Haglund’s Deformity in a Patient with Long-Standing Type 2 Diabetes Mellitus: Implications for Tendon Pathology and Surgical Risk
Smit Christian1*, Marion Yau2, Sahar Abolhassani2, Joseph Olivelle1
1Foot and Ankle Centre, England.
2Harley Medical Foot and Nail Laser Clinic London, England.
*Corresponding Author: Smit Christian, Foot and Ankle Centre, England.
https://doi.org/10.58624/SVOAOR.2026.06.007
Received: February 15, 2026
Published: March 02, 2026
Citation: Christian S, Yau M, Abolhassani S, Olivelle J. Haglund’s Deformity in a Patient with Long-Standing Type 2 Diabetes Mellitus: Implications for Tendon Pathology and Surgical Risk. SVOA Orthopaedics 2026, 6:2, 51-55. doi: 10.58624/SVOAOR.2026.06.007
Abstract
Background: Haglund’s deformity is a posterosuperior calcaneal prominence frequently associated with insertional Achilles tendinopathy (IAT). Although traditionally considered a mechanical cause of posterior heel pain, the relationship between deformity size and symptomatic tendinopathy remains debated. Type 2 diabetes mellitus (T2DM) has been associated with increased risk of tendinopathy, likely through metabolic effects on tendon structure.
Case Description: A patient with long-standing T2DM presented with chronic posterior heel pain. Clinical and radiographic assessment revealed Haglund’s deformity, posterior heel spur formation, increased calcaneal pitch angle, and ultrasound-confirmed insertional Achilles tendinopathy. Conservative management from a podiatric perspective included footwear modification, custom orthotic therapy with heel elevation, and extracorporeal shockwave therapy. Surgical options were considered in light of systemic metabolic risk.
Conclusions: Emerging evidence suggests that Haglund’s deformity size alone does not predict insertional Achilles tendinopathy. Structural alignment, insertional degeneration, and systemic metabolic factors such as T2DM may be more significant contributors. Podiatric biomechanical management plays a central role in f irst-line treatment and may reduce the need for operative intervention in metabolically vulnerable patients.
Keywords: Haglund’s Deformity; Insertional Achilles Tendinopathy; Type 2 Diabetes Mellitus; Cavus Foot; Orthotic Therapy