Category Archives: Musculoskeletal

Stretching for Haglund’s deformity? What am I missing?

I really do not get this one, perhaps someone can explain it to me.

Haglund’s deformity (pump bump, retrocalcaneal exostosis, Bauer bump, etc) is an enlargement of the bone at the back of the heel that is irritated by the footwear causing a bursitis and the painful symptoms. I do not think that there is anything controversial about this and what it is.

I recently did a bit of a dive into Haglund’s as I had to write something about it. What I was surprised and perplexed as is that probably over 90% of the articles I came across on this on websites recommended that calf muscle stretching be done to help Haglund’s.

If you want to have a look, check this Google search. Look at some of the sources for the “best exercises” for Haglunds! eg WebMD, Livestrong, American College of Foot and Ankle Surgeons etc. I was prepared to give some of them the benefit of the doubt in that they may be confused between an insertional Achilles tendinopathy and the bony bump of Haglund’s, but, no, they all generally defined it as a bony bump at the back of the heel and advised stretching exercises!

Can someone please explain to me why? Why would stretching the calf muscles stop the shoe from irritating an enlarged bit of bone at the back of the heel?

I did not bother for a literature search looking for evidence on this as I know there is none.

[I suppose some could argue that if the calf muscles are tight that this might cause excessive movement of the foot/heel in the shoe and increase the rubbing on the Haglund’s deformity, but I have not seen that and even if that was a problem, it would only help if the calf muscles were tight and only after months of stretching.]

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Does calcaneal apophysitis occur in adults?


Of course it doesn’t. Its a disorder of the calcaneal growth plate that can not happen after the teenager stops growing as that growth plate merges with the rest of the calcaneus and is no longer there to cause problems. So why are you writing a blog post for on does calcaneal apophysitis occur in adults? Good question, glad you asked it. Here is why:

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The Dilemma Faced by Athletes

One of my favorite reads from a few years ago (2017) was ‘The Athletes Dilemma’ by John Weston and I have just now re-read sections of it. Anyone who is working with athletes needs to read this book or at least be familiar with the issues that are addressed in the book. While the book is heavily weighted to the USA sporting context, the issues are applicable to any sport in any country and those issues are faced by all those working in sports medicine on a very regular basis.

The book does a deep dive into the length that professional athletes go to compete with little or no regard to the long term health consequences to themselves. Weston does an excellent analysis as to why they are so willing to do that. The institutions that facilitate this are also critiqued.

The risk of seeing the elite professional athletes do this is the example that they are setting for children for their sporting careers and the lengths that they may feel empowered to go to in order to succeed.

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What is the best-selling product on for ‘Sever’s Disease’?

I was doing some digging around to see what sorts of products people are buying for the self-care of their foot problems and this one for Sever’s disease stuck out like a sore thumb. I can’t say I am surprised by this. What I was surprised by was I had never seen or heard of the product before and just how well it is selling.

It was this ‘half sock’ with a gel under the heel:


They are proving to be very popular on and just go to further illustrate what my not-so-scientific study on calcaneal apophysitis found in the most cases they seem to be self-managed and do just fine.

Link to the product on

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My Not So Scientific Study on Calcaneal Apophysitis (Sever’s Disease)

I have previously written on all my clinical work, research and teaching experiences with calcaneal apophysitis and just how much I realised I did not know and just how much I learnt when my own child got it. As my daughters have just come out of the age bracket where the condition is common, I used that opportunity over the last few years to chat to as many of their friends and their friend’s parents that I could about their experiences with ‘Severs Disease’ whenever I could (an unrepresentative purposively selected sample with recall bias and no ethics approval, but, hey no worries).

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Bunion corrector gullibility

Some people must think some people are really stupid. I recently screen shot some pictures posted on a website that I stumbled across and has now been taken down. They must think that people really are that stupid. It was from a website promoting and selling a “bunion corrector”.

Here is the first image. This was the bunion allegedly before the use of the bunion corrector:

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