Retrocalcaneal bursitis and Achilles bursitis are the most widely spread types of ankle / heel bursitis out there. However, there are several bursa lubrication fluid sacs behind the heel bone
protecting this area that may become irritated, inflammed and painful.
Improper foot wear, tight shoes or shoes that do not fit properly can cause extra pressure and friction on the back of the heel. Overtime, this pressure causes irritation of the bursae that protects
the Achilles tendon causing one or both to swell and become inflamed. Athletes who overtrain or runners that increase their distance to quickly are at greater risk of experiencing Achilles bursitis.
With over use, the Achilles bursae and tendon can become irritated and inflamed leading to thickening of the bursae lining and wearing of the tendon. Fluid builds in the bursa when it becomes
irritated causing swelling of the Achilles bursa and pain at the back of the heel.
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.
A physical examination will be performed to determine if you have any signs of Achilles Bursitis or other ankle injury. He/she will look and feel the soft tissue and bones in your ankles to note any
differences between the two of them. This will identify any abnormalities, such as swelling, bone deformities, atrophied muscles, redness and/or warmth on the skin. In many cases, the first sign that
you have Achilles bursitis is swelling in the back of the foot and ankle pain.
Non Surgical Treatment
Treatment consists of anti-inflammatory therapy with the use of ice, short term non steroidal therapy including ibuprofen and naproxen and selective use of cortisone injections. Cortisone injections
have been shown to be a highly effective anti-inflammatory measure for relieving foot and ankle pain. Care must always be taken by the physician to insure that the injection is administered into the
bursal sac and not the Achilles tendon which can cause tendon injury. Treatment also consists of the use of heel lifts or the temporary use of a shoe with a low heel. The heel lift decreases the
mechanical load on the Achilles tendon. Gentle stretching of the Achilles tendon, the possible use of a splint that is worn at night as well as physical therapy as directed by your physician can be
employed. Temporary activity limitations for fitness must be incorporated into the treatment plan. Any weight bearing activity for exercise that actively lifts your heel off of the ground including
running, walking stair stepper will interfere with effective conservative care. Low impact activity including biking and pool tend to be safe exercises during your recovery.
Contact your physician if bursitis pain is disabling (when movement of the joint is largely or entirely restricted), if the pain doesn?t subside after a week of self-care, or if the joint is red and
swollen. Also call your doctor if you develop a fever, which could signal infectious bursitis-a condition that especially can afflict the elbow. Except for the fever, symptoms resemble other forms of
bursitis, but infectious bursitis requires immediate medical attention.