"Pump Bumps" Haglund’s deformity is a bony enlargement of the back of the heel bone (calcaneus). This bony enlargement results in pain, specially when patients wear shoes. The Achilles’ tendon attaches to the heel bone and it is often involved in the patients symptoms. The insertion point of Achilles’ tendon becomes inflamed due to irritation against shoe gear. Almost all patients also have a very tight Achilles’ tendon.
Often times these deformities are associated with retrocalcaneal exostosis which makes it even more painful to wear shoes. When you see me in the clinic, I start with taking a detailed history and performing a thorough physical exam. I also get X-rays to confirm the diagnosis.
When you see me in the clinic, I start with taking a detailed history and performing a thorough physical exam. I also get X-rays to confirm the diagnosis.
Treatment usually depends on the severity of the symptoms. I usually start treatment by utilizing non invasive modalities such as offloading the Achilles’ tendon and the heel bone with heel lifts, immobilization in CAM boot, formal physical therapy, treatment with NSAIDs and occasionally oral steroids as well. When acute issues resolve I recommend custom orthotics for my patients which can prevent recurrence of symptoms.
If these treatment options fail, I consider the best surgical treatment option for my patients based on their individual symptoms and needs. Below is an animation of the surgery.
Below is a cadaver surgery of the procedure
Some surgeons prefer to cut and add the flexor digitorum Longus tendon called a FDL transfer; however, most of the time it is not needed and the patient still have full function of their toes.
If you are having any of these symptoms, please give us a call and schedule an in person visit of a virtual appointment.
Dr. Danniyal Shahid DPM, MD