More than Portugal’s World Cup defeat in the last 16 in Spain, it was an image that had fans throughout the stadium and the Internet shocked and amazed. Pedro Neto was seen with a modified football foot. The wing had cut a large section off the back of his expensive shoes, with his sock sticking out of the heel. While one can assume that it is a complete joke or just a pair of used shoes, it highlighted a little-known problem that affects many professional soccer players.The image may have gone viral now, but the players of the time featured the cut heels. Philippe Coutinho, Roberto Firmino, Mats Hummels and Daniele De Rossi all wore similar cut-out boots. Football players have modified their cleats to reduce the friction between the shoe and the heel. In a sport where the cleats are fitted to the millimetre, and every sprint requires a sudden change of direction, discomfort in the heel can throw the whole game of the player and that of his team off balance.It all boils down to heels. Everyone has a different size and some have a “bigger heel” than others. With footwear, this 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 2026 FIFA World Cup 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 inflammation.
According to the American Academy of Orthopedic Surgery, 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 inflammation. Technically a “deformity”, the symptoms associated with it, such as insertional tendinopathy and discomfort when wearing closed 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 has worked with elite footballers 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. “This bursa, essentially, 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 becomes more painful. That soreness means that there are changes in the bone, which means that then it becomes more painful.”Treatment depends on the severity of symptoms or pain. The first option is to modify the shoes. It is recommended to wear cushioned shoes and avoid tight shoes and the second is to use protective heels. Since soccer cleats are essential for regulation, they cannot be replaced, but they can be modified.According to Michael Robson, a specialist musculoskeletal physiotherapist at LDN Physio, people can have the syndrome without having any symptoms. “It only really becomes a painful syndrome when the enlarged bone repeatedly irritates the soft tissues around it,” he told the outlet.
The soccer shoe
The best way to treat the condition, at least in football, is to make room for the heel to go somewhere, in the back.
In professional football, 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 customize them to adapt to the shape of their feet or relieve specific discomforts.The sight gained attention after player Pedro Neto wore two pairs of cleats with the heel section cut off. The football boot he wore with the cut-off heel was a Nike Mercurial Vapor 16 Elite. While Neto has not publicly explained why his boot was modified, Haglund’s syndrome or just a blister could be the explanation.If a player manages the syndrome, opening the back of the boot can reduce the pressure on the heel. Otherwise, stiff heels can press directly into the irritated area and cause pain. Other ways to manage the condition are through physical therapy, shock wave therapy, injection therapy and changes in activity. “They’re not going to stop playing because of a little pain in the back of their heel,” Hudson-Gill said. “They may be needed for a cup final or World Cup qualifiers.”Even a century later, the best way to treat the condition, at least in football, is to make room for the heel to go somewhere, in the back.