Retrocalcaneal Bursitis

Retrocalcaneal Bursitis

(Heel Bursitis)

What is Retrocalcaneal Bursitis?

Retrocalcaneal bursitis is the most common heel bursitis.

Retrocalcaneal bursitis is inflammation of the bursa (a small, cushioning sac located where tendons pass over areas of bone around the joints), which lies over your heel (calcaneum) where your Achilles tendon inserts.

What is Bursitis?

What are Retrocalcaneal Bursitis Symptoms?

You may experience one or more of the following symptoms:

• Pain and swelling are occurring over the rear of your heel.
• Pain when you are leaning on your heel, e.g. sitting with heels on the ground.
• Increased pain when using your calf muscles. e.g. running, walking, calf raises

What Causes Retrocalcaneal Bursitis?

The retrocalcaneal bursa may be inflamed by your Achilles tendon rubbing over the bursa and causing friction against the heel bone. This injury can occur traumatically from a fall or a sport-related impact contusion.

It can also be a gradual onset via a repetitive trauma to the bursa from activities such as running and jumping (with inferior muscles control or technique) or excessive loading on your heel.

It is also a secondary injury associated with chronic conditions such as:

• Achilles Tendinopathy
• Plantar Fasciitis
• Heel Spurs
• Fibromyalgia
• Rheumatoid arthritis.

How is Retrocalcaneal Bursitis Diagnosed?

Your physiotherapist or doctor will provide you with an assessment of your medical history and a physical examination of your heel and ankle. A hallmark sign is swelling or tenderness of your heel around the insertion of your Achilles tendon.

Medical imaging techniques that include ultrasound scan & MRI confirm your diagnosis.

What is Retrocalcaneal Bursitis Treatment?

Ice

Bursitis is an inflamed bursa. Daily application of ice packs is highly recommended to reduce your pain and swelling.

Medications

NSAIDs or anti-inflammatory drugs (i.e. ibuprofen). Use of these medications should be discussed with your doctor.

Corticosteroid Injections

Single injection of a corticosteroid with a local anaesthetic into the bursa may be required to stimulate your healing response. It is preferable to have this injection using ultrasound guidance.

Retrocalcaneal Bursitis Treatment

PHASE I – Pain Relief & Protection

Managing your pain. Pain is the main reason that you seek treatment for retrocalcaneal bursitis. In truth, it was actually the final symptom that you developed and should be the first symptom to improve.

Managing your inflammation. Bursa inflammation is best eased via ice therapy and techniques or exercises that de-load the inflamed structures.

Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include: ice, electrotherapy, acupuncture, de-loading taping techniques, soft tissue massage etc.

PHASE II – Restoring Normal ROM, Strength

As your pain and inflammation settles, your physiotherapist will turn their attention to restoring your normal ankle joint range of motion, muscle length and resting tension, muscle strength, endurance and proprioception.

Please ask your physio for their advice.

PHASE III – Restoring Full Function

The final stage of your rehabilitation is aimed at returning you to your desired activities. Everyone has different demands for their lower limbs that will determine what specific treatment goals you need to achieve.

Your physiotherapist will tailor your elbow rehabilitation to help you achieve your own functional goals.

PHASE IV – Preventing a Recurrence

Retrocalcaneal bursitis can return if you annoy your bursa. The main reason it is thought to recur is due to insufficient rehabilitation or not understanding your condition.

Retrocalcaneal Bursitis Surgery

Surgery is not a common path. However, in persistent cases, removal of the bursa – known as a bursectomy – can be performed.

How Can You Prevent Retrocalcaneal Bursitis?

Muscle weakness or fatigue is a potential cause of retrocalcaneal bursitis. So addressing your strength and endurance is necessary to avoid a recurrence.

What Results Can You Expect for Retrocalcaneal Bursitis?

While some people can respond quickly to physiotherapy treatment within a few weeks, more chronic cases where an Achilles tendinopathy, plantar fasciitis, heel spur or other lower limb injury co-exists, can require a few months to achieve recovery.

Retrocalcaneal bursitis is successfully managed in the vast majority over a period of approximately six weeks. It is important to not stop your rehabilitation exercises as soon as your pain abates. Hydrocortisone injections may be helpful in the short-term to reduce the inflammatory response within the bursa.

Please follow the advice of your physiotherapist or doctor.