Haglund’s Deformity: Symptoms, Causes, and Treatments

Haglund’s deformity, often referred to as “pump bump,” is a bony enlargement on the back of the heel bone (calcaneus). This condition can cause significant discomfort and limit mobility, particularly in individuals who wear shoes with rigid backs. Understanding the symptoms, causes, and available treatments can help manage this condition effectively.

Symptoms of Haglund’s Deformity

1. Bony Growth: The most noticeable sign is a prominent bony bump on the back of the heel. This enlargement can vary in size and may become more pronounced over time.
2. Pain and Discomfort: Individuals often experience pain in the heel, especially when pressure is applied, such as when wearing shoes. The pain may worsen with activities like walking, running, or standing for extended periods.
3. Swelling and Inflammation: The area around the deformity can become swollen and tender, leading to increased sensitivity when touched.
4. Soreness: The heel may feel sore, particularly after physical activity or prolonged periods of wearing shoes that rub against the bump.
5. Bursitis: In some cases, Haglund’s deformity can lead to inflammation of the bursa (a fluid-filled sac that reduces friction), resulting in retrocalcaneal bursitis, which can exacerbate pain and discomfort.

Causes of Haglund’s Deformity

Haglund’s deformity typically arises from a combination of factors, including:

1. Genetics: Some individuals may have a genetic predisposition to developing a bony enlargement due to inherited foot structure or mechanics.
2. Foot Mechanics: Abnormal foot mechanics, such as overpronation or a high arch, can increase pressure on the heel, contributing to the development of Haglund’s deformity.
3. Footwear: Wearing rigid or poorly fitted shoes, particularly those with a stiff heel counter (like pumps or dress shoes), can irritate the back of the heel, leading to inflammation and the formation of the bump.
4. Repetitive Stress: Activities that place repetitive stress on the heel, such as running or jumping, can contribute to the development of this condition.
5. Injury: Previous injuries to the heel or Achilles tendon can increase the risk of developing Haglund’s deformity.

Treatments for Haglund’s Deformity

Treatment for Haglund’s deformity typically begins with conservative measures. In more severe cases, surgical intervention may be necessary. Here are some common treatment options:

1. Rest and Activity Modification: Reducing activities that aggravate the condition can help alleviate symptoms. Incorporating rest periods can allow inflammation to subside.
2. Ice Therapy: Applying ice to the affected area for 15-20 minutes several times a day can help reduce swelling and pain.
3. Footwear Changes: Switching to shoes with a softer heel counter or wearing open-back shoes can alleviate pressure on the deformity. Custom orthotics may also provide additional support.
4. Physical Therapy: Stretching and strengthening exercises, particularly for the Achilles tendon and calf muscles, can help improve foot mechanics and reduce pain.
5. Medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help manage pain and inflammation.
6. Corticosteroid Injections: In cases of severe pain or inflammation, a healthcare provider may recommend corticosteroid injections to reduce swelling.
7. Surgery: If conservative treatments fail to provide relief, surgical options may be considered. Surgery typically involves the removal of the bony prominence and may also include addressing any associated issues, such as bursitis or tendonitis.

Haglund’s deformity can significantly impact daily life, but understanding its symptoms, causes, and treatment options is essential for effective management. Early intervention with conservative measures can often alleviate symptoms and improve mobility. If you suspect you have Haglund’s deformity or are experiencing persistent heel pain, consult a healthcare professional for a proper diagnosis and tailored treatment plan.