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.

Call (+6) 6471 2674 (24 Hour) to fix an appointment to treat Retrocalcaneal Bursitis today.

Pain in the sole of the foot, directly under the heel, is often caused by plantar fasciitis. This troublesome condition causes pain which is particularly severe when you first get out of bed in the morning but then eases a little as you continue to walk. The plantar fascia is a tough fibrous band, shaped like a triangle, which joins the ball of the foot with the heel bone. The strain and inflammation occur at the joint where the fascia joins the heel bone. Sometimes, an extra bit of bone, known as spur, may grow at this point.

Plantar Fasciitis

Plantar fasciitis often affects people who are on their feet a lot in their work and those who are overweight, so good footwear and losing weight can help. It an also be a feature of some types of inflammatory arthritis, but this is unusual.

In older people, pain under the heel can also be the result of thinning of the fat pad. There is normally a dense cushion of tissue, mostly fat, under the heel, which acts as a shock absorber when walking. This cushion may become thin as you get older and the heel bone is no longer so well protected. Well-fitting shoes with soft, sponge rubber soles and heels, perhaps with a soft insole as well, will protect the heel.

Heel Pad
Heel Cups

Treatment for Heel Pain

Anti-inflammatory injection often helps plantar fasciitis. Anti-inflammatory drug, wearing heel cups do help with the symptoms.

Shockwave therapy and Platelet Rich Plasma Therapy are more advanced treatment for heel pain.

Call (+65) 6471 2674 (24 Hour) to make an appointment to treat your heel pain today.

Plantar Fasciitis

Plantar fasciitis, also known as heel-spur syndrome is a widespread problem amongst people who are active in sports, particularly runners. It starts as a dull, intermittent pain in the heel. If not treated correctly, it will progress to a sharp, persistent pain. Dr. Kevin Yip tells how the condition can be managed.

Plantar Fasciitis

What is plantar fasciitis?

Plantar fasciitis is an inflammation of the plantar fascia, which is a thick band of tissue that runs from the heel of the foot to the toe. The pain is generally characterised as a dull, aching pain. In some cases, it can be a sharp, acute pain due to the inflammation.

What are the causes of plantar fasciitis?

The main cause of plantar fasciitis is due to overuse – such as running or standing all day. Teachers and factory supervisors who stand all day tend to get it due to increased pressure placed on the plantar fascia. We see it amongst long distance runners too. However, overuse is not enough to cause plantar fasciitis. We usually examine risk factors as well. One of them is the tightness of the calves, which is one of the leading causes of plantar fasciitis.

Another risk factor would be foot abnormalities. These include high arch foot (pes cavus) or flat-footedness (pes planus). In pes cavus, tension underneath the foot is going to be very high. With flat-footedness, the arch tends to collapse, creating a ‘windshield wiper’ effect. The bottom of the foot keeps rolling in, rendering it unstable.

Obesity is another reason – the extra weight can cause excess stress on the plantar fascia. Women may be more prone to develop plantar fasciitis due to long term use of high heels leading to tightening of the calves.

What are the signs and symptoms of plantar fasciitis?

Pain in the heel. This is most significantly felt in the mornings, during the first step of the day. Athletes, who run a lot, will feel it at the end of a run. The pain will be worse the following morning.

What can an athlete do to relieve the pain?

Painkillers can be taken or athletes can undergo the RICE therapy which is Rest, Ice Compression, Elevation therapy. It has an anti-inflammatory effect. The next step would be to reduce risk factors, which should be the highest priority. Daily stretching of the calves and the toes helps to stretch the plantar fascia, and bring some relief.

What are the other forms of treatment like for plantar fasciitis?

When the pain gets better. we start to strengthen the calves. Another way is to again look at reducing risk factors such as foot abnormalities.

Abnormal motion of the foot when walking such as overpronation, can be corrected with orthotic insoles, which we would get from a podiatrist to be custom made. A night splint is also used to keep the foot at 90 degress angle to maintain the pressure on the plantar fascia. Cortison injections are another form of approach in dealing with plantar fasciitis. It brings immediate relief but comes with side effects such as weakening of the tendons.

Shockwave therapy is another method that helps to promote our own body’s self healing mechanism to heal the plantar fascia naturally.

What is the rehabilitation process about for plantar fasciitis?

We start with the stretching and strengthening exercises. At more advanced levels, we move on to agility exercises like walking and running biomechanics as well as balance exercises. There has to be a certain degree of recovery before this stage can be reached.

What are the ways to prevent plantar fasciitis?

Plantar Fasciitis Stretching Exercise

Regular stretching exercises and strengthening of the calves are crucial when it comes to preventing plantar fasciitis. Use of appropriate footwear is also important.

Call +65 64712674 to treat your plantar fasciitis today.