Haglund's Deformity: What It Is, Why It Happens, and How It's Treated
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
Haglund's deformity is a bony protrusion on the back of the heel bone where the Achilles tendon attaches, often called a pump bump because high heels or stiff shoes irritate it [5] [6]. Symptoms include a visible bump, heel pain and swelling [5]. Most cases are managed with supportive shoes, heel cups, icing and stretching, and surgery is reserved for severe cases [4] [5].
What the research says
Most heel pain, including Haglund-related retrocalcaneal bursitis, improves without surgery. According to PubMed, a clinical review reports that heel pain accounts for 2 million office visits a year, that retrocalcaneal bursitis is more common in women aged 40 to 60 with Haglund deformity and a thickened Achilles tendon, and that most people improve with conservative treatment, with surgery reserved for cases that do not respond (Morancie et al., American Family Physician, 2025) [1].
If surgery is needed, endoscopic removal had fewer complications than open surgery. A systematic review of 35 studies (1,260 ankles in 1,147 patients) found complications in 4.1% of endoscopic procedures versus 15.5% of open ones, and a return to sport at about 11.9 versus 20.7 weeks (Alessio-Mazzola et al., Knee Surgery, Sports Traumatology, Arthroscopy, 2021) [2].
Surgery can restore function when other treatments fail. In 40 people with chronic retrocalcaneal bursitis who had surgery after conservative treatment did not work, the average AOFAS foot score rose from 46 to 89 out of 100 at 1 year, and 90% had a satisfactory outcome (Rahman et al., Mymensingh Medical Journal, 2021) [3].
Study details are from PubMed abstracts.
What Is Haglund's Deformity?
Haglund's deformity is a condition characterized by a bony growth on the calcaneus, which is your heel bone. This growth occurs specifically at the point where the Achilles tendon (the large band of tissue connecting your calf muscles to your heel) attaches to the bone [5] [8]. This protrusion often creates a noticeable bump that can be seen and felt through the skin [5].
Because the bump is located at the back of the heel, it is frequently irritated by footwear. This has led to the common nickname "pump bump," as the rigid backs of pumps or high-heeled shoes often press directly against the growth [5] [6]. Over time, the constant pressure and friction can lead to secondary issues such as Achilles tendinitis (inflammation of the tendon) or heel bursitis (inflammation of the fluid-filled sac near the joint) [5] [6].
Characteristic | Description |
Location | Back of the heel bone (calcaneus) |
Physical Sign | Visible, palpable bony protrusion |
Common Nickname | "Pump Bump" |
Related Issues | Achilles tendinitis, heel bursitis |
Frequency | Very common; often bilateral (affects both feet) |
What Are the Symptoms of Haglund's Deformity?
The most prominent sign of Haglund's deformity is a visible bump on the back of the heel [5] [6]. For many people, this bump is accompanied by varying levels of pain, particularly when wearing shoes with stiff backs. The area around the growth may also become swollen or show signs of skin discoloration, such as redness or darkening [5].
In most instances, Haglund's deformity develops on both feet simultaneously, a condition known as bilateral development [4] [5]. While the growth itself is permanent unless removed by a surgeon, the symptoms like pain and swelling are often intermittent and triggered by specific activities or footwear choices.
What Causes Haglund's Deformity to Develop?
Medical experts have not identified a single, definitive cause for Haglund's deformity, meaning it is often considered idiopathic [5]. However, research suggests that genetics may play a significant role, as the condition often runs in biological families [4] [5]. Beyond heredity, several physical factors and lifestyle habits can contribute to the development or aggravation of the bony growth.
High-arched feet and tight Achilles tendons are common structural factors that increase the likelihood of developing Haglund's deformity [4] [5] [6]. Additionally, gait disorders, which affect the way a person walks, can place uneven pressure on the heel bone [5]. External factors, such as overusing the heel through running or consistently wearing narrow, tight-backed shoes, are also major contributors to the condition's progression [5] [6].
Risk Factor | Impact on the Heel |
Foot Structure | High arches or tight tendons increase pressure on the calcaneus. |
Footwear Choice | Stiff-backed shoes like pumps cause friction and irritation. |
Activity Level | Runners and athletes are at higher risk due to heel overuse. |
Genetics | Family history is a strong predictor of developing the growth. |
Gender | Women are more frequently affected, often due to shoe styles. |
How Is Haglund's Deformity Diagnosed?
A healthcare provider typically diagnoses Haglund's deformity through a physical examination. During this visit, they will feel the bump on your heel and discuss your symptoms and shoe preferences. To confirm the diagnosis and assess the size of the growth, imaging tests are usually required [5].
X-rays provide a clear picture of the bony protrusion and help rule out other potential causes of heel pain, such as heel spurs [5]. If surgery is being considered, a magnetic resonance imaging (MRI) scan may be ordered to evaluate the condition of the surrounding soft tissues, including the Achilles tendon and nearby bursae [5].
What Are the Treatment Options for Haglund's Deformity?
The primary goal of treatment is to alleviate pain and reduce inflammation rather than removing the bony growth itself [5] [6]. Most people find relief through conservative, non-surgical methods [1] [4]. These include using over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to manage pain and applying ice to the heel to reduce swelling [5] [6].
Modifying footwear is perhaps the most important step in management. Switching to more supportive shoes with soft backs or open heels can significantly reduce irritation [6]. Orthotics, such as custom-made heel cups or shoe inserts, can also help by changing the position of the foot within the shoe [5] [6]. Physical therapy is often recommended to provide specific stretches that improve the flexibility of the Achilles tendon and ankle [5] [6].
