HAGLUND’s DEFORMITY

 Haglund’s deformity is a bony enlargement on the back of the heel. The soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes.

 This often leads to painful bursitis, which is an inflammation of the bursa (a fluid-filled sac between the tendon and bone).

People also refer to the condition as “pump bump,” as wearing rigid-backed, pump-style shoes appears to aggravate the enlargement. Other shoes featuring rigid backs can also have this effect. 

 Haglund’s syndrome, which involves three conditions: 

• Haglund’s deformity: A bony bump that develops on the back of the heel bone.

• Insertional Achilles tendinopathy: when the enlarged heel bone and the Achilles tendon rub together, leading to a breakdown of the tenon.

• Retrocalcaneal bursitis:  when a fluid-filled sac develops between the Achilles tendon and the heel bone.

In fact, any shoes with a rigid back can cause this irritation such as:-  

• ice skates
• men’s dress shoes
• women’s pumps

To some extent, heredity plays a role Haglund’s deformity. Inherited foot structures that can make one prone to developing this condition include:

• high-arched foot
• tight Achilles tendon

 tendency to walk on the outside of the heel.

Haglund’s deformity can occur in one or both feet. The symptoms include:

• A noticeable bump on the back of the heel.
• Pain in the area where the Achilles tendon attaches to the heel.
• Swelling in the back of the heel.
• Redness near the inflamed tissue.
• a visible bump on the back of the heel
• calluses or blisters where the bump rubs against shoes

To help prevent a recurrence of Haglund’s deformity:

• wear appropriate shoes; avoid shoes with a rigid heel back.
• use arch supports or orthotic devices.
• perform stretching exercises to prevent the Achilles tendon from tightening.
• avoid running on hard surfaces and running uphill.

Some nonsurgical treatment choices include:

• changing the type of shoes, especially avoiding rigid-backed shoes and pumps
• placing heel lifts in shoes to help bring the heel up and avoid friction
• using heel pads inside the backs of shoes to help reduce irritation and friction on the heel
• inserting footwear arch supports for people with high arches
• using ice on the heel to help relieve inflammations  and pain
• performing stretching exercises to alleviate a tight Achilles tendon
• avoiding exercises that aggravate the condition, especially running and running uphill
• using a soft cast or walking boot to help keep the heel bone from rubbing on the bursa or Achilles tendon
• trying physical therapy to bring relief

Here are some exercises that may help.

1. Heel raise

• Using a step, a person can combine the heel raise and heel drop exercise.

2. Heel drop

• Stand on a low block or stair facing a chair or wall for support.
• Move back slightly, so the balls of the feet are on the block, but the heels are off the edge.
• Bend the knee of one leg, bringing the foot up behind you, so your body weight is on the standing foot.

      3. Towel stretch

• Sit on the floor with both legs out in front. 
• Loop a towel around one foot, holding both ends.
• Gently pull on the towel, pulling the ball of the foot toward the body. There should be a gentle stretch in the calf muscle.

       4. Towel Scrunches

• This exercise helps increase general foot dexterity and reduce tightness in the Achilles tendon. 
• Place a towel flat on the ground in front of a chair, then sit down in the chair with your heels on the edge of the towel. 
• With one foot, reach out and use your toes to grab the towel, then pull the towel toward you under your feet. 
• Repeat until you run out of towel, then repeat the whole exercise with your other foot.