Retrocalcaneal bursitis
Retrocalcaneal bursitis is inflammation of the small fluid-filled sac (bursa) between the back of the heel bone and the Achilles tendon, just above the point where the tendon connects to the bone. The inflammation causes swelling, tenderness, and pain on the back of the foot.
Retrocalcaneal bursitis develops gradually, usually from pressure from the back of a shoe. Activities that repetitively overflex the foot upward, such as hill running, cause the Achilles tendon to press against the bursa and can also cause inflammation. Wearing shoes and being active can often make symptoms worse. But symptoms usually improve with rest.
Treatment for this condition may include changing footwear if needed, ice massage, and nonsteroidal anti-inflammatory drug (NSAID) treatment. After 3 days, you can try heat, or you can alternate heat and ice. Runners are advised to avoid hill running, reduce mileage, and run on a soft yet firm surface while rehabilitating.
How can you prevent heel pain from bursitis or tendinopathy?
An injury to the Achilles tendon (Achilles tendinopathy) can cause pain and stiffness on and above the back of the heel. Bursitis can also cause pain and swelling at the back or bottom of the heel.
To prevent and ease pain during work, play, or daily activities:
- Stay at a weight that's healthy for you. Talk to your doctor if you need help losing weight.
- Do calf stretches with your toe pointed slightly in. Make sure your body is warmed up (from walking or biking) before fully stretching your Achilles tendon.
- Avoid strenuous activity that your body is not conditioned for.
- Try changing what activities you do or how you do them. For example, if running caused the injury, try swimming some days.
- Wear shoes, heel pads, or orthotics (shoe inserts) that cushion your heels during sports or strenuous activities.
- Avoid poorly fitting shoes or shoes that press on the backs of the heels.
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