The problem that you are describing has different names depending upon the type of shoewear. In hockey, it has been called a boot bump but it has also been called a pump bump due to the presence of this in women who wear pump shoes. It has also been noted to occur frequently in snowborders as this sport's popularity has increased.

The reason that you are getting this problem is because of an irritation on the small bursa that is present between your achilles tendon and your heel bone (calcaneus). A bursa is a potential space between two moving objects in the body. In this case, there is a small potential space with an actual cavity present where it can secrete joint fluid when necessary. When extra pressure is placed on this, there will be an increase in the amount of joint fluid that is produced. The technical name for this is retrocalcaneal bursitis. The normal heel bone in this location is rounded but in most athletes who develop problems with a pump or boot bump, the heel bone is somewhat square. When this happens, there is less space present between the achilles tendon and the heel bone, and any pressure on this area will cause the bursa to become inflamed and to secrete more fluid.

The treatment for this problem is to decrease the pressure on the area and decrease the inflammation in the bursa. Our trainer at the University of Minnesota, Bob Broxterman, MS, ATC, uses foam pads or gel pads over the back of the heel in this location to take the pressure off the retrocalcaneal bursa. This is most commonly effective.

In severe cases, a few days of not wearing skates will help to decrease some of the pain and inflammation. In cases that have been present for long periods of time, you may either need to change the type of skate you are wearing such that there is not as much pressure in this location, or cut out a portion of the skate lining in this location to take the pressure off it. In severe cases that don't respond to these measures, surgery may be indicated. Surgery consists of taking out a portion of the heel bone to make it more rounded and less square such that there is not as much pressure on the bursa. In athletes, the most common reason for doing this is for high level skiers. In most hockey players, the nonoperative measures mentioned above will suffice for treatment.

In your case, I would first work on trying to decrease the pressure on the area by using a foam or silicone type pad over your bursa in the region where it hurts. If it is really inflamed, you may want to consider stopping skating for a period of time to let the pain decrease, and then try the pad. If you have new skates, time and further breaking in of the skate may also help with your problem. If follow up with a physician is needed, please be sure to bring in your hockey skates at the time of your appointment to see if further modification of your skates may be of assistance to you.