Synonyms
Haglund heel, Haglund exostosis, Haglund exostosis, Calcaneus altus et latus
Definition
The Haglund heel is a shape variant of the heel bone body, which is prominently formed in its lateral and back part and can therefore lead to pressure pain in the shoe. The Haglund’s heel often occurs in connection with a heel spur.
Anatomical Structure
The heel bone (calcaneus) is part of the foot and is involved in the shaping of the lower ankle joint. Numerous ligaments, tendons and muscles are attached to it. The Achilles tendon is attached to its dorsal part.
By pulling the Achilles tendon, the foot can be lowered and the tip-toe position can be taken. Some small foot muscles and the plantar fascia (plantar aponeurosis) responsible for the longitudinal arch of the foot originate from the lower part of the calcaneus. Towards the front, the heel bone is connected to the tarsal bones, and upwards via the lower ankle joint to the ankle bone (talus). CT foot laterally:
- Metatarsal bone (Os metatarsale)
- Sphenoid bone (Os cuneiforme)
- Scaphoid (Os naviculare)
- Cuboid bone (os cuboideum)
- Hock leg (talus)
- Heel bone (calcaneus)
- Shinbone (Tibia)
- Achilles tendon
Cause and origin = Ethiopathogenesis
In Haglund exostosis (also known as Haglund heel), there is increased ossification at the base of the Achilles tendon at the heel, which causes pressure pain in this area, especially when wearing shoes. The cause of the ossification has not yet been fully clarified. On the one hand, there is the theory that Haglund’s exostosis is congenital, while other experts suspect that the disease may also be caused secondarily by overloading the Achilles tendon with subsequent Achilles tendon inflammation or even poorly-fitting footwear.
It is being discussed whether a combination of these factors can also be the cause, i.e. whether the Haglund exostosis is partly congenital and can be worsened by incorrect/overloading of the heel. This theory is supported by the fact that Haglund exostosis occurs very frequently in young, active people. Especially the pressure of the shoe edge on the calcified tendon attachments provokes pain and often leads to secondary bursitis in this area. These manifest themselves as severe discomfort when running, pronounced pain under pressure and in many cases swelling, redness and overheating of the tissue.
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