Haglund’s Deformity

What is Haglund’s deformity?

Haglund’s deformity is a bony growth on your heel bone (calcaneus) where your Achilles tendon attaches. The growth causes a bump you can see and feel through your skin.

Haglund’s deformity can cause heel pain, especially when you wear shoes that press tightly against the back of your heel. Over time, pressure and irritation on the growth can cause other conditions in your heel and feet, including Achilles tendinitis and heel bursitis.

It’s usually treated with heel cups, orthotic inserts, changing the shoes you wear and over-the-counter medicines to alleviate pain.

It’s rare to need surgery to remove the growth caused by Haglund’s deformity, but some people need it if other treatments don’t relieve pain and other symptoms.

How common is Haglund’s deformity?

Haglund’s deformity is very common, but it’s hard for experts to estimate exactly how many people have it at any one time. Many people with mild (or no) symptoms never get their heel pain diagnosed as Haglund’s deformity.

What are Haglund’s deformity symptoms?

Symptoms of Haglund’s deformity include:

• Heel pain.
• A bump on the back of your heel that you can see and feel.
• Swelling.
• Skin discoloration around the bump.

Haglund’s deformity almost always develops on both feet (bilaterally).

What causes Haglund’s deformity?

Experts don’t know for certain what causes Haglund’s deformity. Studies have found that it might be genetically inherited (passed down through generations of a biological family).

Other causes might include:

• Irritation and pressure from shoes.
• Overusing your heel (especially in athletes like runners).
• High-arched feet.
• Tight Achilles tendons.
• Certain gait disorders that affect how you move and walk.

Haglund’s deformity risk factors

Haglund’s deformity can affect anyone, but certain groups of people are more likely to develop it:

• People who wear tight, narrow shoes.
• Women and people assigned female at birth.
• People with a direct family member who’s experienced Haglund’s deformity.

How is Haglund’s deformity diagnosed?

A healthcare provider will diagnose Haglund’s deformity with a physical exam and imaging tests. They’ll discuss your symptoms and feel the bump on your heel.

You might need X-rays to take a full picture of the bony growth and to see if anything else is causing issues with your foot or ankle. Your provider might use magnetic resonance imaging (MRI) before surgery (if you need it).

How is Haglund’s deformity treated?

Your provider will suggest treatments for Haglund’s deformity that relieve your symptoms rather than removing the growth. You might need some or all of the following:

• Over-the-counter NSAIDs to relieve pain and inflammation.
• Icing your heel.
• Wearing different, more supportive shoes.
• Orthotics: Over-the-counter or custom-made inserts or heel cups you wear inside your shoes.
• Physical therapy: Your provider or physical therapist will give you stretches or exercises to increase the flexibility in and around your heel and ankle.

If these conservative treatments eliminate your symptoms, that’s probably all the treatment you’ll need.

Haglund’s deformity surgery

It’s rare to need surgery to treat Haglund’s deformity.

Your provider will likely only recommend surgery if you have severe symptoms that haven’t gotten better after other treatments.

Your surgeon will remove the bony growth and any inflamed tissue in your heel. Most people need a few months to recover fully from Haglund’s deformity surgery

How do I manage my Haglund’s deformity symptoms?

The most important way to manage your symptoms is to avoid the types of shoes or activities that make your symptoms worse.

Haglund’s deformity is sometimes called a “pump bump” because it’s especially painful to wear shoes like pumps (high heels) that have tight backs. If you know which kinds of shoes cause your pain, you should avoid them as often as possible. Some people are never able to wear certain styles of shoes, even after their symptoms get better or they have surgery to remove the bony growth.

If your provider or physical therapist gives you exercises or stretches to improve your flexibility, try to do them as often as they suggest.

How soon after treatment will I feel better?

Most people feel better over time as they manage their symptoms and avoid the shoes or overuse that caused their pain.

If you need surgery to remove the Haglund’s deformity growth, you should feel better gradually as you heal and regain your strength and ability to walk like you usually can. This typically takes between several weeks and a few months.

How can I prevent Haglund’s deformity?

Because experts aren’t sure what causes Haglund’s deformity, there might never be a way to fully prevent it from developing. It’s what’s known as an idiopathic condition, which means it can appear with no cause or trigger.

Even if you might not be able to totally prevent Haglund’s deformity, maintaining good foot and ankle health can help prevent pain and other issues:

• Wear comfortable, supportive shoes: Avoid shoes that hurt your feet and ankles or are uncomfortable to wear. Don’t wear shoes with a stiff back that presses against your heels.
• Strengthen other muscles: By keeping your muscles strong, you’ll support your ankles and heels and reduce your injury risk.
• Stop if you feel pain: Don’t ignore pain. If a movement or activity is uncomfortable, take a break. See a provider if the pain doesn’t get better. Continuing to exercise through pain can make minor injuries worse.
• Warm up properly: Stretch before exercising. You’re less likely to injure your muscles, ligaments and tendons when they’re warm before you start physical activity.

What can I expect if I have Haglund’s deformity?

If you have Haglund’s deformity, you shouldn’t have any long-term issues. Once you learn to manage your symptoms and make any changes to your daily routine to avoid pain, Haglund’s deformity shouldn’t have an impact on your health.

How long does Haglund’s deformity last?

If you don’t have the bony growth surgically removed, Haglund’s deformity is technically a lifelong condition. But once you know how to manage your symptoms (like occasional pain or swelling), Haglund’s deformity won’t impact your life or health.

Will I need to miss work or school?

You shouldn’t need to miss work or school even while you’re treating Haglund’s deformity.

If you have surgery to remove the bony growth, you might need to avoid certain activities while you’re recovering. Talk to your provider or surgeon about your specific recovery timeline and before you resume any physical activities after surgery.

When should I see my healthcare provider?

Talk to your provider if you notice any of the following:

• New pain that gets worse or doesn’t go away after a few weeks.
• Trouble standing, walking or using your feet the way you usually can.
• Swelling.

When should I go to ER?

Go to the emergency room if you suddenly lose the ability to use or move your foot, or if you’re experiencing severe pain.

If you experience a trauma or think you have a bone fracture, go to the ER right away.

What questions should I ask my doctor?

• Is Haglund’s deformity causing the pain?
• Which treatments will I need?
• Will I need surgery?
• Will I need physical therapy?
• Do I need orthotics or shoe inserts?

What is Haglund’s deformity vs. a heel spur?

Both Haglund’s deformity and heel spurs are bony growths on your heel.

Heel spurs poke out from the bottom of your heel, where your heel bone connects to the ligament running between your heel and the ball of your foot (the plantar fascia).

Haglund’s deformity always forms at the back of your heel bone, where your Achilles tendon attaches.

Fortunately, treatment for Haglund’s deformity and heel spurs is very similar. No matter what’s causing your heel pain, talk to a healthcare provider.

A note from Cleveland Clinic

Haglund’s deformity — a bony growth on your heel bone where your Achilles tendon attaches — is a manageable condition that you might never even notice you have. Even if your pain is minor — or it comes and goes — talk to your provider about any new symptoms. You might need something as simple as a new pair of shoes to feel a lot better.