Retrocalcaneal bursitis and Haglund’s Deformity are painful conditions involving the back of the heel bone.

A fluid filled sack termed the retrocalcaneal bursa is sandwiched between the back of the heel bone and the Achilles tendon attachment. The bursa functions to decrease the friction from the heel bone on the Achilles tendon during walking. Tight calf muscles, prominence of the heel bone including bone spurs at the attachment of the Achilles tendon can cause inflammation and pain to this region.

The pain associated with Haglund’s Deformity also termed “pump bump” is a result of abnormal friction that occurs from the shoes heel counter against the outer portion of the heel bone. The pain from Haglund’s Deformity is usually more localized on the outside portion of the heel while the pain from retrocalcaneal bursitis usually fans out to the whole back of the heel at the attachment of the Achilles tendon.

Calf stretching, activity limitation as well as inflammatory medications and ice are standard treatment recommendations for both of these conditions. Additional treatments including night splints, cast boots and cortisone injections may be warranted based on the severity of the pain. Firm heel lifts used within an athletic shoe, heeled dress shoes or boots, clogs and most preferably heeled backless shoes are ideal aids in treatment. Heeled shoe wear decreases the mechanical load on the Achilles tendon and bursa during walking which substantially aids to recovery.