Retrocalcaneal Bursitis

Retrocalcaneal bursitis is a condition where there is tissue damage and inflammation of the retrocalcaneal bursa, a small fluid filled sac located between the Achilles tendon and back of the heel bone (calcaneus) causing pain in the heel region.

Pain is usually experienced during activities requiring strong or repetitive calf contractions such as walking, running, jumping or hopping. Often pain is worse after these activities when resting, particularly in the evening or the morning after. Other symptoms may include tenderness when firmly touching the affected bursa, redness, pain when lowering heels down and swelling around the Achilles region.

Causes:

• Trauma from a fall or a sport-related impact contusion.
• It may be a secondary injury associated with chronic conditions such as:
  • Achilles Tendonitis
  • Plantar Fasciitis
  • Heel Spurs
  • Fibromyalgia
• Over Pronation (rolling in of the ankles).
• Tight or ill-fitting footwear.
• Joint stiffness (particularly the ankle, subtalar joint or foot).
• Bony anomalies of the heel bone.
• Change in training conditions or surfaces.

At Mint Foot Care Podiatry, we can this condition by taking a thorough history, performing a biomechanical assessment and video gait analysis. Diagnostic imaging such as Ultrasound and MRI may be necessary for diagnosis.

Based on the findings a combination of treatment options may be prescribed including:

• Rest and Ice – keeping off the foot and reducing activity prevents further injury and encourages healing. Ice can reduce inflammation, swelling and symptoms.
• Non-steroidal anti-inflammatory medication – help reduce the pain and inflammation such as ibuprofen or aspirin.
• Proper fitting and supportive footwear recommendations.
• Custom made orthotic therapy – orthotics may be prescribed to address any biomechanical factors such as over pronation.
• Immobilization – restricting movement in a brace or cast is sometime necessary to reduce symptoms.
• Exercises/stretches.
• Ultrasound therapy.
• Dry Needling.
• Surgery is indicated in severe cases when conservative treatment has not resolved the problem.

It is important to see your podiatrist as early diagnosis of this condition is crucial to enable rapid healing before a more serious rupture occurs.