What Is Haglund's Deformity?

A pronounced bump on the back of your heel that's prone to irritation

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Haglund's deformity is a bony bump where your Achilles tendon attaches at the back of your heel bone. Because of its prominence, the bump is subject to the effects of constant friction. This causes redness and irritation, and can cause skin thickening, pain, swelling, and increased skin lines.

Haglund's deformity usually develops due to shoes rubbing up against the heel. Abnormalities in foot function, position, or a genetic predisposition may also contribute to the condition.

Also Known As

Haglund's deformity (also known as Haglund's syndrome) got its name from Patrick Haglund, who first described it in 1927. It is also called:

  • Retrocalcaneal exostosis
  • Mulholland deformity
  • "Pump bump"

Symptoms of Haglund's Deformity

Haglund's deformity usually appears on both feet, rather than just one. The primary symptoms are:

  • A noticeable bump on the back of the heel
  • Pain
  • Swelling
  • Redness
  • Blisters and/or callouses on and around the bump due to increased friction from shoes
Haglund's Deformity

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Complications

When the bony lump of Haglund's deformity rubs against shoes, it can cause other nearby tissues to become inflamed.

That can lead to complications, including:

  • Bursitis: Inflammation of the bursa, a fluid-filled sac that cushions a tendon against bone, can cause swelling and tenderness.
  • Achilles tendonitis: Symptoms of Achilles tendonitis such as pain and swelling can occur a few centimeters above the area where the tendon attaches to the back of the heel.

Over time, chronic injury to the Achilles tendon can cause it to weaken and break down, a condition known as tendinosis.

What Causes Haglund's Deformity?

Haglund's deformity is relatively common but not very well understood. It's most common in middle age and affects women more often than men.

Along with genetics and a potentially misshapen bone, issues that can contribute to Haglund's deformity include:

  • High arches
  • A tight Achilles tendon
  • Walking on the outside of your feet
  • In runners, over-training
  • Tight or poor-fitting shoes
  • Abnormal foot biomechanics due to joint misalignment

The type of shoes you wear can influence whether you develop Haglund's deformity, too. Those most often linked to this problem have a stiff back and include:

  • Ice skates
  • Men's dress shoes
  • Women's pumps
  • Work boots

Diagnosis

You may start by seeing your primary healthcare provider, who might refer you to a podiatrist or foot and ankle specialist.

Haglund's deformity can be diagnosed based on a physical examination and X-rays. Sometimes a magnetic resonance imaging (MRI) scan may be ordered as well.

This condition is sometimes mistaken for other causes of pain in the rear of the foot, so your healthcare provider will use the information they gather to rule out:

Treatment for Haglund's Deformity

An array of conservative treatments are aimed at reducing pressure, pain, and inflammation. They don't shrink the bony protrusion itself, but that's typically not necessary.

Surgery to do so is not common, but may be considered if other options fail and you're in significant pain.

Conservative Treatments

When a pump bump becomes inflamed, the most important part of treatment is to reduce pressure and friction at the site of the bump.

The best way to do this is to ensure that you are wearing a shoe that fits well and offers adequate support. Usually, shoes that fit poorly will make it worse.  

Other conservative approaches to treating Haglund's deformity include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Ice to lower inflammation
  • Stretching exercises for the Achilles tendon
  • Heel pads to reduce irritation
  • Heel lifts to decrease pressure on the bone for people with high arches
  • Backless or soft backed shoes
  • Custom foot orthotics that improve biomechanics
  • Night splints
  • Immobilization, such as with a cast or soft boot to allow it to heal
  • Physical therapy
  • Modalities like ultrasound can lower inflammation

Surgery

If these approaches don't adequately alleviate your pain, you may need to have surgery.

Surgery may include removal of the bump, and it usually provides pain relief and a return back to a normal lifestyle with no restrictions after a period of recovery.

You should expect to have a non-weight bearing cast on, meaning you can't walk, for about three weeks. After that, you'll likely have a walking cast or boot and start physical therapy.

It may be between three and six months after surgery before you can wear high heels again.

A Word From Verywell

If you notice a hard, painful lump on the back of your heel, don't wait—bring it up with your healthcare provider before it gets worse and puts you at risk for complications.

The earlier it's caught, the better chance you have of needing only conservative treatments to restore your function and get rid of the pain.

Frequently Asked Questions

  • Is Haglund's deformity a bone spur?

    No. A bone spur is defined by calcifications, or calcium deposits. Haglund's deformity is not.

  • Can you get rid of a Haglund's deformity bump?

    You can lessen irritation of a Haglund's deformity, which may help it appear smaller, but surgery is the only way to get rid of it for good.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American College of Foot and Ankle Surgeons. Haglund's deformity.

  2. American Podiatric Medical Association. Haglund's deformity.

  3. Pękala PA, Henry BM, Pękala JR, Piska K, Tomaszewski KA. The Achilles tendon and the retrocalcaneal bursa: An anatomical and radiological study [published correction appears in Bone Joint Res. 2019 Oct 3;8(9):437]. Bone Joint Res. 2017;6(7):446–451. doi:10.1302/2046-3758.67.BJR-2016-0340.R1

Additional Reading

By Catherine Moyer, DPM
Catherine Moyer, DPM, is a podiatrist experienced in the diagnosis, treatment, and prevention of disorders of the foot and ankle.