Retrocalcaneal refers to “behind the heel bone.” Bursitis means inflammation of a bursa, which is a fluid filled sac commonly found between tendons and bones. Retrocalcaneal bursitis is a common problem in athletes and is often associated with Achilles tendonitis.
- Pain at the back of the heel with running or with impact activity
- Pain with closed heel shoes
- Tenderness and swelling at the back of the heel
- Pain with side to side compression of the Achilles tendon
The bursa allows the Achilles tendon to smoothly glide over the heel bone without pain. An increase in pressure, friction, impact activity or change in shoe gear can cause the bursa to become inflamed. A tight Achilles tendon or heel spurs are the main contributing factors of retrocalcaneal burisits.
A bursitis in general responds well to conservative treatment. Athletes are encouraged to rest and avoid impact activities. Cross training exercises such as bicycling, elliptical and rowing are a few alternative activities to running. Icing, anti-inflammatory medications and ultrasound can help reduce inflammation and swelling. An off-loading pad such as a donut shaped pad can be placed over the Achilles tendon to relieve pressure from the bursa. Stretching the Achilles tendon and use of heel lifts or a high-heeled shoe will decrease the pull of the Achilles tendon and thus reduce inflammation and swelling of the bursa. In some cases a small amount of cortisone can be injected into the bursa, but it is crucial that the cortisone be injected into the bursa, and not the Achilles tendon as it can cause a rupture of the tendon. An alternative to cortisone is Traumeel, a natural anti-inflammatory medication that can be injected into the bursa with no risk of rupturing the Achilles tendon.
For more information about retrocalcaneal bursitis, come see one of our physicians at Foot & Ankle Doctors, Inc