One of the most common problems doctors see with hockey players and other frequent skaters is Haglund's deformity, which is also known as a "retrocalcaneal spur." This spur occurs at the Achilles tendon, just behind the heel bone.

Haglund's deformity is different than a traditional heel spur, which is more common and found underneath the heel. However, if either is ever suspected, both conditions must be ruled out with an x-ray evaluation.

For those who don't know, a heel spur is a bone outgrowth of the heel bone that is often very hard and painful. It can occur under the heel or at the back, where the Achilles tendon attaches itself to the heel bone. When this area is examined and palpated, there is a feeling of hardness rather than the typical suppleness of a healthy Achilles tendon.

Typically, an episode of tendonitis will also have occurred with Haglund's deformity, which makes a skater more prone to suffering a recurrence. At this point, it is important to stop all activities, rather than continuing to skate and possibly rupture the tendon.

Proper training shoes with good heel cushioning and stability can protect the area from additional trauma. As always, preventative measures are of great importance. Hockey players and casual skaters can both protect themselves by stretching and strengthening the area through exercise to gain better flexibility. This injury can be very painful in acute stages and can become chronic, creating problems for years. If you believe you may be suffering from either type of heel spur, be sure to rest the area and seek medical attention.

In rare cases, certain heel spurs can require surgery. Other treatments include customized orthotics, anti-inflammatorymedicationand cortisone shots.

Dr. Robert F. Weiss is a podiatrist specializing in foot and ankle surgery.

He was a member of the Medical Advisory Committee for the 1984 and 1988 Olympic Marathon Trials. Weiss is a veteran of 35 marathons and has a practice in Darien, The Foot & Ankle Institute of Darien. For info visit his Web site at www.therunning

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