Heel bursitis is a common foot pain in athletes, and is often mistaken for Achilles tendinitis, although it can also occur together with Achilles tendinitis. Heel bursitis occurs when small cushions
in the heel called bursas become inflamed and swell with fluid irritating surrounding tissue and pressing on nerves. Other names given to heel bursitis are Achilles bursitis and Retrocalcaneal
Repetitive overuse injury of the ankle during long periods of running and or walking. Tight shoes. The heel counter of the shoe constantly rubbing against the back of the heel. Wearing shoes with a
low cut heel counter. Abnormal foot mechanics (abnormal pronation). Poor flexibility. Inappropriate training.
Symptoms include pain at the back of the heel, especially when running uphill or on soft surfaces. There will be tenderness and swelling at the back of the heel which may make it difficult to wear
certain shoes. When pressing in with the fingers both sides are the back of the heel a spongy resistance may be felt.
Plain radiographs of the calcaneus may reveal a Haglund deformity (increased prominence of the posterosuperior aspect of the calcaneus). However, on weight-bearing lateral radiographs, the
retrocalcaneal recess often appears normal even in patients with retrocalcaneal bursitis, limiting its usefulness in making this diagnosis.Radiographs may be used as a diagnostic measure to support a
clinician?s diagnosis of retrocalcaneal bursitis. Individuals with retrocalcaneal bursitis may have an absence of the normal radiolucency (ie, blunting) that is seen in the posteroinferior corner of
the Kager fat pad, known as the retrocalcaneal recess or bursal wedge. This may occur with or without an associated erosion of the calcaneus.
Non Surgical Treatment
The most important factor in healing bursitis is resting your foot and ankle. This can be difficult when you have to carry on with daily activities, but resting and elevating your foot whenever you
can is recommended. During your recovery you will probably have to modify or avoid the activities that stress your bursa until your pain and inflammation settle.
Prevention can be accomplished by controlling your foot structure with good supportive shoes or arch supports. Pay attention to early signs of friction like blister formation. This tells you where
the areas that are more likely to cause a bursa to form and subsequently a bursitis.