Haglund's Surgery - Yes or No and alternatives?

I used heel lifts for 30 years. Cut off the back of the

insoles of your old shoes and put them under the insole of

the shoe you are wearing.

I had the surgery on each foot. I think it depends on the surgeon. I had a great surgeon who had the surgery himself and is an ironman athlete. I chose him as he had done the surgery with great success to many excellent runners and slower runners who are no less dedicated. Everyone I spoke to said they should not have waited to get the surgery. I have had 100% success.

Had the surgery after years of just dealing with it. Had to go under twice, once through the tendon (split it) the other from the side. I would recommend the surgery to everyone. I feel better than I did since my sophmore year of college when I injured it. And have reset all PR's since. If you just get surgery from the side, the recovery is actually really quick, I was back running after 6 weeks or so. You just have to go by feel.

I would say to look for their specialty/fellowship experience and make sure they specialize in the foot and ankle area and have an equivalvent of the US Board Certified Orthopedic Surgeon. But, you sometimes just have to geta good feeling from teh doc.

Good Luck.

Surgery complications on all recent literature is few to none. Its not a complicated surgery escpecially since you have no tendinitis to deal with. Haglunds is becoming more common with the older generation who has consistently ran their whole life.. If you are interested in the exact surgery I believe the surgeon will perform a simple Keck and Kelly procedure and debride your inflammed bursa. If you want to know more about the procedure/complication rates/post op then post your email. Otherwise Id go for the surgery, Haglunds wont go away. Id stay away from a steroid shot too in the achilles area. If youve done NSAIDs/heel lifts/different shoes then there isnt much left for options

Thanks so much for all the advice. I really appreciate it. I will meet with the surgeon in a couple weeks for a consult. I was very impressed with the practice and they work with many of the national sports teams here and are very much athlete-oriented, so I feel somewhat better about that. I have a few more specific questions:

1. His assistant mentioned that they either go through the Achilles (split it) or through the side to get at the bone. The surgeon will have to look at my xrays to determine this, but I'm wondering if one is better than the other? I assumed that sideways would be less invasive and shorter recovery, but I found a case study online (involving Saxena and experience with track athletes) that said the tendon splitting group recovered faster? Since the tendon is fine, I really don't want to mess with it.

2. How long were you non-weightbearing if you only had the bone/bursa removed and the tendon was left alone? Since I rely on walking and public transport to get around, I'm a bit concerned about being on crutches for several weeks. I was told I would be weight-bearing in a boot within days of the surgery. Does that sound feasible?

3. Has anyone had issues with the bone growing back after the surgery? Did you have to get orthotics afterwards or change your shoes, or did you just return to your previous footwear without recurrence?

4. What kind of rehab is required in terms of physio/strengthening? Is it mostly a matter of just allowing the bone and incision to heal (and strengthing the calf after being in a boot/cast)?

Many thanks again. I'm really grateful for your input and advice.

Simple, don't run like me

http://gallery.mailchimp.com/2bce68ec1ae3f7a95fa27bb95/images/mark_wetmore_coaching_beyond_college.jpg

1. Supprised that tendon splitting recovered faster, for me it was 3-4 weeks non-weight bearing after the tendon splitting and about a week after the from the side surgery. My surgeon said he could get to the problem areas better when we goes through the tendon. Though I may have had a bit of additional damage that you don't since I had some tendon detachment which required bone anchors and several bone spurs in other places.

2. 4-5 weeks (split) 2 weeks (from the side, mainly for the incision to heal). But you have to play it by ear. I remember reading some post from a guy that was back running in a 2 weeks, so it all depends.

3. My second surgery for for bone re-growth. Not attached to the bone but I regrew several pieces of calcium in the general area that had to be removed. Low probability though, doc said he hardly sees my situation except in car accident or traumatic damage situations.

4. Rehab was 6 weeks PT for the first no PT for the second. And the PT is really only usefull to get the exercises to do yourself and make sure you don't develop a limp of some compensation issues. They do massage the incision areas to break up scar tissue but you can just do some self massage if you want.

Thanks FE. That's really helpful. I'm working on setting up consults with 2 different drs. and managed to find one of the best ortho clinics in the country (and in Europe) so I feel pretty confident whoever does the surgery will know what they're doing.

Six week return to running sounds awfully optimistic, but it would be nice to at least get back to regular shoes and able to cross-train (gym bike, pool, elliptical) within a month or so of the surgery. A lot of the general info on Haglunds online describes super long recovery times, however most of those seem to be older, sedentary people who've done quite a bit of damage to the Achilles, so hopefully I'm on the shorter side of the recovery spectrum. I really rely on walking and public transport to get around here and it would be hard to be on crutches for an extended period.

Yeah, I went to a butcher for my first haglund's surgery. non-healing incision and staph infection after didn't help. Make sure you go to the best so you won't have any regrets. Just battling through the scar tissue will be tough enough rather than have "the surgeon did the surgery wrong?" in the back of your mind. If only I can go back. 6 years later, I still have the same problem but I really don't have the opportunity to sit on my butt for the next couple months allowing it to heal correctly. This issue sucks and I feel for anybody who's running careers took a turn for the worst with this issue.

