The back of your shoe rubs against your heel—again. After a long day on your feet, the pain is sharp, your heel looks swollen, and the bump near your Achilles tendon seems more inflamed than usual. That hard lump isn’t just a blister; it might be Haglund’s deformity, a painful bone enlargement often worsened by the wrong shoes and too much pressure.
At Austin Foot and Ankle Specialists, Dr. Craig H. Thomajan and his team have seen how Haglund’s deformity can disrupt everyday life. Fortunately, for many patients, surgery isn't the first—or only—solution. With conservative care and the right tools, including custom orthotics, it's often possible to reduce irritation, relieve pain, and prevent further damage.
If you've been told you have Haglund’s deformity or suspect that’s what's behind your heel pain, you're not alone—and there’s hope.
What Is Haglund’s Deformity and Why Does It Hurt So Much?
Haglund’s deformity is a bony enlargement that forms on the back of the heel bone, right where the Achilles tendon attaches. This extra bone growth can rub against shoes, causing irritation to surrounding soft tissues.
Why the Right Shoes Make a Big Difference
The nickname “pump bump” comes from the classic trigger—rigid-backed dress shoes (especially women’s pumps). But any tight or stiff footwear can aggravate the area, especially if you have a naturally high arch or a tight Achilles tendon. Over time, this repeated friction leads to:
- Swelling and redness near the heel
- Sharp or aching pain when walking, especially in certain shoes
- Increased risk of bursitis, the inflammation of the fluid-filled sac between the bone and the tendon
Even though the bone itself isn’t inflamed, it causes a domino effect of pain and dysfunction. That’s why reducing pressure and improving biomechanics is key.
How Custom Orthotics Help with Haglund’s Deformity
Custom orthotics are not a cure for Haglund’s deformity, but they play a crucial role in managing the condition non-surgically. Designed to support your unique foot structure, they address some of the primary causes of irritation.
Correcting the Source of Pressure
Many patients with Haglund’s deformity also have high arches, tight calves, or abnormal foot mechanics. These factors increase strain on the heel and Achilles tendon, potentially leading to Achilles tendinitis. Orthotics can:
- Redistribute pressure across the foot to reduce stress on the heel
- Control abnormal motion, especially overpronation or oversupination
- Support the arch to offload the back of the heel during movement
- Cushion the heel, absorbing shock that might otherwise inflame the tissue
When your feet move in better alignment, that bone bump gets less pressure—and your pain begins to ease.
Orthotics Are Just One Piece of the Treatment Puzzle
While orthotics offer significant relief for many patients, they work best as part of a comprehensive, individualized treatment plan. Depending on your symptoms and foot structure, your podiatrist may also recommend:
- Heel lifts or pads. These reduce the pull of the Achilles tendon and lessen direct pressure on the bump.
- Stretching routines. Tight calves and Achilles tendons contribute to pain—daily stretches can help.
- Anti-inflammatory medications. Oral or topical NSAIDs may reduce swelling and discomfort.
- Physical therapy. Techniques like ultrasound or massage can relieve soft tissue inflammation.
- Footwear changes. Backless shoes or those with soft heel counters minimize aggravation.
Custom orthotics support these efforts by maintaining better biomechanics throughout the day.
When Pain Persists Despite Conservative Care
Some cases of Haglund’s deformity prove stubborn. If you’ve tried orthotics, physical therapy, and other non-surgical methods without relief, your doctor might consider more advanced options.
Corticosteroid Injections: Use with Caution
In some cases, a targeted corticosteroid injection may reduce bursitis-related swelling. However, this treatment carries risks—especially near the Achilles tendon. Repeated injections could weaken the tendon and increase the risk of rupture, so your provider will weigh this carefully.
Surgical Intervention as a Last Resort
Surgery may be necessary if the bony enlargement becomes too painful or restricts your mobility. Procedures vary but often involve removing the excess bone and smoothing the heel to prevent further irritation. Recovery can take several weeks to months, but many patients return to activities pain-free after healing.
The goal is always to exhaust conservative care first—and for many people, orthotics play a central role in that success.
What to Expect from Custom Orthotics at Austin Foot and Ankle Specialists
At Austin Foot and Ankle Specialists, your orthotics aren’t just “shoe inserts”—they’re medical devices tailored to your exact needs. That process includes:
- Detailed gait and pressure analysis. Understanding how your foot moves helps target treatment.
- 3D foot scanning or casting. These high-tech molds ensure a perfect fit.
- Customization for your condition. Your orthotics will account for Haglund’s deformity and any coexisting concerns like flat feet, high arches, or tendonitis.
- Follow-up adjustments. If your pain patterns shift or your feet change, your orthotics can too.
Properly fitted orthotics do more than relieve symptoms—they may help prevent future problems by supporting better foot function.
Understanding Heel Pain Is the First Step Toward Relief
Heel pain can be more than just annoying—it can reshape your life, keeping you from staying active, working comfortably, or enjoying time with loved ones. Whether your Haglund’s deformity just flared up or has been bothering you for years, understanding your treatment options gives you power.
Custom orthotics don’t make the bone bump disappear, but they can make living with it a lot more comfortable. With a full toolbox of conservative care strategies, Dr. Thomajan and the team at Austin Foot and Ankle Specialists are dedicated to helping patients get back on their feet, one step at a time.
