Haglund’s deformity is a bony enlargement, or bump, on the back of the heel. The soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes. This often leads to pain and discomfort. There are a variety of conservative treatment options for this condition. However, if pain continues despite these measures, surgical intervention may be necessary. An x-ray is usually the first step to identifying a Haglund’s deformity and an MRI may be warranted to evaluate the soft tissue structures in the area, particularly the Achilles tendon. If surgery is needed, rehabilitation depends on the extent of the procedure and if any additional soft tissue work is necessary.

Symptoms

• Noticeable bump on the back of the heel
• Pain in the back of the heel
• Swelling
• Redness
• Difficulty with ambulation and activity
• Callus formation
• Bursitis: inflammation of a fluid-filled sac between the tendon and bone

Treatments

• Shoe gear modification
• Padding and heel lifts
• Activity modification
• Ice therapy
• Anti-inflammatory medications
• Physical therapy
• Stretching exercises
• Orthotics and bracing
• Surgical removal of the enlarged bony prominence and any pathologic soft tissue