Why Is the Back of My Heel Red and Swollen?

 (It’s Not Just a Blister)

You bought a new pair of dress shoes or rigid retro sneakers. After a few wears, you notice a painful, red bump forming on the back of your heel. You assume it’s a blister caused by breaking in the shoe, so you bandage it and wait.

But weeks later, the bandage is off, and the bump is still there. It’s hard, tender to the touch, and makes wearing closed-back shoes agonizing.

This isn’t a blister; it’s a bony enlargement called Haglund’s Deformity (often nicknamed the “Pump Bump” because of its historical link to high heels). While it might look like a skin issue on the surface, the problem lies deep in the bone structure of your heel. Lionel G. Hausman explores the problem below.

Why Does It Happen?

Haglund’s occur when there is chronic friction on the back of the heel bone (calcaneus).

• The Anatomy: If you have a naturally prominent heel bone or high arches, the bone physically rubs against the rigid back of your shoe with every step.
• The Reaction: To protect itself from this constant trauma, the bone builds up extra calcium, creating a permanent bump.
  • The soft tissue over it (the bursa) becomes inflamed, leading to retrocalcaneal bursitis. This is what creates that angry, red, swollen appearance.

The Culprit: Stiff Shoes

While high heels are the classic cause, we are seeing a resurgence of this condition in both men and women, thanks to modern footwear trends:

• Rigid Dress Shoes: Men’s loafers and dress shoes often have stiff counters that dig into the Achilles insertion.
• Ice Skates & Ski Boots: The hard plastic shell presses directly on the bone, common in winter athletes.
• Trendy “Retro” Sneakers: Many fashion sneakers use stiff leather that doesn’t break in easily, creating a friction point right at the heel.

How to Fix It (Without Surgery)

You don’t always need to shave the bone down. Conservative care works effectively if you catch it early:

1. Heel Lifts: Adding a small silicone or cork lift inside the shoe raises your heel above the rigid back of the shoe. This simple geometry change removes the friction point instantly.
2. Backless Shoes: Give the area a “vacation” by wearing slides, clogs, or backless mules for a few weeks. This allows the bursitis (inflammation) to calm down without constant irritation.
3. Ice & Padding: Ice the inflammation for 20 minutes a day. Use specific “moleskin donuts” (pads with a hole cut in the middle) to float the bump away from the shoe counter.

If the bump is altering your gait or limiting your footwear choices to flip-flops only, come see us. We can help!

If you have a foot problem you’d like to address, you’ll want to visit Gramercy Park for an appointment with Board Certified Podiatrist Lionel G. Hausman, DPM. Whether it’s an ingrown toenail, heel pain, bunions, or plantar fasciitis, Dr. Hausman can expertly treat numerous foot and ankle conditions. If you’re in need of help, get in touch with us today!