What conditions can be associated with plantar heel pain on the posterior aspect of the hindfoot?

Updated: Feb 10, 2020
  • Author: Vinod K Panchbhavi, MD, FACS; Chief Editor: Thomas M DeBerardino, MD  more...
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Conditions that can be associated with pain on the posterior aspect of the hindfoot include the following:

  • Insertional Achilles tendinitis - Pain, tenderness, and a bony prominence are mainly located at the back of the heel; plain radiographs may show calcification at the insertion of the Achilles tendon
  • Haglund syndrome - This is a term given to the prominent posterosuperior corner of the calcaneus that is thought to impinge on the Achilles tendon and give rise to pain, swelling, and tenderness in the posterior aspect of the heel; the diagnosis is made on the basis of plain radiographic findings
  • Pump bump - This is a term used to describe a prominent posterolateral protuberance in the calcaneus near the attachment of the Achilles tendon; the pain is usually caused by friction from footwear and can coexist with Haglund syndrome
  • Flexor hallucis longus tenosynovitis - The pain and tenderness are posteromedial at the level of the subtalar joint and can be aggravated by dorsiflexion of the great toe with the ankle held in full plantarflexion
  • Posterior impingement of the os trigonal or Stieda process or fracture - Usually, activities that require acute plantar flexion, such as a pointe in ballet, can aggravate the pain, and the tenderness is posterolateral at the level of the subtalar joint

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