What it is
In Haglund’s deformity, a bony prominence rubs against the tendon and the shoe. The bursa becomes inflamed, swollen and painful. It is not a callus and it is not plantar fasciitis: plantar fasciitis hurts under the heel.
How it often shows up: “A bump at the back of the heel, where the shoe rubs”.
Inside
At the back of the heel, the Achilles tendon runs down and attaches to the bone. Between the two there is a small fluid-filled sac, the bursa, which reduces friction.
Treatment
The first step is not surgery. Shoes with a soft back, a heel lift and guided exercise help most people. When that does not work, surgery removes the excess bone and cleans out the inflamed area.
It can be open or endoscopic, depending on the case. Every surgery has risks.
Afterwards
Without the prominence, the tendon is no longer pressed against the bone. The period of protection and the physical therapy depend on what was done to the tendon.
Results and recovery vary from person to person.
What I look at in the visit
- Achilles tendoncalf to heel
- Connects the calf to the heel and powers the push-off of each step.
- In the visit I look at: thickness, tender spots and strength on tiptoe.
- Calcaneusheel bone
- Takes the first impact of each step. The Achilles attaches at the back; the plantar fascia, underneath.
- In the visit I look at: whether the pain is at the back or underneath: it changes the diagnosis.
- Plantar fasciasole of the foot
- A firm band that supports the arch. When inflamed, it hurts under the heel with the first steps of the day.
- In the visit I look at: pain when pressing on its origin, at the heel.
- Talusankle joint
- Sits between the leg and the heel and lets the foot move up and down.
- In the visit I look at: looseness and clicking when the ankle moves.