achilles tendon injury -
Haglunds deformity
Haglund's Deformity is an enlargement of the bone on the back of the heel that most often leads to painful bursitis because it becomes irritated by shoes. In Haglund's Deformity, the soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against the shoes being worn.
It normally appears as a red, painful, and swollen area in the back of the heel bone. Women tend to develop the condition more than men because of the irritation from rigid heel counters of shoes rubbing up and down on the back of the heel bone. Another name for Haglund's Deformity is "pump bump". The rigid backs of the pump-style shoes can create pressure that aggravates the bone enlargement when walking. Haglund's Deformity is most common in young women who wear pumps often.
achilles tendon injury -
Causes of Haglunds deformity
To some extent, heredity plays a role in this deformity. Some people can inherit the bone structure that makes them prone to developing Haglund's Deformity. High arches is a major factor of this deformity. The Achilles tendon attaches to the back of the heel bone. With having high arches, the heel is tilted backward into the Achilles tendon. This would cause the uppermost portion of the back of the heel bone to rub against the tendon. Eventually, due to thia constant irritation, a bony protrusion develops and the bursa becomes inflamed. It is the inflamed bursa that produces the redness and swelling associated with Haglund's Deformity.
A tight Achilles tendon can also attribute to Haglund's Deformity, causing pain by compressing the tender and inflamed bursa. In contrast, a flexible tendon would cause less compression against the bursa. Another possible contributor to Haglund's Deformity is a tendency to walk on the outside of the heel. This tendency, which produces wear on the outer edge of the sole of the shoe, causes the heel to rotate inward, resulting in a grinding of the heel bone against the tendon. The tendon protects itself from forming a bursa, which eventually becomes inflamed and tender.
achilles tendon injury -
Diagnosis of Haglunds deformity
The patient is evaluated after the symptoms are explained and the foot will be examined. In addition, X-Rays will be ordered to help better evaluate the structure of the heel bone.
achilles tendon injury -
Symptoms of Haglunds deformity
A bump on the back of the heel.
Pain at the achilles tendon insertion into the heel bone.
Redness and/ or swelling at the back of the heel.
Irritation when wearing certain shoes.
achilles tendon injury -
Treatment: Non-surgical Approaches
Relief of the symptoms is often achieved through treatments that can include a combination of the following:
P - R - I - C - E
Protection - Your ankle may be splinted, taped or braced to prevent further injury. |
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Rest - You should rest from all activities that cause pain or limping. Use crutches/cane until you can walk without pain or limping. |
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Ice - Place a plastic bag with ice on the Achilles for 15-20 minutes, 3-5 times a day for the first 24-72 hours. Leave the ice off at least 1 1/2 hours between applications. |
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Compression - Wrap an elastic bandage from the toes to mid calf, using even pressure. Wear this until swelling decreases. Loosen the wrap if your toes start to turn blue or feel cold. |
Elevate - Make sure to elevate the ankle above heart level (hip level is acceptable during class). |
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Oral medication. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation.
Injections. Sometimes cortisone is injected into the area to reduce the inflammation and pain.
orthotics. If the biomechanics of the foot is faulty it will contribute to mechanical stress behind the heel increasing the chances of irritation from the boney growth. Orthotics can control these unwanted mechanical forces and significantly improve symptoms. A specialist called a podiatrist can help with provision of orthotics.
If the condition is severe. Immobilisation of the ankle may help, particularly when partaking in strenuous activity.
When is Surgery Needed?
Most patients’ symptoms improve with non-surgical treatment. However, in some patients, surgery may be required to relieve the symptoms. Surgery typically involves removal of the the bony lump.