Achilles tendon bursitis, or retrocalcaneal bursitis, can affect anyone, but is typically a foot condition in athletes, especially runners. Because of similar symptoms, this condition is often
confused with Achilles tendinitis. At times, bursitis of the Achilles tendon can occur in conjunction with Achilles tendinitis. When both conditions are present, it is referred to as Haglund's
syndrome. If you are a runner and are experiencing pain in your lower leg and heel area, you may be suffering from Achilles tendon bursitis. Proper treatment of the condition can help relieve the
pain and allow your leg to heal.
Improper foot wear, tight shoes or shoes that do not fit properly can cause extra pressure and friction on the back of the heel. Overtime, this pressure causes irritation of the bursae that protects
the Achilles tendon causing one or both to swell and become inflamed. Athletes who overtrain or runners that increase their distance to quickly are at greater risk of experiencing Achilles bursitis.
With over use, the Achilles bursae and tendon can become irritated and inflamed leading to thickening of the bursae lining and wearing of the tendon. Fluid builds in the bursa when it becomes
irritated causing swelling of the Achilles bursa and pain at the back of the heel.
Common signs and symptoms associated with infracalcaneal bursitis include redness under the heel. Pain and swelling under the heel. Pain or ache in the middle part of the underside of the heel. Heel
pain or discomfort that increases with prolonged weight-bearing activities.
A thorough subjective and objective examination from a physiotherapist may be all that is necessary to diagnose a retrocalcaneal bursitis. Diagnosis may be confirmed with an ultrasound investigation,
MRI or CT scan.
Non Surgical Treatment
The patient with retrocalcaneal bursitis should be instructed to apply ice to the posterior heel and ankle in the acute period of the bursitis. Icing can be performed several times a day, for 15-20
minutes each. Some clinicians also advocate the use of contrast baths. Gradual progressive stretching of the Achilles tendon may help relieve impingement on the subtendinous bursa and can be
performed in the following manner. Stand in front of a wall, with the affected foot flat on the floor. Lean forward toward the wall until a gentle stretching is felt within the ipsilateral Achilles
tendon. Maintain the stretch for 20-60 seconds and then relax. Perform the stretches with the knee extended and then again with the knee flexed. To maximize the benefit of the stretching program,
repeat the above steps for several stretches per set, several times daily. Avoid ballistic (ie, abrupt, jerking) stretches. Other treatment options are microcurrent therapy and corticosteriod
injection into the retrocalcaneal bursa. If conservation treatment fails then surgery is indicated.
Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help