Haglund’s deformity: Causes, symptoms, and treatment

Treatments for Haglund’s deformity may initially include shoe modifications and physical therapy. If these do not relieve pain, a doctor may recommend surgery to remove the bony ridge or repair the Achilles tendon.

People also refer to the condition as Haglund’s syndrome or “pump bump.” The term “pump bump” followed doctors observing that women who wore high-heeled pump shoes had the condition.

Experts now know that Haglund’s deformity can happen to anyone, and pumps and other shoes are not necessarily exclusively to blame.

What causes Haglund’s deformity?

Patrick Haglund first named Haglund’s deformity in 1927. The condition has been described as idiopathic, meaning it has no apparent cause, although doctors have linked it to several factors.

A person’s natural foot structure may sometimes make them more prone to Haglund’s deformity.

Doctors have linked some features to Haglund’s deformity, including:

  • A prominent heel bone that slopes outward, making the heel more likely to rub on the backs of shoes.
  • Feet that roll outward when walking, known as supination.
  • Tight Achilles tendons, which may put pressure on the heel bone.
  • High arches, which can force the heel slightly backward during walking and rub the Achilles tendon.

Wearing certain types of shoes may cause Haglund’s deformity, or some shoes may aggravate the condition and bring on symptoms such as pain.

Shoes or boots with rigid backs can cause friction that aggravates a foot structure that is prone to Haglund’s deformity.

People with the foot types listed above may wish to avoid shoes with rigid backs and ensure their footwear fits properly.

The shoes most often linked to Haglund’s deformity symptoms include:

  • ice skates and roller skates
  • dress shoes, including men’s dress shoes, women’s dress shoes, and high-heeled pumps
  • steel-toed work boots
  • stiff winter boots or rain boots

Haglund’s deformity can cause symptoms that range from mild to severe and may include:

  • pain in the back of the heel when walking
  • a visible bump on the back of the heel
  • swelling or redness on the heel
  • calluses or blisters on the heel where the bump rubs against shoes

A doctor may be able to identify Haglund’s deformity by looking at the heel and discussing the symptoms.

Diagnostic tests, such as an X-ray or MRI, may be used to evaluate the shape of the heel bone and to determine the severity of the condition. An X-ray or other tests can help a doctor decide which treatment options may be best.

People cannot avoid Haglund’s deformity in every case. People may, however, be able to reduce the risk of it developing by taking the following steps:

  • Wearing shoes that have open backs. The American Podiatric Medical Association caution against open-backed shoes if a person has tendinitis, bunions, or other foot problems.
  • Wearing shoes with soft, flexible backs to prevent pressure on the heel.
  • Stretching correctly before and after exercise, especially the calves, Achilles tendon, and feet.
  • Wearing shoes that have proper arch support for people with high arches.
  • Taking a gradual approach to strenuous exercises, such as running, to avoid overuse injuries.
  • Seeing a medical professional right away for heel pain. Haglund’s deformity may get worse over time if it is left untreated.


Haglund’s deformity may be a result of genetic foot structure that people cannot prevent in many cases. Wearing proper footwear and avoiding friction on the heel, however, is a good strategy for preventing this condition.

People who have relatives with Haglund’s deformity may wish to be cautious about footwear choices, avoiding the types of shoes and boots that cause friction on the heel.

Some treatments, fortunately, provide effective relief for Haglund’s deformity. Noninvasive therapies often help relieve pain and may be enough for mild cases. For others, surgery can correct the underlying issue and bring relief.

People should not ignore foot pain. Finding a qualified health professional who treats this condition is key to resuming regular activity as quickly as possible.

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