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

Symptoms:

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

Throbs

Tightness in the Achilles

Conservative treatments:

See 1) NSAIDS such as motrin, etc if tolerated

2) Physical therapy

3) Home stretching excercises

4) Ice

5) Avoid shoes that rub on that area.

6) High Energy Shockwave therapy

7) Platelet Injections

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:
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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.

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Serving Southwest Florida Since 2005, Family Foot & Leg Center has 9 convenient locations throughout Collier, Lee, Charlotte, and Sarasota Counties. Offering pediatric to geriatric family care: Ingrown Toenails, Heel Pain, Bunions, Foot / Ankle Arthritis Pain, Plantar Fasciitis, Foot / Ankle Surgery, Custom Orthotics, and Diabetic Wound Care. In office X-rays, ultrasounds, and minor surgical suite exam rooms. Practice powered by EMR and advanced technologies. Home of the Lam Minimal Invasive No-Scar Bunion Surgery! Come Discover Why Patients Love Our 5-Star Foot & Ankle Care! Same Day Appointments! Easy Online Appointment Scheduling!

Dr. Kevin Lam, D.P.M., F.A.C.F.A.S.

Dr. Kevin Lam, DPM, FACFAS, DABLES, DABPS is Clinical Director of Family Foot and Leg Center, PA — Southwest Florida’s premier podiatric practice. He earned his Doctor of Podiatric Medicine degree with honors from Temple University School of Podiatric Medicine and completed advanced surgical training at Mount Sinai Medical Center and Jackson Memorial Health System, Miami. Named among America’s Top Podiatrists. Board-certified in foot surgery, reconstructive rearfoot and ankle surgery, and lower extremity surgery. Serving Southwest Florida since 2005 across 9 locations from Marco Island to Sarasota.

Written by Dr. Kevin Lam, D.P.M., F.A.C.F.A.S.

Dr. Kevin Lam, DPM, FACFAS, DABLES, DABPS is Clinical Director of Family Foot and Leg Center, PA — Southwest Florida's premier podiatric practice. He earned his Doctor of Podiatric Medicine degree with honors from Temple University School of Podiatric Medicine and completed advanced surgical training at Mount Sinai Medical Center and Jackson Memorial Health System, Miami. Named among America's Top Podiatrists. Board-certified in foot surgery, reconstructive rearfoot and ankle surgery, and lower extremity surgery. Serving Southwest Florida since 2005 across 9 locations from Marco Island to Sarasota.

New Northeast Naples location Coming Soon!

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

Written by Dr. Kevin Lam, D.P.M., F.A.C.F.A.S.

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