Retrocalcaneal bursitis

​Bursae are small fluid filled sacs located around joints, bony prominences, muscles, tendons and ligaments. They work to facilitate movement by creating a cushion and reducing friction between structures. Retrocalcaneal bursitis is a condition in which the bursa which sits between the calcaneus (bone of the heel) and the achilles tendon becomes inflamed. This inflammation leads to friction and therefore irritation and pain in the area. Pain can range from mild and bothersome to severe and debilitating.

Bursitis is more common among older adults, but can still appear in younger individuals as well. It usually appears in those who 

symptoms

  • pain/discomfort at the back of the heel 
  • point tenderness 
  • swelling or redness 
  • decreased ROM 
  • pain during joint movements (e.g. going to tippy toes)

causes

  • direct trauma (a fall or sport related blow)
  • excessive stretch to the Achilles tendon (e.g. wearing high heeled shoes for long periods of time) 
  • excessive pressure to area (e.g. wearing tight/restrictive shoes) 
  • may be a complication of other conditions (e.g. gout, rheumatoid arthritis, seronegative spondyloarthropathies)

treatment

  • Shockwave therapy 
    • high frequency, short duration, bursts of high-energy pulses can be transmitted into affected area to reduce pain and accelerate the healing process
  • Manual therapy 
    • the use of myofascial release, muscle energy techniques, and mobilizations can be used to reduce pain and increase joint range of motion
  • Acupunture
    • the use of small sterile needles into specific spots to reduce pain and control the inflammation 
  • Therapeutic exercises
    • a tailored exercise prescription can be given to help speed up the healing process and get you back to normal functioning 
  • Taping
    • taping can be used around the affected joint for pain relief, support of inflamed soft tissue and stability to the joint during varying ranges of motion
  • Ergonomics 
    • a study of how you interact within your workplace to aid in providing the tools you need  for good posture and body mechanics to prevent further injury and minimize pain
  • Ultrasound 
    • the use of mechanical and thermal/heating mechanisms to reduce swelling, pain and accelerate the healing process 
  • Interferential Current (IFC)
    • the use of electrical current that stimulates the nervous system to allow for pain reduction, aid in tissue healing and reduce swelling

How physiotherapy can help

​Bursitis can be diagnosed by looking at patient history, symptoms, and the results of special tests that the physiotherapist can perform during the assessment. Many of bursitis symptoms can overlap with other conditions and therefore a careful assessment will occur. Once diagnosed, the physiotherapist will curate a rehabilitation plan that may start conservative (icing, rest, taping) and progress to more active rehab involving one or many of the modalities listed. The goal of the treatments will be to reduce pain and swelling, speed the healing process, and provide the tools needed to regain mobility and functioning.