I was a bit unclear in my post, I did not mean return to running in those timeframes, I meant weight bearing in a boot since you were mentioning having to get around on public transportation. Just looked back at the running log for recovery times.

Tendon Split: 4 weeks in a splint/cast, 2 weeks in a walking boot, 2 weeks just walking, and then PT and slowly back running over 6 weeks. Total 14 weeks (3.5 months) back to everyday running and training.

Side Surgery: 2 weeks in a walking boot, 2 weeks just walking, no prescribed PT (doc said I could do my own thing), 4 weeks of own PT and slowly getting back in to running. Total 8 weeks (2 months) back to everyday running and training.

Keep in mind it does take time to get back to feeling 100% and you may need a day here and there or crosstraining. I did a lot of massages, found a really good Graston guy (massages with metal tools, no fun), and heal very fast.

But it is super nice to be able to wear dress shoes and run in spikes again. I broke out some dress shoes that haven't been worn since 2003 and I had my second surgery last year. Good luck.

Sorry to hear about your situation, but sitting around doesn't really help it heal any better. My doc said the tendon fibers need to be loaded (ie running, walking, etc) to heal properly or they tend to be weaker and not heal properly. I do sets of 20 calf raises pretty much every hour at work and have since i could walk after both surgeries. Check out Dr. Amol Saxena's (sp?) website, he is the guy that is in California and world renowed for Achilles surgeries.

You may want to go back for a followup and see if you have some calcium regrowth, some stitches that didn't fully dissolve, or some other issues. May go to a different doc and demand an MRI rather than and xray. And find a Graston person to work on the scar tissue if it is a scar tissue problem.

I had problems with Haglunds & cutting out the heel back worked for me. Prior to that I was putting a small square of

mousepad in the back of my shoe with a donut hole cut in the

middle to surround the lump. Worked OK but not as good as cutting out the heel back. I think my mousepad wasn't thick enough.

Before surgery I'd try the mousepad idea in a new pair of larger casual/work shoes to see if that alleviates it somewhat.

Hope this helps.

Don't get the surgery if you are just now experiencing symptoms. I got haglunds from a diet of too tight running shoes and boat shoes, but I just loosened up my shoes and started wearing Sambas and my feet are alright. This can be worked around - it's not worth the recovery time to get the surgery immediately unless it is already quite advanced.

Thanks. I've already tried cutting the backs of my running shoes and padding, etc. It used to work, but the bump has gotten bigger gradually and is pretty low from the Achilles and to the outside of the heel, so now I need to remove practically the entire heel counter. Casual and work shoes are actually more of a problem than running shoes and I can't wear sandals or clogs all the time. If I ever want to wear normal shoes I would have to do the surgery eventually. The problem has slowly worsened over the past few years and I don't want to wait until the Achilles is damaged to do surgery, which seems like it will be inevitable based on everything I've read.

FE or others, I have a quick question: is there a difference between a Haglund deformity and a heel spur? I just read the x-ray report of my foot and it says "no heel spurs plantar or dorsal." But I can visibly see the Halgund bump on my foot and also the pointed peak of bone in the x-ray at the top of the calcaneus. If there are no spurs, hopefully this makes the Halgund's easier to treat?

I am pretty sure Haglund's was a form of heal spur. I also had other bone spurs as well so not having others does make the side surgery more feasible. I have heard of people getting spurs on the plantaris tendon attachement and the others nearby, so it sounds like you have the standard Haglunds with no other complicating conditions. The doc will probably just shave the spur and clear up the bursa and you will be good to go.

So, I'm checking in 4 months after Haglund surgery on right heel. Things went pretty smoothly--lateral incision, healed quickly, Achilles intact and no detachment needed.

I was allowed to start running at 3 months (1 month ago)and am up to about 30 mpw now. I'm just wondering if I should be at 100% now or if it's normal to still have pain/weakness in the operated heel? It's still very stiff in the morning/after sitting and the first 5 min or so of runs are sometimes very painful. Usually it goes away after that, but I also seem to have strained my Achilles or inflamed it a bit. I added some barefoot strides (used to do them before surgery) and extra calf strengthening last week and I think this was too much and flared it. The general heel/Achilles are is also still sensitive in certain shoes, esp. stiffer ballet flat types. Heel does not look swollen however and the bump is gone. I'm just nervous that I will never get back 100% and would appreciate any advice or reassurance. Thanks.

Why are you doing barefoot strides? Did you have the tendon debrided? I am guessing no bc the recovery is 6 mo. I had the procedure done and the podiatrist didn't touch the tendon so it felt the same when I started running. Had it done again 6 mo later and the M.D. debrided the tendon while taking more off the heel. I felt better immediately. No problems 5 yrs later and I can run as much as I want. Spikes are also no problem.

I didn't mean bf strides--more like a short bf jog. Stupid, I know, but I have been running for a month and things felt ok (except for the start of runs).

Tendon wasn't debrided or touched in surgery. I saw 2 docs and both said tendon was fine. Also, my pain was never in the tendon but always directly on the bump, which was very prominent, red and swollen.

I no longer have the bump or the associated pain, but it's still pretty sore and tender I the whole area. And even though the incision was lateral on the outside, I have some soreness on the inside of the Achilles as well. Just wondering if it's normal for the hell to still be sore at 4 months.