During contraction of the calf muscle, tension is placed through the Achilles tendon and this rubs against the retrocalcaneal bursa. Compressive forces and friction may also be placed on the
retrocalcaneal bursa during certain ankle movements or by wearing excessively tight shoes. When these forces are excessive due to too much repetition or high force, irritation and inflammation of the
bursa may occur. This condition is known as retrocalcaneal bursitis.
Retrocalcaneal bursitis can be caused through injury or infection or be can be triggered by certain health conditions. If bursitis develops as a result of injury then it will normally be due to a
repetitive strenuous activity that encourages the calf muscles (the gastrocnemius and soleus muscle), which attach to the heel bone via the Achilles tendon, to tighten and shorten from overuse, for
example repetitively wearing high heels, running and even wearing tight shoes that pinch at the back of the heel. This puts more pressure over the bursa as the tendon rubs more tightly over it,
irritating it and triggering a painful inflammatory reaction (swelling). This risk of developing bursitis in this way is greater for those whose jobs or hobbies involve a lot of repetitive movements,
for example carpet fitters and gardeners who spend a lot of time kneeling and so are more at risk of bursitis in the knee. Runners have a greater likelihood of developing bursitis in the hip.
Bursitis can also be brought on by excessive pressure or direct impact trauma, such as banging your elbow or dropping on to your knees. Infection is a less common cause of bursitis and normally only
occurs in people who have a weakened immune system from other health issues. The infection can work its way to the bursa from a cut close to the bursa that has become infected, in these cases the
bursitis is termed as septic bursitis. Certain health conditions can also trigger the development of bursitis, such as rheumatoid arthritis and gout, amongst others.
Pain or tenderness at the back of the heel around the Achilles region. Increased pain during activities with strong, repetitive calf contractions, walking (uphill), stair climbing, running, jumping.
Pain may be worse with rest after activity (that night or the next morning) or at the beginning of the excercise. Pain when wearing shoes and the heel is getting rubbed. Bump forming on the back of
the heel. Limping. Stiffness. Decreased range of motion. Redness and warmth (if the bursa gets infected).
The diagnosis is based on the symptoms and an examination. For anterior Achilles tendon bursitis, doctors use x-rays to rule out a fracture of the heel bone or damage to the heel bone caused by
rheumatoid arthritis or other inflammatory arthritis.
Non Surgical Treatment
According to the National Institutes of Health, custom heel wedges can be purchased by people suffering from retrocalcaneal bursitis. These wedges reduce stress on the heel, which can reduce the pain
and inflammation associated with an inflamed bursa. They can be purchased without a prescription, making it easy for anyone experiencing a flare-up of symptoms to get the added support of these
Surgery is rarely done strictly for treatment of a bursitis. If any underlying cause is the reason, this may be addressed surgically. During surgery for other conditions, a bursa may be seen and