Haglund's Deformity: Causes, Symptoms & Treatment

Haglund's Deformity (Pump Bump)

Haglund's deformity is a bony enlargement on the back of the heel, beneath the Achilles tendon. It is also called "pump bump" because rigid-backed shoes (like pumps) often irritate the area.

Pathophysiology

The bony prominence irritates the retrocalcaneal bursa (a fluid-filled sac between the Achilles tendon and heel bone), leading to inflammation (retrocalcaneal bursitis) and pain.

Common Symptoms

• Visible bump on the back of the heel
• Pain and tenderness at the Achilles insertion
• Swelling and redness
• Discomfort when wearing closed-back shoes

Causes & Risk Factors

• Genetic foot structure (high arches, tight Achilles tendon)
• Frequent wear of rigid-backed footwear
• Overuse activities (running, jumping)
• Improper gait or biomechanics

Treatment Options

Conservative: Heel pads, shoe modifications (open-back or soft-backed shoes), orthotics, NSAIDs, ice, physical therapy (Achilles stretching, strengthening).

Surgical: Resection of the bony prominence (calcaneal osteotomy) and bursectomy if conservative measures fail.

Early intervention with footwear changes and therapy often resolves symptoms without surgery.