Haglund’s deformity - not what you think it is (4 min read)
Haglund’s Deformity Isn’t the Villain You Think It Is
If you've been told you have Haglund’s deformity, you might’ve walked away thinking you need surgery, injections, or custom shoes for life.
But let’s slow down for a second.
That bony bump on the back of your heel?
It’s common.
It shows up on imaging all the time—even in people who don’t have pain.
So here’s the truth:
Haglund’s deformity has a weak correlation with Achilles tendon pain.
What Is Haglund’s Deformity?
Haglund’s deformity is a bony enlargement on the back of the heel, where the Achilles tendon attaches.
It’s sometimes described as a “pump bump” and can cause irritation, especially with stiff shoes or high-volume activity.
But here’s the key:
Just because you have a bony bump doesn’t mean it’s the cause of your pain.
The Problem with the “Find It, Fix It” Mentality
That bump shows up on imaging all the time—even in people with zero symptoms.
So when someone points to your x-ray and says, “There’s the problem,” you should ask:
“But is it actually the source of my pain—or just something that’s always been there?”
Because Haglund’s deformity has a weak correlation with Achilles tendon pain.
In other words, just because you see it on an x-ray doesn’t mean it’s causing your symptoms.
The Backwards Approach (That Most People Take)
Most people go straight for:
Cortisone injections (which weaken the tendon)
Surgery (which alters your anatomy and can lead to long, frustrating recoveries)
Custom orthotics and expensive footwear (that often don't solve the real issue)
That’s like changing the tires on your car because your check engine light is on.
Wrong system. Wrong solution.
Here’s What Actually Works for Most People
We start with the basics:
Reset – Calm the tendon down.
Reduce aggravating loads, explore temporary modifications to training or footwear.
Restore – Build tissue capacity.
That means progressive loading. Not rest.
Smart strength training tailored to your tendon’s tolerance.
Reload – Return to the activities you love.
Running, hiking, biking— whatever the goal, gradually and strategically.
The answer is rarely injections or surgeries, and it is never the FIRST answer you should try.
So What Should You Do if You’ve Been Diagnosed with Haglund’s?
Step 1: Don’t panic.
Step 2: Don’t rush into irreversible procedures.
Step 3: Work with someone who understands load management, not just foot shapes on x-rays.
You can’t shave a bone into better function.
But you can build a stronger, more resilient tendon that works.
TL;DR
Haglund’s deformity is often a red herring.
Your pain likely has more to do with tendon capacity than bone structure.
Skip the surgery consult (for now). Conservative care works—and it should always be your first step.
Dr Mark Murdoch
Chiropractor, MS Sports Medicine
P.S. We work with people with Achilles pain every day. Book a Discovery Call to learn how to fix your Achilles tendon pain the right way.