Retrocalcaneal and retroachilles bursitis are both common types of bursitis that can cause pain at the back of the foot, just above the heel. This pain, and often swelling, occurs when one or both
bursae at the back of the heel become irritated and inflamed. Because they have similar symptoms, heel bursitis is sometimes confused with problems affecting the Achilles tendon, which is a long
strip of fibrous tissue that connects the back of the heel to the calf muscle. Other times, Achilles tendon problems may bring about the bursitis. For example, tight calf muscles can contribute to
chronic pulling where the Achilles tendon inserts into the back of the heel. This pulling can result in friction and irritation that eventually lead to bursitis.
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.
Medical experts strongly recommend that you consult a doctor if you have any of the symptoms below. Disabling joint pain that prevents you from doing your daily activities. Pain that lasts for more
than two weeks. Excessive swelling, redness, bruising or a rash around the painful joint. Sharp or shooting pain, especially when you exercise or do something more strenuous. A fever. Any of the
above could be a sign of infection, a condition such as arthritis or a more serious injury such as a tendon tear that may require medical attention.
When you suspect you have retrocalcaneal bursitis, your foot doctor will begin by taking a complete history of the condition. A physical exam will also be performed. X-rays are usually taken on the
first visit as well to determine the shape of the heel bone, joint alignment in the rearfoot, and to look for calcium deposits in the Achilles tendon. The history, exam and x-rays may sufficient for
your foot surgeon to get an idea of the treatment that will be required. In some cases, it may be necessary to get an ultrasound or MRI to further evaluate the Achilles tendon or its associated
bursa. While calcium deposits can show up on xray, the inflammation in the tendon and bursa will show up much better on ultrasound and MRI. The results of these tests can usually be explained on the
first visit. You can then have a full understanding of how the problem started, what you can do to treat prevent it from getting worse/ You will also know which treatment will be most helpful in
making your heel pain go away.
Non Surgical Treatment
Many cases of retrocalcaneal bursitis can be resolved with self-care that is focused on reducing inflammation and eliminating activities or positions that aggravate the bursa. Some cases, however,
may become more serious and require more medical interventions. Rarely, surgery is needed. Following the R.I.C.E. formula, or Rest, Ice, Compression, and Elevation, is often sufficient to treat
aseptic bursitis. Rest. People with retrocalcaneal bursitis should avoid activities that irritate the bursa, such as jogging or excessive walking. Ice. Applying a cold compress to the back of the
ankle for about 20 minutes two or three times a day may help alleviate symptoms and decrease swelling. Compression. An elastic medical bandage (e.g. Ace? bandage) wrapped around the affected heel and
ankle can help control swelling. Elevating the affected heel. Sitting down with the leg elevated on a stool or lying down with the foot elevated on a pillow can help reduce blood flow to the area,
thereby reducing inflammation.
Once your pain and inflammation is gone, you can prevent retrocalcaneal bursitis deformity by wearing the best shoes for your foot type. You should high-heels and pumps if possible. Wear orthotics
(custom arch supports) or over-the-counter orthotic devices. Perform frequent Achilles tendon stretching exercises to prevent it from becoming tight agian. Avoiding running uphill when training. Try
to run on softer surfaces and avoid concrete.