Site news

Many skaters contact us to solve their dilemma with Pump Bump or as many affectionatley refer to as Bauer Bump. 

Other Similar Terms include Haglunds Syndrome or painful heel bumps.

Haglund's foot deformity is a protrusion of the upper posterolateral calcaneum. It is characterized by pain (sometimes debilitating) on the back of the heel, at the region where the Achilles' tendon inserts.

Most athletes and patients who suffer from Haglund’s Syndrome are skaters of all disciplines, hockey, figure, roller and inline, as well as runners and other athletes. Also, women between 15 to 35 years old, many of whom wear high heels all the time. This supports the nick name for this injury namely Pump Bump.

Any who believes they are suffering from this condition should consult with their physician as this condition is frequently misdiagnosed as Achilles' tendonitis.

What are the symptoms of Haglund's Syndrome?

The general symptoms of Haglund's Deformity include pain, blistering, and abrasion in the heel area and often a bump on the back of the heel.

What is the Cause of Haglund's Deformity?

The cause of the Haglund's deformity is still unknown. There is a high incidence of skater's who get a pinching on the back of the heel which appears to be related to the cause of this problem. Additionally, there is a correlation between women who wear high heels and this problems which suggests that heeled shoes could be the cause. Pressure against the shoes or boots (also called bursitis), got worse when the height of the heel, can lead to Haglund foot deformity.

See also http://www.hkcr.org/publ/Journal/vol11no4/full/183-185%20Haglund.pdf

How to diagnose?

A physician usually assesses first if the foot is suffering from skin breakdown, in which case, he or she may take steps to prevent infection.

After evaluating the patient’s symptoms, the foot and ankle surgeon will examine the foot. In addition, x-rays will be ordered to help the surgeon evaluate the structure of the heel bone.

Haglund's Deformity Correction and Treatment

Milder cases of Haglund’s syndrome can be self-treated. The swelling can be relieved by ice and compression. Many athletes and patients wishing to avoid the pain associated with problem use a padding device such as an Achilles Tendon Pad.

If Haglund foot deformity is persistent, the doctors may also advise the patient to wear prescription shoes, heel grip pads, Achilles Heel pads, and orthotics. These all help reduce heel pressure, and Haglund's syndrome. If this still does not solve the problem, surgical intervention may be offered.

Non-surgical treatment of Haglund’s deformity is aimed at reducing the inflammation of the bursa. While these approaches can resolve the bursitis, they will not shrink the bony protrusion. Non-surgical treatment can include one or more of the following:

• Medication: Anti-inflammatory medications may help reduce the pain and inflammation. Some patients also find that a topical pain reliever, which is applied directly to the inflamed area, is beneficial.
• Ice: To reduce swelling, apply a bag of ice over a thin towel to the affected area for 20 minutes of each waking hour. Do not put ice directly against the skin.
• 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: Placing pads inside the shoe cushions the heel and may help reduce irritation when walking.
• Shoe modification: Wearing shoes that are backless or have soft backs will avoid or minimize irritation.
• Physical therapy: Inflammation is sometimes reduced with certain forms of physical therapy, such as ultrasound therapy.
• Orthotic devices: These custom arch supports are helpful because they control the motion in the foot, which can aggravate symptoms.
• Immobilization: In some cases, casting may be necessary to reduce symptoms.

If non-surgical 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 post-surgical care.

Avoiding Haglund's Deformity

A recurrence of Haglund’s deformity may be prevented by:

• Wearing appropriate shoes and skates; avoid pumps and high-heeled shoes.
• Using arch supports or orthotic devices.
• Performing stretching exercises to prevent the Achilles tendon from tightening.
• Avoiding running on hard surfaces and running uphill.