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What is Haglund’s Deformity?
Haglund’s deformity is a bony change in the foot where the Achilles tendon attaches into the back of the heel. It’s caused by prolonged stress, irritation or pressure on the area. This can be caused by shoes that rub repetitively, tight calves or anatomical factors with the feet.
A bony lump is visible on the heel; or heels if both feet are affected. The size of this outgrowth varies from person to person.
Patients often first notice this problem when they change to new or more rigid shoes which cause discomfort on the heel.
What causes the pain in the back of the heel?
Haglund’s deformity develops gradually due to a constant “pull” on the bone when tight calf muscles cause irritation where the Achilles tendon attaches. Shoes that are too stiff or tight can also create pressure on the heel bone and cause the problem to develop.
The body’s response to this is inflammation, swelling, soreness and – over time – the growth of extra bone on the heel.
As the heel bone expands outwards it rubs against shoes causing discomfort. This is especially the case with people who wear pump-style (high heeled) shoes.
What are the signs and symptoms of Haglund’s syndrome?
- A lump – the heel bone expands outwards and a bony outgrowth develops.
- Pain – when shoes rub on it, the area can become red and blisters can form on the skin.
Is Haglund’s deformity painful?
Yes it often is. The pressure or rubbing from stiff or rigid shoes against the bony outgrowth causes pain in the back of the heel.
When correctly managed, patients can prevent the condition from flaring up and avoid discomfort.
How is Haglund’s Deformity treated?
The discomfort people feel when they have Haglund’s deformity is caused by shoes exerting pressure and rubbing on the bony deformity which ‘sticks out’. A Podiatrist can help the patient manage both the short-term flare up and assist with long term management:
Immediate treatments:
- Loosen tight calf muscles with massage and foam rolling
- Taking over-the-counter anti-inflammatories
- Offloading the pressure caused by footwear by wearing an alternative style of shoes for a period of time
Long-term management:
- Strengthening supporting calf muscles
- Advising on footwear options that won’t rub or irritate the back of the heel
- Lifting the foot in the shoe with heel raise inserts or orthotics to make it more comfortable.
Once a bony lump has developed, it’s permanent. But if there’s enough accomodation (or ‘space’) within shoes to avoid irritating the heel then patients can continue with their usual activities without experiencing ongoing problems.
Is Haglund’s Deformity genetic?
It’s not clear what causes some people to develop this condition and not others.
The anatomy of the foot can contribute to the likelihood of the problem occurring and this is sometimes hereditary.
High arches in the feet can stretch the Achilles tendon and this tension on the bone over a prolonged period of time can cause the bony outgrowth seen in Haglund’s deformity.
Can Haglund’s Deformity go away?
No, the bones become permanently prominent so treatment focuses on management not resolution.
Surgery to resolve the issue is rare and tends to involve a calf lengthening procedure to reduce the tension on the area or shaving back the bone that’s sticking out to reduce the bulk.