Brief Outline of Retrocalcaneal Bursitis
The retrocalcaneal bursa helps to lubricate and cushion the tendon as it runs over the heel. This bursa takes a lot of stress during repetitive flexing and extending of the foot, such as during running, walking or jumping. Worn or incorrectly sized footwear or excessive pronation of the foot can also lead to problems with this bursa, as well as the Achilles tendon. Shoes that fit too tightly, especially in the back, may put additional stress on the tendon and bursa.
Anatomy and Physiology of Retrocalcaneal Bursitis
The retrocalcaneal bursa lied between the anterior Achilles tendon insertion and the calcaneus (heel bone). The repetitive friction of the tendon running over this bursa during active plantar flexion during push-off compresses the bursa between the tendon and bone, and can cause inflammation.
Cause of Retrocalcaneal Bursitis
Repetitive stress to the bursa by the friction of the Achilles tendon during walking, running, or jumping. Increasing duration or distance too quickly. Improper footwear or waling/running gait. Injury to the Achilles tendon.
Signs and Symptoms of Retrocalcaneal Bursitis
Pain especially with walking, running, or jumping. Tenderness over the heel area. Redness and slight swelling may be noted over the heel.
Complications of Retrocalcaneal Bursitis
The bursa can rupture completely if the injury is left unattended. This complete rupture could lead to other problems with the Achilles tendon due to increased friction. The pain may make it difficult to get up on the toes during walking, running, or jumping.
Immediate Treatment for Retrocalcaneal Bursitis
Rest, Ice. Anti-inflammatory medication and injection. Shockwave therapy.
Long-term Prognosis for Retrocalcaneal Bursitis
Proper treatment and rest should lead to a complete recovery. In rare cases the fluid that builds up due to the inflammation may need to be drained to facilitate healing. Surgery is only necessary in extreme cases that do not respond to rest and rehabilitation.