What is Retrocalcaneal Bursitis and how can it be treated?

What is the Retrocalcaneal Bursa and where is it located?

The Retrocalcaneal bursa is a fluid filled cushion that sits between the achilles tendon and the heel bone at the back of the heel, reducing friction where the Achilles tendon bends over the back of the heel before it goes up the leg. You cannot usually feel it, unless it is painful (!), but if you slide your fingers down either side of your Achilles tendon to just where it meets the heel bone, it sits there underneath the tendon.

What causes it to hurt?

Certain activities, such as running or walking up hills a lot, can increase compression and irritation of the bursa. Wearing tight shoes that press against the back of the heel can also cause irritation.

How do I know if I’ve got it.

The area around the back of the heel will feel very sore, sometimes described as a burning sensation, and you may notice a reddening of the skin and warmth local to the site of pain. It will likely be more painful if you walk up steep hills or stairs, or wear tight fitting shoes

What should I do?

If the pain is acute, rest, apply ice packs and take Ibuprofen if you need to, but once the acute pain has settled and the skin is a normal temperature, applying heat packs to the area will increase blood flow to the area, helping it to heal.

Do not on any account do heel drops below a step, as this will increase compression and irritation, making the pain worse. Avoid hills and stairs if you can, and wear comfortable shoes that are not too tight with the heel higher than the toes, such as a typical trainer type shoe.

How long does it take to get better?

It really depends, but if you catch it early and do the above, it should settle in 2 – 3 weeks. Getting a proper diagnosis and treatment plan will definitely speed your recovery.

How can a Podiatrist help?

As a Sports Podiatrist, I am experienced in the diagnosis and management of Retrocalcaneal Bursitis. As part of your treatment plan, having properly diagnosed your injury, I will give you advice on how to avoid stress through the injured area, together with graded exercises to restore strength and flexibility. I usually recommend high frequency laser treatment to relieve pain and inflammation so the area can heal more quickly, and may refer you for a steroid injection if the pain does not settle.

If you have a painful Achilles that is not settling, consider whether it might be Retrocalcaneal Bursitis and give me a call so I can help you.

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