Have you ever wondered why a particular shoe aggravates the back of your heel? If your heel bone sticks out slightly, you may have what is called Haglund’s Deformity, informally known as a “pump bump.” Certain rigid-heeled shoes such as women's pumps, men's dress shoes, and skates will create pressure that irritates the enlargement when walking.
Medically known as Haglund's Deformity, a pump bump is an abnormality in the shape of the heel bone where the back of the bone is enlarged. As a result, there is a visible and palpable "bump" at the back of the heel. Patients can experience pain when the soft tissue surrounding the enlarged bone rubs against their shoes or the bone bump itself.
A Haglund's Deformity will feel like a hardened, enlarged "bump" at the back of the heel bone. You may experience pain when that bump is pressed against your shoes because it can irritate the soft tissue structures around it. However, just because there is a bump at the back of the heel doesn't mean that you necessarily experience pain, and pain may not occur until later in your life.
Haglund's Deformity is fairly common. The symptoms most commonly are felt in people who often wear shoes with stiff soles, such as pumps, which is why the term is also called a "pump bump." It is also common in runners and other athletes, as the pain can be exacerbated by tightness in the Achilles tendon.
The bump itself is usually caused by genetics - your genetics determine the type of foot you have, including Haglund’s Deformity. It is more common in patients who have a high-arched foot type. However, the symptoms of a pump bump can be caused by shoes with stiff soles, tightness in the Achilles’ tendon, and overuse injury.
There are conventional and surgical ways to treat Haglund's Deformity. Traditional treatments include modification of shoe gear to something without a back or with a soft back (such as sneakers), Achilles tendon stretches, RICE (rest, ice, compression, elevation), physical therapy, and anti-inflammatory medications. Surgical treatment includes resectioning the bump or removing unhealthy tissue from the Achilles tendon where it attaches to the bone. The physician can suggest the best course of action depending on the severity and duration of the symptoms.
Yes, podiatrists can treat Haglund's Deformity both conventionally and surgically. A podiatrist will be able to assess the deformity clinically and radiographically to determine the best course of treatment.
The best shoes for Haglund's Deformity are shoes with a soft back or no back. These can include sandals and sneakers. Running shoes are the best choice, as they provide the best support for your feet overall and have a soft cushion at the heel. Shoes with stiff backing should be avoided, such as pumps and leather dress-type shoes.
No, a Haglund's Deformity is different from a bone spur. A bone spur is caused by the Achilles tendon or the plantar fascia pulling on the bone and causing the bone to change shape to accommodate the pull on the bone. A Haglund's Deformity is an enlargement of the heel bone and is not caused by external forces from the soft tissue.
Yes, you can still run and participate in other sporting activities with Haglund's Deformity. The deformity itself should not deter you from any activities, but if you experience pain, you should rest, ice, and stretch the area. It is also recommended that you see a physician when the pain interferes with running and other activities.
Exercises that can help with the symptoms of Haglund's Deformity focus on stretching the Achilles tendon. Stretching the Achilles tendon will reduce the pressure of the tendon rubbing against the bone or the bursa, a fluid sac that helps to glide the tendon against the bone, which is located between the bump and the Achilles tendon.
Once a pump bump develops, it does not go away on its own. However, the symptoms can ease or go away completely with treatment, such as stretching, cold therapy, and rest. If the symptoms do not go away with traditional treatments, surgical resection of the bump may be necessary.
Haglund's Deformity may stay the same, or it may get worse with time. The most important things to do if you experience pain associated with Haglund’s Deformity are to stretch the Achilles’ tendon and wear supportive shoes with a soft back at the heel.
Surgery is required to get rid of the pump bump. The surgery involves detaching the Achilles tendon from the heel bone, resecting the bump, and then reattaching the Achilles tendon onto the remaining heel bone. Surgery is considered when pain persists after conventional treatment fails.
Surgery is needed for Haglund's Deformity when the pain level affects your day-to-day activities, despite traditional treatment, such as changing shoe gear, stretching, and physical therapy. Some experience significant pain to the point where they cannot walk or stand in their regular shoes for long periods.
Most insurance companies cover Haglund’s Deformity surgery. Our Surgical Coordinator can review your benefits to confirm the coverage of your plan before scheduling the procedure.
Recovery from Haglund's Deformity surgery requires approximately two weeks of non-weight bearing in a cast or controlled ankle movement (CAM) walking boot and about 3-4 more weeks of walking in a CAM boot. Physical therapy is also recommended starting around the second or third week post-operatively to stretch and strengthen the Achilles tendon.
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