Haglund’s Deformity and Heel Bursitis

Your amazing feet are intricately constructed to allow for stability, weight-bearing, and a variety of movements, but with so many parts (26 bones, 33 joints, hundreds of ligaments, tendons, muscles, nerves in each one) it is easy for something to go wrong. We want to focus on just two issues—Haglund’s deformity and heel bursitis—and how they play off each other.

The Infamous “Pump Bump”

The deformity usually occurs because of irritation from shoes—especially women’s pumps, which is where the name pump bump comes from. Any footwear that has curved, rigid backs that press against your heel bone (calcaneus) can lead to friction at that spot. Ice skates and men’s dress shoes are also common culprits.

Friction causes your body to build up calcium deposits at the hot spot to protect the bone. The deposits build up into a protrusion or bone spur at the back of the calcaneus. This deformed bone may actually be visible from the outside of the foot. Other factors can also lead to formation of these bony bumps, such as inheriting feet with high arches or tight Achilles tendons.

The Source of Irritating Heel Pain

While the bone itself may not hurt, what it does to the surrounding tissue can cause discomfort. The Achilles tendon is attached to the calcaneus at about the same spot where the bony spur forms. There are two bursae (one between bone and tendon, another between tendon and skin) which cushion and help protect these tissues.

When the bony bump presses on these fluid sacs, the bursae become irritated and inflamed. That is called bursitis (inflammation of a bursa), and it is also what is causing your pain. The area may also swell up, and any pressure from swollen tissues can cause discomfort, too. Certain positions of the foot are more prone to increase the pressure on the bursae, and thus the pain.

Two Treatment Options

As always, we can consider two avenues of treating this foot issue: conservative care and surgery.

Conservative care is focused on relieving the pain and other symptoms. That includes remedies such as wearing open back shoes or a heel pad that slightly raises the heel, or using gentle massage and ice therapy (over your sock) for 10 minutes several times a day. Topical analgesic creams or oral pain killers can also help with swelling and discomfort.

As mentioned earlier, certain foot conditions make Haglund’s deformity more likely, including flat feet, high arches, tight or short Achilles tendons, or gait problems like overpronation or supination (feet rolling too far inward or outward during walking). We may try to correct these problems conservatively with the use of custom orthotics.

The goal of these foot supports is to relieve the pressure and inflammation that are causing pain. Since the bony projection puts more pressure on the tissues when the foot is flexed upward, using custom supports under the heel to elevate it slightly can lessen tension on the Achilles and reduce how much the bone presses against the bursa.

If none of these treatments enable you to walk and function without pain, we may need to treat the underlying deformity by removing the bony bump surgically. If this is the case, we will give you all the information you need to make the right decision for your feet, including risks and recovery times involved with the procedure.

Your Spring Valley Foot Specialist Wants to Help

For heel pain or any other foot problem you face, Dr. Stuart Birnbaum stands ready to help. We want you to be able to enjoy life without pain in your feet, so call our Spring Valley office by calling (845) 352-0757. To schedule online, fill out our contact form. Whatever method you use, don’t wait so long that surgery is your only option for relief—get in touch with us today!

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