Why is my heel pain not like everyone else’s? Brian’s Foot Story
I first met Brian a month or so ago when he came into the clinic. He’s a Diesel Mechanic and had pain at the back of his left heel that came and went. Brian told me that his wife used to have heel pain too - but that she’d describe it as a sharp pain first thing in the morning, and that’s not what he felt at all. It didn’t feel like a bruise either. His wife tried Googling heel pain and all it seemed to come up with was pain at the bottom of the heel called Plantar Fasciitis - but it didn’t match Brian’s symptoms.
The only incident Brian could remember was having someone run a shopping trolley into the back of his heel about 3 months ago, which is when the pain first started. Examining Brian’s foot, there was a noticeable bump on the back of his heel that looked swollen and red. I asked Brian about his shoes to find that he spends most of his time in his oldest work boots and thongs as with the pain, they’re the only shoes he can wear comfortably.
Brian was actually struggling to get through a work day with the pain.
Thankfully all of the different kinds of heel pain is what we specialise in here at The Podiatrist and I knew exactly what was wrong with him:
Brian has a Haglund’s Deformity.
What is Haglund’s Deformity?
Haglund’s deformity is a bony enlargement (bump) at the back of the heel bone. This bump can be present for years without causing any pain or issues. If the soft tissue near where the achilles tendon attaches into the heel becomes irritated, it can lead to a painful bursitis (inflammation of a fluid filled cushion that sits between the achilles tendon and the heel bone to reduce friction).
Irritation can occur from trauma or even just shoes with a firm heel counter. Other factors that may contribute are having tight calf muscles or achilles tendons, a high arched foot, or a foot that rolls inward or outward too much.
Brian had a classic case of Haglund’s deformity, brought on by the shopping trolley incident. On examination he had a similar deformity on the other foot that he had no idea about. He had a large bony bump with swelling, heat and pain where the achilles tendon inserted into the heel. Likely brought upon by his limping, he was also very tight in his calf and achilles tendon, and he had a tendency to roll out (supinate) when walking.
Brian had x-rays taken to show the size of his deformity on both feet that also showed he had not only the bony bump but spurs (bony outgrowth) on both feet.
Treatment for Brian included icing the swollen area and starting to gently stretch the back of his leg. While the inflammation was settling down, we put some heel raises in his shoes to relieve tension away from the tight leg muscles and soft cushioning for the bump on the heel in his shoes.
Brian responded quite quickly and his pain was manageable after only 2 weeks. To stop the pain from coming back long-term, Brian was fitted with custom orthotic devices (made from 3D scans of his feet!) to stop the way his feet roll out (supinate) from contributing to his pain coming back. Brian has promised to look for softer heeled shoes in the future and avoid grocery stores!
Good luck Brian and we’re glad we could make a difference and eliminate your heel pain!
Here at The Podiatrist we don’t just treat your symptoms but also ensure you don’t keep suffering from the same pain again in the future! Pain is not a normal part of life and shouldn’t have to be put up with. Even if you’re like Brian and the cause of your pain may not be so obvious or well known, our expert team specialises in heel pain and will help you get back on your feet and get back to doing the things you love!
About the Author
Kylie joined our team of Podiatrists at the beginning of June 2013. Kylie brings with her, a wealth of experience and knowledge within the Podiatry field. Kylie graduated from QUT in 2004, and returned to her home town of Toowoomba to work for two years. She then worked in the UK for 3 ½ years, where sheran 3 busy biomechanical clinics. While working in the UK, Kylie has treated high profile athletes, and has also rehabilitated a patient who was told he may never walk again after a motorcycle accident. Kylie is passionate about podiatry and loves helping people and relieving their pain.