Some people develop a bump on the back of the heel. This bump is called a Haglund's deformity, more commonly referred to as a pump bump. For some people, the bump doesn't cause any problems. But sometimes, because of the pressure from the back of a shoe, that bump gets inflamed and painful.
Anyone can develop a Haglund's deformity. But women are most often affected by a pump bump. And that's because the shoes that they wear, especially high heels and ballet flats, are more likely to irritate the back of the heel. How could ballet flats be as hard on your feet as stilettos? Well, those stretchy foot openings tend to cut into the back of your heel; the resulting pressure can cause blisters and many other problems, one of which is a pump bump. (Plus, the thin flat soles can lead to heel pain and plantar fasciitis.)
Now, that's why your pump bumps may start to hurt. But why do they form in the first place? Read on to find out.
What is a Bone Spur?
As we just explained, a bone spur is a bump that develops on your foot, formed from excess bone matter. And that bump forms on top of another bone, often at the site of joints or bone ridges.
Even more often, those spurs form at spots that absorb pressure or trauma, like the back of your heel. Unlike other growths on your body, bone spurs aren't a medical problem. They may not even cause symptoms for you, especially when they're small. Or in spots that your shoes don't rub against.
Still, they change your foot shape, which can make wearing shoes extremely painful. Often, that's why people seek treatment for their pump bumps. But it's easier to stop a bump from forming than to correct it after. So let's explore why bone spurs develop on your heel in the first place.
What Makes You Develop a Bump on Back of Heel (AKA a Pump Bump)?
Is that bump on the back of your heel caused by a bone spur? The simple answer is yes. A pump bump is caused by a bone spur that forms on the back of the heel. And that bone spur forms for one of two reasons.
The first? It could be due to excessive pulling of the Achilles tendon on the heel bone. And that pulling occurs due to a tight or shortened Achilles tendon. (Something that could happen from overuse, from poor shoe choice, or simply from your body's faulty biomechanics.)
The other reason you may develop a pump bump is due to the rocking motion of the heel bone while you walk. If this is part of your gait, it places shear forces on the back of the heel. In response to that pressure, your body may build up bone for protection. And that bone takes the form of your pump bump.
Preventing Haglund's Deformity
If you want to prevent a pump bump from forming, we have to keep pressure off your heels. To that end, make sure to wear shoes that fit your feet properly. And, if you have biomechanical challenges, it's worth investing in and wearing your prescribed orthotics.
You also need to keep your Achilles tendon nice and loose. To do so, you can try regularly stretching your calf muscles and Achilles tendon. This is especially important after running or engaging in other workouts.
Padding can also help you avoid a pump bump. If you have to wear shoes that rub and press on the back of your heels, try adding shoe pads. Even better, if fashion allows, wearing padded socks can help keep pressure off your feet, helping you avoid a Haglund's deformity.
Treating a Bone Spur That's Not Painful
In and of itself, a bone spur isn't a problem. For that reason, many people avoid dealing with the bumps on the backs of their heels...Until they end up in our office, dealing with pain and inflammation. And in desperate need of help.
We understand the decision to avoid treating issues that aren't causing your problems. But we also want to let you in on a secret. If you catch a bone spur when it's still forming, and before it becomes painful, we can intervene so it doesn't cause problems. In fact, it is usually effectively treated with a custom orthotic device.
Non-Surgical Pump Bump Treatments
Adding an orthotic is one of the best non-surgical ways to treat a Haglund's deformity. Why does this minimally invasive option work so well? The orthotic helps to stabilize the foot function, correcting faulty biomechanics. In turn, that limits pressure and pulling on the heel bone, so your bone spur won't get larger.
Even if your bone spur is already inflamed, you may not need surgical treatment. In addition to orthotics, we can also address your pain and inflammation. I may recommend taking daily Advil or other NSAIDS (non-steroidal anti-inflammatories) for a few days. This can help with your pain. And it can also reduce inflammation.
After adding an orthotic, we may still have to change your footwear. You'll want to avoid any pairs that rub against your bone spur. At least while you're experiencing painful bone spur symptoms.
For some people, these interventions are all the treatment you'll ever need. But, in more severe cases, especially if your bump gets inflamed? Then, you may need foot surgery to provide complete relief.
Treating a Haglund's Deformity with Surgery
If we decide you need surgical treatment, there are several different approaches that can help. The one we choose for you depends on your pain, the size of your bump and your Achilles tendon health.
After any type of foot surgery, you'll need to rest your foot. We may need to immobilize your foot, either with crutches or a boot. And you should expect to change your activities for at least a few weeks after surgery.
Don't want to deal with all that? Let's try to intervene earlier, when you first notice changes to your foot shape. In other words, don't wait for pain to start before asking for help. Instead, call your Houston podiatrist before a problem starts. That way, we'll have more and less invasive options for delivering pain relief.