Is Surgery Necessary for Haglund's Deformity?
Surgery is rare and is only considered when severe symptoms persist despite months of conservative treatment [5] [7]. During the procedure, a surgeon removes the bony growth and any inflamed tissue in the heel [5]. While the surgery is effective, the recovery process is significant, typically requiring several weeks to a few months to regain full strength and mobility [5].
How Can Haglund's Deformity Be Prevented?
While it may not be possible to prevent the bony growth entirely due to genetic factors, you can take steps to prevent the pain and complications associated with it. Maintaining good foot health is essential. This includes wearing comfortable, supportive shoes and avoiding any footwear that presses painfully against the back of the heel [5] [6].
Strengthening the muscles that support your ankles and heels can reduce the risk of injury and overuse [5]. It is also vital to listen to your body; if an activity causes heel pain, you should stop and rest immediately [5] [8]. Properly warming up and stretching before exercise can help keep the tendons and ligaments flexible, further protecting the heel from excessive strain [5] [8].
Conclusion
Haglund's deformity is a common bony growth that can cause significant heel pain, but it is highly manageable. By choosing the right footwear, utilizing orthotics, and maintaining flexibility through stretching, most individuals can lead active lives without the need for surgery. If you notice a new bump on your heel or experience persistent pain, consulting a healthcare provider is the first step toward finding relief.
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Frequently Asked Questions
What is the difference between Haglund's deformity and a heel spur?
While both are bony growths on the heel, Haglund's deformity occurs at the back of the heel where the Achilles tendon attaches. Heel spurs form on the bottom of the heel bone.
Why is it called a "pump bump"?
Haglund's deformity earned this name because the rigid backs of "pumps" (high-heeled shoes) are a common cause of irritation and pain for people with this condition.
Can Haglund's deformity go away on its own?
No. The bony growth is permanent. However, the symptoms like pain and swelling can be eliminated through proper management.
Is Haglund's deformity dangerous?
No, it is not dangerous to your overall health, but it can be very painful and may lead to Achilles tendinitis if left untreated.
Do I have to stop running if I have Haglund's deformity?
Not necessarily. Many runners manage the condition with proper shoe selection, orthotics, and stretching, though you should rest during flare-ups.
Are there specific exercises that help?
Yes, stretches that target the Achilles tendon and calf muscles are highly effective at reducing the tension that aggravates the deformity.
Does icing really help a bony growth?
Icing doesn't change the bone, but it is excellent for reducing the inflammation in the soft tissues (bursae and tendons) surrounding the growth.
Can children develop Haglund's deformity?
Yes, it can appear in children and adolescents, often becoming more noticeable during growth spurts or when they start wearing stiffer shoes.
What kind of shoes are best for Haglund's deformity?
Shoes with soft backs, backless shoes (like clogs), or those that are professionally fitted with orthotics are generally best.
How long is the recovery after surgery?
Full recovery usually takes between several weeks and a few months, depending on the extent of the procedure.
Can I wear high heels again after treatment?
Some people can, but many find that they must avoid shoes with stiff, narrow backs permanently to prevent symptoms from returning.
Is Haglund's deformity always on both feet?
Haglund's deformity is almost always bilateral, meaning it develops on both heels, though one side may be more painful than the other.
Can physical therapy cure the bump?
Physical therapy cannot remove the bone, but it can "cure" the symptoms by reducing inflammation and improving foot mechanics.
What happens if I ignore the pain?
Continuing to irritate the area can lead to chronic bursitis or a tear in the Achilles tendon, which are much more serious conditions.
Should I see a podiatrist or an orthopedic surgeon?
Both specialists are qualified to diagnose and treat Haglund's deformity.
Related Reading
References
Morancie NA, et al. Heel Pain: Diagnosis and Management. Am Fam Physician. 2025;112(6):648-656. PMID 41533410. https://pubmed.ncbi.nlm.nih.gov/41533410/
Alessio-Mazzola M, et al. Endoscopic calcaneoplasty for the treatment of Haglund's deformity provides better clinical functional outcomes, lower complication rate, and shorter recovery time compared to open procedures: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2021;29(8):2462-2484. PMID 33216187. https://doi.org/10.1007/s00167-020-06362-1
Rahman KH, et al. A Study on Outcome of Surgical Treatment of Chronic Retrocalcaneal Bursitis. Mymensingh Med J. 2021;30(4):903-906. PMID 34605454. https://pubmed.ncbi.nlm.nih.gov/34605454/
Vaishya R, et al. Haglund's Syndrome: A Commonly Seen Mysterious Condition. Cureus. 2016;8(10):e820. PMID 27843738. https://doi.org/10.7759/cureus.820
Cleveland Clinic. Haglund’s Deformity. Cleveland Clinic. Last updated July 17, 2023. https://my.clevelandclinic.org/health/diseases/25134-haglunds-deformity
American College of Foot and Ankle Surgeons. Haglund’s Deformity – Pump Bump on Heel. Foot Health Facts. Accessed October 15, 2026. https://www.foothealthfacts.org/conditions/haglund%E2%80%99s-deformity
American Academy of Orthopaedic Surgeons. Heel Pain. OrthoInfo. Accessed October 15, 2026. https://www.orthoinfo.org/diseases--conditions/heel-pain/
Mayo Clinic Staff. Achilles tendinitis - Symptoms & causes. Mayo Clinic. September 19, 2025. https://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/symptoms-causes/syc-20369020
Medical Disclaimer
This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have about a medical condition. Never disregard professional medical advice or delay seeking care because of something you have read here. If you think you may have a medical emergency, call your doctor or emergency services immediately.
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