Although bursae helps to reduce friction, it can become inflamed and irritated when the back of the heel rubs against the back of shoes when walking. This leads to bursitis, also known as the inflammation of the bursae. Bursitis will then lead to calcium buildup in the heel bone– when in combination with Haglund’s deformity, the lump will become bigger and more painful. 

• Wearing tight shoes
• Wearing stiff shoes

• Bony bump on the back of your heel
• Sensitivity or extreme pain in your Achilles tendon while walking
• Worsening pain while walking
• Swelling in the bursa at the back of your heel
• Redness at the affected area
• Callusing, bruising, or blistering of your heel

However, if left untreated, the condition can worsen and develop into severe pain in the heel area. This starts becoming especially noticeable when wearing shoes and while walking.

However, there are several factors that increase your risk, these are:

• Gender: women are more prone to developing Haglund’s deformity due to the use of high-heeled shoes.
• Genetics: individuals with a certain type of bony structure in their heel are more prone to developing Haglund’s deformity.
• High foot arch: in individuals with high arches, their heel tilts into their Achilles tendon, this causes a bony protrusion to form together with a bursa, leading to inflammation and swelling.
• Walking on outside of heel: individuals who walk on the outside of their heel will cause the heel to rotate inwards, resulting in friction. This causes a bursa to form which will eventually become inflamed and swell.
• Weight gain: excess weight will cause excess pressure on the heel and thus the development of Haglund’s deformity.
• Runners: constant pressure on the heel against shoes can cause the development of Haglund’s deformity.

• Physical examination: check for a heel bump, signs of injury,  swelling, tenderness, and discolouration in the affected area. 
• Magnetic resonance imaging (MRI): an MRI may be requested to confirm the diagnosis, determine the presence of bursa, and the condition of the Achilles tendon. 
• X-ray: an X-ray will be used to determine the presence of a bony protrusion.

Treatment options include:

• Rest: limit the use of your heel, treat the area with ice and compression.
• Medication: anti-inflammatory medications and painkillers help to reduce inflammation and alleviate pain.
• Physiotherapy: physiotherapy involves gentle and therapeutic exercises that help strengthen your muscles and bones.
• Surgery: surgery can be conducted to remove the bony protrusion or to treat bursitis/tendonitis. 

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There are ways to prevent Haglund’s deformity from developing or getting worse, such as:

• Avoid wearing tight and stiff high heels for long periods of time
• Avoid running on hard surfaces (especially uphill)
• Start wearing open-back shoes
• Start wearing fitted and padded socks with non-slip soles in your shoes
• Stretch regularly to prevent your Achilles tendon from tightening