Retrocalcaneal bursitis is the inflammation of the fluid-filled sac (bursa) at the back of the heel bone (calcaneus). The retrocalcaneal bursa is located between the Achilles tendon and the heel bone
and is designed to reduce friction between the Achilles tendon and the heel bone. During contraction of the calf muscle, tension is generated through the Achilles tendon and it rubs against the
retrocalcaneal bursa. When there is excessive friction due to repetitive rubbing of the tendon against the bursa or high impact force translating through the Achilles tendon, irritation and
inflammation of the bursa may occur. The inflammation can also be aggravated by pressure, such as when athletes wear tight-fitting shoes. This condition is often mistaken for Achilles tendinitis but
it can also occur in conjunction with Achilles tendinitis.
Bursitis has many causes, including autoimmune disorders, crystal deposition (gout and pseudogout), infectious diseases, traumatic events, and hemorrhagic disorders, as well as being secondary to
overuse. Repetitive injury within the bursa results in local vasodilatation and increased vascular permeability, which stimulate the inflammatory cascade.
Bursitis usually causes a dull pain, tenderness, and stiffness near the affected bursa. The bursa may swell and make the skin around it red and warm to the touch. Bursitis is most common in the
shoulder camera.gif, elbow camera.gif, hip camera.gif, and knee camera.gif. Bursitis may also occur near the Achilles tendon or in the foot. Symptoms of bursitis may be like those of tendinopathy.
Both occur in the tissues in and around the joints. Check with your doctor if your pain is severe, if the sore area becomes very hot or red, or if you have a fever.
The doctor will discuss your symptoms and visually assess the bones and soft tissue in your foot. If a soft tissue injury is suspected, an MRI will likely be done to view where and how much the
damage is in your ankle. An x-ray may be recommended to rule out a bone spur or other foreign body as the cause of your ankle pain. As the subcutaneous bursa is close to the surface of the skin, it
is more susceptible to septic, or infectious, bursitis caused by a cut or scrape at the back of the heel. Septic bursitis required antibiotics to get rid of the infection. Your doctor will be able to
determine whether there is an infection or not by drawing a small sample of the bursa fluid with a needle.
Non Surgical Treatment
Many times, Achilles tendon bursitis can be treated with home care. However, if self-care remedies do not work, your doctor may need to administer additional treatments. Home care. The most important
thing you can do to help your healing is to refrain from activities that could further aggravate the bursitis. Typical home-care treatments for Achilles tendon bursitis include Anti-inflammatory
medication. Take over-the-counter pain medication, like aspirin or ibuprofen, to reduce pain and swelling. Heel wedges. An over-the-counter or custom heel wedge can be placed in your shoe to minimize
stress in the Achilles tendon. Ice. Apply ice or other cold therapy to your sore heel several times a day. Rest. Limit your activity on the injured leg, avoid putting pressure on it whenever
possible. Also, elevate your leg during non-use to help reduce the swelling. The above remedies may be used on their own or in combination with others on the list. Physician-administered treatments.
If the above self-care remedies are not effective, you should visit your doctor for additional treatment. Possible Achilles tendon bursitis treatments your doctor may administer include
immobilization. If the bursitis is combined with Achilles tendonitis, your doctor may place a temporary cast on the ankle to prevent movement and allow it to heal. Physical therapy. Exercises may be
used to improve the ankle's strength and flexibility. Steroids. Injection of steroids into the retrocalcaneal bursa (not the Achilles tendon) may be necessary. Surgery. In very rare circumstances,
surgery may be needed to remove the retrocalcaneal bursa, however, this is typically a last resort.
Protect that part of the body that may be most vulnerable, If you have to kneel a lot, get some knee pads. Elbow braces can protect tennis and golf players. If you are an athlete or avid walker,
invest in some good walking or running shoes. When doing repetitive tasks have breaks. Apart from taking regular breaks, try varying your movements so that you are using different parts of your body.
Warm up before exercise. Before any type of vigorous exercise you should warm up for at least 5 to 10 minutes. The warm up could include walking at a good speed, slow jogging, or a cycling machine.
Strong muscles add extra protection to the area. If you strengthen the muscles in the area where you had bursitis (after you are better), especially the area around the joint, you will have extra
protection from injury. Make sure you do this well after your bursitis has gone completely.