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Haglund's Deformity | Pump Bump | Bump On Heel

Haglund’s Deformity is a bony enlargement on the upper portion of the back of the heel bone. This enlargement, or "bump" of bone, may sometimes trap the soft tissue of the Achilles tendon between the heel bone and the shoe resulting in irritation of the tendon, skin, and other soft tissue. Constant rubbing of the back of the shoe on this area can also lead to bursitis, an inflammation of the fluid-filled sac between the achilles tendon and bone. The result is very significant heel pain.

Haglund’s deformity is nicknamed “pump bump”, because the rigid backs of pump-style shoes create pressure that aggravates the enlargement. In fact, the deformity is most common in young women who wear pumps, but may be created by any rigid shoe back, like men's dress shoes or ice skates.

Symptoms of Haglund's Deformity

  • Noticeable bump on the back of the heel
  • Pain and swelling in the area where the Achilles tendon attaches to the heel
  • Redness near the inflamed tissue
  • Tenderness in the back of the heel

Causes of Haglund's Deformity

  • Heredity: The type of foot structure that makes you prone to developing Haglund's Deformity is an inheritable trait
  • High arches: If you have a high arch, the heel bone tilts backward into the Achilles tendon where the tendon and bone connect. This causes the uppermost portion of the back of the heel bone to rub against the tendon. Eventually a bony protrusion develops and the bursa becomes inflamed
  • A tight Achilles tendon may cause pain by compressing the tender and inflamed bursa
  • A tendency to walk on the outside of the heel creates wear on the outer edge of the sole of the shoe. This in turn causes the heel to rotate inward, resulting in the grinding of the heel bone against the tendon

How to prevent Haglund's Deformity

  • Wear appropriate shoes - avoid pumps, high-heeled shoes, and any rigid back shoes
  • Use arch supports or orthotic shoe inserts to balance the foot
  • Perform stretching exercises to keep the Achilles tendon loose
  • Avoid running on hard surfaces and running uphill

Treatment of Haglund's Deformity
**The inflammation of the bursa can be treated and reduced. However, this will not shrink the bony protrusion.

Your podiatrist at PA Foot and Ankle Associates may recommend one or more of the following treatments to manage your heel pain from Haglund's Deformity:

  • Anti-inflammatory medication to help reduce pain and inflammation
  • Ice - 20 minutes each hour
  • Physical therapy and stretching exercises to help relieve tension from the Achilles tendon
  • Heel lifts
  • Heel Pads
  • Shoe modifications
  • In-shoe orthotic devices to control motion in the foot
  • Immobilization is sometimes necessary to reduce symptoms

When Is Surgery Needed? 
If non-surgical treatment fails to provide adequate pain relief, surgery may be needed to relieve Haglund's Deformity. Your  podiatric surgeon will determine the procedure that is best suited for you.

Watch a patient testimonial on Haglund's Deformity surgery