The effectiveness of heel raises in managing Haglund deformity pain in figure skaters – a pilot study

Abstract

Haglund’s deformity (HD) is an abnormal protrusion on the posterosuperior aspect of the calcaneus and a common foot deformity in skaters. Pain due to HD can hinder the skater’s balance and performance on ice. One of the non-surgical management of HD pain is to insert a heel raise into footwear. However, the use of heel raises may impact the biomechanics of skating and increase injury risk in the lower limb. The primary aim of this pilot study was to investigate whether the use of heel raises reduced pain caused by HD in figure skaters effectively. Eight experienced figure skaters performed 10 minutes of on-ice skating under two conditions 1) with heel raises and 2) without heel raises. To reduce bias, the order of the conditions was randomly assigned. Each skater provided their pain perception due to their HD according to a 10 cm visual analogue scale. Other variables such as foot posture, skate foot fit and HD size were also compared. The pilot results concluded that figure skaters with high arched foot types were more prone to more severe HD. Custom fit skates should be done weight bearing to allow for better accommodation of HD, and heel raise use did not significantly reduce HD pain. This pilot study provides initial evidence that challenges the current management of HD pain in figure skaters.