What Is Retrocalcaneal Bursitis?

Causes, Symptoms, and Physio Solutions

Retrocalcaneal bursitis is a common but often misunderstood condition. Causing pain and discomfort at the back of the heel. Involving inflammation of the bursa, which is a fluid-filled sac, specifically located between the Achilles tendon and the heel bone. Affecting people of all activity levels, from athletes to those with more sedentary lifestyles. Fortunately, physiotherapy offers effective solutions to manage and treat the symptoms of this form of heel pain.

What Is Retrocalcaneal Bursitis?

Retrocalcaneal bursitis occurs when the bursa becomes inflamed/irritated due to overload from excessive friction, pressure, or repetitive loads. The bursa itself is there to act somewhat as a cushion, reducing the friction between the Achilles tendon and the heel bone. When this area becomes irritated from the above methods, it can result in pain, swelling, and reduce functional capacity.

Causes of Heel Pain

Several factors can contribute to the development of heel pain and retrocalcaneal bursitis, including:

• Overload: Repetitive loading actions such as running or jumping, can strain the area irritating the bursa.
• Footwear: Certain traits in shoes, such as those with a hard or tight heel counter can create pressure and friction, leading to inflammation around the heel.
• Biomechanics: Structural variations including foot posture and foot & ankle mobility can increase stress on the heel area.
• Medical: Underlying medical conditions, gout, rheumatoid arthritis… can predispose individuals to developing bursitis.

Symptoms of Retrocalcaneal Bursitis

Common signs and symptoms may include:

• Pain and tenderness at the back of the heel, especially when walking or standing. Also local pain on palpation of the heel is common.
• Swelling and redness, this isn’t always dramatic but is sometimes noticeable when comparing to the unaffected side near the Achilles tendon.
• Sensation of stiffness, or actual reduced range of motion in the ankle. This is often a painful restriction.
• Worsening pain when wearing tight or rigid footwear with a hard external heel counter.

How Physiotherapy Can Help Heel Bursitis

Physiotherapy and Podiatry are both commonly used as a cornerstone of treatment for retrocalcaneal bursitis. Offering non-invasive, effective solutions to reduce pain, improve mobility, and assist in preventing recurrence.  Your physio will assessing your condition, by getting an understanding of the history of the complaint. Then a physical assessment looking at your movement and biomechanics to identify any underlying contributing factors.

Treatment approaches for retrocalcaneal bursitis man include:

• Pain Management, this may include manual therapy, as well as appropriate electrotherapy including laser, cryotherapy, use of appropriate topical gels and education around home management.
• Loading Exercises, address movement imbalances and improve strengthen and mobility as appropriate.
• Biomechanical Adjustments, various foot mechanics may exacerbate heel pain. Gait patterns, insoles, heel cups, shoe changes may all play a role in helping reduce heel pain.

Preventing Retrocalcaneal Bursitis

Practical tips to minimize heel pain:

• Consider Your Footwear: Choose shoes with a soft heel counter and adequate arch support.
• Warm Up Before Activities: Prepare your tissues with a progressive relevant and dynamic warm up, prior to engaging in aggressive physical activities.
• Strengthen: Condition your foot and leg muscles so they are appropriately strong for the loads you want to put through them.
• Recovery: Avoid overtraining, allow time to “recover” between workouts.

When to Seek Professional Help

If symptoms of retrocalcaneal bursitis persist beyond a couple of weeks despite self-care measures, consider consulting a physiotherapist. Untreated heel pain can lead to significant functional limitations and greatly impact quality of life.

Retrocalcaneal bursitis is ideally a very treatable condition that can cause significant discomfort if not addressed. With the help of physiotherapy, individuals can generally find relief from pain, and regain their function. Don’t let heel pain hold you back. Proper management and prevention strategies can help ensure you overcome heel pain.