A Haglund deformity is a bony prominence at the upper back of the heel bone. It may rub against shoes and irritate nearby bursae or the Achilles tendon attachment. However, a prominent bone shape does not cause symptoms in everyone.
A sudden snapping sensation with loss of push-off strength may indicate an Achilles tendon rupture and should be examined promptly.
Causes and risk factors
Foot and heel shape, shoe pressure and repeated loading can interact. Changes at the Achilles tendon attachment often coexist. These must be distinguished from problems in the middle portion of the tendon.
Typical symptoms
Pain at the back of the heel, tenderness and swelling are typical. Firm heel counters can be uncomfortable. Running, walking uphill or pushing off through the forefoot may worsen symptoms.
Diagnosis
We examine the bony prominence, bursae, Achilles tendon and movement. X-rays show the bone shape; ultrasound or MRI may provide further information about the tendon when appropriate. Findings are compared with the location of the pain.
Non-surgical treatment
Soft or adapted heel counters, temporary activity changes and sometimes a heel lift may reduce pressure. Exercises are adapted for insertional symptoms: lowering the heel deeply over the edge of a step can be irritating in this situation. Insoles are selected after examination.
Surgical options
For persistent, significant symptoms, removal of the prominence and, if necessary, treatment of diseased tendon tissue may be considered. This requires individual planning by a foot surgeon. We assess whether specialist care would be appropriate.
Aftercare and rehabilitation
The progression of activity depends particularly on tendon involvement. After surgical tendon treatment, a protective boot and a longer period of reduced weight-bearing may be needed. Return to sport is guided by strength and function, not a fixed date alone.
Common questions
Is this the same as a heel spur?
A Haglund prominence is at the upper back of the heel. The common plantar heel spur is underneath the heel; the symptoms differ.
Can a different shoe help?
A softer heel counter that avoids pressure can reduce irritation. Associated tendon symptoms often need additional measures.
Arrange a consultation
We discuss which treatment is suitable for your findings and which procedures are available within our outpatient service during a personal consultation. Outpatient operations take place at an external surgical centre.
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Further reading
Selected external resources about this condition. Some linked publications are in German.
Medical background
Sources & further information
These professional and patient resources provide further information about this condition. The text on this page is independently written.
NHS: Posterior heel painNHS: Insertional Achilles tendinopathy