Haglund's Syndrome & Deformity
Haglund's Syndrome is a condition that occurs at the back of the heel when you are suffering from Achilles tendonitis and bursitis in the retrocalcaneal bursa. The retrocalcaneal bursa is a small fluid-filled sac at the back of the calcaneus (heel bone) that allows the Achilles tendon to slide smoothly over the heel bone.
Achilles tendinitis (also spelled tendonitis) is inflammation in the Achilles tendon, often due to irritation and/or micro-tearing of the collagen fibers. Achilles bursitis occurs when the retrocalcaneal bursa is irritated from frequent pressure and it becomes inflamed. In some cases, the inflamed bursa also becomes infected with bacteria (referred to as septic bursitis) and it is necessary to see a doctor to get rid of the infection.
Haglund's Deformity is a painful, enlarged boney protrusion of the upper posterolateral calcaneus that is caused by calcification of the heel bone due to the inflammation of Haglund's Syndrome. Unfortunately, the boney protrusion causes further irritation to the retrocalcaneal bursa and achilles tendon due to excess compression of the Achilles tendon and bursa between the protrusion and the back of shoes or other footwear. This increased irritation than causes Haglund's Syndrome to become worse.
Due to similar symptoms and the location in the Achilles tendon area, Haglund's Syndrome is frequently misdiagnosed as Achilles tendonitis.
Symptoms of Haglund's Syndrome
Sufferers of Haglund's Syndrome may experience:
- Pain at the back of the calcaneus and up the Achilles tendon, especially with jumping, hopping, tip-toeing, walking or running uphill or on soft surfaces.
- Stiffness in your Achilles tendon when you wake in the morning.
- Tenderness, warmth and swelling which might make it difficult to wear certain shoes.
- As the retrocalcaneal bursa becomes more inflamed you will experience swelling. Swelling can cause difficulties moving the affected area and the range of motion in the ankle is usually affected.
- Limping due to the pain may occur.
- Possibly a fever if you are suffering from septic bursitis (You will need to see a doctor for medication to get rid of the infection).
- The Achilles tendon and retrocalcaneal bursa are irritated by heat but feels good when treated with cold compression and rest.
- Weakness in the Achilles tendon and gastrocnemius or soleus muscles can develop as the pain worsens and the inflammation in the area spreads.
- For individuals who wear high-heeled shoes frequently, they may also feel an increase in pain when they are wearing flat shoes. When wearing high-heels, the calf muscles and Achilles tendon remain in a shortened position. When flat shoes are worn it causes the calf muscles and Achilles tendon to stretch more than usual causing the tendon to tighten around the heel bone and the tendon and bursa become irritated.
Risk Factors for Acquiring Haglund's Syndrome
Haglund's Syndrome is a very common runner's injury as well as with other athletes. It often results from sport footwear (i.e. runners, golf shoes or hockey skates) frequently compressing the retrocalcaneal bursa and Achilles tendon while participating in sports.
Women aged 15-35 who wear high heeled shoes also have a high incidence of Haglund's Syndrome and Deformity. It is thought that the pressure on the Achilles tendon and retrocalcaneal bursa is made worse by the height of the heel. Due to the relationship between women's shoes and Haglund's Syndrome, the swollen bump that forms at the back of the heel because of this condition is often referred to as "pump bump".
It is important to treat Haglund's Syndrome in the early stages to reduce the symptoms, minimize damage and maintain motion and strength in your foot. Resting your ankle, using proper cushioning, wearing comfortable footwear and reducing any activities that add pressure on your retrocalcaneal bursa and Achilles tendon will help to reduce your pain and inflammation. By treating Haglund's Syndrome in the early stages you are more likely to prevent long-term damage and chronic conditions from setting in.
Conservative Treatment Options for Haglund's Syndrome
Relieving the symptoms of Haglund's Syndrome initially focuses on taking the pressure off the retrocalcaneal bursa and reducing inflammation in the Achilles tendon. This can be done with proper cushioning, inserts, or footwear but may require surgery to reduce the enlarged heel bone if the syndrome is caused by Haglund's Deformity. Preliminary treatment starts with cold therapy. Once initial inflammation has subsided somewhat, begin Deep Tissue Regeneration Therapy treatments to further accelerate the body's own healing process.
The most important factor in healing Haglund's Syndrome (Achilles bursitis and tendonitis) is resting your ankle. This can be difficult when you have to carry on with daily activities, but resting and elevating your foot whenever you can is recommended. During your recovery you will probably have to modify or avoid the activities that put stress on your retrocalcaneal bursa and Achilles tendon until your pain and inflammation settle.
If you are suffering from subcutaneous bursitis or retrocalcaneal bursitis, there is a high probability you are suffering from achilles tendonitis as well. With bursitis and tendinitis both being soft tissue injuries, rest is recommended, however, some careful movement is required to prevent the joint from freezing and losing range of motion. See your doctor or physical therapist for stretches that will not cause further injury to your achilles. Avoid activities that cause pain or may have caused the injury and begin cold compression treatments as soon as possible.
