What is Haglund’s Deformity?

Haglund’s Deformity is a bony growth on the back of the heel bone (calcaneus). This enlargement can rub against shoes, irritating the surrounding soft tissues. The condition is nicknamed “Pump Bump” because it is often aggravated by rigid‑backed shoes such as high heels or pumps. Over time, the constant friction can inflame the bursa (a fluid‑filled sac that cushions the tendon) and even irritate the Achilles tendon, leading to pain and swelling.

Causes

The exact cause isn’t always clear, but several factors increase risk:

  • Footwear – stiff‑backed shoes, pumps, skates, or boots that press on the heel

  • Foot structure – high arches or walking on the outside of the foot increase pressure on the heel

  • Tight Achilles tendon – adds stress to the heel and bursa

  • Genetics – inherited foot shape or family history of Haglund’s deformity

  • Overuse – running, jumping, or repetitive heel stress

Symptoms

Patients typically notice:

  • A visible hard bump on the back of the heel

  • Heel pain that worsens with shoes pressing on the area

  • Swelling and redness around the bump

  • Stiffness or tenderness at the Achilles tendon insertion

  • Pain that may occur in both heels (bilateral cases are common)

Diagnosis

Diagnosis usually involves:

  • Physical exam – feeling the bump and checking for tenderness

  • X‑rays – to confirm the bony enlargement and rule out other causes

  • MRI or ultrasound – if tendon or bursa damage is suspected

Nonsurgical Treatment

Most patients improve with conservative care:

  • Footwear changes – avoid rigid‑backed shoes; choose soft‑backed or open‑heeled shoes

  • Heel pads or orthotics – cushion the heel and redistribute pressure

  • Ice therapy – reduce swelling and pain

  • NSAIDs – over‑the‑counter anti‑inflammatory medications

  • Physical therapy – calf stretches, Achilles tendon flexibility, and strengthening

  • Activity modification – avoid running uphill or activities that aggravate symptoms

When is Surgery Needed?

Surgery is considered when:

  • Pain persists despite months of nonsurgical treatment

  • The bony prominence is severe and interferes with daily activities

  • Associated conditions (like Achilles tendon damage or chronic bursitis) develop

Surgical options include removing the bony growth, repairing the Achilles tendon if damaged, and sometimes removing the inflamed bursa. Recovery may take several weeks to months, depending on the extent of surgery.