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Haglund’s deformity is a bony enlargement on the back of the heel that most often leads to painful bursitis, which is an inflammation of the bursa (a fluid-filled sac between the tendon and bone). In Haglund’s deformity, the soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes.

Haglund’s deformity is often called “pump bump” by podiatrist because the rigid backs of pump-style shoes can create pressure that aggravates the enlargement when walking. In fact, the deformity is most common in young women who wear pumps.

Haglund’s deformity can occur in one or both feet. The signs and symptoms include:

To some extent, heredity plays a role in Haglund’s deformity. People can inherit a type of foot structure that makes them prone to developing this condition.

For example, high arches can contribute to Haglund’s deformity. The Achilles tendon attaches to the back of the heel bone, and in a person with high arches, the heel bone is tilted backward into the Achilles tendon. This causes the uppermost portion of the back of the heel bone to rub against the tendon. Eventually, due to this constant irritation, a bony protrusion develops and the bursa becomes inflamed. It is the inflamed bursa that produces the redness and swelling associated with Haglund’s deformity.

A tight Achilles tendon can also play a role in Haglund’s deformity, causing pain by compressing the tender and inflamed bursa. In contrast, a tendon that is more flexible results in less pressure against the painful bursa.

Another possible contributor to Haglund’s deformity is a tendency to walk on the outside of the heel. This tendency, which produces wear on the outer edge of the sole of the shoe, causes the heel to rotate inward, resulting in a grinding of the heel bone against the tendon. The tendon protects itself by forming a bursa, which eventually becomes inflamed and tender.

Radiographs, ultrasound and MRI along with a physical signs and symptoms are utilized to diagnose the condition.

Non-surgical podiatric treatment of Haglund’s deformity is aimed at reducing the inflammation of the bursa. While these approaches can resolve the bursitis, they will not shrink the bony protrusion. Non-surgical treatment can include medication, icing, stretching, lifts, orthosis, physical therapy and extra corporeal. If non-surgical treatment fails to provide adequate pain relief, surgery may be needed.

A variety of surgical techniques can be utilized to restore function

Dr. Richard Perez, DPM - San Antonio Podiatrist Foot Doctor
This content was authored by: Dr. Richard Perez

Dr. Perez is board certified by the American Board of Foot & Ankle Surgery and a Fellow of the American College of Foot and Ankle Surgeons. His clinical interest include sports injuries, aesthetic bunion surgery, heel pain and resident education.