Haglund’s Deformity (Pump Bump)

Haglund’s deformity is a bony enlargement on the back of the heel that, when it rubs against shoes, may irritate the soft tissues near the Achilles tendon. This also often leads to painful bursitis, which is an inflammation of the bursa (a fluid-filled sac between the tendon and bone).

Causes

This deformity is often called “pump bump” because the rigid backs of pump-style shoes can create pressure that aggravates the enlargement when you are walking. In fact, any shoes with a rigid back, such as ice skates, men’s dress shoes or women’s pumps, can cause this irritation.

Haglund’s deformity can also be hereditary. Inherited foot structures that can make one prone to developing this condition include:

• A high-arched foot
• A tight Achilles tendon
• A tendency to walk on the outside of the heel.

Symptoms

Haglund’s deformity can occur in one or both feet. The symptoms include:

• A noticeable bump on the back of the heel
• Pain in the area where the Achilles tendon attaches to the heel
• Swelling in the back of the heel
• Redness near the inflamed tissue

Potential Treatments

A nonsurgical treatment is aimed at reducing the inflammation of the bursa. While these approaches can resolve the pain and inflammation, they will not shrink the bony protrusion.

A nonsurgical treatment can include one or more of the following:

Medication. Your doctor may recommend oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen to reduce the pain and inflammation.
Ice. To reduce swelling, apply an ice pack to the inflamed area, placing a thin towel between the ice and your skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
Exercises. Stretching exercises help relieve tension from the Achilles tendon. These exercises are especially important if you have a tight heel cord.
Heel lifts. If you have high arches you may find that heel lifts placed inside the shoe decrease the pressure on the heel.
Heel pads. Pads placed inside the shoe cushion the heel and may help reduce irritation when you are walking.
Shoe modification. Backless or soft backed shoes help avoid or minimize irritation.
Physical therapy. Physical therapy modalities, such as ultrasound, can help to reduce inflammation.
Orthotic devices. Custom arch supports control the motion in your foot.
Immobilization. In some cases, casting may be necessary.

If nonsurgical treatment fails to provide adequate pain relief, surgery may be needed. Your doctor will determine the procedure that is best suited to your case. It is important to follow any instructions given for post-surgical care.