Retrocalcaneal bursitis is the painful inflammation and swelling of the retrocalcaneal bursa that is situated between the calcaneus (heel bone) and the Achilles tendon. A bursa is a small fluid
filled sac that forms around joints in areas where there is a lot of friction between muscles, tendons and outcrops of bone. The bursae position themselves in between the tendon or muscle and the
bone, buffering any friction from movement. To picture a bursa imagine it as a very small water filled balloon that sits in places where things rub against each other, such as in between a tendon and
a bone, to provide a soft smooth cushion for the tendon to pass over painlessly. The covering of the bursa also acts as a lubricant and aids the tendon?s movement. It is estimated that there is over
150 bursae in your body which protect the joint and tendons from wear. They are all very small and unnoticeable until they become swollen and painful with bursitis.
Wearing poorly fitting or constrictive footwear can cause the heel to become irritated and inflamed. Shoes that dig into the back of the heel are the primary cause of retroachilles bursitis. Foot or
ankle deformity. A foot or ankle deformity can make it more likely to develop retrocalcaneal bursitis. For example, some people can have an abnormal, prominent shape of the top of their heel, known
as a Haglund's deformity. This condition increases the chances of irritating the bursa. A trauma to the affected heel, such as inadvertently striking the back of the heel against a hard object, can
cause the bursa to fill with fluid, which in turn can irritate and inflame the bursa's synovial membrane. Even though the body usually reabsorbs the fluid, the membrane may stay inflamed, causing
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.
Before making a diagnosis of retrocalcaneal bursitis, a doctor must rule out other possible problems, such as arthritis, a fracture or tumor. A doctor also will try to determine if the Achilles
tendon itself is a source of pain. To make a diagnosis, a doctor will use some or all of the diagnostic tools below Patient interview. A doctor will ask a patient about medical history, and to
describe the onset of his or her symptoms, the pattern of pain and swelling, and how symptoms affect lifestyle. For example, doctors may ask patients what types of shoes they wear and what they do
for exercise. A patient's reported symptoms are important to diagnosis and treatment. The doctor will also ask what home treatments have helped the condition. Physical exam. A doctor will examine the
patient's foot, noting swelling, tenderness and pain points, and range of motion. The doctor also may ask the patient to point and flex the feet and stand on his or her toes.
Non Surgical Treatment
Treatments should involve decreasing swelling, relieving pain and stress on the Achilles, correcting any biomechanical dysfunction (over-pronation or flat feet), treating scar tissue, and then
restoring strength and movement. If you are performing an activity that could cause further trauma to the bursa, it is recommended that you protect the area with padding and/or proper footwear to
prevent further irritation or damage.
Bursectomy is a surgical procedure used to remove an inflamed or infected bursa, which is a fluid-filled sac that reduces friction between tissues of the body. Because retrocalcaneal bursitis can
cause chronic inflammation, pain and discomfort, bursectomy may be used as a treatment for the condition when it is persistent and cannot be relived with other treatments. During this procedure, a
surgeon makes small incisions so that a camera may be inserted into the joint. This camera is called an arthroscope. Another small incision is made so that surgical instruments can be inserted to
remove the inflamed bursa.