Complete Guide To Haglund’s Deformity

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Our feet often go overlooked. From long walks to ill-fitting shoes, most of us have accepted that sore feet are just a fact of life.

However, some types of foot pain are more serious than others – and shouldn’t be ignored, as they can grow worse if left untreated. For example, with too much abuse, you may end up with Haglund’s Deformity.

pump bump

The most obvious sign of Haglund’s Deformity is a bump at the heel. This bump is often painful and can get worse over time. If you think this deformity has affected you, what can be done?

How can you relieve the pain and fix your condition? Here we’ll discuss all its symptoms, causes, and forms of treatments, so you can get back to a comfortable lifestyle.

Ready to identify and handle your case of Haglund’s Deformity? Let’s dive in.

What Is Haglund’s Deformity?


Haglund’s Deformity is named after Patrick Haglund, who defined the condition in 1927. Other names for Haglund’s Deformity include Bauer bump, pump bump, or Mulholland deformity, though it’s most commonly known as Haglund’s heel.

In practice, it refers to an abnormality that occurs in the foot bone and soft tissues. This abnormality is an enlargement on the back of the heel, specifically a bony bump that occurs where the Achilles tendon is attached.

This bump is often painful, making it hard to wear shoes and socks, as well as do normal activities – like walking and running.

Other than pain caused by the bump, Haglund’s Deformity can be aggravated and accompanied by bursitis, a secondary condition.

Bursitis

Our joints are accompanied by fluid-filled sacs, called bursae. These bursae are found surrounding bones that meet with tendons, skin, and muscle tissue. Their function is to lubricate these areas, reducing the friction that occurs between the bone and the surrounding structure.

However, because of the stress that is often applied to our joints, they can become inflamed. Inflammation of the bursae is very uncomfortable – and is officially known as bursitis.

While it’s painful on its own, bursitis can escalate your case of Haglund’s Deformity. When the bump (caused by Haglund’s Deformity) rubs against shoes, the bursa near the Achilles tendon may become irritated.

Inflammation of the heel then causes calcium to build up in the bone. This means that the bony bump, because of the excess calcium, becomes even larger and more painful.

Bursitis that occurs specifically due to Haglund’s is called retrocalcaneal bursitis.

haglund's heel

Causes of Haglund’s Deformity

Haglund’s Deformity is considered idiopathic; in other words, the cause has yet to be discovered.

However, there is a good reason to believe that Haglund’s is a result of frequent pressure applied to the back of the heels. For example, Haglund’s Deformity is also referred to as the ‘pump bump’, as doctors observed that women who often wore ‘pumps’ (or heels) would develop the condition.

Of course, heels are not the only suspected cause of Haglund’s Deformity. Most close-toed shoes with rigid backs have been known to put you at greater risk for developing the condition. These include:

  • Ice and roller skates.
  • Ridged dress shoes.
  • Steel-toed work boots.
  • Winter boots.
  • Rain boots.

Other than the choice of footwear, a person’s foot structure may also be the reason for developing Haglund’s Deformity. Some features that can increase your risks of developing the condition include:

  • A prominent heel bone that slopes outward.
  • Feet that roll outward, or supination.
  • Tight Achilles tendons that increase pressure on the heel bone.
  • High arches, forcing the heel to move slightly backward while walking, putting pressure on the Achilles tendons.

People with these types of foot anatomy are encouraged to avoid the footwear listed above, especially for longer periods of time.

If you really need to wear these types of footwear, you may need to talk to your doctor about ways to lessen your chances of developing Haglund’s Deformity.

Who Is At Risk?

Data shows that Hugland’s deformity is most common in females aged 15 to 35, because of their most common footwear.

Haglund’s Deformity is also typical in runners, who routinely place a great deal of pressure on their feet.

Other factors that increase your risk of developing Haglund’s Deformity include:

knot on back of heel

  • Genetics: The bone structure of a person’s feet places them at greater risk for developing Haglund’s Deformity. Specifically, bone structure that places exceptional pressure on the heel will cause severe irritation, causing the body to attempt to build a cushion – which inadvertently becomes a bony bump.
  • Walking on the Outside of the Heel: Just like your bone structure, irregular walking patterns can also cause deformities. When walking on the outside of the heel, the outer edge of the sole becomes worn, causing it to rotate inward. This causes the grinding of the heel bone against the tendon, which results in bursitis.
  • Increased Weight: A sudden increase in weight can put pressure on your feet, causing friction against footwear. This is especially true if your shoes lack additional cushion or inserts that lessen pressure on your feet.
  • Injury: Injury to the foot, or any injury that causes you to walk differently than you normally would, can predispose you to Haglund’s disease. A change in the way that you walk can cause friction against your shoes, which was previously absent.
  • Tight Shoes: Tight shoes can inflame the joint, forcing it into an awkward position. In an attempt to compensate, the body will develop bursitis, which causes pain.

Symptoms of Haglund’s Deformity

The intensity of the symptoms for Haglund’s Deformity changes from person to person, ranging from mild to severe. They may occur in one or both feet, and will often be more painful whenever shoes are worn.

These symptoms include:

  • A bony bump on the back of the heel.
  • Pain where your Achilles tendon attaches to your heel, especially when you walk or when you wear shoes.
  • Swelling at the bump on the heel, specifically the bursa.
  • Redness due to inflammation at the back of the heel.
  • Calluses or blisters due to friction, indicating that the bump is rubbing against footwear.

