What is Haglund's Deformity?
Haglund's Deformity is a bony enlargement of the back of the heel bone. Sometimes it's called “pump bump” because the deformity often occurs in those who wears pumps or high heels.
The shape of your foot can contribute to the development of Haglund's Deformity. If you have high arches, a tight Achilles tendon, or a tendency to walk on the outside of your feet, you're more likely to develop Haglund's Deformity than other people. Wearing shoes with a firm, rigid back may also contribute to the development of Haglund's Deformity. The root cause is a biomechanical change that will increase tension of the Achilles tendon on you heel bone (calcaneus).
The primary symptoms of Haglund's Deformity are an enlarged bony prominence on the back of the heel and associated heel pain. You might also develop blisters on your heels as a result of your shoes rubbing against the bump.
Heel pads placed in the backs of your shoes may relieve and redistribute some of the pressure. Applying ice to the area after removing your shoes may ease some of the acute pain, swelling, and discomfort. If you have an otherwise normal foot, wearing open-heeled shoes may provide relief. Open-heeled shoes are not a good idea, though, if you have tendinitis, bunions, foot pain, or a structural deformity of the foot.
When to Visit a Podiatrist
If the pain persists despite your home remedies, or if the bump continues to enlarge, it's time to see a podiatrist. A podiatrist can carefully evaluate your feet and create a treatment plan tailored to your feet.
Diagnosis and Treatment
A podiatrist will begin by carefully examining your feet and taking a thorough medical history. X-rays will be ordered to get a biomechanical understanding of the structure of your feet. Sometimes, an MRI or ultrasound might be ordered as well as this issue is often accompanied with long standing Achilles tendon pain.
Treatment will depend on the severity of the condition. Options include:
- Shoe modification. Your podiatrist can recommend over-the-counter heel pads, heel lifts, or arch supports, or create custom orthotic supports to change the position of your feet in your shoes to relieve pressure on the back of your foot.
- Medication. Topical anti-inflammatory medication, applied directly to the heel, may provide pain relief. Oral anti-inflammatory medication (such as ibuprofen or steroids) can help as well.
- Immobilization. If the area is extremely inflamed, a custom-made soft cast or walking boot may be used to immobilize the area and allow it to heal.
- Surgery. If none of the non-surgical methods provide adequate relief, your podiatrist may recommend surgery to correct the deformity. Podiatrists are specially-trained foot and ankle surgeons who can surgically re-shape the heel bone.
Avoid shoes with rigid backs. If you have a high arch or tight Achilles tendon, wearing appropriate shoe inserts can provide biomechanical relief of excess strain. Adequately and properly stretching the Achilles tendon will usually provide the most benefit in preventing the development of Haglund's Deformity or the deformity progressing.