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PUMP BUMPS (HAGLUND’S DEFORMITY)

A pump bump is a variant of Haglund’s deformity, a congenital prominence at the posterior (back) superior (higher) aspect of the calcaneous (heel) where there is inflammation near the insertion of the Achilles tendon. 

Pump bumps occur in either of two places:  (1) on the Achilles tendon above the rear end of the heel bone and (2) at the throat line of the foot just behind the toes. 

Pump bumps are a bony growth and/or swollen bursa in these two sensitive areas.  A bump behind the heel is caused by the excessive pressure of the rear top line of the shoe against the heel tendon and bursa.  At the throat line site, a vamp cut too high for the foot causes it.  The pressure buildup causes the fleshy area behind the toes to swell, which further increases the pressure and rubbing of the throat line. 

Contrasted with an oxford or strap shoe, high heels and pumps don’t have anything to hold them on to the foot.  To prevent heel slippage, the pattern has to be cut higher in back and the last requires more back curve to grip the heel.  In front, the last has to be shallower and the throat line snugger, also to grip the shoe on the foot. 

Other names or similar foot conditions:

• Retrocalcaneal bursitis
• Haglund’s deformity

Symptoms:

• Swollen and/or bony prominences in heel or at throat line
• Pain at these points

Signs to look for:

• Nearly always seen in women vs. men
• History of pump wear
• Noticeable bumps in one or both or these areas

Possible Causes:

• Congenital
• Friction from shoes that rub in these areas

Goals:

• Eliminate the bump
• Remove pressures at the sites

Solutions:

Arch Supports:

• Bio-Orthotics Winstep or Sundance exercising support with metatarsal lift

• Lower and thinner arch support with longitudinal and metatarsal support, such as the Bio-Orthotics Journey or Silhouette, for use when shoes cannot accommodate the Winstep or Sundance exercising support

• Extra depth shoes with firm heel counter, rocker soles and steel shank

• Ideally, pumps and heels should be worn for short periods of time only vs. every day and/or all day

Other: 

• Rubber heel lift can lift heel above the area rubbing at the heel but discard when inflammation resolves so Achilles tendon is not shortened on a long term basis

• A donut pad at heel counter around the bony prominence, just below the top line of the shoe, can provide enough space to relieve pressure

• Spot stretch at heel with ball and ring stretcher

This information does not constitute a diagnosis of your condition and does not take the place of a doctor’s care.  The information has been compiled from sources available to the general public and referenced below.  Copyright 2005 Carole Romig

Sources  Image:  NSRA, PFA, AOFAS, When the Shoes Fits  Text:  D. Janisse, CPed, Editor, Introduction to Pedorthics, PFA, Professional Shoe Fitting (Pedorthic Footwear Association), B. Meanwell, CPed, A. Decker, S. Albert, Contemporary Pedorthics