heel, and exercise regularly to keep your foot muscles strong.
What’s more, if you’re concerned about the health of your feet or ankles, don’t hesitate to make an appointment with a Resurgens specialist. They can provide you with clear answers and advanced treatment options.
Haglunds deformity is a painful bump that develops on the back of the heel bone (calcaneus). It’s triggered by pressure against the back of the heel, especially when wearing shoes with stiff backs. This pressure forces the Achilles tendon to rub against the enlarged bony protrusion, which can cause pain and inflammation in the soft tissue around the area. The condition commonly occurs in women who wear pumps, though men with tight shoes or high arches are also at risk.
The best way to treat Haglund’s is to relieve the pressure against the Achilles tendon by wearing shoes with a flexible back or using heel pads. Ice and compression are also helpful in relieving the inflammation and pain. If these conservative methods don’t alleviate symptoms, a podiatrist can surgically remove the enlarged portion of the heel bone. A new surgical technique, called SpeedBridge, allows the podiatrist to access the growth without removing the entire Achilles tendon. This can result in quicker recovery and improved long-term outcomes for patients.