Haglund's Deformity surgery anyone?

dmm13,

Am considering Haglunds surgery after many years of pain and not running. I am in Chicago...who do you recommend?

PS thanks so much to all you posters...very informative.

How much help will I need from other people to help me during the recovery process post-surgery? For example, if I live alone, will I have any problems?

HI EVERYONE--I AM HAVING HAGLUNDS SURGERY FRIDAY-NOV. 13 AFTER A 2 YEAR STRUGGLE WITH THIS BEAST OF AN INJURY. I AM A BASKET CASE OVER THE IDEA OF NOT EXERCISING POST-OP--AND BEING ON CRUTCHES FOR A MONTH--I AM ALSO SCARED OF THE PAIN--YA-IM A BIG-49 YEAR-OLD BABY--THIS IS MY FIRST INJURY IN 30 YEARS---AND 90K MILE.....RUNNING IS ONE OF THE MOST OMPORTANT THINGS TO ME-AFTER FAMILY....IT IS NEXT UP...I AM AN ATTORNEY...AND IT MEANS AS MUCH T ME AS MY TICKET TO PRACTICE....SO--YA--I AM FREAKING OUT---ALSO -MY OTHER HEEL IS BOTHERING ME---SO THAT ADDS TO THE STRESS...I AM ALREADY THINKING ABOUT THAT ONE--AND MORE SURGERY-

I NEED A GOON SLAP--AND ALSO MAYBE SOME INSIGHT ON THE RECOVERY...WHAT CROSS TRAINING PEOPLE HAVE DONE...BESIES BIKE ....ELIPTICAL....HOW ABOUT ROWING? POOL RUNNING?

THANKS FOR ANY AN ALL COMMENTS...

HI EVERYONE--I AM HAVING HAGLUNDS SURGERY FRIDAY-NOV. 13 AFTER A 2 YEAR STRUGGLE WITH THIS BEAST OF AN INJURY. I AM A BASKET CASE OVER THE IDEA OF NOT EXERCISING POST-OP--AND BEING ON CRUTCHES FOR A MONTH--I AM ALSO SCARED OF THE PAIN--YA-IM A BIG-49 YEAR-OLD BABY--THIS IS MY FIRST INJURY IN 30 YEARS---AND 90K MILE.....RUNNING IS ONE OF THE MOST OMPORTANT THINGS TO ME-AFTER FAMILY....IT IS NEXT UP...I AM AN ATTORNEY...AND IT MEANS AS MUCH T ME AS MY TICKET TO PRACTICE....SO--YA--I AM FREAKING OUT---ALSO -MY OTHER HEEL IS BOTHERING ME---SO THAT ADDS TO THE STRESS...I AM ALREADY THINKING ABOUT THAT ONE--AND MORE SURGERY-

I NEED A GOON SLAP--AND ALSO MAYBE SOME INSIGHT ON THE RECOVERY...WHAT CROSS TRAINING PEOPLE HAVE DONE...BESIES BIKE ....ELIPTICAL....HOW ABOUT ROWING? POOL RUNNING?

THANKS FOR ANY AN ALL COMMENTS...

Hey, let us know how the surgery goes. I'm debating whether to have the surgery, too. I want to run pain-free again and have the option of having the endoscopic procedure (w/out achilles detachment). I just don't want it to be worse, as a result of the surgery. For example, I can fitness run for about an hour a day in Nike free's through some low level pain, but it flares up a lot when I try to do quality training. I really want to RACE marathons someday, and I feel, after dealing with this for three years, surgery is inevitable. Also, has anyone had both operated on at the same time? I have a month long break from school during which I could be completely lazy, if I wanted, following the surgery. However, at week 5 of recovery, it will be back to business as usual, with school, etc. Anyone have any experience with getting both done at the same time? As I'm told, the recovery usually involves 2 weeks in a cast, followed by 4 weeks in a walking boot (have no experience with walking boots).

Hello,

I live in Carmel, Indiana and have a haglunds

deformity on my right heel. I had ESWT in April 2009

but now 6 months removed it was not successful

as I still have considerable pain. I run 20 mpw and

believe that ultimately I am

going to have to have surgery.

Can anyone recommend a surgeon in or close

to Indianapolis who has performed this type of

procedure?

How long should I

expect for recovery- cast/ crutches, boot, PT?

Also- how long until I can expect to be running again?

