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Episode 9: The Big Four

Let’s talk about the association between The Big Four problems:

  1. Equinus
  2. Haglund’s deformity
  3. Insertional Achilles Tendonitis with bursitis
  4. Retro-Calcaneal bone spurs


Haglund’s deformity is a bony enlargement on the back of the calcaneus/heel bone. There is soft tissue bursa surrounding the insertion of Achilles tendon; it can become irritated when area by the bony enlargement rubs against shoes.  This often leads to painful bursitis.  Long-term equinus and irritation at the insertion of the Achilles tendon and lead to small bone spurs which form at that back of the heel and have involvement with the Achilles tendon itself.

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