Haglund’s Deformity (pump bump)
Haglund’s deformity, also known as a pump bump, is a bone enlargement at the back of the heel. This is also the site where the Achilles tendon attaches to the heel. Haglund’s deformity causes pain and discomfort from rubbing against the back of the shoe. The rubbing can also result in painful bursitis, which is inflammation of the bursa (a fluid filled sac between the tendon and bone).
Heredity plays a role in the formation of Haglund's deformity. A specific group of foot deformities such as high arched foot, tight Achilles tendon, or tendency to walk on the outside of the feet can increase the chance of developing Haglund’s deformity.
Symptoms:
Symptoms of Haglund’s deformity include a noticeable bump at the back of the heel that causes pain and swelling when rubbed against the back of the shoe. The site can become inflamed. Patients can also experience pain at the site of the Achilles tendon, at the back of the heel.
Diagnosis:
Careful examination of the heel can pinpoint the exact site of the pain. A palpable bump at the back of the heel is usually apparent. To further assess the structural deformity, X-rays of the foot can be ordered.
Treatments:
Conservative treatments for Haglund’s deformity are to decrease symptoms and prevent further irritation at the site. It includes the following:
If conservative treatments fail to improve the symptoms, then surgical treatment may be considered. Surgical treatment can include resection of the bump, and reattachment of the Achilles tendon at the site.
Haglund’s deformity, also known as a pump bump, is a bone enlargement at the back of the heel. This is also the site where the Achilles tendon attaches to the heel. Haglund’s deformity causes pain and discomfort from rubbing against the back of the shoe. The rubbing can also result in painful bursitis, which is inflammation of the bursa (a fluid filled sac between the tendon and bone).
Heredity plays a role in the formation of Haglund's deformity. A specific group of foot deformities such as high arched foot, tight Achilles tendon, or tendency to walk on the outside of the feet can increase the chance of developing Haglund’s deformity.
Symptoms:
Symptoms of Haglund’s deformity include a noticeable bump at the back of the heel that causes pain and swelling when rubbed against the back of the shoe. The site can become inflamed. Patients can also experience pain at the site of the Achilles tendon, at the back of the heel.
Diagnosis:
Careful examination of the heel can pinpoint the exact site of the pain. A palpable bump at the back of the heel is usually apparent. To further assess the structural deformity, X-rays of the foot can be ordered.
Treatments:
Conservative treatments for Haglund’s deformity are to decrease symptoms and prevent further irritation at the site. It includes the following:
- Medication. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce the pain and inflammation. Ice. To reduce swelling, apply an ice pack to the inflamed area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
- Exercises. Stretching exercises help relieve tension from the Achilles tendon. These exercises are especially important for the patient who has a tight heel cord.
- Heel lifts. Patients with high arches may find that heel lifts placed inside the shoe decrease the pressure on the heel.
- Heel pads. Pads placed inside the shoe cushion the heel and may help reduce irritation when walking.
- Shoe modification. Backless or soft backed shoes help avoid or minimize irritation.
- Physical therapy. Physical therapy modalities, such as ultrasound, can help to reduce inflammation.
- Orthotic devices. Custom arch supports control the motion in the foot.
- Immobilization. In some cases, casting may be necessary.
If conservative treatments fail to improve the symptoms, then surgical treatment may be considered. Surgical treatment can include resection of the bump, and reattachment of the Achilles tendon at the site.