HI STOCK_I HAD SAME EXACT THING---LEFT FOOT-LATERAL-and supinate--shoes were nightmare for 18 months----or more---just had surgery here near boston, ma--

SURGERY WAS FRIDAY TO REMOVE BONE-DEBRIDE ACHILLES ATTACHMENT--and it went excellent--prognosis great.

Came off perocets Monday morning-no pain since--now its WEDnesday---GETTING CAST OFF FRIDAY---AND KNOW I NEED REMAIN ON CRUTCHES--NO WEIGHT FOR TOTAL 3 WEEKS---THEN GINGERLY PROCEED WITH SOME WEIGHT ON IT......

THIS WAS A LONG---VERY FRUSTRATING ORDEAL---BUT GLAD I DID IT--AND ITS OVER!!!! IF ANYONE WANTS TO EMAIL ME---GO AHEAD---OR EVEN CALL---978-979-0369

I'm in next Thursday (December 10th) to get mine done. Can hardly wait!! It has been a year+ since I could run.

Has running in Nike Free shoes (with or without orthotics) been tried? I've had several patients that had this condition for 1 year plus, swear they needed surgery. They tried these shoes with a soft heel counter and a few months later they're back to running normally. I had one patient cancel the week of surgery because she got better by the time the surgery date came.

If there is actual calcification or tears inside tendon, then the prognosis is poorer vs just "bump" pain for non surgical treatment. Then again this (tendon tear/calcification/heel spur) wouldn't be a true Haglunds Deformity which is just the bump on the back corner of the heel bone and overlying bursitis.

The bump that remains after surgery is usually scar tissue. For my non-athletes I'll actually inject cortisone 2 months after surgery and it helps flatten it down. Of course for my athletes I'm concerned the cortisone may weaken the nearby tendon.

From what I've seen, the biggest difference between going to a sports med vs regular surgeon is not the surgical technique but the post operative protocol. The surgical technique is dictated by the anatomy and pathology whereas the rehab is dictated by the patient's functional goals.

I employ early protected range of motion exercises and protected weightbearing whereas the traditional approach is 4 weeks casted nonweightbearing followed by 4 weeks weightbearing in a cast or boot. And physical therapy is mandatory with the goal of achieving at least 90% strength of the nonsurgical limb and equivalent parameters with regards to range of motion and single leg balance.

dont know much about it, but sounds like it sucks.

OK, here's my cautionary Haglund's surgery tale...I had the surgery in April '09 (52 yrs old, ~ 30 mpw) after months of pain, first trying rest, then PT (iontophoresis) for 3 months, more rest. After much hand-ringing, and probably not enough research, I had the type where the AC is severed to remove the spur. As soon as hard cast came off, a wound developed @ surgery site at the back of my ankle. Surgeon told me no worries, plop some salve in, come back in 2 weeks; this comntinued for ~ 6 weeks as wound worsened; finally went for second opinion & was put on a wound vac 24/7 for 5 weeks to promote bloodflow, tissue growth (wound vac = a "portable" fish pump that sucks at the would via vacuum hose applied to wound; VNA req'd for changing dressings, etc. nightmare!). Finally relized surgeon was clueless re wound care (duh!); fired him & signed on w/ 2nd guy who did recognize problem; entered outpatient wound care at local hospital @ 1/week to treat wound for ~ 6 more weeks; got slightly better but never completely. Infectious disease Drs got in the picture looking for infection (duh!); MRI inconclusive; white blood cell scan showed infection in the calcaneus beneath the wound site where the screw was left from the original surgery to anchor AC to back of calcaneus. Was told I had to have second surgery to remove screw along w/ all the calcaneus around it to remove bone infection ( antibiotic therapy would never completely rid the wound; risk: if too much bone needed to be removed, no running again, maybe not even walking properly); on oral antibiotic therapy for 2+ months. Had to have 3rd surgery to remove antibiotic beads left inside near bone infection/surgery site from 2nd surgery, & to tether AC via suture & surgical button attached to bottom of my heel. Prognosis, thank goodness, is positive now; no signs of continued infection, wounds( now 2 surgical incisions) are healing properly. And that's where I am now...I get "unbottoned" in 2 weeks after >10 weeks on cruthches and boot & no weight on the foot,& then I get a walking boot, then gradually lose the crutches, then PT to regain use of the AC, leg, foot & hopefully begin running in April,a full year after original procedure which I expected to keep me down 8-10 weeks.

