Podiatrists @ Placentia-Linda Foot & Ankle Group

BEHIND THE HEEL PAIN

ACHILLES' TENDONITIS, HAGLAND'S DEFORMITY

When foot pain and tenderness occurs behind the heel, the usual podiatry causes are Achilles' Tendonitis, Peroneal Tendonitis, Retrocalcaneal Bursitis and Hagland's Deformity.

ACHILLES' AND PERONEAL TENDONITIS:

Achilles' tendinitis is a condition that usually occurs from repetitive injury to the tendon.  The location of the pain is usually two places.  The insertion of the Achilles' Tendon onto the heel is the most common location for Tendonitis.  Another usual location for Achilles' Tendonitis is about two inches above the ankle joint at the Myotendonous Junction.  Peroneal Tendonotis usually results in pain to the outside and back part of the ankle and is caused from excessive guarding of the foot in using the Peroneal Tendons to walk a different way to relieve pain in the foot.  Treatment for both Achilles' and Peroneal Tendonitis consists of resting the injured tendon to varying degrees depending on the severity of the injury.  A night splint for mild to moderate Tendonitis is an excellent treatment along with avoiding heavy activity and the use of anti-inflammatory medications.  For severe Achilles' or Peroneal Tendonitis, casting for four to six weeks is essential for healing the injury.  Cortisone injections around or in the Achilles' insertion should not be performed because a rupture can result.  In patients with flat feet and a history of Achilles' Tendonitis, custom molded foot orthotics are indicated.  

HAGLAND'S DEFORMITY:

Hagland's Deformity is a condition where over years bone develops to the back of the heel bone form shoe pressure or some other pressure being exerted on the back of the heel.  Because the location of the bone growth is at the point where the heel bone ends in the back of the foot, this condition is also called a "Pump Bump".  The pain from this condition varies with the severity of the bone growth in the back of the heel.  Treatment is aimed at reducing the amount of pressure on the heel that is causing the bone to develop.  If the bone growth becomes too large, the condition can become very painful.  Surgical correction involves removing the enlarge bone from the back of the heel.  Usually the Achilles' Tendon must be re-attached to the heel and will require a patient to use a cast after surgery for at least six weeks.  Other than the concern over the Achilles' Tendon, the surgery to correct a Hagland's Deformity is a straight forward procedure that has a high success rate.