Pump Up Your Knowledge About Pump Bump

It’s well understood that a good heel can take any ensemble to the next level, but did you know that your heels may add an unsightly and painful bump to your look? Let’s take a look at this funny-sounding—yet potentially painful—foot deformity.

What is pump bump, exactly?

Pump bump—also known as Haglund’s deformity, Haglund’s syndrome, Haglund’s heel or Mulholland deformity—is a disorder of the foot in which an enlargement (read: bump) forms on the bony part of the heel where the Achilles tendon is located.

Pump bump is a type of foot exostosis, a benign growth of new bone on top of existing bone, and can occur in one or both of the feet. When the bump rubs against the backs of stiff shoes, it irritates the tissues and can result in pain and bursitis. Bursitis is an inflammation of the bursa, a fluid-filled sac that rests between the tendon and bone to avoid friction between the two. The rubbing can also cause a calcium build-up over time, making the bump larger and, ultimately, more painful.

What causes pump bump?

As the intro implied, pump bump frequently occurs in patients who have a thing for high heels. However, it also comes from just wearing shoes that are too tight or stiff in the back—even a sneaker—that place frequent pressure on the heel, resulting in the lump. Other patients at risk for pump bump may have issues including:

  • A high foot arch
  • A tight Achilles tendon
  • Walking on the outside of the heel

Pump bump is common in a number of occupations and hobbies, including patients who wear work boots as well as athletes—past and present. In fact, pump bump is frequently seen in runners, both casual and professional alike. Regardless of occupation or interest, all issues with pump bump can usually be handled in an office setting, in most cases.

How is it diagnosed?

Diagnosing pump bump can be tricky because the symptoms can mimic symptoms of other conditions, such as those associated with Achilles tendonitis.

That said, a physician may be able to diagnose pump bump based on the look of the heel combined with an X-ray. The X-ray can help determine if you have the protruding heel bone that indicates the presence of pump bump. It can also help the physician create a customized orthotic that can relieve your heel pain and help stabilize the foot, if necessary.

How is pump bump treated?

The treatment for this issue primarily focuses on taking pressure off of the heel bone and relieving pain. In many cases, this can be accomplished through more conservative evidenced-based methods—many of which can be done in-office or at home—including:

  • Having ultrasound treatments (diathermy) performed to help relieve pain and improve mobility
  • Icing the bump for 20 to 40 minutes a day so the swelling is reduced
  • Indulging in soft tissue massages
  • Receiving an extracorporeal pulse activation technology (EPAT®) treatment to stimulate blood circulation and accelerate the healing process
  • Taking over-the-counter anti-inflammatories, such as ibuprofen or aspirin
  • Wearing a boot or cast provided by a specialist
  • Wearing heel pads to keep pressure from shoes off of the heel
  • Wearing open-back shoes (think clogs)
  • Wearing the aforementioned custom orthotics

Should all other methods of treatment fail, a surgical a procedure known as resection of Haglund’s deformity to remove the excess bone from the heel is performed. During this procedure—which can be performed with minimally invasive techniques as well as open ones—the bone may also be filed down and smoothed if bursitis is present so pressure is taken off of the bursa and soft tissue. In certain situations, the surgery may be more involved if the Achilles tendon is damaged and needs to be surgically repaired.

How do I keep pump bump from happening?

By simply taking care and listening to your body (i.e., paying attention to pain), you can keep your heels bump-free:

  • Avoid wearing shoes with stiff, tight heels for lengthy periods of time
  • Don’t run uphill or on hard surfaces
  • Implement stretching exercises to keep the Achilles tendon from tightening
  • Incorporate open-back shoes into your wardrobe
  • When wearing shoes with socks, be sure to put on socks that are well-fitted and have non-slip soles

Don’t let a pump bump put a damper on your plans (or your outfit). If you’re experiencing any kind of heel pain, contact our specialists today for a consultation.