So, like I said, a cautionary tale. Probably among the "worst case" scenario outcomes they gloss over when describing what a relatively simple procedure Haglund's surgery is. I'm currently plus 20 lbs, in the hole several $K (despite decent insurance), & have had an eye-opening medical experience that hopefully will result in nothting worse than a year's running loss. Hindsight, the first Dr. didn't know what a wound was or how to diagnose the cause of one or properly treat one. He seemed to check out OK, a runner himself, trainer, etc. I guess the message is make sure to get good, reliable recos & check the win/loss record of whoever you decide to work with.

I have a couple quick questions. First, a little background. I have been having Achilles pain since October (helped a girl change a tire, started running again and had pain), since then I've been able to manage it until January. As of Jan, I ran a race, wasn't able to compete at the level I wanted due to pain and the limp causing problems with my other leg. At this point I took a few weeks off, and started back running. It was then that I got an MRI and learned I had a Haglunds Deformity. No change, then I got into a boot for 30 days to try and lessen the pain.

I have started running again lightly and still have lots of pain the Achilles. I have been trying to avoid surgery at all costs, and trying to manage the discomfort, but I cannot train at the level I need to in order to remain competitive.

My question is has anyone been able to use PT or any sorts of drills, stretching, exercises to manage the pain and run successfully? (I'm hoping to maintain 100-125 mpw).

If not, and you had the surgery, where did you get it done, who did it, and your thoughts. I am looking at having the surgery done arthoscopically so that the AT doesn't have to be involved. I don't want to, but at this point have started contacting surgeons because I don't think I can avoid it. I just want to re-iterate that I am only having the pain in my Achilles, and the actual heel doesn't seem to be giving me many problems.

Thanks for your time.

I am a British runner and I had surgery to remove the haglunds boney lump and an inflamed bursistis 3 and a half weeks ago.

I didn't realise how serious this issue was until Jn of 2010 but its been effecting me to one degree or another since 2008 - I was only in Dec of last year that it got so bad that I couldn't run at all.

Anyway - I had the surgery and I've had it done without them unattaching the achilles tendon. This was possible for 2 reasons - One my bump/pain/bursitis were lateral so the surgeon was able to come in from the side not the back. 2 - The surgeon is world class and realises that unattaching the tendon is bad news for a runner and had the skill to avoid doing it.

So far my recovery is going exactly the plan. 2 weeks in a cast NWB, into a walking boot with crutches gradually increasing the weight through it by less pressure through the crutcvhes - should be crutch free by this time next week.

I can't do any rehab at all (for fear of agrivating the bone and encouraging it to grow!) for the first 6 weeks. All I can do is a small ammount of stretching. 1 week into 30 seconds of stretching per day and I have almost a full ROM (better than it was pre surgery already!) My physio is also what I would consider world class in treating runners and I have 100% confidence in his rehab program and the job my surgeon has done.

Just a matter of time now and not being impatient and doing things too soon as it feels great at the moment.

So - morale of the story is as follows: Find a surgeon and a physio you have 100% trust in and follow their advice to the letter!

Hi,

On the following any input would be appreciated, i am struggling to make an informed decision.

I am 27, very active- martial arts/ climbing/ running/ cycling. In fact i type this in an ache ridden state from a 127 mile charity bike ride yesterday!

So starts the monologue...

I have had a 2 1/2 year history of insidious onset unilateral left heel pain. (although i do seem to remember a vague history of similar when in teens).

At the time low mileage running/ climbing/ dojo training etc.

Multiple investigations followed a six month trial anti-inflamatories/ RICE/ massage/ eccentric load bearing PT/ 1 year abstinance from running/ shoe fitting post treadmill analysis/ arch supports/ heel lifts/ focussed achilles/ gastroc/ soleus stretching and topical analgesics.

During the above time i was seen by two consultant, a physio consultant and a physio practitioner whom tried to 'recreate symptoms'. I had one trial of cortisone injections and spent over six months in crocs with no pressure on heels. I have never been a fashionista with any concern on wearing 'pumps'.

From an investigation point of view i have had all view plain xrays, two MRI scans/ one CT scan/. Ultra sound scans pre/ post treadmill run.

I have since obtained a second consultant opinion from a recommended foot and ankle specialist. (previous consultant advised i live with the pain or advised a closed wedge calcaneal osteotomie).

Now- pain is constant, ache, stiff, worse in the morning, Nothing has aleviated the pain yet conversley nothing bar direct pressure makes it worse. Pain is 4/10 always. I have bilateral pain now.

Achilles-not tight.

Arches-high

Bony protrusion-haglunds bilateral red/ swollen.

