Haglund's Deformity
What is Haglund's Deformity?
Haglund's deformity is a bony enlargement on the back of the calcaneus (heel bone), causing irritation or bursitis where the Achilles tendon attaches.
- Often called 'pump bump' due to irritation from rigid shoes
- Can lead to heel pain, swelling, and redness
Overview of the Condition
Excessive rubbing or pressure from footwear aggravates the bony prominence, inflaming the retrocalcaneal bursa and Achilles tendon insertion.
Symptoms
- Pain at the back of the heel
- Swelling near the Achilles insertion
- Irritation and redness from shoe contact
Causes
Repetitive friction from tight or rigid shoes contributes to bony overgrowth. High arches and tight Achilles tendons may also predispose individuals to Haglund's deformity.
Diagnosis
Physical examination and imaging (X-rays) show the prominent heel bone and possible associated bursitis or Achilles tendon inflammation.
Treatment Options
- Wearing open-backed or soft-heeled shoes
- Heel lifts or orthotics
- NSAIDs or ice to reduce inflammation
- Surgery if conservative measures fail
Conservative Management
Reducing friction is key. Heel pads, changing footwear, and physical therapy focusing on Achilles flexibility often alleviate symptoms.
Rehabilitation Exercises
- Heel cord stretching to reduce tension
- Calf strengthening for balanced foot mechanics
- Icing the heel after activities
When is Surgery Needed?
Surgery is considered if pain and swelling persist despite conservative treatment. It involves removing the bony prominence and addressing any damaged Achilles tendon tissue.
Surgical Procedures
- Calcaneal osteotomy or resection of the bony spur
- Debridement of inflamed bursa
- Achilles tendon repair if necessary
Anatomy Overview
The calcaneus is the largest tarsal bone forming the heel. The posterior superior aspect can enlarge, impinging the retrocalcaneal bursa and Achilles tendon insertion.
Affected Areas
- Posterior calcaneus (heel bone)
- Retrocalcaneal bursa
- Achilles tendon origin
Frequently Asked Questions
| Question | Answer |
|---|---|
| Will changing shoes help? | Yes, shoes with a soft or open back significantly reduce irritation to the bony prominence. |
| How long is recovery after surgery? | Recovery can range from 6 weeks to several months, depending on the extent of bony resection and tendon involvement. |
Prevention Strategies
- Choose well-fitting, low-heeled shoes
- Regularly stretch the calf muscles
- Use heel pads or lifts to reduce pressure