Haglund's Bursitis

What Is Haglund’s Deformity?

Haglund’s deformity is a bony enlargement on the back of the heel. The soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes. This often leads to painful bursitis, which is an inflammation of the bursa (a fluid-filled sac between the tendon and bone).

Cause of Haglund's Deformity

Haglund’s deformity is often called “pump bump” because the rigid backs of pump-style shoes can create pressure that aggravates the enlargement when walking. In fact, any shoes with a rigid back, such as ice skates, men’s dress shoes or women’s pumps, can cause this irritation.

To some extent, heredity plays a role in Haglund’s deformity. Inherited foot structures that can make one prone to developing this condition include:
  • A high-arched foot
  • A tight Achilles tendon
  • A tendency to walk on the outside of the heel.

Symptoms of Haglund's Deformity

Haglund’s deformity can occur in one or both feet. The symptoms include:
  • A noticeable bump on the back of the heel
  • Pain in the area where the Achilles tendon attaches to the heel
  • Swelling in the back of the heel
  • Redness near the inflamed tissue

Diagnosis of Haglund's Deformity

After evaluating the patient’s symptoms, the foot and ankle surgeon will examine the foot. 

Further examination of the foot can be very important, particularly for subtle injuries which require a high index of suspicion. 

In addition, x-rays will be ordered to help the surgeon evaluate the structure of the heel bone.

Treatment of Haglund's Deformity

Non-Surgical Treatment

Nonsurgical treatment of Haglund’s deformity is aimed at reducing the inflammation of the bursa. While these approaches can resolve the pain and inflammation, they will not shrink the bony protrusion. Nonsurgical treatment can include one or more of the following:
  • Medication. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce the pain and inflammation. Ice. To reduce swelling, apply an ice pack to the inflamed area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
  • Exercises. Stretching exercises help relieve tension from the Achilles tendon. These exercises are especially important for the patient who has a tight heel cord.
  • Heel lifts. Patients with high arches may find that heel lifts placed inside the shoe decrease the pressure on the heel.
  • Heel pads. Pads placed inside the shoe cushion the heel and may help reduce irritation when walking.
  • Shoe modification. Backless or soft backed shoes help avoid or minimize irritation.
  • Physical therapy. Physical therapy modalities, such as ultrasound, can help to reduce inflammation.
  • Orthotic devices. Custom arch supports control the motion in the foot.
  • Immobilization. In some cases, casting may be necessary.

When Is Surgery Needed?

If nonsurgical treatment fails to provide adequate pain relief, surgery may be needed. The foot and ankle surgeon will determine the procedure that is best suited to your case. It is important to follow the surgeon’s instructions for postsurgical care.

Treatment of Haglund's Deformity

To help prevent a recurrence of Haglund’s deformity:
  • wear appropriate shoes; avoid shoes with a rigid heel back
  • use arch supports or orthotic devices
  • perform stretching exercises to prevent the Achilles tendon from tightening
  • avoid running on hard surfaces and running uphill

Treatment Process

Preparation for Surgery

  • Provide a complete list of your medications so you can be advises which to stopped prior to surgery,
  • Treat any tooth, gum, bladder or bowel problems before surgery to reduce the risk of infection
  • Stop anti-inflammatory medications (NSAIDs) at least seven days before the procedure.
  • Stop or cut down smoking to reduce your surgery risks and improve your recovery
  • Consider losing weight (if overweight) before surgery

Day of Surgery

  • Report any infections to me prior to surgery as the procedure cannot be performed until all infections have cleared up.
  • Do not consume alcohol - 24 hours prior to treatment,
  • Do not eat or drink anything, including water, for 6 hours before surgery
  • Avoid vigorous physical activity or exercise 24 hours prior to surgery,

During Surgery

  • Administration of general anesthesia or sedation and local anesthesia
  • The entire procedure can take 60 minutes to two hours.
  • Procedure is performed and sent to recovery room, for observation
  • Pain medications are prescribed to help with pain during the recovery phase. 

After Surgery

  • Do not consume large amounts of alcohol after surgery,
  • Avoid vigorous physical activity or exercise until advised,
  • Follow the Post Surgery Treatment Plan proscribed by the surgeon and post op care specialists.
  • Any questions or complications should be communicated directly to the surgeon

Common Questions

If you have a specific question about your treatment, we recommend contacting the clinic
  • Hospital Discharge?

    The patient is then discharged from the hospital in a day or two after the procedure. 


    Patients are advised on the steps to keep the wound dry and clean and on scar management.


    The patient is advised to maintain a strict elevation of the joint for ten days. 

    • arrange help to assist with chores, and
    • avoid putting any weight on the joint, with the help of crutches and walkers. 
  • Recovery After Haglund's Bursitis?

    Even minor injuries can have a prolonged recovery period. 


    Patients are normally immobilised in a below-knee cast or boot for 6 weeks.


    Other conditions include:

    • no weight-bearing during this time, and 
    • often a further 4-6 weeks in a boot is required once walking is started. 

    Return to maximum function often takes up to one year after the injury.

  • Wound Management?

    At the time of discharge patients are advised on:

    • The necessary steps to keep the wound dry,
    • Wound care and Cleaning, and 
    • On scar management. precautions.
  • What if I Am Pregnant?

    It is not recommend surgery while pregnant, as the risks are uncertain due to the lack of information available about the effect on the fetus. 


    For more information please call us on and request to speak with one of our medically-trained registered doctor or nurse.

  • Post Surgery Treatment Program

    Long term outcomes depend on the severity of the initial injury. 


    Some patients won’t get back to their pre-injury function or sport, even with well-performed surgery. 


    Ten Days After Surgery

    X-rays are repeated ten days after the procedure to determine the situation. 


    Physiotherapy

    For the best possible outcome, postoperative physical therapy plays an important role in proper recovery following your procedure. 


    This postoperative management includes regular scheduled visits with a physical therapist 


    Extended Recovery Period

    The patient is advised to limit their activities for six to eight weeks after the surgery.


    Certain activities such as driving are also restricted for up to six weeks post-surgery. 

  • Possible Risks or Side Effects?

    The procedure carries all the risks associated with surgery, such as 

    • infection, 
    • bleeding and 
    • a severe allergic reaction to anesthesia. 

    Redness and bruising at the site of injection may be seen which should resolve over time. 


    You may experience post operative pain for prolonged period or other serious side effects contact your surgeon, as well as:

    • damage to the structures around the operative zone such as nerves, blood vessels, tendons, muscles,
    • chronic pain due to nerve entrapment
    • delayed healing
    • wound infection or breakdown.
  • Possible Complications of Surgery?

    If this condition or injury is missed or untreated can result in the collapse of the arch of the midfoot with significant pain, and the development of arthritis. 


    When surgery is performed, risks include damage to the structures around the top of the foot (nerves, blood vessels, tendons, muscles), as well as a risk of wound infection or breakdown.


    It is common to sustain cartilage damage at the joint surfaces during the initial injury, and some people develop midfoot arthritis and ongoing pain down the track. 


    Some patients require further surgery to fuse the midfoot joints to relieve arthritis pain.

  • Do You Offer Discounts?

    Due to strict regulations set by the Australian Medical Board it is against the law to offer surgical inducements. 


    Discounted treatments should raise alarm bells when you are choosing which specialist to trust your treatment to. 


    The surgeon's skill is more important than price. Effective surgery will maximise your health outcome.