Haglund’s Deformity

This very common condition was first described by Patrick Haglund in 1927 (Vaishya et al., 2016) and as you can see above, it refers to a bony enlarged bump that occurs at the back of the heel, generally in both feet. This condition is most commonly seen in ladies, particularly those who wear pump shoes (hence the nickname). 

It comes about as a result of pressure on the back of the heel, where the Achilles tendon attaches to the calcaneus (heel bone). This pressure is generally due to footwear – with pumps or smart shoes with hard heel counters being the main culprits. Some clinicians have linked a tight Achilles tendon and a high arch as risk factors for this condition and stated that there are some genetic links to the condition that make certain people more susceptible to developing it (Vaishya et al., 2016).

As the bump is protruding out into the area of insertion of the Achilles tendon where there is also some soft tissue structures and a fluid-filled sac called the retrocalcaneal bursa, you tend to see some inflammation and tenderness of these structures as part of the Haglund’s deformity. Management of this condition will therefore require management of these structures too. 

In very severe cases, where the patient is in a good deal of pain, corticosteroids can be injected into the area or the bony protrusion can be surgically resected (cut back), but generally this condition is managed conservatively with ice, rest, some physiotherapy to strengthen the calf muscles and in some cases oral anti-inflammatory medications are used (Ross, 2010). 

Backless shoes such as sandals are advised for some people who experience moderate discomfort. General footwear assessment and modifications are strongly advised as they could be the leading cause of the condition, or at the very least, causing further irritation.

References

Ross, J.A. (2010). “Sports Medicine and Injuries”, in Frowen, P., O’Donnell, M., Lorimer, D., & Burrow, G. Neale’s Disorders of the Foot. 8th edn. Elsevier Churchill Livingstone, pp. 337

Vaishya, R., Agarwal, A.K., Azizi, A.T., & Vijay, V. (2016). Haglund’s Syndrome: A Commonly Seen Mysterious Condition, Cureus, 8(10), pp. e820. Doi: 10.7759/cureus.820

This article was intended as an information piece and should not be taken as medical advice. If you or someone you know suspects that they have a malignant lesion, you should consult your doctor as soon as possible.

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