More than Portugal’s World Cup last-16 defeat to Spain, it was an image that had fans across the stadium and the internet shocked and amazed. Pedro Neto was seen with a modified football foot. The winger had cut out a large section from the back of his expensive footwear, with his sock protruding through the heel. While one may assume it is a healthy prank or just a pair of used footwear, it highlighted a little-known issue that affects several professional footballers.The image may have gone viral now, but players across time have featured the cut-off heels. Philippe Coutinho, Roberto Firmino, Mats Hummels and Daniele De Rossi have all worn similar cut-out boots. Footballers have modified their cleats in order to reduce the friction between the shoe and the heel. In a sport where cleats are fitted to the millimetre, and every sprint requires a sudden change of direction, discomfort in the heel can put a player’s entire game off balance and that of their team.It all boils down to the heels. Everyone has a different size and some have a “larger heel” than others. With footwear this can cause different types of discomfort, such as chafing and blisters, soreness and chronic conditions like 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 inflammation.
According to the American Academy of Orthopaedic 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 inflammation. 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 has worked with elite footballers at a FIFA Medical Centre of Excellence the condition develops through a combination of heel bone shape, thickening of the Achilles tendon and inflammation of the surrounding bursa. “That bursa, essentially, is like a shock absorber,” he said to The Athletic “The tendon becomes thicker, the bursa gets irritated, then the bone starts to get irritated. “They load it more, it gets more sore. That soreness means there are changes in the bone, which means it then gets more sore.”Treatment depends on the severity of the symptoms or pain. The first option is to modify the footwear. It is recommended to wear cushioned shoes and avoid tight-fitting ones and the second is to use protective heel pads. Since soccer cleats are a must 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 really only becomes a painful syndrome when that enlarged bone repeatedly irritates the soft tissue around it,” he told the outlet.
The soccer shoe
The best way to deal with the condition, at least in football, is to make space for the heel to go somewhere, in the back.
In professional soccer, there is no one-size-fits-all shoe. Though models used in the World Cup are the same as those available in the market, players often customise them to fit the shape of their feet or alleviate specific discomforts.The sight gained attention after player Pedro Neto wore two pairs of cleats with the heel section cut off. The soccer shoe he was wearing with the cut-off heel was a Nike Mercurial Vapor 16 Elite. While Neto has not publicly explained why his boot was modified, Haglund syndrome or just a blister could be the explanation.If a player is managing the syndrome, then opening up the back of the boot can reduce pressure on the heel. Otherwise, the rigid heel counters can press directly into the irritated area and cause pain. Other ways to manage the condition are through physiotherapy, shockwave therapy, injection therapy and changes to activity. “They’re not going to stop playing because of a little bit of pain in the back of their heel,” said Hudson-Gill. “They might be needed for a cup final or World Cup qualifiers.”Even a century later, the best way to deal with the condition, at least in football, is to make space for the heel to go somewhere, in the back.
