Haglund’s Deformity: A Bone of Contention in Podiatry

Haglund’s Deformity is a challenging foot condition that is rooted in both genetic predisposition and external factors. This condition presents as a bony prominence at the back of the heel, leading to discomfort, inflammation, and a range of distressing symptoms.

In this article, we will explain the complexities of Haglund’s Deformity, delving into its impact, diagnostic nuances, and available treatment options. Keep reading to learn more.

What is Haglund’s deformity?

Haglund’s deformity, also known as “pump bump,” is a bony enlargement that occurs on the back of the heel. It typically affects the area of the foot where the Achilles tendon attaches to the heel bone. This condition can be quite painful and is often caused by wearing tight shoes or high heels that constantly rub against the back of the heel.

What symptoms do I need to watch out for?

Haglund’s deformity can manifest itself through a variety of symptoms and signs.

If you have this condition, you may experience pain and tenderness at the back of your heel, especially when wearing shoes that put pressure on the area. The skin around the bony prominence may become red and swollen. In some cases, you might develop blisters or calluses due to friction between the shoe and the enlarged bone.

Walking and running can be uncomfortable with Haglund’s deformity, as the Achilles tendon and surrounding tissues may become inflamed. You may also notice a visible bump on the back of your heel, which is the prominent bone causing the issue. These symptoms can vary in severity from person to person, but if you suspect you have Haglund’s deformity, it’s best to consult a podiatrist for an accurate diagnosis.

Can anyone get Haglund’s Deformity?

Haglund’s deformity can arise due to a combination of genetic and external factors.

Some people naturally have a prominent bony structure on the back of their heels, making them more susceptible to this condition. People with flat feet or feet that pronate are often seen to suffer from Haglund’s deformities because of the position these movements shift the heel into. In addition, wearing shoes with a rigid back or those that put excessive pressure on the heel can contribute to the development of Haglund’s deformity.

High-heeled shoes, in particular, are notorious culprits as they force the foot into a position that increases pressure on the back of the heel. This prolonged irritation can lead to the formation of the bony enlargement.

Other factors that can contribute to Haglund’s deformity include having a high-arched foot, a tight Achilles tendon, or a history of other foot conditions like Achilles tendonitis.

What can I do to prevent Haglund’s Deformity from forming?

While it’s not always possible to prevent Haglund’s deformity completely, there are some steps you can take to reduce the risk or minimise its progression. Here are some tips:

• Wear appropriate footwear: Opt for shoes with a soft and cushioned back to minimise friction and pressure on the heel. Avoid tight-fitting shoes or those with rigid backs that can aggravate the condition.

• Choose low-impact activities: Engage in exercises and activities that are gentle on your feet and reduce the strain on the Achilles tendon. Consider low-impact options like swimming or cycling instead of high-impact activities like running or jumping.

• Stretch and strengthen: Perform regular stretching exercises that target the calf muscles and Achilles tendon. Strengthening exercises can help improve the overall stability of the ankle and reduce the risk of deformity.

• Gradual increase in physical activity: When starting a new exercise routine or sport, gradually increase the intensity and duration rather than pushing yourself too hard too soon. This allows your body to adjust and adapt, reducing the risk of overuse injuries.

• Take breaks and rest: Give your feet and ankles regular breaks, especially after prolonged standing or physical activity. Resting allows your body to recover and reduces the chances of developing overuse injuries.

• Use orthotic inserts: Consider using heel pads or orthotic inserts in your shoes to cushion the heel and reduce pressure on the area. These can provide additional support and help alleviate discomfort.

• Maintain a healthy weight: Excess body weight puts added stress on your feet and heels. Maintaining a healthy weight can reduce the strain on your feet and lower the risk of developing Haglund’s deformity.

• Listen to your body: Pay attention to any pain, discomfort, or swelling in your heels or Achilles tendon. If you notice any symptoms, it’s important to seek medical advice promptly to address the issue before it worsens.

