If you’ve ever noticed a painful bump forming at the back of your heel—especially where the heel rubs against your shoe—you may be dealing with Haglund’s deformity, commonly known as a “pump bump.” This condition occurs when a bony enlargement develops at the back of the heel, causing irritation, inflammation, and discomfort.

It’s especially common in people who wear stiff-backed shoes, such as dress shoes, skates, or high heels (“pumps”), but anyone can develop it.

At Restore Foot & Ankle Specialists, we diagnose and treat Haglund’s deformity regularly—and with the right approach, the pain is highly manageable. Here’s everything you need to know about this often misunderstood condition.

What Is Haglund’s Deformity?

Haglund’s deformity is a bony prominence on the upper portion of the back of the heel bone (calcaneus). This bump can rub against shoes, causing a painful combination of:

• Inflammation of the soft tissue

• Irritation of the Achilles tendon

• Bursitis (inflammation of the bursa between the tendon and heel bone)

• Redness and swelling at the back of the heel

Over time, the constant friction can lead to thickened skin, callus formation, and chronic irritation.

Why Is It Called “Pump Bump”?

The nickname comes from the classic trigger: rigid-backed pumps or dress shoes. The stiff heel counter digs into the back of the heel, repeatedly rubbing against the bone and causing irritation.

But this condition isn't limited to pumps. We often see it in:

• Runners

• Hikers

• Ice skaters

• Soccer players

• Anyone wearing stiff or tight shoes

What Causes Haglund’s Deformity?

Haglund’s deformity develops due to a combination of mechanical factors and genetics. Common causes include:

1. Foot Structure

Some people are predisposed to developing Haglund’s deformity due to the natural shape of their feet. Risk-increasing foot types include:

• High arches (cavus foot type)

• Tight Achilles tendon

• Rigid heels

• A prominent or angled calcaneus

These structures increase pressure at the back of the heel, making irritation more likely.

2. Improper or Rigid Footwear

Shoes with stiff heel counters put repeated pressure on the heel, especially:

• High heels

• Skating boots

• Dress shoes

• Work boots

• Soccer cleats

3. Overuse or Repetitive Movement

High-impact activities like running, jumping, and sprinting pull on the Achilles tendon and rub the heel bone, worsening inflammation.

4. Tight Calf Muscles

Limited ankle mobility increases tension on the Achilles tendon, putting more friction and pressure where the tendon attaches at the heel.

Symptoms of Haglund’s Deformity

Common symptoms include:

• A visible bump on the back of the heel

• Pain when wearing closed-back shoes

• Swelling or redness at the heel

• A burning or aching sensation

• Stiffness or tightness in the Achilles tendon

• Blistering or callus formation

• Pain that worsens after activity

Some patients also develop Retrocalcaneal bursitis, which causes throbbing, heat, and swelling.

How Haglund’s Deformity Is Diagnosed

At Restore Foot & Ankle Specialists, diagnosis typically includes:

• Evaluation of symptoms and shoe history

• Physical examination

• X-rays to confirm the shape and size of the bone

• Possible ultrasound to assess tendon or bursa inflammation

We determine whether the pain is coming from the bone, the bursa, the tendon, or a combination of factors.

Effective Treatment Options for Haglund’s Deformity

The good news: most cases can be treated without surgery, especially when addressed early. Our approach focuses on reducing pressure, minimizing inflammation, and correcting biomechanical issues.

1. Footwear Modifications

✔ Soft-backed shoes
✔ Open-heeled shoes when possible
✔ Avoiding rigid heel counters
✔ Switching to well-padded athletic shoes with cushioned heels

Proper footwear is one of the fastest ways to reduce irritation.

2. Padding & Heel Lifts

Special pads can protect the heel from rubbing. Heel lifts temporarily decrease tension on the Achilles tendon.

3. Stretching the Calves & Achilles Tendon

Tight tendons increase pull and worsen symptoms.

We recommend daily stretching to improve mobility and reduce pressure at the heel.

4. Anti-Inflammatory Treatments

• Ice therapy

• Oral or topical NSAIDs (if approved by your doctor)

• Ultrasound or laser therapy (if offered in-office)

These reduce swelling and pain around the bursa and tendon.

5. Orthotics

Custom or prefabricated orthotics address structural causes such as high arches or supination. They redistribute pressure more evenly and reduce strain on the heel.

6. Physical Therapy

Therapists can help with:

• Strengthening foot and calf muscles

• Improving ankle mobility

• Reducing inflammation

• Correcting gait patterns

7. Immobilization (CAM Boot)

If symptoms are severe, a boot provides rest and minimizes movement that worsens inflammation.

8. Injections

Corticosteroid injections may be used around—but not into—the tendon to treat bursitis. This must be done carefully to avoid weakening the Achilles tendon.

When Is Surgery Needed?

Surgery is recommended only when:

• Pain persists despite months of conservative care

• The bony prominence is large and continues to rub

• The Achilles tendon is involved

• Chronic bursitis does not respond to treatment

Surgical procedures may include:

• Removing the bony enlargement

• Smoothing the heel bone

• Repairing the Achilles tendon (if damaged)

Thanks to modern techniques, most patients experience improved comfort and mobility after recovery.

How Restore Foot & Ankle Specialists Can Help

Our podiatrists are highly experienced in diagnosing and treating Haglund’s deformity. We offer:

✔ On-site X-rays for fast diagnosis
✔ Custom orthotics
✔ Advanced, non-invasive therapies
✔ Padding, bracing, and footwear guidance
✔ Personalized treatment plans
✔ Surgical options if conservative care fails

We don’t just address the bump — we treat the root cause to prevent future flare-ups.

The Bottom Line

Haglund’s deformity may start as a simple irritation, but without proper care, it can turn into a painful, chronic condition that affects your mobility and daily life. Luckily, the podiatrists at Restore Foot & Ankle Specialists offer a full range of effective, personalized treatment options to help you stay active and pain-free.

If you’re struggling with heel pain or think you have a pump bump, schedule an appointment today. Relief is closer than you think. Contact our office today with Dr. Gireesh Reddy or Dr. Sirisha Pokala by calling (469) 573-3427 or by booking an appointment online.