Haglund's Deformity, also known as "pump bump" or "Mulholland deformity," is a bony enlargement on the back of the heel.
This enlargement forms where the Achilles tendon attaches to the heel bone (calcaneus). The soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against the shoes, leading to painful bursitis.
Haglund's Deformity is often seen with Achilles tendonitis and heel bursitis. It can lead to pain, swelling, redness, and increased pain when walking or wearing certain shoes. Learn more about Haglund’s deformity.
What Causes Haglund’s Deformity
Several factors can contribute to the development of Haglund's Deformity, including:
- The natural shape and structure of your foot may make you more prone to developing this condition. High arches, tight Achilles tendons, and a tendency to walk on the outside of the heel can increase risk.
- Shoes with a rigid back, such as pumps or ice skates, can put pressure on the heel bone and irritate the bursa and Achilles tendon. This is why the condition is sometimes called "pump bump."
- Repetitive actions and excessive walking, running, or jumping can strain the Achilles tendon and lead to Haglund's Deformity, especially in those with high arches or tight Achilles tendons.
- Age: this condition is most common in young adults, especially women.
How to Relieve Haglund’s Deformity
You can treat/relieve Haglund’s deformity in the following ways.
- RICE (rest, ice, compression, and elevation) helps reduce inflammation and discomfort in the affected heel area. Apply ice for 15-20 minutes at a time, several times a day, particularly after activities that aggravate the condition.
- Choose shoes with soft or no back counter to reduce pressure on the bony enlargement. Open-back shoes, heel lifts, and shoes with extra depth in the heel area can significantly reduce irritation and inflammation of the bursa.
- Physical therapy exercises focusing on stretching the Achilles tendon and calf muscles can help reduce tension on the heel. Regular stretching exercises, including wall stretches and towel pulls, can improve flexibility and decrease pressure on the affected area.
- Using heel pads or orthotics with a heel cup design helps to redistribute pressure away from the bump and provide cushioning. These orthotic devices can be particularly effective when they include a central groove to reduce direct pressure on the prominence.
- Anti-inflammatory treatments, including both oral NSAIDs and topical anti-inflammatory medications, can help manage pain and reduce swelling around the deformity. This approach is often most effective when combined with other conservative treatment methods like ice therapy and proper footwear.
How Insoles Help With Haglund’s Deformity
Insoles can help treat/ease Haglund’s deformity in the following ways:
- Help distribute body weight more evenly, reducing pressure on the heel bone.
- Provide cushioning through materials like gel or foam to help absorb shock and reduce stress on the heel.
- Arch support and heel stabilization features help control excessive foot motion that can strain the Achilles tendon.
- Prevent the foot from rubbing against the shoe, reducing irritation.
- Combining insoles with other non-surgical treatments, such as wearing appropriate shoes, can effectively manage symptoms of Haglund's Deformity and prevent recurrence.