Haglund's Deformity

Haglund’s deformity, sometimes called Mulhulland deformity or pump bump, is a bony bump that develops on the back of the heel, usually due to frequent use of high heeled shoes.

Symptoms

Haglund’s deformity can appear on one or both heels. The condition is characterized by a noticeable bump on the back on the heel that may be inflamed, red, swollen and painful. If the condition persists, it can lead to bursitis, which is a very painful inflammation of the bursa (a fluid-filled sac located between the bone and the tendon).

Causes

Haglund’s deformity develops when the soft tissue near the Achilles tendon at the back of the heel consistently rubs against shoes and becomes enlarged. It is often called a “pump bump” due to high heel shoes often being the culprit. However, all shoes with a rigid, uncomfortable back can cause the bony enlargement, including men’s dress shoes, ice skates and ski boots.

While everyone is susceptible to developing Haglund’s deformity, people with tight Achilles tendons, high-arch foot and abnormal gait are at a higher risk of developing the condition. In some cases, Haglund’s deformity is hereditary.

Treatment

Non-surgical treatment of Haglund’s deformity is often prescribed first. Some of the methods that may help reduce the pain and swelling include non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, ice, heel lifts, shoe modifications and orthotic devices. In addition, stretching exercises and physical therapy can help reduce inflammation and pain.

When Is Surgery Needed?

If conservative treatments of Haglund’s deformity fails and pain still persists, a patient may need surgery. An examination by a podiatrist or orthopaedic surgeon can help determine if surgery is necessary.

Prevention of Haglund’s Deformity

Haglund’s deformity and reoccurrences of the condition can be prevented with a few simple changes, including wearing comfortable shoes, avoiding high heels, engaging in foot and ankle exercises that keep the Achilles tendon stretched and wearing arch supports or orthotic devices when necessary.