Monday, December 1, 2014

Lump on back of the heel: Haglund's deformity, Achilles tendonitis, Tendonosis

Lump on back of the heel is the complaint most people put as the reason for their office visit. Diagnosis for this case is:  Haglund's deformity (aka pump bump), Achilles tendonitis / Tendonosis

Burning in the achilles, unable to run, jump or wear shoes due to the rubbing of the achilles. 
Tightness in the Achilles

Conservative treatments:
See 1) NSAIDS such as motrin, etc if tolerated
2) Physical therapy
4) Ice
5) Avoid shoes that rub on that area. 
7) Platelet Injections / Stem Cell therapy

Diagnostic tests:
  • MRI will likely show degeneration, partial tears or chronic inflammation, value of such is questionable. 
  • Xrays are great for seeing the bony deformity that is causing this condition and surgical planning. 

Surgical treatment:
  • Removing of the Bump 
  • Removing of any spurs as indicated. 
  • Removing inflammed or damaged achilles tendon
  • Repair of the Achilles back into the insertion.
Below is an actual FFLC patient preop Xrays and clinical photos. 

Notice the bump right above the achilles insertion
Another view of the swelling
Side view of the painful bump
What is looks like on Xray, Multiple issues to be addressed.
1) Haglund's Deformity (top Arrow)
2) Insertional spur growing into the achilles tendon (bottom arrow)
3) bone cyst / erosion from chronic inflammatory condition. 

Patient is an active runner, pain immediately subsided after surgery. 
"Bump" no longer visible or irritated. 
4 wks in a cast, then another 2 wks in a boot that he can remove to start range of motion excercises. 
Physical therapy and boot to be used for walking at 6 weeks. 
Tens unit can be used to help with the cast disease that develops from not using the limb for some time. 

Overall, this is a very simple surgery to correct the condition.  Technique chosen by your surgeon varies.    I personally prefers to keep the achilles attachment and remove the spurs from varying angles to avoid prolonged recovery.  This also allows for anatomical repair without a question as to where mother nature intended. 

FFLC taking new patients
239 430 3668 option 2 for scheduling or you can request online through our PATIENT PORTAL. 


  1. This sort of article is fascinating and enjoyable to peruse. I cherish perusing and I am continually hunting down useful data like this. joint reconstruction

  2. Lower back pain remedy is the therapy to cure the lower back pain. It happened when we are carrying something heavy and our position is not correct. It will cause "the disk down" (part of our body's bones) raise up, the main spine and bones cards together. Below are 4 remedies to solve back pain problem:does inversion table help back pain

  3. This is truly a great read for me. I have bookmarked it and I am looking forward to reading new articles. Keep up the good work!. double block and bleed

  4. I am happy to find your distinguished way of writing the post. Now you make it easy for me to understand and implement the concept. Thank you for the post. นกเขาไม่ขัน

  5. All you have to do is to take the shoe to your hand and see whether you can bend it ... Based on the severity of Plantar Fasciitis, you can go for the perfect level of ... these details

  6. Absorb your feet a powerless fade arrangement. That CANNOT be protected! foot cramps

  7. This is truly an practical and pleasant information for all. Thanks for sharing this to us and more power Acupuncture Pen

  8. Wow i can say that this is another great article as expected of this blog.Bookmarked this site.. Back pain relief

  9. I enjoy every one of the content, I must say i appreciated, I would really like more details concerning this, due to the fact it is extremely great., Thank you regarding revealing. Hair Care

  10. Hi there, I discovered your blog per Google bit searching for such kinda educational advise moreover your inform beholds very remarkable for me. How quickly does CBD pain cream work for pain?

  11. This comment has been removed by the author.

  12. Allow us to see the general tips on diminishing the spam score level for your website or blog.