H is for Haglunds Deformity

November 17, 2012

Haglunds is an enlargement of the bone at the posterior dorsal aspect of the calcaneus. It can cause problems from poor shoe fitting.

Haglund’s deformity, also known as “pump bump” or “retrocalcaneal bursitis,” is a condition that affects the foot, specifically the back of the heel. It involves the enlargement and irritation of the bony prominence at the back of the heel bone (calcaneus), as well as inflammation of the surrounding soft tissues.

  1. Bony Enlargement: Haglund’s deformity is characterized by the presence of a bony prominence at the back of the heel bone. This bony enlargement can be caused by a combination of factors, including a prominent heel bone structure, excessive pressure or friction on the area, and certain foot biomechanics.
  2. Symptoms: The condition can cause pain, swelling, and inflammation in the back of the heel. The pain is typically worse when wearing tight or rigid shoes, such as high heels or dress shoes, which can rub against the prominent area. Activities that involve repetitive or forceful movements of the foot, such as running or jumping, may also exacerbate the symptoms.
  3. Retrocalcaneal Bursitis: The bony prominence associated with Haglund’s deformity can irritate and inflame the retrocalcaneal bursa, a fluid-filled sac located between the Achilles tendon and the calcaneus. This inflammation, known as retrocalcaneal bursitis, can cause additional pain and swelling in the area.
  4. Causes and Risk Factors: Haglund’s deformity can develop due to a combination of factors, including inherited foot structure, abnormal foot mechanics (such as high arches or inward rolling of the foot), tight or ill-fitting shoes, and repetitive trauma to the back of the heel.
  5. Diagnosis: A healthcare professional, such as a podiatrist, can diagnose Haglund’s deformity based on a physical examination of the foot and the patient’s medical history. X-rays or other imaging tests may be ordered to assess the bony prominence and rule out other conditions.
  6. Treatment: Treatment options for Haglund’s deformity aim to alleviate symptoms, reduce inflammation, and address the underlying causes. Conservative measures include:
    • Switching to footwear with open backs or low heels to reduce pressure on the area.
    • Applying ice packs to reduce pain and inflammation.
    • Using non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and inflammation.
    • Physical therapy exercises to stretch and strengthen the calf muscles and Achilles tendon.
    • Orthotic devices or shoe inserts to correct foot mechanics and reduce pressure on the heel.
  7. In some cases, when conservative measures do not provide sufficient relief, surgical intervention may be considered. The surgical procedure may involve removing the bony prominence, reducing the pressure on the Achilles tendon, and addressing any associated soft tissue inflammation or damage.


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