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What is Haglund's Deformity?

Haglund's Deformity is a foot condition characterised by a noticeable bump on the back of the heel due to a bony protrusion. This enlargement can cause heel pain, especially when wearing shoes with rigid backs that rub against the bump, leading to irritation and inflammation.

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The condition can also lead to swelling and redness in the area, and in some cases, the development of secondary conditions such as painful bursitis, where the small fluid-filled sac near the Achilles tendon becomes inflamed. Proper footwear and treatment are essential in managing the symptoms and preventing further complications.

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Causes of Haglund's Deformity

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1. Footwear: Wearing pump style shoes, including women's pumps, men's dress shoes, or Runners that cut into the bump can exacerbate the condition. When the bony enlargement rubs against the rigid back, this creates pressure on the soft tissue around the Achilles tendon and causes irritation. This condition is often termed "Pump Bump" due to its association with such footwear.

2. High Arches: Having a high arched foot can create pressure on the back of the heel.

3. Tight Achilles Tendon: A tight heel cord, where the Achilles tendon attaches from the calf to the back of the heel, can exacerbate this condition.

4. Walking on the Outside of Your Heel: If your walking style (gait) tends to put more pressure on the outside of your heel, this could contribute to Haglund's Deformity.

5. Genetics: The shape of your heel bone is determined by your genetics. If your heel bone is shaped in a way that it protrudes more at the back, you could be more susceptible to developing this condition.

6. Repetitive Stress: Activities that put repeated pressure on the heel, such as running or jumping, can also be an irritating factor.

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Remember, these factors increase the risk but do not necessarily mean you will develop the condition. If you suspect you might have Haglund's Deformity, please consult with our podiatrists for a proper diagnosis and treatment plan to provide adequate pain relief.

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Symptoms of Haglund's Deformity

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• Bony bump at the back of the heel: One of the most noticeable signs of this condition is the presence of a bony prominence on the heel at the back.

• Inflammation of the Bursa: When the bursa, a small sac near the heel, becomes inflamed, it can lead to painful bursitis, which is characterised by sharp or dull aches on the heel at the back. Inflammation of the bursa is especially common following activities such as walking or running.

• Pain and Inflammation: You may experience heel swelling which can be painful.

• Heel Redness: The skin over the heel bump may exhibit redness near the inflamed tissue.

• Blisters or calluses: Continuous friction from shoes may lead to the formation of blisters or calluses on the heel.

• Increased discomfort with shoes: Wearing shoes can cause discomfort near the inflamed tissue, particularly in shoes with a rigid back like women's pumps.

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Each patient's symptoms can vary from person to person. Some may have obvious physical symptoms but little to no pain, while others might be in a fair bit of discomfort despite having less pronounced physical signs.
 

If you are experiencing these symptoms, especially if they are causing you a significant amount of pain or affecting your day-to-day activities, it is important to see a podiatrist.

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How Can A Podiatrist Help?

It is vital to have your symptoms assessed by a podiatrist early on. If left unaddressed, Haglund's Deformity can cause heel pain which may become progressively harder to manage, and can lead to complications affecting not only the heel but also the ankle, heel and toes.

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If you're experiencing pain or redness near the inflamed tissue, diagnosis by a podiatrist is important, as the symptoms can be similar to those of other conditions like plantar fasciitis and heel spurs.

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The presence of a bony enlargement at the back of the heel could also indicate an underlying issue. Our podiatrists will identify the root cause of your symptoms through a biomechanical assessment and by reviewing your medical history. This assessment is a physical evaluation of your foot and body’s biomechanics.

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This approach enables us to pinpoint the cause, such as structural abnormalities in the foot or soft tissue injury, and ensures the provision of appropriate treatment for the condition by ruling out other possible causes such as plantar fasciitis.

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Treatment of Haglund's Deformity (Pump Bump)

These treatments are designed to mitigate pain and inflammation, as well as reduce swelling, and prevent the further progression of pump bump.
 

It's crucial to recognise that an approach effective for one individual might not yield the same results for another. Our Sydney podiatrists will provide a precise diagnosis and formulate a treatment plan.

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Footwear Modification

The initial approach to treatment typically involves walking shoe modification to reduce irritation from the shoe. Cushion the heel with soft-backed shoes instead of the rigid heel back often found in heels, dress shoes, runners etc. Wearing a flexible back and having adequate arch support will help reduce swelling and support/control the motion of the foot.

 

Custom Orthotics

To reduce inflammation orthotic devices are commonly used. We craft custom orthotic devices to match the unique shape of your feet. The arch supports redistribute the pressure, steering it away from the sore area at the back of the heel.

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Custom arch supports control foot motion, which can relieve the strain on the heel and reduce inflammation. Orthotics are instrumental in improving foot alignment and function, and can be advantageous in both treating and preventing additional issues linked to this condition.

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Stretching Exercises and Physical Therapy Modalities

Where there is no surgery needed but there is still pain and irritation, physical therapy and engaging in stretching exercises can help. When combined, they will strengthen the muscles surrounding the heel, enhance flexibility, and relieve tension on the heel bone, particularly if there is a tight Achilles tendon involved. Such stretching exercises help relieve tension on a tight Achilles tendon to improve the overall functionality of the foot and reduce discomfort and irritation.

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Ice Application

To combat pain and inflammation, ice can be applied to the affected area. It's important to remember that with inflammation, ice should never be placed directly onto the skin; instead, it should be wrapped in a thin towel or an ice pack should be used. When it comes to providing relief from pain and inflammation, ice applied in a safe manner can be very beneficial.

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Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be effective in reducing inflammation and providing temporary relief from pain associated with this condition.

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Padding and Heel Lifts

Using special heel pads and heel lifts placed inside the shoe can be a practical approach to managing Haglund's Deformity.

Heel pads act as a shoe cushion and work to decrease the pressure exerted on the heel bone, which helps in alleviating discomfort.

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Patients may find that heel lifts placed inside the shoe decrease the pressure on the heel.

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Referral to Allied Health Practitioners

When non-surgical treatment fails to provide adequate pain relief, surgery may be the only option. In this instance, we may refer you to a foot and ankle surgeon. Surgery generally entails the removal of the excess bone from the heel. It's important to consider surgery as a last resort, to be pursued only in severe cases where nonsurgical treatment fails and adequate pain relief cannot be achieved.

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What to Bring to My Appointment

For your appointment, it is important to come prepared with the following items:
 

• Everyday Shoes: Please wear or bring along the shoes that you typically wear on a daily basis.

• Sports Shoes: If you engage in sports or exercise, please also bring your sports shoes.

• Shorts: Wear or bring a pair of shorts so that you can comfortably participate in the assessments.

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Don’t Ignore Haglund's Deformity

It is vital not to ignore Haglund's Deformity, as not only can it be painful it can lead to secondary issues such as bursitis, chronic inflammation, Achilles tendonitis, or damage to the soft tissue around the heel.

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If you suspect you have Haglund's Deformity or are beginning to experience pain at the back of the heel, it is advisable to see a podiatrist for assessment and management.

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At North Sydney Podiatry, we are committed to helping you regain your foot health and return to your normal activities with as little discomfort as possible.

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​Frequently Asked Questions