Bursitis is the inflammation of a bursa. Retrocalcaneal bursitis is in inflammation of the bursa located between the calcaneus and the anterior surface of the Achilles tendon.There are two bursae
located just superior to the insertion of the Achilles (calcaneal) tendon. Anterior or deep to the tendon is the retrocalcaneal (subtendinous) bursa, which is located between the Achilles tendon and
the calcaneus. Posterior or superficial to the Achilles tendon is the subcutaneous calcaneal bursa, also called the Achilles bursa. This bursa is located between the skin and posterior aspect of the
distal Achilles tendon.Inflammation of either or both of these bursa can cause pain at the posterior heel and ankle region. It is also known as Achille tendon bursitis. It can often be mistaken for
Achilles tendonitis or can also occur in conjunction with Achilles tendonitis.
The most common causes of bursitis are injury or overuse, although infection may also be a cause. Bursitis is also associated with other causes, such as arthritis, gout, tendinitis, diabetes, and
Patients with this condition typically experience pain at the back of the ankle and heel where the Achilles tendon attaches into the heel bone. Pain is typically experienced during activities
requiring strong or repetitive calf contractions (often involving end of range ankle movements) such as walking (especially uphill), going up and down stairs, running, jumping or hopping (especially
whilst wearing excessively tight shoes). Often pain may be worse with rest after these activities (especially that night or the following morning). The pain associated with this condition may 'warm
up' with activity in the initial stages of injury. As the condition progresses, patients may experience symptoms that increase during sport or activity, affecting performance. In severe cases,
patients may walk with a limp or be unable to weight bear on the affected leg. Other symptoms may include tenderness on firmly touching the affected bursa and swelling around the Achilles
Diagnosis of heel bursitis can be made by your health practitioner and is based on the following. Assessing the location of the pain by palpating the back of the heel. Assessment of any inflammation
at the back of the heel. Assessment of biomechanics and foot function. Ultrasound or MRI can reveal inflammation of the retro calcaneal bursa.
Non Surgical Treatment
Rest, ice, and anti-inflammatory medication will help with pain and swelling. Physical therapy can help stretch the Achilles to relieve any impingement. Also, a switch to properly-fitting shoes will
help to prevent the condition from worsening or recurring. You might also find relief with shoe inserts such as heel cups or padding. If you have tried these measures, yet symptoms remain severe and
continue to progress, surgical intervention is a possibility. Calcaneal bursitis surgery consists of excision or removal of the inflamed tissues and resection of the boney prominence. Debridement of
the affected area near the Achilles may also be performed, as well as repair of the Achilles if the condition has gone so far that the tendon ruptures.
Surgery is rarely done strictly for treatment of a bursitis. If any underlying cause is the reason, this may be addressed surgically. During surgery for other conditions, a bursa may be seen and