Retrocalcaneal bursitis is the inflammation of the retrocalcaneal bursa, which is located behind the heel bone, also known as the calcaneal bone (hence the name retrocalcaneal). The retrocalcaneal
bursa is a thin, slippery, fluid-filled sac that serves as a both a cushion and lubricant between the heel bone and the Achilles tendon. Inflammation of the retrocalcaneal bursa usually results from
irritation of the bursa. This irritation may be due to certain activities, an underlying health condition such as arthritis, or an abnormality of the foot, such the development of a boney prominence
on the calcaneal bone, called a Haglund's deformity.
As ligaments and tendons stretch and tear, blood from ruptured blood vessels becomes trapped in the local tissues. As the trapped blood clots up, it sticks the tissues together creating adhesions.
Adhesions cause pain, inflammation and restricted movement because the layers of tissue that used to slide smoothly across one another now adhere and snap which interferes with normal functioning. It
is essential to break up clotted blood as quickly as possible to prevent adhesions and scar tissue from forming.
Where the tendon joins the calcaneal bone, friction can cause the spaces between the tendon, bone and skin to swell and inflame with bursitis. This constitutes a calcaneal bursa. Apart from swelling
over the back of the heel, you?ll feel acute tenderness and pain when you move it or even apply light pressure. Your swollen heel may look more red than the other one, and the swelling is often so
hard it can feel like bone, partly because it sometimes is, as a bony overgrowth can occur in chronic cases.
Diagnosis is first by clinical suspicion of symptoms. This can be mistaken for gout or infection especially in the big toe region. A diagnosis of bursitis is usually used in combination of the
underlying cause, for instance a bunion deformity, Haglund's deformity, or Heel Spur Syndrome. Many times the cause needs to be addressed to rid the problem of bursitis.
Non Surgical Treatment
The initial course of treatment for this problem, after the usual ice and ibuprofen/aspirin routine or course, is to change footwear, especially if the onset of the problem was coincidental with a
new pair of shoes. If this fails, a small heel lift (no more than ??) in both shoes may provide enough biomechanical adjustment to relieve the stress and/or friction over the area. If there is still
no improvement, complete rest from running is probably advised, along with a professional consultation.
Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help
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.