A Haglund’s deformity is a bony enlargement on the back of the heel that can lead to a painful bursitis or irritation of the soft tissue near the achilles tendon when the bump rubs against the shoe.
A Haglund’s deformity is often called a pump bump because the rigid backs of certain dress shoes can create pressure that aggravates the enlargement when walking. The deformity is very common in women who wear pumps.
Heredity can play a role in the formation of a Haglund’s deformity as we inherit the shape of our heel bone. A person with tightness in the achilles tendon (equinus) can also be more prone to having a prominent bump on the back of the heel. We see Haglund’s deformities in people that have a foot type that flattens or pronates excessively during gait. Pronation can cause the heel to rotate and contribute to excessive rubbing on shoe gear.
What we can do to help you solve this problem
If you are having pain and swelling on the back of your heel, we recommend that we see you as a patient.
Initially, we will perform a complete history and physical examination of your feet to determine the cause of your Haglund’s deformity. We will perform a comprehensive biomechanical examination to determine what role this may play in the formation of the problem. We will educate you on the proper shoe gear to help prevent aggravation of the pain. Prescription anti-inflammatory medications can sometimes be helpful in reducing the inflammation associated with a Haglund’s deformity.
Arch supports can be very helpful in the treatment of a Haglund’s deformity. If your symptoms are mild, we may be able to use a pre-made arch support to control the abnormal flattening of your arch and movement of your heel bone. We carry arch supports in our office that are typically much better than what you will find in the store. Some cases of Haglund’s deformity are more severe and may require the use of a prescription orthotic. This is a custom-made arch support that is made from a plaster impression or digital scan of your foot and arch. Unlike pre-made arch supports, however, an orthotic completely controls abnormal pronation or flattening of the arch and movement of the heel bone. Read more about custom orthotics.
If non-surgical treatment fails to provide adequate pain relief, surgery may be needed. Surgical treatment consists of debridement of any excessive tendon thickening and excision of any retrocalcaneal bursa and Haglund’s deformity. If there is extensive involvement of the Haglund’s deformity within the achilles tendon, it sometimes is necessary to detach a portion of the tendon to ensure complete removal of the bone. If this is required, we typically will use absorbable tendon anchors to re-attach the achilles back to the heel bone.
The doctors at Council Bluffs Foot & Ankle Care are experts in the treatment of this painful condition. If you are tired of not being able to wear the shoes that you want due to this pain, call to request an appointment.