Haglund's Deformity

Back of two feet and ankles with a highlighted red area over the Achilles tendinopathy showing pain

The back of the heel is not an area we look at too often, so we often see many patients with a bump at the back of their heel who are unsure how long it has been there, what has caused it, or even if it’s something they’ve had their whole life. Regardless of how long it has been present, having a bump at the back of the heel can be worrying, and make it difficult to fit shoes comfortably.

What Is A Haglund's Deformity Or "Pump Bump"?

A Haglund’s deformity is a bony enlargement (bump) that develops right at the back of the calcaneus - your heel bone. These bumps can vary in size, and are both palpable and noticeable when looking. While the term ‘Haglund’s deformity’ was given because the condition was first discovered by Patrick Haglund, the term pump bump was coined because of the pump-style shoes with firm straps that tend to rub against the back of the heel, and contribute to painful symptoms.

Symptoms: How To Know If You Have A Haglund's Deformity

Interestingly, the bony enlargement itself is actually asymptomatic and painless. When symptoms present, it is actually coming from the surrounding structures, such as the Achilles tendon or the bursa at the back of the heel, which can become irritated from the way the presence of the bump causes them to be used, or from shoe straps rubbing against them. As such, you may experience:

  • Pain at the back of the heel
  • Inflammation
  • Redness and warmth over the bony bump
  • Callus may form over the bony bump with repeated rubbing and friction
  • Pain from exercise, particularly where the Achilles tendon is engaged
  • Pain when walking after rest
  • Limping during walking

What Causes A Haglund's Deformity?

The condition is still poorly understood by researchers, without a clear aetiology or understanding as to why the particular bony section of the back of the heel where the Achilles tendon inserts becomes enlarged. While it is often considered idiopathic (meaning that it can occur spontaneously), what is known is that the bump can cause the surrounding tissues to become irritated from rubbing against footwear, which is why we can suddenly develop symptoms when switching to a new pair of shoes. It is thought that this repetitive rubbing at the back of the heel may play a big role, too.

Risk Factors

Several risk factors have been suggested to play a role in the development of a pump bump, including:

  • Over-practice in runners, which means that the Achilles tendon is repetitively rubbing against the back of the heel
  • Tight or poorly fitting shoes, which rub against the back of the heel
  • Altered biomechanics of foot joints because of the improper alignment of a joint close to the ankle called the subtalar joint 


A Haglund’s deformity can be confidently diagnosed by our podiatrists from a clinical examination, and your history. Medical imaging may be used to provide further clues about the cause of the pain - whether that is from an inflamed bursa, damage to the Achilles tendon at its insertion, or something else. Your podiatrist will thoroughly examine your heels, going beyond noting the presence of the deformity to uncovering what is causing your painful symptoms, to best guide your treatment and recovery.

Treatment For A Haglund's Deformity

Treating a Haglund’s deformity really means treating the damaged tissues at the back of the heel in order to relieve symptoms, and then preventing them from recurring. Your podiatrist will discuss the best treatment options for you following your assessment, which may involve:

  • Using ice and anti-inflammatories to help relieve your painful symptoms at home
  • Using temporary heel lifts to reduce the strain on the tissues at the back of your heel, thereby reducing pain
  • Avoiding footwear that is tight and rubs against the back of the heel, helping to prevent your symptoms from worsening
  • Making shoe modifications to your existing footwear, a unique treatment option that our Brisbane and Newmarket clinics can offer directly
  • Using custom foot orthotics to help permanently reduce excess tension on the back of the heel by addressing identified biomechanical factors, and potentially having a slight in-built heel raise if indicated
  • An exercise program to stretch tight muscles like the Achilles tendon
  • ASA Laser, a safe and painless low-level laser that radiates specific wavelengths of light to reduce inflammation, support faster cell repair, and offer faster pain relief

Once the pain has gone, your podiatrist will then work with you to help set you up for success in the future and prevent your symptoms from returning. This includes educating you on the how’s, what’s and why’s of having a pump bump, so you know exactly what you should be doing and avoiding, including the best shoes for your feet. As experts in foot health, working with a podiatrist means that you stay supported every step along the way, to help you get the best outcomes for your foot health.


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