Definition

Haglund exostosis, also called Haglund's deformity or spur and, colloquially, pump bump, is an abnormal bony prominence on the postero-superior (upper rear) part of the calvaneum (heel bone) adjacent to the bottom of the Achilles Tendon. 

Causes

In mamny cases the cause is unknown, but abnormal biomechanics of the foot, such as a tight Achilles Tendon, or poor footwear and over-training in runners may contribute to the problem. 

Symptoms

Haglund's deformity may cause few problems in some people, but in others it can irritate the nearby soft tissues such as the restrocalcaneal bursa and Achilles Tendon causing pain at the back of the heel (Haglund's syndrome).

It may also form part of a wider Insertional Achilles Tendinpothay.

Diagnosis

Your doctor may be able to diagnose Haglund's deformity or syndrome from your symptoms and by examining your foot.

X-rays and MRI scans can add further infromation.

Medical treatment

Changing your footwear, heel lifts and Achilles tendon stretching exercises can help to reduce the pain of Haglund's syndrome. 

Surgical treatment

Surgery for Haglund's syndrome may be appropriate if non-invasive measures have failed.

The overgrowth of bone can be removed either by open surgery or arthroscopically (key-hole surgery) and any soft tissue damage repaired at the same time.

Alternatively the bone overgrowth can be made less prominenent by cutting and re-aligning the heel bone (Zadek osteotomy).

Both techniques have shown good results although recovery from the Zadek osteotomy is slower requiring a longer period (up to six weeks) non-weight bearing in a plaster cast or walker boot.