The Center for Podiatric Care and Sports Medicine

Haglund’s Deformity: What To Do When You Have The Dreaded Pump Bump

Posted by on Thursday, August 8th, 2013

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The news is full of high heel critics who insist that the better a shoe looks, the more damage it’s probably doing to your feet. Is this really true? Are we sacrificing our health for fashion, or are these just petty trifles that will go away in time? While it’s unlikely that high heels will ever go “out-of-style,” the casualties continue to mount. One of the most common injuries we see is called Haglund’s Deformity (or “Pump Bump”), a bony enlargement on the back of the heel. While not always painful, a Haglund heel could eventually lead to painful bursitis — inflammation of fluid-filled sacs between the tendon and the bone. Here’s all you need to know about coping with this condition.

 

Pump Bump: What Are The Symptoms?

You might have Haglunds Deformity if you notice…

  • A bump on the back of the heel
  • Pain near where the Achilles tendon attaches to the heel
  • Heel swelling
  • Redness

Here are a few photos to give you an idea of what this condition might look like:

What Causes Haglunds Deformity?

This heel deformity occurs as the soft tissue near the Achilles tendon is constantly irritated as the bone rubs against the shoe. Women’s pumps, men’s dress shoes and ice skates often create the pressure necessary to aggravate the condition. However, it’s unfair to say that shoe choice is the only culprit. To some extent, heredity is partly to blame. People with high arches, tight Achilles tendons or a gait which involves walking on the outside of the heel have an increased risk of developing pump bump.

Pump Bump Treatment: How Is Haglunds Deformity Treated?

Treatments for pump bump are generally designed to cut back on the pain, rather than correct the unsightly bump itself. Ibuprofen and ice may be recommended to ease the inflammation. Achilles tendon stretches can loosen the heel cord and reduce pressure. Heel lifts or pads, orthotic inserts and shoe modification can reduce irritation or a worsening of heel pain. New physical therapy using shockwaves can reduce pain symptoms. In some cases, a cast may be used to give the foot a chance to recuperate.

Pump Bump Surgery: What To Expect

There are several different procedures used to correct Haglund’s Deformity. Dr. Geldwert will discuss which type of surgery is best for your unique case, but generally speaking, the goal of surgical intervention  is to reduce the prominence of the deformity so shoe pressure and inflammation does not happen again.

  • Bump Removal – The Achilles tendon is moved aside and some of the bony growth is removed using a surgical saw. The calcaneus is shaped and rounded to cut back on pressure. The small incision is closed with stitches and a bulky bandage is applied. Sometimes a splint from the knee to the toes is used to further immobilize the patient following surgery.
  • Osteotomy – A wedge of bone is removed from the calcaneus to shorten it. According to an article published in the Journal of Foot & Ankle Surgery, “Healing with a wedge osteotomy can be faster and more predicable than tendon healing at the Achilles insertion, which is beneficial to the young and active population that tends to have this condition.”

Following either type of surgery, you may need crutches for a few day, your dressing changed in a week, and stitches removed in 10-14 days. You can expect to return to normal activity in about six weeks.

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.