A bursa is a small sack of fluid that sits between a tendon and a bone to help the tendon move smoothly over the bone. The retrocalcaneal bursa in situated in the feet between the Achilles tendon and the calcaneus or heel bone. With repeated trauma the bursa can become inflamed. Achilles tendon bursitis is often mistaken for achilles tendinitis. It is possible for the athlete to have both achilles tendinitis and achilles tendon bursitis at the same time which is known as Haglund’s syndrome.
If the posterior-superior portion of the heel has an abnormally large bony prominence protruding from it (called a Haglund’s Deformity), in some instances it may rub against the Achilles Tendon. When this occurs, the bursa between the bone and the tendon will become inflamed, swollen, and painful. This condition is called Retrocalcaneal Bursitis. The presence of a Haglund’s Deformity does not insure that these problems will occur. In order for these problems to occur, the heel and foot must be tilted in such a way as to actually force this bony prominence into the bursa and tendon.
The signs and symptoms of heel bursitis can include heel pain wearing particular footwear, Pain or discomfort in the heel when walking, jogging or running, Swelling or inflammation in the heel.
To begin with, your doctor will gather a medical history about you and your current condition and symptoms. He/she will inquire about the level of your heel pain, the how long you have had the symptoms and the limitations you are experiencing. Details about what and when the pain started, all are very helpful in providing you with a diagnoses of your ankle / heel.
Non Surgical Treatment
Gradual and progressive stretching of the Achilles tendon. Exercises to strengthen and support the ankle. Rest or reduced weight bearing activities. Immobilisation in a cast for 4-6 weeks for severe cases. Ice. Proper fitting and supportive footwear. Massage. Joint mobilisation. Anti-inflammatory medications: only if this does not have adverse results with the patient’s current medication. Heel pads and heel lifts. Footwear Advice. Strapping and padding Orthoses/innersoles. The orthotics prescribed and designed by the podiatrists at the Heel and Arch Pain Clinic (affiliated with Beyond Podiatry) are made to align the foot in the correct posture. Surgery is indicated in severe cases when conservative treatment has not resolved the problem.
Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help symptoms.
To prevent bursitis of the heel in the first place, always keep proper form during exercise. In addition, don?t jump into exercises that are too intense without building up to them. Strengthen and flex your ankle.