Haglund’s Deformity: Otherwise Known as the Bauer Bump
Hockey Kids and the Bauer Bump
Hockey moms are a rare breed. We spend an enormous amount of time freezing our tails off watching our sons whack a puck with a stick. We wake early and drive several hours every week to allow our children to play a sport that requires signing a waiver warning of serious injury, paralysis and possible death. We are required to release all liability against the hockey organization and the rink. Most hockey parents think the biggest risk is obtaining a concussion. Many, like myself, have researched concussions so we can identify the warning signs. However, another fairly common risk, rarely talked about at the rinks, is called Haglund’s deformity, or otherwise known as the “Bauer Bump” or “Pump Bump.” Though the severity is not close to the same as a concussion, the implications of Haglund's Deformity can be long lasting.
What is Haglund's Deformity?
Haglund’s deformity is a bony growth on the back of the heel. It literally looks like an extra bone is growing out of the heel. My thirteen year-old son, who has been playing ice hockey for five years, has Haglund’s deformity. My son’s sports medicine physician recognized it immediately it and cited his hockey skates as the culprit. I never knew my son would have this massive growth on the back of his heel from wearing skates so much. This is not a callus or a blister—it is a hard bone that is growing. The doctor assured me that professional hockey players have much larger growths. The bone growth occurs at the base of the Achilles tendon. The area near this tendon becomes inflamed when the bony protrusion rubs inside shoes or skates and can often lead to painful bursitis.
What Causes Haglund's Deformity?
Wearing shoes that do not fit properly or that apply excessive pressure and friction on the heel bone is the main cause. This constant irritation of the upper portion of the heel bone rubbing against the Achilles tendon eventually causes the bony protrusion and possible bursitis.The rigid backs of skates can create pressure that aggravates the enlarged bone when skating. In fact, any shoes with a hard back, such as ice skates, men’s dress shoes, or women’s pumps, can cause this irritation. Heredity can even play a role in Haglund’s deformity. Certain types of foot structures, such as high arches, can make you more prone to developing this sometimes painful condition. With high arches, the heel bone is tilted backward into the Achilles tendon. This causes the inflamed bursa that creates the redness and swelling associated with Haglund’s deformity. A tight Achilles tendon can also play a role in Haglund’s deformity, causing pain by compressing the tender and inflamed bursa. A more flexible tendon has less pressure against the painful bursa.
Not Just Bauer Skates
It may be called the Bauer Bump at the ice rinks, but make no mistake, Haglund's deformity is not exclusive to Bauer skates. My son wears Canadian-made Grafs, which are worn by many professional hockey players. The brand of skate is no determining factor, but the fit of the skate is extremely important. If a skate is too big, there will be more friction. If a skate is too small, there is excessive pressure on the heel bone. Haglund's deformity can also be known as the "Pump Bump" when seen in women who wear high heels for long periods of time.
Depending on the level of pain associated with the bony protrusion, there are non-invasive treatment options.
- Use a heel lift or gel pad to remove pressure
- Anti-inflammatories such as Motrin
- Exercises to stretch the Achilles tendon
When all other treatment fails and the pain associated with Haglund's deformity inhibits desired activities, surgery to remove the bone growth is used as a last resort.