Haglund’s Disease

Haglund’s disease is a rear-foot condition related to a malformation of the heel bone (calcaneus) that is abnormally prominent and aggressive. Its shape is sharp, oriented toward the upper and back of the foot.

This anatomical peculiarity causes repeated friction between the shoe and the back of the heel, which leads to inflammation of the Achilles tendon and surrounding tissues. Over time, this friction from Haglund’s deformity can become painful and interfere with walking, shoe fitting, or sports activity. Understanding his foot condition helps patients seek appropriate care.

Often, Haglund’s syndrome is bilateral, meaning it affects both feet simultaneously, even though the intensity of symptoms may vary from one side to the other. Cases where Haglund’s deformity affects one foot more severely are known as Haglund’s deformity one foot presentation.

Related treatment(s)

MHaglund’s Deformity: Cause and Diagnosis

Haglund’s deformity cause is multifactorial: it most often appears due to a particular anatomical background, associated with repeated mechanical constraints. Several well-identified causes and risk factors can contribute to its appearance and evolution:

• Shoes causing excessive pressure (rigid heel counter, heels, safety shoes)
• Morphological foot factors (such as high arches)
• Sports activity (running, football, tennis, basketball, handball, volleyball…)
• Age (young adults, between 20 and 30 years old)

The Haglund deformity causes are varied, which explains the diversity of profiles that can develop this condition. Whether it manifests as Haglund’s bump, Haglund achilles involvement, or Haglund foot issues, proper diagnosis is essential.

Haglund’s Syndrome: Diagnosis and Examinations

The diagnosis of Haglund’s syndrome is based on precise clinical analysis and targeted medical imaging examinations. This approach allows confirmation of bone malformation, assessment of the Achilles tendon condition, and definition of the most appropriate therapeutic strategy. But who to consult for Haglund’s disease? For this condition, it is recommended to turn to a surgeon specialising in foot and ankle surgery.

As part of specialised care, the diagnosis is made from several complementary examinations, carried out progressively. During the consultation, the surgeon evaluates:

• pain localised at the back of the heel
• presence of a visible and palpable bone prominence
• functional impact on walking, shoe fitting, and sports activity

Radiography is then generally indicated. It allows:

• identification of a calcaneus Haglund deformity (heel bone deformation)
• evaluation of rear-foot morphology
• detection of indirect signs of Achilles tendon tendinopathy

If needed, an ultrasound can be performed as a complementary examination. It allows detection of Haglund bursitis or Haglund’s disease with inflamed Achilles tendon. The presence of tendon involvement modifies the medical approach and may extend post-operative recovery if surgical treatment such as Haglund’s bone spur removal or Haglund’s debridement is considered.

When clinical symptoms suggest tendinopathy but ultrasound does not clearly demonstrate it, an MRI may be prescribed. This examination offers more detailed analysis of tendon structures and soft tissues to refine the diagnosis for better management of Haglund’s disease.

Haglund’s Disease: Symptoms and Clinical Manifestations

Haglund’s disease has progressive symptoms, mainly localised at the back of the heel. Their intensity varies depending on the degree of bone malformation and mechanical constraints exercised, particularly by shoe fitting and physical activity. The main symptoms observed are:

• Pain at the heel level, often persistent, both when walking and at rest
• Visible bone prominence at the back of the heel (Haglund’s heel appearance)
• Inflammation of the Achilles tendon at its insertion (insertion Achilitis)
• Redness and swelling of the heel (local inflammation)
• Sensation of stiffness at the back of the foot, after a period of inactivity
• Retrocalcaneal bursitis (inflammation between the heel bone and tendon)
• Limitation of sports activity, or even complete cessation of certain activities

Haglund’s deformity pain is the most frequently reported symptom. It can become almost permanent, intensify when walking, and sometimes cause limping. Some patients experience Haglund’s deformity with no pain initially but develop it over time with continued pressure on the affected area.

As the condition progresses, simply wearing closed shoes can become particularly uncomfortable, even impossible, directly affecting daily quality of life. The presence of Haglund’s deformity soft lump on back of heel is often accompanied by redness and tenderness.

In case of Haglund’s disease, what to do? The combination of pain, redness, swelling, and sometimes skin lesions constitutes a warning signal justifying specialised consultation.

Haglund’s Deformity of the Foot: Specialised Treatments Adapted to the Stage of the Condition

Before considering a Haglund’s deformity surgical intervention, management always begins with non-surgical treatment, also called medical treatment. This approach represents the first line of care, even though the condition rarely heals spontaneously long-term.

Medical Treatment of Haglund’s Disease

With medical treatment, the objective is to reduce heel pain from Haglund’s disease, limit inflammation, and decrease the constraints exerted on the back of the heel, while monitoring the condition’s evolution.

How to treat Haglund’s disease without intervention? Under the supervision of a specialist surgeon at International Elite Care, several options can be proposed, depending on the patient’s profile and lifestyle:

• Shoe adaptation (wide, comfortable shoes, without rigid heel counter)
• Orthopaedic insoles and heel cups
• Local anti-inflammatory treatment (non-steroidal)
• Functional rehabilitation (targeted stretching, massage, mobility exercises)

Despite these treatments, Haglund’s disease remains progressive due to the underlying bone malformation. Based on follow-up results, intervention may become necessary. If you are considering surgery to treat Haglund’s disease, who to consult? Once again, the foot and ankle specialist surgeon is the most qualified practitioner to obtain satisfactory results.

Surgical Treatment of Haglund’s Disease

At International Elite Care, the intervention is planned by a surgeon expert in foot and ankle pathologies, trained in the most recent surgical techniques.

The most commonly used technique consists of removing the bone prominence of the calcaneus (heel bone), responsible for friction at the back of the heel related to Haglund’s disease. This may involve Haglund’s debridement of surrounding inflamed tissues or treatment of associated conditions like Haglund bursitis.

Two approaches are then considered: open surgery or minimally invasive arthroscopic surgery. When possible, arthroscopy is preferred because it allows:

• Reduction of post-operative pain
• Limitation of damage to surrounding tissues
• Facilitation of functional recovery

The intervention is performed using a camera introduced into the surgical area, allowing great precision. If the Achilles tendon is affected, additional procedures can be performed during the same intervention.

The surgery is performed on an outpatient basis and lasts approximately 30 minutes. Anaesthesia is general or local.

In certain particular situations, a calcaneal osteotomy may be proposed. This technique modifies the orientation of the heel bone to correct the mechanical constraints at the origin of symptoms. It is reserved for specific indications, after thorough analysis.

Our Answers to Your Questions About Haglund’s Bursitis