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Haglund’s Deformity – Pump Bump on Heel

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Haglund's deformity

Haglund’s Deformity

The most common reason for the bulge and protrusion behind the heel is malformation and bone protrusion. Thorns at the junction of the Achilles tendon with the heel, inflammation of the Achilles tendon and xanthoma are other factors.
Haglund’s deformity is a bony prominence that appears on the back of the heel bone. This ridge is formed where the Achilles tendon is attached to the heel. This disease often requires treatment if it causes leg pain or problems with walking.
Treatments for bunions may initially include shoe modifications and physical therapy. If these methods do not relieve the pain, the doctor may recommend surgery to remove the bone spur or repair the Achilles tendon.

What is the extra bone behind the heel?

One of the most important causes of the bulge behind the heel is Haglund’s deformity. This condition is caused by a bony protrusion in the heel that can involve all or part of the back of the heel.

This ridge is usually located on the upper part of the bone and in front of the Achilles tendon. The contact of this ridge with the Achilles tendon during ankle movements can cause pain and the occurrence of retrocalcaneal bursitis, which appears as swelling on both sides of the Achilles tendon, which is also painful to the touch.

Haglund's deformity

Treatment of backbone protrusion

This treatment involves removing the pressure and avoiding wearing shoes that pull on the back of the heel and rub against it.

Orthotics, moulds inserted into the shoe, can help reduce the back-and-forth movement of the heel that worsens painful areas.

In severe cases, plastering the area below the knee can reduce or eliminate the pain. If other pain reduction methods do not work, surgery can be used to treat this pain. This surgery can be performed arthroscopically and closed.

The cause of extra bone protrusion in the heel

The shape of the heel bone varies from person to person. In some people, the heel bone at the Achilles tendon junction is more prominent than usual.

This extra bone protrusion in the heel can be caused by the different bones built up after continuous and repeated Achilles tendon stretching. The Achilles tendon attaches to the back of the heel bone, and repeated stretching of this tendon on the bone can lead to the formation of extra bone on the back of the heel.

The soft tissue is more pressed to the shoe in people whose heel bone is more prominent in the back. Gradually, this soft tissue becomes inflamed due to pressure, and this inflammation causes thickening and swelling of the tissue, and this swelling increases the prominence and worsens the condition.

Broken Kneecap

What factors cause ankle bone protrusion?

Some features that change the shape of extra bone behind the heel (Haglund’s Deformity) are:

  • A prominent heel bone that slopes outward causes the heel to rub against the back of the shoe.
  • Feet that roll outward when walking are known as supination.
  • Tight Achilles tendons, which may put pressure on the heel bone.
  • High arches can push the heel back when walking and rub the Achilles tendon.
  • Wearing certain types of shoes may cause Haglund’s deformity, or some shoes may worsen the condition and cause symptoms such as pain.
  • Shoes with rigid backs can create friction that makes the foot structure susceptible to Haglund’s deformity.


Haglund’s Deformity treatments

Doctors usually try non-surgical treatments for Haglund’s deformity first.

Although none of these treatments can change the bones or structure of the foot, they may relieve pain and improve the quality of life in some people.

Some non-surgical treatment options include:

  • We are changing the type of shoes worn, especially avoiding shoes with stiff backs.
  • Inserting a heel lifter into the shoe to help lift the heel and prevent friction.
  • Use heel pads on the back of the shoe to help reduce irritation and friction on the heel.
  • Placing shoe arch supports for people with high arches.
  • I took anti-inflammatory medications, such as ibuprofen, to relieve pain from an inflamed bursa or Achilles tendon.
  • Applying ice to the heel to help relieve inflammation and pain.
  • I am doing stretching exercises to reduce the Achilles tendon.
  • I am avoiding sports that aggravate the condition, especially running and climbing.
  • I am seeking help from a physiotherapist for pain relief.

It is also important to note that if the problem persists, surgery can be an option to remove the bony prominence of the heel.

Foot and ankle surgeons can perform several types of surgery to correct Haglund’s deformity.

Haglund's deformity

Symptoms of extra bone behind the heel

A bunion or Haglund’s deformity can cause symptoms that range from mild to severe and may include:

  • Pain in the back of the heel when walking
  • A visible bump on the back of the heel
  • Swelling or redness on the heel
  • Callus or blister on the heel

An orthopedic specialist diagnoses the abnormality of the protrusion of the ankle bone by observing the heel.

Heel spur at the Achilles tendon junction

Another case that is relatively similar to Hagland’s deformity is a bump that occurs due to the formation of a sizeable bony spur at the point where the Achilles tendon joins the back of the heel. The treatment of this condition is similar to the treatment of Hagland’s malformation, with the difference that the surgical procedure to remove this thorn is more complicated, and the recovery time after the operation is more extended.

Cyst behind the heel or inflammation of the Achilles tendon

Swellings and lumps can appear in the Achilles tendon just above the junction of this tendon with the heel bone. If this condition is not treated, the tendon is at risk of rupture. The treatment of this condition includes immobilization by casting, using crutches to reduce weight on the leg, oral anti-inflammatory drugs, and in severe cases, surgical intervention. Intensive physical therapy and stretching exercises for the calf muscle are recommended when the area is repaired.

There is another small tendon attached to the back of the heel that can be injured. This tendon is called plantar and can be torn or torn during exercise, in which case severe pain occurs. This pain is similar to the pain of inflammation of the Achilles tendon.


An uncommon cause of small masses in the Achilles tendon is xanthoma, caused by extremely high cholesterol levels in the bloodstream. This complication is a hereditary disorder that leads to the deposition of cholesterol in the Achilles tendon. This complication is a severe condition (cardiovascular) and requires serious treatment by a doctor to reduce blood cholesterol levels. If high blood cholesterol levels are not treated, they can lead to early heart attacks and death.

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