Haglunds Deformity

Haglund’s Deformity, otherwise known as “pump bump” or retrocalcaneal bursitis, is characterized by a bony enlargement on the back of the heel. The condition is caused by the inflammation of the bursa, a fluid-filled sac between the tendon and bone. This enlargement often rubs against footwear and causes painful irritation, which leads to bursitis. The rigid backs of pump-style shoes and other shoes with rigid heels, such as ice skates, men’s dress shoes, or women’s pumps, can cause this irritation.

Heredity also plays a role in the development of Haglund’s deformity. Inherited foot structures that make one prone to the condition include:

– A high-arched foot
– A tight Achilles tendon
– A tendency to walk on the outside of the heel.

Symptoms include a noticeable bump on the back of the heel, pain in the area where the Achilles tendon attaches to the heel, swelling in the back of the heel, and redness near the inflamed tissue. A foot and ankle surgeon usually performs a physical examination and x-rays to evaluate the heel bone’s structure to diagnose the condition.

Non-surgical treatment aims to reduce inflammation of the bursa but will not shrink the bony protrusion. Non-surgical treatment may include medication, ice to reduce swelling, exercises to relieve tension from the Achilles tendon, heel lifts to decrease pressure on the heel, heel pads to cushion the heel and reduce irritation, custom arch supports to control foot motion, and physical therapy modalities, such as ultrasound, to reduce inflammation. In some cases, casting may be necessary.

If non-surgical treatment fails to provide pain relief, surgery may be required. The foot and ankle surgeon will determine the procedure that is best suited to the patient case. Patients should follow their surgeon’s post-surgical care instructions.

A recurrence of Haglund’s deformity can be prevented by wearing appropriate shoes (avoid rigid heel backs), using arch supports or orthotic devices, performing stretching exercises to prevent the Achilles tendon from tightening, and avoiding running on hard surfaces and running uphill.

Haglund’s deformity can be painful and cause disruption in daily activities. Changing shoes, soaking feet, and anti-inflammatory medications can help mitigate the symptoms of this problem. However, seeking medical advice is recommended as early detection and timely treatment can help prevent future complications or permanent damage to the foot. For more information, consult a professional foot and ankle surgeon experienced in the treatment of Haglund’s deformity. Dr Gilbert Huang DPM is an expert in treating foot and ankle deformities and can provide the necessary care for Haglund’s deformity.


Hallux Rigidus