Summary
- Associated with Haglund’s Deformity and Insertional Achilles Tendinitis.
- Retrocalcaneal bursitis is a condition characterized by tissue damage and inflammation of the retrocalcaneal bursa causing pain in the heel region.
- Compressive forces and friction on the retrocalcaneal bursa, or wearing excessively tight shoes may cause retrocalcaneal bursitis.
Diagnostic tips
- Pain at the back of the ankle and heel at the Achilles tendon insertion (experienced during activities requiring strong or repetitive calf contractions such as walking, running, jumping or hopping.
- Pain is worse with rest after these activities (especially that night or the following morning).
- Pain associated with this condition may ‘warm up’ with activity in the initial stages of injury; as the condition progresses, patients may experience symptoms that increase during sport or activity, affecting performance.
- Limping.
- Tenderness on firmly touching the affected bursa
- Swelling around the Achilles region.
Tests and Imaging
- Physical examination.
- Ultrasound MRI and CT scans confirm diagnosis.
Immediate Treatment
- Advise to avoid shoes that will irritate the inflamed and enlarged area behind the heel itself.
- Consider heel raise to avoid friction directly on the site.
- Guided injection may provide temporary relief.
- Advise weight loss.
Possible Referral
- Podiatry for biomechanical assessment and heel raises, orthoses, footwear advice.
- Orthopaedic foot surgeon for surgical approach if there is deformity.