Overview
There are two main bursae involved in heel bursitis, the subtendinous calcaneal bursa and the subcutaneous calcaneal bursa. Both of these bursa are located near the Achilles tendon. The subtendinous calcaneal bursa, which is also referred to as the retrocalcaneal bursa, is on the back of the heel and is deeply situated between the Achilles tendon and the calcaneus. The subcutaneous calcaneal bursa, which is commonly referred to as the Achilles bursa, is located near the bottom of the heel between the skin and the distal aspect of the Achilles tendon. It?s much more superficial to the Achilles tendon than the subtendinous calcaneal bursa.
Causes
A rapid increase in physical activity levels or thinning of the heel?s protective fat pad are factors that may contribute to infracalcaneal bursitis. Other possible causes of infracalcaneal bursitis include blunt force trauma, acute or chronic infection, and arthritic conditions. The following factors may increase your risk of experiencing bursitis, including infracalcaneal bursitis. Participating in contact sports. Having a previous history of bursitis in any joint. Poor conditioning. Exposure to cold weather. Heel striking when running, especially in conventional running shoes with heel elevation.
Symptoms
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
When you are experiencing Achilles pain at the back of your heel, a visit to the doctor is always recommended. Getting a proper diagnosis is important so you can treat your condition correctly. A doctor visit is always recommended.
Non Surgical Treatment
The most important factor in healing bursitis is resting your foot and ankle. This can be difficult when you have to carry on with daily activities, but resting and elevating your foot whenever you can is recommended. During your recovery you will probably have to modify or avoid the activities that stress your bursa until your pain and inflammation settle.
Surgical Treatment
Only if non-surgical attempts at treatment fail, will it make sense to consider surgery. Surgery for retrocalcanel bursitis can include many different procedures. Some of these include removal of the bursa, removing any excess bone at the back of the heel (calcaneal exostectomy), and occasionally detachment and re-attachment of the Achilles tendon. If the foot structure and shape of the heel bone is a primary cause of the bursitis, surgery to re-align the heel bone (calcaneal osteotomy) may be considered. Regardless of which exact surgery is planned, the goal is always to decrease pain and correct the deformity. The idea is to get you back to the activities that you really enjoy. Your foot and ankle surgeon will determine the exact surgical procedure that is most likely to correct the problem in your case. But if you have to have surgery, you can work together to develop a plan that will help assure success.
There are two main bursae involved in heel bursitis, the subtendinous calcaneal bursa and the subcutaneous calcaneal bursa. Both of these bursa are located near the Achilles tendon. The subtendinous calcaneal bursa, which is also referred to as the retrocalcaneal bursa, is on the back of the heel and is deeply situated between the Achilles tendon and the calcaneus. The subcutaneous calcaneal bursa, which is commonly referred to as the Achilles bursa, is located near the bottom of the heel between the skin and the distal aspect of the Achilles tendon. It?s much more superficial to the Achilles tendon than the subtendinous calcaneal bursa.
Causes
A rapid increase in physical activity levels or thinning of the heel?s protective fat pad are factors that may contribute to infracalcaneal bursitis. Other possible causes of infracalcaneal bursitis include blunt force trauma, acute or chronic infection, and arthritic conditions. The following factors may increase your risk of experiencing bursitis, including infracalcaneal bursitis. Participating in contact sports. Having a previous history of bursitis in any joint. Poor conditioning. Exposure to cold weather. Heel striking when running, especially in conventional running shoes with heel elevation.
Symptoms
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
When you are experiencing Achilles pain at the back of your heel, a visit to the doctor is always recommended. Getting a proper diagnosis is important so you can treat your condition correctly. A doctor visit is always recommended.
Non Surgical Treatment
The most important factor in healing bursitis is resting your foot and ankle. This can be difficult when you have to carry on with daily activities, but resting and elevating your foot whenever you can is recommended. During your recovery you will probably have to modify or avoid the activities that stress your bursa until your pain and inflammation settle.
Surgical Treatment
Only if non-surgical attempts at treatment fail, will it make sense to consider surgery. Surgery for retrocalcanel bursitis can include many different procedures. Some of these include removal of the bursa, removing any excess bone at the back of the heel (calcaneal exostectomy), and occasionally detachment and re-attachment of the Achilles tendon. If the foot structure and shape of the heel bone is a primary cause of the bursitis, surgery to re-align the heel bone (calcaneal osteotomy) may be considered. Regardless of which exact surgery is planned, the goal is always to decrease pain and correct the deformity. The idea is to get you back to the activities that you really enjoy. Your foot and ankle surgeon will determine the exact surgical procedure that is most likely to correct the problem in your case. But if you have to have surgery, you can work together to develop a plan that will help assure success.
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