So you have had a bump on the back of your heel for a long time. Why is it starting to hurt?

That bump on the back of your heel is called a "Haglund’s deformity". Sounds ugly doesn’t it? And some times the pain with it is uglier than the name! A Haglund’s deformity is an enlargement of the back part of your heel bone. Your Achilles tendon attaches back there as well. The rubbing back and forth of the Achilles tendon on this enlarged "bump" causes inflammation of the tendon which can then result in pain. If the inflammation gets bad enough, you can get swelling, redness and increasing pain which in turn ends up limiting the types of shoes that you wear and the activities you want to do. The bump itself is only the start of the problem. It is the type of foot you were born with and how you have treated your feet to this point that can determine if yours will become symptomatic.

Shoe wear is a big component to a painful Haglund’s deformity; so much so that this condition is also known as a "pump bump". Can you guess why? All you women wearing those high heels and making your foot work harder to stabilize itself are also making that Achilles tendon wiggle back and forth over that boney prominence more! More wiggle equals more inflammation which equals more pain.

A tight Achilles tendon, known as an "equinus" can aggravate the condition because there is more pressure against the bone and more scraping against the bone can irritate the tendon. Some tight Achilles tendons are hereditary and some are created (yes, we are talking to all you high heel wearers!)

People with a higher arch can get a symptomatic Haglund’s deformity. The heel bone actually is leaning back more against the tendon with this foot type and the pressure can aggravate over time. People born with this foot type also tend to walk more on the outer edge of their foot. As the foot rolls forward when we walk, and our weight pushes the foot down, the heel can roll inward more than a neutral foot type and the Achilles tendon in turn rubs the back of the heel bone more.

Conservative treatment for this condition is aimed at reducing the irritation and inflammation. Anti-inflammatories, ice, heel lifts, stretching, padding, orthotic devices, physical therapy and to some extremes, immobilization, all play a role in conservative treatment. If conservative treatment has been exhausted and the area is still painful, then surgery may become necessary.

If the back of your heel is causing pain, contact our office and let us help you make the right choices for treatment.