A haglund’s bump is an enlargement or lump of bone, which forms on the back of the heel.  This can become a very painful condition due to unavoidable shoe pressure and accessibility to injury.  It is not uncommon that this condition also involves Achilles tendon discomfort since the tendon has fibrous attachments into that area of the heel.  There may or may not be soft tissue swelling around the bump itself but regardless, pressure on the area itself produces significant discomfort.  This condition is also referred to as a “pump bump” for it was originally found most frequently in women wearing dress pumps.  Today however, we find these problems in both males and females and of various age groups.

What causes it?

There is some confusion as to the particular cause of a haglund’s bump.  Some authorities believe that it is the result of an internal bone spur or calcium deposit on the heel, which then enlarges in response to pressure and friction.  Another theory that is more widely accepted today is that certain rotational motions of the heel during walking cause the bump to form as a protective mechanism.  In other words, the way one walks causes the heel bone to move with each step eventually causing a thickening of the bone to form.  As the individual continues to walk and the rear counter of the shoe continues to irritate the heel, the bump gets bigger and the pain and disability worsens.

How do you treat it?

The treatment of a haglund’s bump is directed at relieving the shoe pressure, stabilizing the heel or reducing its motion in the shoe and relieving any soft tissue swelling or skin irritation if present.  Protective padding, shoe modifications, occasional injection therapy, physical therapy, and orthotics are effective in the management of this annoying problem.  In some cases, immobilization or casting is beneficial while in certain instances where the condition seems resistant to care, surgery can be an effective approach.

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