Pump Bumps

You are or had been experiencing pain on the back of your heel bone, which is now all of a sudden starting to fade away. Why? Now that it is finally summer and many patients are more often than not wearing sandals, the heel bone is relieved from the constant rubbing caused by some shoes. The heel bone is called the calcaneus and it is the largest bone in the foot. This heel pain is very different from plantar fasciitis, which is a common complaint of pain on the bottom of the heel. The heel pain on the outer side of the heel, which is often associated with a visible bump in the same location, is called Haglund’s Deformity or “Pump Bump.”

The cause of Haglund’s Deformity can often be blamed on shoe gear that continuously rubs on the back of the heel. Since the deformity is most commonly caused by shoe gear, women are more susceptible to forming Haglund’s Deformity because of their wearing of high heels or pumps. However, men are not exempt from acquiring this “pump bump” since rigid thick backed dress shoes affect the heel similar to how pumps and high heels affect the heel bone in women. In addition to shoe gear, patients with higher risk of developing Haglund’s Deformity include:

  • Patients with a high arched foot
  • Patients who walk on the outer side of their heel; this is called calcaneal inversion
  • Patients with a tight Achilles tendon; the Achilles tendon is the tendon that is formed from the muscles that are located in the back of the calf. The Achilles tendon connects to the back of the heel bone, which if it is too tight, will cause increased pulling on the heel bone leading to formation of a bump. In addition, the tight Achilles tendon may also cause irritation to a fluid-filled sac (called a bursae) that is between the Achilles tendon and the heel bone

The symptoms of Haglund’s Deformity include:

  • A visible bump on the outer side of the heel
  • Pain on the outer side of the heel
  • Redness in the area of the heel
  • Callus formation (the thickening of skin) is noticed on the outside of the heel; the callus is due to the skin trying to protect itself from the continuous rubbing on the heel bone.
  • Increased pain while wearing shoes

Haglund’s deformity can be treated without surgery with various modalities. Some of these include:

  • Ibuprofen or other non-steroidal anti-inflammatory over-the-counter medications
  • Temporarily switching to open-back sandals for relief
  • A heel pad placed around the heel in the area that the shoe rubs on

Specifically, the following treatment options can only be provided by a podiatrist and should not be tried for self-treatment:

  • Temporarily wearing a cast to prevent the foot from moving, which wearing the cast will not cause any rubbing on the heel
  • Stretching exercises to help reduce the tightness of the Achilles tendon
  • A heel lift for the inside of the shoe, which will raise the heel up to prevent the continuous rubbing in the area
  • Custom made orthotics to promote proper functioning of the foot

If these non-surgical treatments fail to provide relief after trying the various treatments alone or in combination for 9 months to 1 year, surgical intervention becomes a possible treatment option, but only after all non-surgical treatments have been attempted and have failed to relieve the pain.

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