Remember, these preventive measures can help reduce the risk of Haglund’s deformity, but they may not guarantee complete prevention. If you suspect you have Haglund’s deformity or are experiencing persistent symptoms, it’s always best to consult a healthcare professional for an accurate diagnosis and appropriate treatment recommendations.

Who do I call if I feel like I have Haglund’s Deformity?

A medical practitioner who specialises in ailments of the foot is called a podiatrist.
Podiatrists employ various methods to diagnose Haglund’s deformity. They typically begin by conducting a thorough examination of the affected foot, assessing the heel for any visible signs of enlargement, redness, or swelling. The podiatrist will also inquire about your symptoms and medical history to gather additional information.

To confirm the diagnosis, the podiatrist may order imaging tests such as X-rays(most common) or an MRI scan. X-rays can reveal the bony prominence on the back of the heel and help determine its size and shape. An MRI scan provides a more detailed view of the soft tissues, allowing the podiatrist to assess the condition of the Achilles tendon and identify any associated inflammation or damage.

How can Haglund’s Deformity be treated?

When it comes to managing Haglund’s deformity, conservative treatment methods are often the first line of defense.

These non-surgical approaches aim to alleviate symptoms, reduce inflammation, and prevent further irritation to the heel.Treatment can include:

• Footwear changes to reduce pressure on the heel
• Exercise programs that focus on creating better calf flexibility
• Use of orthotics to control causative foot movements
• Padding inside shows to minimise heel contact and irritation
• Heel raises to offload bone from irritating portions of shoes
• Topical anti-inflammatories to reduce pain and swelling

If conservative measures don’t provide sufficient relief, your podiatrist may explore other options, including orthotic devices or immobilization in a walking boot to alleviate pressure on the heel. In more severe cases, when conservative treatments fail, surgery may be considered.

When will surgery be an option for Haglund’s Deformity?

Surgical intervention for Haglund’s deformity is typically reserved for cases where conservative treatments have been ineffective in providing relief. It may also be recommended if the condition is severe, causing significant pain, or leading to complications such as chronic inflammation or Achilles tendon damage.

Surgery aims to address the underlying bony prominence on the back of the heel. The specific procedure chosen will depend on the individual’s condition and the extent of the deformity.

Common surgical techniques involve removing or reshaping the bony prominence, and in some cases, repairing or lengthening the Achilles tendon.

What long term effects can I expect from Haglund’s Deformity and its treatment?

While the majority of individuals experience successful outcomes with appropriate treatment, there can be potential complications and long-term effects associated with Haglund’s deformity and its treatment.

Surgical procedures, although generally safe, carry inherent risks such as infection, bleeding, nerve damage, or poor wound healing. It’s important to discuss these risks with your podiatrist and follow their post-operative instructions to minimise the likelihood of complications.

In some cases, despite treatment, there may be residual pain or discomfort. This can occur if the deformity was severe or if there were underlying conditions affecting the foot or ankle. Additionally, there is a small risk of the deformity recurring after surgical correction, especially if the underlying factors that contributed to its development, such as improper footwear, are not addressed.

Regular follow-up visits with your podiatrist are crucial to monitor your progress, address any concerns, and make necessary adjustments to your treatment plan. By working closely with your healthcare provider and adopting appropriate preventive measures, you can minimise the chances of complications and achieve the best possible outcome for your Haglund’s deformity.

Don’t let Haglund’s deformity hold you back

Haglund’s deformity, also known as “pump bump,” can be a painful and bothersome condition that affects the back of the heel.

Whether you’re experiencing the symptoms or seeking preventive measures, it’s important to consult a trusted podiatrist for an accurate diagnosis and tailored treatment plan. The skilled team at Hurst Podiatry is dedicated to providing comprehensive foot care, including the diagnosis and management of Haglund’s deformity. From conservative approaches to surgical interventions, their expertise and personalised care ensure that you receive the most appropriate treatment for your specific needs.

Don’t let Haglund’s deformity hold you back from enjoying an active and pain-free lifestyle. Schedule a consultation with Hurst Podiatry and take the first step towards healthier feet and a more comfortable future.