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What is Haglund’s Deformity? | Find Your Stride | Edinburgh Podiatrist

Introduction

Haglund's deformity is a bony growth that develops on the back of the heel. It often affects athletes and individuals who wear tight or ill-fitting shoes, causing pain and discomfort. In this blog post, we will delve into the anatomy of the heel, the symptoms associated with Haglund's deformity, and conservative management options.


Lateral x-ray of a left ankle
This x-ray shows the location of Haglunds deformity

Anatomy

The heel bone, also known as the calcaneus, is one of the largest bones in the foot. It plays a crucial role in supporting body weight and facilitating movement. The back of the calcaneus is covered by the Achilles tendon. Haglund's deformity becomes painful when the bony prominence at the top of the heel rubs against the Achilles tendon irritating the soft tissues, which can lead to inflammation, and a more prominent bone on the back of the heel.


Symptoms

Individuals with Haglund's deformity often experience pain, swelling, and redness on the back of the heel. The discomfort may intensify when wearing shoes that press against the bony growth, such as high heels, hard-backed shoes, or footwear with a rigid construction. In severe cases, the pressure exerted by the shoes can exacerbate the symptoms, leading to difficulty walking and performing daily activities.


Conservative Management

Conservative management is often the first line of treatment for Haglund's deformity. This approach aims to alleviate symptoms, reduce inflammation, and prevent further irritation to the bony growth. Non-invasive interventions may include:


1. Rest: Taking a break from activities that aggravate the symptoms, such as high-impact sports or wearing tight shoes, can help alleviate discomfort and promote healing.


2. Ice therapy: Applying ice to the affected area can help reduce pain. It is recommended to place a thin towel between the ice pack and the skin.


3. Shoe modifications: Switching to shoes with a wider, softer backing or using heel pads can help reduce friction and alleviate pressure on the bony growth.


4. Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medications such as ibuprofen or naproxen can provide pain relief and help reduce inflammation.


5. Podiatry/Physio: Exercises and/or foot orthoses can strengthen the achilles and alleviate stress/friction acting on the calcaneus.


In cases where conservative management fails to provide relief, surgical intervention may be considered to remove the bony growth and address any underlying issues contributing to the deformity. It is crucial to consult with a healthcare professional to determine the most appropriate treatment approach based on individual circumstances.


Conclusion

Haglund's deformity can be a source of significant discomfort and functional impairment for those affected. Understanding the anatomy of the heel and the associated symptoms is vital. Conservative management strategies, such as rest, ice therapy, shoe modifications, NSAIDs, orthoses and exercises can provide relief for many individuals. However, in cases where these approaches are ineffective, surgical intervention may be necessary.


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