For many people, foot pain can become an everyday challenge, particularly for those who wear high heels or spend long hours on their feet. Jane Porter, a retired school counselor, knows all about both.
“I wore high heels for years in the school. I didn’t think anything of it until the pain started. Now I understand how those shoes may have contributed to my problem,” Jane says.
She became acutely aware of a pain on the back of her left heel, realizing that it was persistent and getting worse. She knew that her colleagues spent long days on their feet, too, and sought advice from them. Many fellow educators referred her to their physical therapists or doctors.
Each time Jane would take someone’s advice, it often led her down the path of a new treatment. She was initially diagnosed with plantar fasciitis and wore a boot as recommended, eventually wearing the bottom out of the boot by wearing it for so long. Then she was diagnosed with Achilles tendonitis and given physical therapy.
“I did everything they told me, but the pain just got worse,” she says.
The pain persisted for nearly a decade. She tried shoe inserts, rest, ice and pain medication. Soon wearing shoes with backs became unbearable, and so did walking. Eventually, Jane became almost completely sedentary and gained 50 pounds.
Understanding Hagland’s Deformity
Haglund’s deformity, often referred to as “pump bump,” is a bony prominence located at the back of the heel where the Achilles tendon attaches to the bone. This condition typically causes pain and irritation, especially when wearing shoes with tight backs, such as high heels, but can be diagnosed in men or women.
“It’s called ‘pump bump’ because high heels, with their tight backs, often irritate the bump,” explains Dr. DeKarlos Dial, a podiatric specialist in foot and ankle surgery at Atrium Health Wake Forest Baptist. “Over time, this irritation worsens and can lead to inflammation of the Achilles tendon, and patients may also have a bone spur in this region as well. There’s no one cause, but wearing tight-fitting shoes, overuse and certain foot types can make people more prone to developing the condition.”
Haglund’s deformity can cause a sharp, cutting pain, especially at the back of the heel.
“It feels like someone is cutting the back of your heel with a knife,” Jane elaborates. “I couldn’t even walk on the beach. The pain was so intense that I would avoid activities I once loved.”
Seeking Solutions to Hagland’s Deformity
After about eight years of trying and failing to find relief for her pain, Jane finally learned about Dr. Dial and his expertise. He ordered an X-ray, and Jane had answers and one solitary solution.
“I had been to so many doctors who missed the diagnosis,” Jane says. “But when Dr. Dial did an X-ray, the bump was obvious. I couldn’t believe it had been missed all those years.”
Dr. Dial broke the news to Jane about the Haglund’s deformity bump that he spotted on her X-ray and told her all other solutions were just delaying the inevitable — she would need surgery.
Dr. Dial’s surgical approach involves removing the bony prominence at the heel and, if necessary, repairing the Achilles tendon using specialized bone anchors.
“Dr. Dial didn’t sugarcoat it. He told me, ‘The three reasons to consider surgery are pain, pain and pain,’” she recalls.
Healing and Looking Forward to Living Life Pain-free
The surgery itself is outpatient, but the recovery is long.
“Patients are typically non-weight bearing for 4 to 6 weeks post-surgery,” says Dr. Dial. “They transition into a walking boot and gradually return to normal activity over the following months.”
Jane underwent surgery on both feet, starting with her left in 2022 and her right in 2023. While her left foot healed completely after a year, her right is still in recovery.
“It takes a full year to really heal,” Jane explains. “I’m not panicking like I did with the first one because I know what to expect now.”
But while she recovers, she is looking forward to picking back up some of the activities she loved so many years ago, including walking around amusement parks (she loves the roller coasters at Dollywood) and even riding a unicycle. She had been well-known for this last talent in her church and school communities. Having received a unicycle on her 9th birthday, it was the only toy she had kept from her childhood.
“I look back and wonder how I lived with that pain for so long,” Jane says. “Now, I’m looking forward to riding my bike, walking on the beach and ready to try my unicycle again. Dr. Dial changed my life.”
If you are suffering from foot pain and would like to make an appointment with one of our foot specialists at Atrium Health Wake Forest Baptist, call 336-713-FOOT (3668).