Haglund's Deformity

What is Haglund's Deformity?

Haglund's Deformity is a bony enlargement of the back of the heel bone. Sometimes it's called “pump bump” because the deformity often occurs in women who wears pumps.

Causes

The shape of your foot can contribute to the development of Haglund's Deformity. If you have high arches, a tight Achilles tendon, or a tendency to walk on the outside of your feet, you're more likely to develop Haglund's Deformity than other people. Wearing shoes with a firm, rigid back may also contribute to the development of Haglund's Deformity. 

Symptoms

The primary symptoms of Haglund's Deformity are an enlarged bony prominence on the back of the heel and heel pain. You might also develop blisters on your heels as a result of your shoes rubbing against the bump.

Home Care

Heel pads placed in the backs of your shoes may relieve and redistribute some of the pressure. Applying ice to the area after removing your shoes may ease some of the pain and discomfort. Switching shoes can help, too. If you have an otherwise normal foot, wearing open-heeled shoes may provide relief. Open-heeled shoes are not a good idea, though, if you have tendinitis, bunions, foot pain, or a structural deformity of the foot.

When to Visit a Podiatrist

If the pain persists despite your home remedies, or if the bump continues to enlarge, it's time to see a podiatrist. A podiatrist can carefully evaluate your feet and create a treatment plan tailored to your feet.  

Diagnosis and Treatment

A podiatrist will begin by carefully examining your feet and taking a thorough medical history. X-rays may be ordered to get a good look at the structure of your feet. Sometimes, an MRI or ultrasound might be ordered as well.

Treatment will depend on the severity of the condition. Options include:

• Shoe modification. Your podiatrist can recommend over-the-counter heel pads, heel lifts, or arch supports, or create custom orthotic supports to change the position of your feet in your shoes to relieve pressure on the back of your foot.
• Medication. Topical anti-inflammatory medication, applied directly to the heel, may provide pain relief. Oral anti-inflammatory medication (such as ibuprofen) can help as well.
• Immobilization. If the area is extremely inflamed, a custom-made soft cast or walking boot may be used to immobilize the area and allow it to heal.
• Surgery. If none of the non-surgical methods provide adequate relief, your podiatrist may recommend surgery to correct the deformity. Podiatrists are specially-trained foot and ankle surgeons who can surgically re-shape the heel bone.

Prevention

Avoid shoes with rigid backs. If you have a high arch or tight Achilles tendon, wearing appropriate shoe inserts and/or adequately stretching the Achilles tendon can help prevent the development of Haglund's Deformity.