Haglund’s Syndrome: Wearing Ill-Fitted Heels Or Stiff Shoes Can Lead To This Condition

Haglund's Deformity is when the back of your heel becomes inflamed and leads to the malformation of the bone and soft tissue. Here's everything you need to know.

Haglund's deformity is a bone and soft tissue malformation in the foot, caused by an expansion of the bony part of the heel (where the Achilles tendon is implanted). The soft tissue around the back of the heel can get inflamed when the huge, bony lump rubs against stiff shoes, causing Bursitis.

What Causes Haglund's Deformity?

Haglund's deformity develops when the backs of your heels are repeatedly pressed, possibly caused by wearing ill-fitted or rigid heels. It is commonly referred to as "pump bump" since it occurs frequently in women who wear pump-style high heels.

If you have a high foot arch, a tight Achilles tendon, or walk on the outside of your heel, you may be more susceptible to Haglund's deformity.

What Are The Symptoms?

Haglund's deformity can affect either one or both of your feet. Among the signs and symptoms are:

• The rear of the heel has a bony hump
• Significant pain in the Achilles tendon's attachment point to the heel
• The bursa, a fluid-filled sac in the back of the heel, is swollen.
• Redness in the vicinity of the inflammatory tissue

How Is It Diagnosed?

Haglund's deformity can be difficult to diagnose since the symptoms are similar to those of other foot problems such as Achilles tendinitis.

The doctor may be able to diagnose the problem based on the appearance of your heel, with the help of an X-ray of the heel bone to determine the disease's characteristic protruding heel bone.

To treat heel discomfort, the doctor may use an X-ray to construct orthotics, which are custom-made shoe inserts that assist keep your feet stable.

What Are The Treatment Options?

Haglund's deformity is usually treated by alleviating discomfort and relieving pressure on the heel bone. Among the non-surgical options are:

• wearing clogs or other open-back shoes
• NSAIDs, such as ibuprofen (Advil, Motrin IB) or aspirin, are nonsteroidal anti-inflammatory medications
• icing the bump twice a day for 20-40 minutes to minimize swelling
• undergoing ultrasound therapy
• getting a massage
• Using orthotics
• Putting on heel pads to relieve pressure
• wearing a cast or immobilizing boot

If less intrusive treatments fail, surgery may be performed to address Haglund's deformity, by removing the excess heel bone. The bone can also be filed down and smoothed, relieving stress from the bursa and soft tissue. Surgery can be done through arthroscopy, which is a keyhole technique.

If the Achilles tendon is damaged and needs to be repaired, a general anaesthetic is commonly used.

It may take up to eight weeks for complete recovery. To protect the foot, a boot or cast might be recommended. However, one might also need to wear crutches for a few days or weeks.

What Can Be Done To Prevent It?

By taking care of your feet, the chances of having Haglund's deformity can be reduced:

• Avoid wearing tight or stiff heels for long periods of time
• Running on hard terrain or uphill should be avoided
• Wear shoes with an exposed back
• Fitted, padded socks with non-slip soles are recommended
• Undertake stretching exercises to prevent constricting of the Achilles tendon

(The article is contributed by Dr Raghu Nagaraj, Senior Consultant, Orthopedics and Bone & Joint Surgery, Fortis Hospital, Cunningham Road, Bangalore)