What is it?

A bursa is a fluid filled sack that acts as a cushion between tendons, bones, joints and muscles. The Retrocalcaneal Bursa is located on the back of the heel and acts as a lubrication layer between the Achilles Tendon and the bony heel. The Achilles Tendon is capable of up to 450kg of force and is the largest and strongest tendon in the body. As such the Retrocalcaneal Bursa is subject to regular and high forces. When the compressive and friction forces applied to the bursa are high during certain ankle movements and when wearing tight shoes, the bursa can become swollen and painful. This is called Retrocalcaneal Bursitis.

Patients with this condition typically experience pain in the back of the ankle and heel where the Achilles tendon attached to the heel bone. Pain is typically experienced with activities involving strong, regular movements of the ankle at end of range. Activities such as uphill walking, going up and down stairs, running, jumping or hopping are commonly contribute to the bursitis.

4 Life Podiatry

Conservative treatment of Retrocalcaneal Bursitis has an excellent prognosis for a full recovery. Minor cases which have not been present for long often make a full recovery within weeks. In patients with severe symptoms, or who have had the condition for a long time, it can take some months to resolve. As such early treatment is vital to ensure a quick recovery.

Treatment options include joint mobilisation techniques, soft tissue release, dry needling, stretches, arch support and taping. The use of heel wedges and compression stockings may also be used in the initial stages of treatment. Poor foot mechanics, particularly “flat feet: can predispose patients to bursitis and orthotics are often recommended.

Prevention & Home Management Strategies

There are a number of preventative strategies that you can use to help prevent or manage Retrocalcaneal Bursitis, such as:

• Wearing appropriate footwear, ensuring they are not too tight at the heel
• Not dramatically increasing exercise programs, unless under the guidance of a professional
• Maintaining a healthy body weight
• Improving pelvic floor and core muscle strength
• Including an adequate warm-up, stretching and recovery programs with sports
• Improving balance and proprioception by completing balance exercises.
• Applying ice after activity