Achilles tendon (on MRI 'virginial' not calcified/ torn at all)

Low lying soleous insertion.

Lost relative muscle mass in lower limbs.

2nd consultant has advised due to no tendon involvement the biomechanics will cause NO further problems simply pain. I am now nearing the end of the 3month trial of training how i want to live.

I run twice/three times week 10k's or less, i train barefoot in a dojo twice a week. I do not climb. I walk the dog greater than 3miles day. I only wear crocs or nike frees. I Run in vibram five fingers. (all to reduce posterior heel pressure). I stretch twice daily with powerstretch and sleep with feet elevated. Some hillwalking too.

the crux is this.. This consultant has stated the only option now if this all does not work is to have a operation. I have clarifed due to where pain is (low insetional) from lateral to medial the bumpectomie would require disconnection of tendon and reattactchment with bone screws into cancelous area. The approach would be a j shaped incision. I have read lots about scar tissue/ rehab/ but have been given expectation of 2week equinous cast, followed by boot with slow return to weight bearing.

So sorry its a lot of info but would really appreciate any opinions. Thanks

Hi,

Apologies if etiquette lacking, not sure if new thread is way forward so as not to hijack others 'issue'.

On the following any input would be appreciated, i am struggling to make an informed decision.

I am 27, very active- martial arts/ climbing/ running/ cycling. In fact i type this in an ache ridden state from a 127 mile charity bike ride yesterday!

So starts the monologue...

I have had a 2 1/2 year history of insidious onset unilateral left heel pain. (although i do seem to remember a vague history of similar when in teens).

At the time low mileage running/ climbing/ dojo training etc.

Multiple investigations followed a six month trial anti-inflamatories/ RICE/ massage/ eccentric load bearing PT/ 1 year abstinance from running/ shoe fitting post treadmill analysis/ arch supports/ heel lifts/ focussed achilles/ gastroc/ soleus stretching and topical analgesics.

During the above time i was seen by two consultant, a physio consultant and a physio practitioner whom tried to 'recreate symptoms'. I had one trial of cortisone injections and spent over six months in crocs with no pressure on heels. I have never been a fashionista with any concern on wearing 'pumps'.

From an investigation point of view i have had all view plain xrays, two MRI scans/ one CT scan/. Ultra sound scans pre/ post treadmill run.

I have since obtained a second consultant opinion from a recommended foot and ankle specialist. (previous consultant advised i live with the pain or advised a closed wedge calcaneal osteotomie).

Now- pain is constant, ache, stiff, worse in the morning, Nothing has aleviated the pain yet conversley nothing bar direct pressure makes it worse. Pain is 4/10 always. I have bilateral pain now.

Achilles-not tight.

Arches-high

Bony protrusion-haglunds bilateral red/ swollen.

Achilles tendon (on MRI 'virginial' not calcified/ torn at all)

Low lying soleous insertion.

Lost relative muscle mass in lower limbs.

2nd consultant has advised due to no tendon involvement the biomechanics will cause NO further problems simply pain. I am now nearing the end of the 3month trial of training how i want to live.

I run twice/three times week 10k's or less, i train barefoot in a dojo twice a week. I do not climb. I walk the dog greater than 3miles day. I only wear crocs or nike frees. I Run in vibram five fingers. (all to reduce posterior heel pressure). I stretch twice daily with powerstretch and sleep with feet elevated. Some hillwalking too.

the crux is this.. This consultant has stated the only option now if this all does not work is to have a operation. I have clarifed due to where pain is (low insetional) from lateral to medial the bumpectomie would require disconnection of tendon and reattactchment with bone screws into cancelous area. The approach would be a j shaped incision. I have read lots about scar tissue/ rehab/ but have been given expectation of 2week equinous cast, followed by boot with slow return to weight bearing.

So sorry its a lot of info but would really appreciate any opinions. Thanks

Robisca -

I know I'm digging up an old thread here, but what happened with the ankle you had the "bad" doctor do the Haglund's procedure on? Did you eventually make a full recovery? How long did it take?

I feel like I'm in a similar situation. I had a very successful Haglund's surgery on my right ankle in '09, and had the left ankle done in April of this year. Alas, whereas after the '09 procedure I was running at the five month mark, this time I'm six months in and still can't jog a mile - even the pain walking is still intense. Wondering now if it will ever recover on its own or if I should be looking at getting a new MRI and seeing WTF is going on

bump

I am considering surgery. Been deaing with this for quite awhile now. Any one know of a great surgeon in either Ventura county, California or Los Angeles area?

bump