What is Haglund's deformity? Also known as the pump bump? It got its name because it was thought at one time that this condition only developed when a woman's pump rubs on the back of her heel causing enlargement and pain. There are a lot of people who develop Haglund's deformity who don't wear pumps.
What Causes Haglund's Deformity or Pump Bump?
Let's take a look at the foot from the back side. So here's the skeletal model looking from the back of the heel in my drawing here.Up on the right side of this right heel, in this upper outer corner right here, that's where people develop this irritable bump.
People with high arches tend to develop Haglund's deformity more often.
Why is that? If you look at the foot, when it collapses, the arch rolls in and down flat. But when there's a high arch to it, and we look from behind, you can see that the foot is starting to roll foot out. This is typical of the high arched foot. This outward rolling exposes the upper outer corner of the heel bone to excessive pressure. And given that bone is a live tissue, it responds to that irritation by getting larger.
When the bone becomes large enough it becomes sore and people develop redness on the outside of the heel and irritation, when wearing closed shoes.
What is the Treatment for Haglund's Deformity?
Several conservative measures can be taken to treat this condition including;
- A rubber heel cup or other padding to take the pressure off the bump.
- Altering the shoes.
- Treating the mechanical deformity with custom orthotics. Orthotics can prevent a highed foot from rolling out and prevent the rubbing of the outer corner of the shoe. This can also occur in people with flexible flatfoot deformity. And again, custom orthotics can be beneficial.
If the pain persists with those treatments and irritation is great enough, the Achilles tendon has a bursal sac or small sack of fluid in front of it and bursitis can develop in this area. A cortisone shot might be considered in those instances.
Finally, if all conservative measures fail to control discomfort, surgical intervention may be considered. If you're suffering from pain in the back of your heel, come in, have your foot evaluated. And if you have a pump bump, we'll outline the best program of care for you.