What’s that bump on the back of my heel?

14 May

If you’ve noticed a lump right above your heel that’s red and sore and gets worse when you walk or run in shoes, you might have Haglund’s Deformity, also known as “pump bump”.

haglunds_deformity_pumpbumpIt’s remarkable how the combination of heredity and footwear can cause so many foot problems.

In a normal foot, the Achilles tendon attaches to the back of the heelbone (calcaneus). Between the heelbone and the tendon is a bursa, a sac of tissue that allows the tendon to easily slide against the bone when your foot moves. If you’ve inherited Haglund’s Deformity, your calcaneus is shaped differently – you have a prominent bump underneath the attachment of the Achilles tendon. If you went barefoot all the time, you wouldn’t even notice it. But when you wear shoes with hard backs which rub at that exact spot (like high heels and dress shoes), the prominent bump squeezes the soft tissues between the bone and the back of the shoe. Eventually the bursa becomes inflamed (bursitis), causing swelling and thickening of the tissues. This makes the problem worse, creating significant heel pain.

“Pump bump” is most common in young women who wear pumps. But unusually high arches can also be the cause of the problem, as the heel bone is tilted backwards into the Achilles tendon. This causes the uppermost portion of the back of the heel bone to rub against the tendon, creating constant irritation. As a result, a bony protrusion develops and the bursa becomes inflamed. A tight Achilles tendon can also be responsible for this condition, as can a tendency to walk on the outside of the heel.

The good news is that “pump bump” can almost always be relieved without surgery.

Treatment of “Pump bump”

  • Change your footwear to shoes without hard backs or high heels
  • Over the counter anti inflammatory medication like advil (Ibuprofen) or aleve (naproxen)  to relieve pain and inflammation
  • Ice the sore area to reduce inflammation
  • Stretching exercises to relieve tension from the Achilles tendon
  • Orthotic devices and shoe modifications
  • Heel pads to protect the sore area
  • Foot may need to be immobilized

How to prevent “pump bump”

  • Wear appropriate shoes and avoid high heels and pumps
  • Wear arch supports or custom orthotic devices prescribed by your podiatrist
  • Avoid running on hard surfaces
  • If symptoms are present, avoid running uphill and consult a podiatrist

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