Foot Seas Podiatry
Haglund’s deformity has many different names. It is also called a retrocalcaneal exostosis, posterior heel spur, or even a pump bump. The term refers to an overgrowth of bone on the back of the calcaneus or heel bone. The term pump bump comes from the pain often felt when women wear pumps.
Haglund’s deformities can be caused by several different things. The most common cause is an excessive pull of the Achilles tendon on the back of the heel. When the Achilles tendon is too tight it causes a significant amount of tension on the back of the heel during normal walking. The heel bones response to this tension is to build more bone to decrease the length of pull of the Achilles tendon. This growth the bone becomes a spur. The Spurs can also develop spontaneously or due to genetics.
Unlike heel spurs on the bottom of the heel, heel spurs on the back of the heel are often painful. The pain on the bottom of the heel is usually due to plantar fasciitis. But in the case of Haglund’s deformities the actual spur can cause pain due to rubbing of the shoe gear.
Haglund’s deformities are usually accompanied by Achilles tendinitis. Often it is difficult to determine whether the pain that the patient as experiencing is coming specifically from the Haglund’s deformity or inflammation in the Achilles tendon. This also makes treatment difficult due to the different modalities that would be used for each diagnosis.
In all cases of pain in the back of the heel conservative treatment is attempted first. These treatments include accommodations, physical therapy, resting and icing. Upon presenting to the office x-rays will be taken to confirm or deny the existence of a spur.
After an adequate amount of conservative treatment has been attempted. Surgical intervention may be warranted. The surgical procedures are tailored specifically to the deformity that the patient is experiencing. The procedure and postop course will be discussed at length with the patient before any decisions are made.
If you develop pain on the back of the heel, it may be a Haglund’s deformity. However, it is extremely important to have a full evaluation before any treatment is rendered. Many times these problems can be alleviated with simplistic treatments. Presenting to the office as soon as possible is the best course of action.