What is Haglund’s Deformity?
Haglund’s deformity is a bony enlargement that develops on the back of the heel, where the Achilles tendon attaches to the heel bone. This abnormal growth can lead to irritation and inflammation in the surrounding soft tissues, especially in the retrocalcaneal bursa, a fluid-filled sac that cushions the tendon.
Also known as “pump bump,” this condition often affects people who wear stiff-backed shoes or engage in repetitive heel-striking activities. Over time, pressure and friction on the heel bone cause inflammation and discomfort, making walking and wearing certain shoes painful.
Causes and Risk Factors of Haglund’s Deformity (Retrocalcaneal Bursitis)
Haglund’s deformity or Retrocalcaneal bursitis is a condition that occurs when the bursa, a small fluid-filled sac that acts as a cushion between the Achilles tendon and the heel bone, becomes inflamed. There are several causes and risk factors associated with this condition, including:
Repetitive or overuse activities
Engaging in repetitive activities like running or jumping can put excess pressure on the bursa, leading to inflammation and irritation.
Foot structure
People with high arches or flat feet may be at an increased risk of developing retrocalcaneal bursitis due to the abnormal distribution of weight and pressure on the foot.
Tight footwear
Wearing shoes that are too tight or have a stiff heel can cause irritation and inflammation of the bursa.
Previous injury
A previous injury to the Achilles tendon or the heel bone can increase the risk of developing retrocalcaneal bursitis.
Medical conditions
Certain medical conditions like rheumatoid arthritis, gout, or psoriatic arthritis can increase the risk of developing bursitis.
Age
Older adults are more likely to develop retrocalcaneal bursitis due to the natural wear and tear on the foot over time.
Symptoms of Haglund’s Deformity (Retrocalcaneal Bursitis)
The symptoms of Haglund’s deformity can vary depending on the severity of the condition, but common signs and symptoms include:
- A visible bump at the back of the heel, which may be red, swollen, or tender to the touch.
Pain or discomfort in the heel, especially when wearing shoes or walking on hard surfaces.
Inflammation of the Achilles tendon, which can cause stiffness, swelling, and pain in the back of the ankle. - Limited range of motion in the ankle, which may make it difficult to walk or perform other physical activities.
- Blisters or calluses on the heel, which may develop as a result of friction from shoes rubbing against the bony prominence.
- Difficulty fitting into shoes or wearing certain types of footwear due to the enlarged heel bone.
Haglund’s Deformity (Retrocalcaneal Bursitis) Treatment Options
Treatment usually begins with non-surgical approaches aimed at reducing inflammation and relieving pressure on the heel. This often includes:
- Switching to open-backed or cushioned footwear
- Applying ice to reduce swelling
- Taking anti-inflammatory medications like ibuprofen
- Stretching exercises to loosen tight calf muscles
- Physical therapy to improve ankle mobility and offload the tendon
Heel pads or orthotics can also help cushion the heel and improve foot alignment. In more severe cases, corticosteroid injections or immobilization with a walking boot may be recommended.
If conservative treatments fail to relieve symptoms, surgery may be considered to remove the bony prominence and reduce tendon or bursa irritation. This is generally reserved for chronic cases where daily activities are significantly impacted.
FAQs
The bony prominence itself won’t go away without surgery, but symptoms like inflammation and pain can often be managed with non-surgical treatments and footwear adjustments.
Without treatment, the condition may worsen over time. Chronic inflammation can lead to tendon damage, persistent pain, and difficulty with everyday activities like walking or exercising.
A physical exam is often the first step. Your provider may also order imaging tests like X-rays to view the bony enlargement or an MRI to assess inflammation in the bursa or damage to the Achilles tendon.
