What is Haglund's Deformity?

Understanding the Bony Heel Condition

Haglund’s deformity, often referred to as “pump bump,” is a bony enlargement on the back of the heel. This condition occurs when the soft tissues surrounding the Achilles tendon become irritated due to friction or pressure, often caused by rigid shoes or certain foot mechanics. Haglund’s deformity is not just a cosmetic concern—it can lead to significant discomfort, inflammation, and difficulty wearing regular footwear.

At Gotham Footcare, we specialize in diagnosing and treating Haglund’s deformity to alleviate pain and restore your mobility and comfort.

Causes of Haglund’s Deformity: Why Does It Occur??

Footwear Pressure

Shoes with stiff backs, such as high heels, pumps, or athletic shoes, can cause repetitive friction against the back of the heel, leading to irritation and the development of Haglund's deformity.

High-Arched Feet

Individuals with high-arched feet are more prone to Haglund’s deformity because their heels tend to tilt inward, increasing pressure on the back of the heel.

Tight Achilles Tendon

A tight Achilles tendon can increase tension on the heel, exacerbating the irritation that leads to Haglund’s deformity.

Genetic Predisposition

Foot structure and biomechanics often run in families, so genetics can play a role in the development of Haglund’s deformity.

Repetitive Activity

Activities such as running or walking that put repeated stress on the back of the heel can contribute to the condition, especially when performed in poorly fitting footwear.

Symptoms of Haglund’s Deformity: How to Identify It

Visible Bump

A noticeable bony lump on the back of the heel is the hallmark sign of Haglund’s deformity.

Pain and Swelling

Pain is typically localized to the back of the heel, and the area may become swollen and tender.

Redness and Inflammation

The skin over the bony prominence may appear red and irritated, especially after wearing tight or rigid shoes.

Difficulty Wearing Shoes

Many individuals with Haglund’s deformity find it challenging to wear closed-back shoes without experiencing discomfort.

Blisters or Calluses

Prolonged friction can lead to the formation of blisters or calluses over the bony bump.

Diagnosing Haglund’s Deformity

How Gotham Footcare Can Help

Thorough Physical Examination

Our podiatrists will carefully examine your heel for signs of swelling, redness, and the characteristic bony enlargement.

Medical History and Activity Assessment

We will review your medical history and daily activities to identify potential contributing factors, such as footwear choices or repetitive movements.

Imaging Tests

X-rays are often used to confirm the presence of a bony protrusion and evaluate its severity. In some cases, additional imaging like an MRI may be recommended to assess soft tissue damage or inflammation.

Treatment Options for Haglund’s Deformity at Gotham Footcare

Comprehensive and Personalized Care

Non-Surgical Treatments

Footwear Modifications
Switching to shoes with soft backs or open-heeled designs can significantly reduce irritation. Properly fitted footwear with ample cushioning is essential to alleviate symptoms.
Heel Pads and Orthotics
Custom orthotics or heel pads can provide cushioning and redistribute pressure away from the affected area.
Anti-Inflammatory Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.
Ice Therapy
Applying ice packs to the heel can minimize swelling and relieve discomfort, particularly after prolonged activity or shoe wear.
Stretching Exercises
Targeted stretching routines, especially for the Achilles tendon and calf muscles, can improve flexibility and reduce tension on the heel.

Advanced Treatments

Platelet-Rich Plasma (PRP) Injections
In severe cases, PRP injections may be administered to promote tendon healing, reduce inflammation, and provide long-term relief for Achilles tendon issues.
Shockwave Therapy
This non-invasive treatment uses sound waves to stimulate healing, reduce inflammation, and alleviate pain.

Surgical Treatments

If conservative treatments are unsuccessful, surgery may be necessary. Surgical options include:

Excision of the Bony Enlargement
This procedure involves removing the bony protrusion to eliminate friction and pressure on the heel.
Tendon Realignment
If the Achilles tendon is significantly affected, minimally invasive surgical intervention may be required to realign or repair the tendon.
Minimally Invasive Techniques
Endoscopic surgery offers a less invasive option with quicker recovery times for certain cases of Haglund’s deformity.

Duration of Treatment

How Long Does It Take to Recover from Haglund’s Deformity?

Timeline for Non-Surgical Treatments

Most patients experience relief within a few weeks to months when following a conservative treatment plan, including footwear modifications and physical therapy.

Recovery After Surgery

Surgical recovery times vary depending on the procedure. On average, patients can expect to resume normal activities within six to twelve weeks, with physical therapy aiding the rehabilitation process.

Preventing Haglund’s Deformity

Tips for Healthy Heels

Choose Supportive Footwear
Opt for shoes with soft backs, good arch support, and a proper fit. Avoid high heels and rigid shoes that can increase pressure on the back of the heel.

Stretch Regularly
Incorporate stretching exercises into your daily routine to keep the Achilles tendon and calf muscles flexible and reduce tension on the heel.

Use Heel Pads or Orthotics
Cushioned heel pads or custom orthotics can help protect the back of the heel and prevent friction.

Alternate Footwear
Avoid wearing the same type of shoes every day, especially those with rigid backs. Rotate between supportive, comfortable footwear options.

Frequently Asked Questions About Haglund’s Deformity

What Causes Haglund’s Deformity?

Haglund’s deformity is caused by repeated friction or pressure on the back of the heel, often from ill-fitting or rigid footwear, combined with certain foot structures like high arches or a tight Achilles tendon.

Can Haglund’s Deformity Be Cured Without Surgery?

In many cases, non-surgical treatments such as footwear modifications, orthotics, and physical therapy can provide significant relief. Surgery is only necessary for severe cases that do not respond to conservative care.

How Can I Prevent Haglund’s Deformity?

Preventing Haglund’s deformity involves wearing properly fitted shoes, incorporating regular stretching exercises, and using heel pads or orthotics to reduce friction.

Is Haglund’s Deformity a Permanent Condition?

While the bony enlargement itself does not go away without surgical intervention, symptoms can often be managed effectively with conservative treatments.

Does Haglund’s Deformity Affect Both Heels?

Haglund’s deformity can occur in one or both heels, depending on individual foot structure, activity levels, and footwear habits.

Your First Step to Getting Better

At Gotham Footcare in NYC, we strive at recognizing your individual needs and desired outcomes while formulating an effective and personalized treatment plan with the highest quality care available.

What sets Gotham Footcare apart from other podiatry offices is our dedication to providing you with the education you need to make well-informed decisions regarding your care. Regardless of what your foot and ankle trouble may be, at Gotham Footcare our team will work tirelessly to help you feel better. At Gotham Footcare, we help you put your best foot forward.

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