The Achilles tendon and bursae are difficult to rest as they are essential for walking and daily activities. Fortunately, there are conservative treatment protocols that can help treat tendons, muscles and bursae, and speed up the healing process so you can get back to a life without pain and risk of further injury.
Although steroid injections may provide temporary relief from the pain of an a soft tissue injury in the achilles and heel, they should generally be undertaken with caution as they weaken strained tendons... and may lead to a complete rupture. If you do opt for an injection, doctors usually recommend that you do not participate in strenuous activities for several weeks to reduce the risk of a rupture.
Conservative Treatment Step 1: Reduce The Initial Inflammation
Inflammation is the body's natural response to an immediate achilles injury and is a normal part of the healing process - helping to reduce tissue infection in the early stages of injury. Swelling, pain, heat sensation, redness, and loss of function are the main symptoms experienced.
The R.I.C.E. (rest, ice, compression, eleveation) treatment philosophy is used to decrease inflammation and relieve the pain of Haglund's Syndrome quickly when your retrocalcaneal bursa and Achilles tendon are inflamed and painful.
- Rest and limit your activity, to decrease swelling and minimize further inflammation in the Achilles bursa and tendon.
- Cool the back of your heel to help reduce blood flow and fluid build up.
- Compress the area if possible by adding light pressure to minimize swelling (make sure the wrap is snug, but not too tight as it could cause more pain on the bursa).
- Elevate your foot to relieve the pressure from swelling.
Applying cold to your Achilles bursa and tendon will decrease the swelling and redness at the back of your heel. In addition, it will numb the pain in your heel and help to control the inflammation. Simply, apply cold to your ankle as needed throughout the day, for approximately 10-15 minutes at a time.
The combination of rest, topical pain relief cream and cold therapy is the gold standard in medicine for minimizing tissue damage, reducing heel pain and reducing inflammation after injury or activity. It serves as a critical bridge into the next phase of the healing process.
Conservative Treatment Step 2: Enhance Blood Flow to the Injured Soft Tissue
Once the inflammation in the heel bursae and tendons have been reduced, nourishing and strengthening the injured soft tissue is recommended.
It is through the blood that the body carries nutrients, oxygen, and antibodies that injured tissue needs to repair and rebuild. Research shows that electromagnetic energy is a very effective treatment for stimulating blood flow to dense tissues such as tendons, ligaments, bursae, muscles, and even vascular portions of cartilage. This dramatically improves the healing process.
Electromagnetic energy is an energy waveform that is absorbed by dense tissue (muscles, tendons, ligaments) and not absorbed much by less dense tissue (fat cells, skin). Absorption of this energy translates to thermal heat, and the body increases blood flow to the area as a response to this heat. This increased blood flow speeds up the healing process, clearing the area of toxins and excess fluid build up, thereby reducing inflammation. More details on this can be found here.
Electromagnetic Energy is recognized in scientific circles as a legitimate treatment for many forms of muscle and soft tissue injuries.
Conservative Treatment Step 3: Recognize That Healing is a Process
With dedication, the right tools, and the right information - you will achieve your goal of a sustainable recovery. A combination approach of cold therapy, deep heat treatments, and functional movements will make it happen much more quickly. Healing takes a comprehensive approach and will differ from person to person.
If you have questions, we welcome you to call our office toll-free at 1-866-237-9608 (Continental US), or Internationally at +1-705-532-1671.
The Achilles T•Shellz Wrap® - Heal Your Achilles Tendonitis and Haglunds Syndrome For The Long Term
The best option we came across in our research to accomplish faster healing of soft tissue injuries in the achilles is the Achilles T•Shellz Wrap®. Use of this device results in a significant increase in blood flow to the injured tissues located deeper within the body - all in a non-invasive manner.
Have you seen what happens when you add water to a flower wilted from drought? In essence, your injured heel is much like a "wilted" flower; your body wants to heal its injury, but needs lots of nutrients to do it. Blood brings new life to your cells by delivering healing nutrients and oxygen that are vital to your tissue. In addition, the blood carries away toxins and cellular waste cleaning the area and healing it faster. Without a good supply of blood, your achilles simply won't heal properly.
This process is an effective method to treat your swollen and painful bursa, reduce the inflammation in your tendon and improve the health of the soft tissue in your ankle.
Pain and Anti-inflammatory (NSAIDs - Non-steroidal anti-inflammatory drugs) can be used if required to help manage your pain. However, these aren't recommended for long term use, as they can cause gastrointestinal difficulties and increase the risk of cardiovascular disease. The use of cold therapy and Blood Circulation Boost Therapy in conjunction with NSAIDs can greatly improve the effect of this medication and can help to heal quicker.
Using a T•Shellz Wrap® will not expose you to the risk of causing further harm to soft tissue like you can when using rigorous exercise. The Achilles T•Shellz Wrap® accomplishes the goal of enhanced blood flow without the need for intensive exercise and as such reduces your risk of re-injury.
Learn More About Achilles Injuries & Treatments
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