More than Portugal’s loss in the last-16 of the World Cup in Spain, it was an image that had fans all over the stadium and the internet in shock and awe. Pedro Neto is seen with a modified football foot. The winger cut a large section from the back of his expensive boot, with his sock protruding from the heel. While one might think it’s a healthy prank or just a pair of used shoes, it highlights a little-known issue that affects many professional players.The image may have gone viral now, but players have been sporting cut-off heels all season. Philippe Coutinho, Roberto Firmino, Mats Hummels and Daniele De Rossi all wore similarly cut boots. Football players modify their cleats to reduce friction between the shoe and the heel. In a sport where cleats are fitted to the millimeter, and every sprint requires a sudden change of direction, heel discomfort can throw off the balance of the player’s and their team’s entire game.It all boils down to the heel. Everyone has a different size and some have a “bigger heel” than others. With footwear it can cause different types of discomfort, such as chafing and blisters, pain and chronic conditions such as bone deformities. Among the most cited explanations for heel discomfort during the FIFA World Cup 2026 is Haglund’s syndrome.
Haglund’s syndrome
This condition is a bony growth or prominence on the back of the heel bone that can rub against the Achilles tendon and cause pain and swelling.
According to the American Academy of Orthopedic Surgeons, this condition is a bony growth or prominence on the back of the heel bone that can rub against the Achilles tendon and cause pain and swelling. Technically a “deformity”, the symptoms associated with it, such as insertional tendinopathy and discomfort when wearing closed-toe shoes, make it a condition or a syndrome. The condition, also called ‘pump bump’, is named after Patrick Haglund, the Swedish surgeon who described it in 1927.According to Bartholomew Hudson-Gill, a physiotherapist who works with elite players at a FIFA Medical Center of Excellence, the condition develops through a combination of the shape of the heel bone, thickening of the Achilles tendon and inflammation of the surrounding bursa. “That bursa, really, is like a shock absorber,” he told The Athletic. “The tendon gets thicker, the bursa gets irritated, then the bone starts to get irritated. “They load it more, it hurts more. That pain means there are changes in the bone, which means it hurts more.”Treatment depends on the severity of symptoms or pain. The first option is to change the shoes. It is recommended to wear cushioned shoes and avoid tight ones and the second is to use protective heel pads. Since soccer cleats are required by regulation, they cannot be replaced, but can be modified.According to Michael Robson, a specialist musculoskeletal physiotherapist at LDN Physio, people can have the syndrome without experiencing any symptoms. “It can only become a painful syndrome when the enlarged bone repeatedly irritates the soft tissue around it,” he told the outlet.
The soccer shoes
The best way to deal with the condition, at least in football, is to make room for the heel to go somewhere, behind.
In professional soccer, there is no one size fits all shoe. Although the models used in the World Cup are the same as those available in the market, the players often adjust them to fit the shape of their feet or relieve specific discomforts.The scene drew attention after player Pedro Neto wore two pairs of cleats with the heel part cut off. The soccer shoes he wears with the cut out heel are Nike Mercurial Vapor 16 Elite. While Neto has not publicly explained why his boot was changed, Haglund syndrome or just a blister could be the explanation.If a player is managing the syndrome, then opening the back of the boot will reduce the pressure on the heel. Otherwise, rigid heel counters may press directly on the irritated area and cause pain. Other ways to manage the condition are through physiotherapy, shockwave therapy, injection therapy and activity modifications. “They don’t stop playing because of a little pain in the back of their heel,” Hudson-Gill said. “Maybe they need it for a cup final or World Cup qualifiers.”Even a century ago, the best way to deal with the condition, at least in football, was to make room for the heel to go somewhere, in the back.