This video goes into more detail on Haglund’s deformity.

When to Visit a Doctor

Haglund’s Deformity, especially when it occurs alongside bursitis, can be very painful. It can stop you from walking as you usually do, as well as wear most types of footwear.

When you notice that your foot pain is beginning to affect your daily life – be it due to Haglund’s Deformity or other sources of pain – it’s best to seek medical attention.

Specifically, you will need to be attended to by a podiatrist, or a doctor that specializes in foot-related medical problems.

You may make an appointment with your general practitioner, although they will likely recommend you to a podiatrist.

Home Care

There are home remedies that can reduce inflammation before it develops into a case of Haglund’s Deformity.

When you notice pain or irritation in that area, or you experience greater friction in your shoes, preemptive actions are your best approach.

Once the deformity has occurred, it will need to be looked after by a doctor.

  • Heel Pads: Heel pads are meant to reduce friction between the shoe and the foot. They can also be used to reduce pressure on the heels, redistributing it to the other parts of the foot.
  • Ice: Ice should be your first step in reducing inflammation. Ice applied to the area can reduce pain as well.
  • Changing Footwear: This may include changing to softer shoes, wearing open-toed shoes, or not wearing shoes at all. While it may not be a long-term solution, it can lessen the severity of your case and prevent it from escalating into a deformity.

bump on back of heel

Diagnosis

Haglund’s Deformity can be hard to diagnose because the symptoms are similar to other foot issues. To make sure that you are suffering from Haglund’s Deformity, rather than a different condition, your doctor will diagnose you in a few ways.

First, your podiatrist will examine your feet. They will also check your medical history, as provided by your general practitioner or from questions asked of you directly.

Other than an initial visual examination, your podiatrist may order tests to look at the structure of your feet. The most common test for diagnosing Haglund’s diagnosis is an X-ray.

An X-ray will determine if there is any bone protrusion in your heel. Additionally, an X-ray will be helpful if your doctor needs to develop customized orthotics to stabilize your foot.

In some cases, your doctor may order an ultrasound or an MRI, so as to determine if there are any other problems in your foot.

Here’s a video with a closer look on Haglund’s deformity and identifying it.

Treatment

Once your doctor has determined that your condition is Haglund’s Deformity, there are several treatment options available to you.

Commonly, you will be recommended physiotherapy, medication, and orthotics. In extreme cases, where non-surgical options are ineffective, surgery may be needed.

Here are your common treatment options:

Medication

Alongside other treatments, your doctor is likely to prescribe medication to ease the pain in your foot. This will typically be anti-inflammatory medication, such as ibuprofen.

Topical pain relievers that you can apply directly to the area are also helpful. While this does not cure the issue, it will relieve your discomfort and help lessen the inflammation, so other treatments are more effective.

Physiotherapy

Physiotherapy, or physical therapy, can greatly reduce discomfort in the heel. Specifically, it helps to correct poor stance, work out inflammation, and improve the movement of your joints.

Additionally, ultrasound therapy, a form of physiotherapy, can sooth pain and other symptoms.

Exercises

Stretching exercises that remove tension in your Achilles tendons may be helpful to reduce inflammation. This treatment may be recommended alongside other options, such as medication and physical therapy.

Overall, by improving the day-to-day condition of your heel, you can lessen the aggravating causes behind Haglund’s.

Orthotics

Orthotics refer to any type of device that supports or corrects the movable parts of your body. They can be in the form of a brace or splint, among others.

Orthotic devices that are helpful for treating Haglund’s include shoe inserts, which can correct irregular or abnormal walking patterns.

Orthotics that control the movement of the foot are also important for limiting bad habits that aggravate the deformity.

Immobilization

Beyond orthotic devices, your doctor may recommend immobilizing the foot. Immobilization is helpful in cases where a great deal of inflammation is present and escalates your condition.

Casts are often used to immobilize the foot, such as soft casts and walking boots.

pump bump

Shoe Modification

Orthotics can alter the movement of the foot, but you can also modify the shoe itself.

For example, you can modify the shoe to have a softer back, or remove the back entirely. This is especially helpful during the recovery process.

Heel pads and heel lifts can also be used alongside bigger modifications to make the show more comfortable.

Surgery

Haglund’s Deformity will rarely need surgery to treat, but there are some cases where it’s necessary.

However, all non-surgical options will be tried first. If those treatments fail to work, you will be recommended to a foot and ankle surgeon to determine the best type of surgery for your case.

Endoscopic surgery is a common type used to address Haglund’s Deformity. Endoscopic surgery requires a small incision, which means that recovery is shorter than conventional types.

Conventional surgery has also been shown as effective in addressing Haglund’s Deformity, but the recovery could take up to several months.

How to Prevent Haglund’s Deformity

Whether or not you’ve previously suffered from Haglund’s Deformity, there are some methods of preventing this condition.

These include:

  • Wearing comfortable shoes, and avoiding shoes with rigid backs (such as high-heels).
  • Using orthotic devices that support the arch and protect the heel.
  • Exercises that stretch the knot on the heel, especially the Achilles tendon, to prevent it from tightening.
  • Avoiding running on hard surfaces and uphill without enough support.

Conclusion

Foot pain is a common type of discomfort, but there are cases wherein medical attention is important and necessary.

Haglund’s Deformity is an example of this complication. While you can’t ignore the problem, take heart: there are many easy ways to treat it, so you can get back to everyday life.


What’s your experience with Haglund’s deformity?

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