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haglunds deformity

Discussion in 'Ask your questions here' started by loislevel, Mar 28, 2010.

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  1. loislevel

    loislevel New Member


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    I have been diagnosed with Haglunds Deformity. It started bothering me in July '09. I compete in Masters Track and field as a Sprinter. I have been prescribed Voltaren Gel, ibuprofen, and Voltaren Tablets. I also have an ultrasound unit that I use on it. There is an occasional soreness in the morning. I was able to finish the indoor season with no problems from the heel. No i am transistioning to the outdoor season. This week, it started bothering me a little more. I was able to train on Wed. but not on saturday. I want to know if there are some other options as far as treatment is concerned? Also, I want to know a little more about the surgery. i am hearing that the achillies would have to be detached. Is this a good thing for a sprinter? Or is it not worth it? What is the recovery time for the surgery?
    Any help would be appreciated.
    thanks,
     
  2. FootDoc

    FootDoc New Member

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    ************************************************** *********
    First of all, I will assume that you really have Haglund's defomity and not insertial osteoarthritis of the Achilles tendon, which may present similarly, but is not difficult to distinguish on x-ray. True Hanglund's defomity is simply a prominence of the slightly-lateral portion of the posterior aspect of the calcaneus, sometimes occasioned by a less than normal or a reverse slope of the posterior calcaneal surface. This can result in a bump which is irritated bt the counter of the shoe, and such irritation when chronic can cause an adventisous bursa to be formed, or an inflammation of the retrocalcaneal bursa. Conservative management involves whatever is necessary to mitigate or negate the irritation from the shoe counter. This may often be accomplished with heel pads inside of the shoe to lift the bump above the counter, or with the wearing of shoes with a very soft counter or none at all, or with padding about the bump to protect it or sometimes an orthotic, when appropriate to correct the position of the heel in the shoe. The bursitis can be treated with local cortico-steroid injections, but as such medication has a propensity to weaken soft tissues, including the very important Achilles tendon, special instructions for limited stressing need to be given the patient to lessen the possibility of tendon rupture, which, although it is not a routine occurrence, is not out of the question.

    When conservative measures have failed or are inadequate, surgery to remove the bump may be considered. If there is normal anatomy, as the bony bump is generally slightly lateral to the insertion of the Achilles tendon, the tendon does not, in my experience, generally have to be detached and re-attached as is often the case with the aforementioned insertional osteoarthritis of the Achilles tendon. The bump is then exposed and resected with care to avoid damage to the sural nerve which courses in the area. Any inflamed bursae, if present, need be addressed as necessary. I generally place my Hanglund's deformity patients in a posterior lower leg and foot splint and have them avoid weight-bearing for a few weeks after surgery. Recovery time varies, but most of my patients are back to normal activities in 2 months or less. There are, of course, as with all surgeries, the possibilities of complications and extended post-operative periods. In the case of a sprinter, although I cannot recall operating one for this purpose, I would think that it might take longer to get back to competition shape, although, in my experience, athletes often have both higher pain tolerance and a greater dedication to post-operative physical therapy.
     
    Last edited: Mar 28, 2010
  3. loislevel

    loislevel New Member

    Thank you. I hope I don't have to go the surgery route. I am not against the shot but am fearful of the effects it may have on the achillies. That would be the worst thing that could happen to me is to rupture the achillies. I would be out of commision for a while. It is amazing how you hear different things from different dr's. The first couple of doc's I went to just said it was a Bone Spur. One had a some special insoles made for me. They were very uncomfortable to run in. I had to go to a University specialist to find out that it was Haglunds.
     
  4. FootDoc

    FootDoc New Member

    I really have to wonder if you actually have Haglund's or if it's the insertional osteoarthritis that I mentioned in my previous post, as that is more analogous to a bone spur. Keep in mind that the when there are two diagnoses of any condition, the second one is not necessarily the correct one. Of the two, I would much prefer Haglund's.
     
  5. Unregistered

    Unregistered Guest

    I had the surgery a week ago to the day. I am in a cast and two things are driving me crazy.
    1 they wrapped my little
    Toe in the cast and it rubs .
    2 I feel wetness inside the cast in the packing .
    I cOntacted the ortho and he pretty much was like wait till Monday and we will see then or it's normal.

    I'm not thrilled with that answer . Did anyone else have the same wet feelings? I know I had partial torn Achilles beside the hagulands fixed. I want out of this ASAP and back to working out riding and swimming again. I gained like 30 pounds from the lack of exercise I could do leading to this point and I want the weight off now from when it's over.
     
  6. Unregistered

    Unregistered Guest

    How did the surgery turn out? Are you back to normal? What options did you try before the surgery? I am considering buying a home ultrasound machine to treat it. Thanks.
     
  7. Unregistered

    Unregistered Guest

    I have had the surgery on both heels. The right one five years ago and the left two weeks ago. I was off crutches after two weeks. The right has felt completely better and I can now bear weight on the left, although I am in a walking cast for the time being.
     
  8. jet958

    jet958 Guest

    I have had the heel pain for several years maybe 4. I finally went to the doctor and was diagnosed as having Haglunds Deformity, a calcaneal spur and calcific tendinitis. I did the six weeks of physical therapy which included the ultrasound, the electrical ion pack stuff and very little exercise/stretching. It did little to help for five weeks and then all of a sudden the severe pain at the back of my heel went away. I thought I was good, but now I have pain a little higher and in the tendon itself. It has pain and almost feels weak. Its hard to explain the feeling that goes with the pain. I fear that I have put off the surgery and now may have caused partial tears in the achilles tendon. I have a job where I have to be completely healed and 100% to go back to work and my surgeon said that I will be no weight bearing for 6 weeks before going to a walking cast. Then it's therapy to rebuild the muscles from lack of use for 84 days(twice the time you are non weight bearing). This decision is such a hard one on whether to have the surgery or not, as the pain has changed and isnt as bad as before.
     
  9. Unregistered

    Unregistered Guest

    I had surgery on my Haglund's 12 weeks ago and am still having pain. The pain is in the same area as before the surgery, and actually hurts more than before surgery. The dr ordered a gel for pain and inflammation when I went in three weeks ago, it does not seem to do much, is expensive $48 (small bottle that has to be compounded), and is not covered by insurance. Unless I keep it wrapped, the whole outside area of my foot swells up, and I have enough pain that I am usually limping. I was in PT, but the dr asked if I thought it was doing any good, I said no, and he said to quit. I really want to be at a point where I can walk without pain and start exercising.
     
  10. Unregistered

    Unregistered Guest

    I have a question regarding Haglunds Deformity. If the "pump bump" appears does that indicate the presence of a bone spur? Is it possible to catch the problem early when it is just inflammation or does the "bump" automatically mean a bone spur has already developed?

    Thanks.
     
  11. bSUE

    bSUE Guest

     
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