Haglunds Deformity (Heel Pain) and its Physiotherapy Management

Haglunds Deformity (Heel Pain) and its Physiotherapy Management

What is Haglunds Deformity?

An anomaly of the bone and soft tissues in the foot known as Haglunds deformity is characterized by an expansion of the bony portion of the heel where the Achilles tendon inserts. Running, walking, and even wearing specific types of shoes might become uncomfortable. The tendon may thicken first, causing Achilles pain that scrapes against the bone. Numerous physiotherapy treatments can help reduce the pain brought on by Haglund’s deformity. There is a good probability that your heel discomfort will go away if the tendon and bursae can be adjusted. Certain situations will call for additional surgical intervention. Because these situations don’t improve with conservative care alone, surgery is necessary.

Middle-aged persons are most frequently affected by Haglund’s, and women are more prone to get it than males are. People who are overweight, have high arches in their feet, have an excessively tight Achilles tendon, or who walk on the outside of their feet have a higher risk of developing Haglunds. It might be found in just one heel. People more frequently experience Haglund’s deformity in both heels.

Causes of Haglunds deformity:

  • High foot arches
  • Tight Achilles Tendon
  • Increase in weight
  • Injury
  • Over-practice in runners.
  • Tight or poorly fitting shoes.
  • altered foot joint biomechanics as a result of the defective subtalar joint.

Signs and symptoms:

One or both feet may develop Haglunds Deformity. The following symptoms describe this extremely painful condition:

  • On the heel’s back, a prominent hump or increased bony protrusion.
  • Heel pain.
  • Constant sharp feet pain
  • After walking you will limp due to pain.
  • Swelling and pain in the Achilles tendon
  • Mild cases typically show intermittent pain following extended periods of inactivity.
  • Severely restricted ankle joint mobility.
  • Redness and swelling.

Diagnosis:

Physical examination.

Functional tests.

X-rays: To identify bony protrusion

Ultrasound or MRI: Analyze the Achilles tendons and the bursa’s pathology.

Treatments:

Medical treatment:

For pain treatment, anti-inflammatory drugs are advised.

Castings may aid with pain management.

Surgical treatment:

Following surgical therapy, alternatives are considered if the first line of treatment is ineffective.

Removal of bony protrusion: But there is a potential side effect of Achilles tendon injury.

Partial removal of bony protrusion: Achilles tendon avulsion is a serious risk in this procedure.

Closing wedge calcaneal osteotomy.

Physiotherapy Management of Haglunds deformity:

Haugland’s Deformity is conservatively managed in large part by physiotherapists.

Management of inflammation:
  • Cryo therapy.
  • Ultrasound.
  • Hig-intensity laser.
  • Kinesio taping.
  • Eccentric gastrocnemius and soleus exercises
  • Stretching exercises-
    • Achilles stretch.
    • Heel cord stretch.
    • Foot sole stretch.
    • Towel stretch
  • Strengthening and endurance of foot and ankle muscles-
    • Calf raises.
    • Heel drops.
    • Toe curls.
  • Foot foam rolling.
    • The golf ball rolling.
  • Customized insoles or orthotic devices to help control the motion of the foot.
Prevention:
  • modification of aggravating variables to reduce friction between the bursa and the Achilles tendon
  • Avoid wearing shoes with hardbacks.
  • Wearing the right shoe inserts if the patient has a high arch or a tight Achilles tendon.
  • Maintain a healthy weight.
  • For runners: Avoid hard surfaces and uphill
  • Achilles stretches to prevent stiffness

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