Retrocalcaneal bursitis is a painful inflammation of the soft tissues at the attachment of the Achilles tendon to the back of the heel bone. The retrocalcaneus identifies the ?retro? or behind and
?calcaneus? or heel bone. Bursitis relates to inflammation of a bursa in the retrocalcaneal region. A bursa anatomically is a fluid filled sack that is located around tendinous attachments in the
body. The retrocalcaneal bursa as identified in the photo 1 protects the Achilles tendon just prior to its insertion to the retrocalcaneal region. The retrocalcaneal bursa cushions the Achilles
tendon and normally allows pain free motion of the Achilles tendon over the calcaneus.
Repetitive, vigorous movement, strenuous and unaccustomed activities that put pressure on a joint, or a blow or other injury can bring on bursitis. The cause can vary depending on where the bursitis
occurs. In the shoulder, for example, it can be brought on by excessive strain, such as from serving in tennis. Kneeling on a hard floor can cause bursitis of the knee, and similarly, repeatedly
resting the elbow on a hard surface (such as a desk) can cause bursitis in that joint. Arthritis, gout, and certain infections can also contribute to the problem. Bursitis, in fact, may signal the
onset of arthritis. While getting older isn't a cause of bursitis, older people, especially older athletes, are more likely to develop the condition.
Your feet are extremely resilient and are designed to stand up to the pressures of day-to-day living. In some cases, though, foot structures may break down when subjected to chronic stress associated
with prolonged periods of weight-bearing activity on concrete, asphalt, or other hard surfaces (especially when your footwear does not allow for appropriate weight distribution). Foot problems,
including infracalcaneal bursitis, are often exacerbated by poorly designed footwear, and pressure, impact, and shear forces can damage your feet over time. Bursal sacs are intended to minimize this
damage, but sometimes the bursa itself becomes inflamed.
Carrying out a diagnosis for bursitis is fairly straightforward. The doctor will examine the affected area and ask the patient some questions about his/her recent activities. If the patient has a
high temperature the physician may take a small sample of fluid from a bursa near the affected body part. The sample will be tested for bacteria, and perhaps also crystals. If the patient does not
get better after treatment the doctor may carry out further tests so that he/she can eliminate the possibility that the symptoms might not be due to something else. These may include an x-ray, to
make sure no bones are broken or fractured. Blood tests, to check for rheumatoid arthritis. A CT scan or MRI scan to see if there is a torn tendon.
Non Surgical Treatment
It is important to treat bursitis in the early stages to reduce the symptoms, minimize damage and maintain motion and strength in your foot. Resting your ankle, using proper cushioning, wearing
comfortable footwear and reducing any activities that add pressure on your bursa will help to reduce your pain and bursitis inflammation.
Continue to wear your orthotics for work and exercise to provide stability and restore foot function. Select suitable shoes for work and physical activity that provide stability for the heel. Regular
stretching of the calf muscle can prevent heel bursitis. Do not suddenly increase activity amount without appropriate conditioning.