The choices we make produce certain outcomes. If you decide to make healthy dietary changes you can shed unwanted weight, reduce your blood pressure, and decrease cholesterol levels. But there are inadvertent long term consequences that sometimes arise as well. A clear example of this is making the choice to wear high-heeled footwear.
Short term intentions are to be fashionable and present a toned, sleek appearance, but the repercussions can include the development of Haglund’s deformity. This is a condition that leads to the development of a swollen, painful bump on the back of the heel. Since this tends to occur most commonly to women who frequently wear high-heeled shoes, the condition is also known as “pump bump.”
Now, the height of the heels plays a role in causing the bump in the back of your foot, but the rigid backs many of these shoes have will also definitely ignite this. This is one of the few foot problems that we can blame on the shoe and not your parents.
The initial problem in this case is pressure and friction. A rigid shoe back will rub against the back of your heel bone (calcaneus). As a defensive measure, a bony enlargement starts to form on the calcaneus that develops into a spur that grows in the Achilles tendon. In a “between a rock and a hard place” kind of scenario, a fluid-filled sac or bursa appears at the shoe contact point. This will become inflamed and painfully swollen in response to its position between the bony growth and rigid shoe back.
Although the issue is given the “pump bump” moniker, pumps are certainly not the only kinds of shoes that can cause this condition. Really, any type of footwear with a rigid back—including men’s dress shoes, boots, loafers, and skates—can lead to the same problem (when worn frequently), and especially if your shoes don’t fit properly! The bone spur will continue to enlarge with time and can eventually produce irritation in any shoe.
This isn’t all to say that you can never wear your favorite heels, though. Instead, simply keep in mind that this footwear should be worn only on special occasions. Even if you are expected to wear heels for work, consider wearing a more comfortable pair for your commute to and from the office.
As an interesting note, England has recently made it illegal to require women to wear high heels in the workplace. The British consider this to be a health risk, and rightfully so! (You will rarely hear me get political but this is one of the few times a bunch of old white guys made a good policy to improve women’s health.)
The other problem that develops with heels is the progressive and predictable tightening of the Achilles tendon. The enlarged bone or spur irritation is amplified when the tendon is under too much tension (like an overly tightened piano string).
Fashion is a difficult opponent to argue against, so I will channel Dear Abby: If you are wearing damaging shoes to attract someone, maybe that is not the right someone. Your primary footwear should be shoes that are comfortable, offer good cushioning, and provide exceptional support for your arches and heels. They should allow your feet to breathe (important for keeping your feet cool and reducing the risk of fungal infections) and have flexible uppers. If your toes cannot wiggle freely, the shoes are too small and you need a pair that fits better.
If you have developed Haglund’s deformity, or are experiencing any other chronic foot problem, give our Indianapolis, IN office a call so your go-to foot doc can accurately diagnose the problem and create a treatment plan to properly address it.
In addition to helping you find the right pair of shoes, we also offer comprehensive medical care for a wide range of conditions. The earlier you contact us, the more likely we can address your issues without having to recommend surgery. To schedule your appointment, dial (317) 545-0505 and our staff will be glad to assist.
A little Podiatry Zen -When you have a choice between 2 options, it is just as easy to choose the better.