Retrocalcaneal Heel Bursitis [Pain in the back of the Heel TREATMENT!]

Summary

This video provides an in-depth explanation of retrocalcaneal bursitis, a condition where the bursa between the Achilles tendon and heel bone becomes inflamed, causing pain and swelling. The causes include overuse, tight muscles, improper stretching, and biomechanical imbalances. Symptoms mirror insertional Achilles tendonitis, with pain at the back of the heel. Treatment focuses on reducing inflammation, stretching, proper footwear, and orthotics. Advanced cases may require physical therapy or surgery. The video emphasizes the importance of maintaining flexibility and avoiding overuse to prevent recurrence.

Takeaways

• 😀 Retrocalcaneal bursitis occurs when the bursa, a fluid-filled sac between the Achilles tendon and heel bone, becomes inflamed.
• 😀 The condition often causes pain at the back of the heel, which can be confused with Achilles tendonitis, but the pain location differs.
• 😀 The most common causes of retrocalcaneal bursitis include overuse, tight muscles, poor warm-ups, and aging.
• 😀 People with jobs requiring long periods of standing or physical activities like running or sprinting are more prone to developing retrocalcaneal bursitis.
• 😀 Inflammation can be managed with ice, anti-inflammatory medications, and low-impact exercise like swimming or cycling.
• 😀 Stretching and massaging the Achilles tendon and calf muscles are crucial steps in recovery, but should be done after reducing inflammation.
• 😀 Proper footwear is essential for managing retrocalcaneal bursitis, with shoes that are stiff in the midsole, supportive in the heel, and flexible in the front.
• 😀 Orthotic inserts can help reduce pressure on the bursa and improve foot alignment, which is crucial for long-term relief.
• 😀 Physical therapy can be helpful to address underlying biomechanical issues and improve muscle flexibility, posture, and gait.
• 😀 In severe cases, treatments like PRP (Platelet-Rich Plasma) or prolotherapy injections, or even surgical removal of a heel spur may be necessary.

Q & A

What is retrocalcaneal bursitis?

Retrocalcaneal bursitis is an inflammation of the retrocalcaneal bursa, a fluid-filled sac between the Achilles tendon and the heel bone, which prevents friction between the two structures. When the bursa becomes inflamed, it causes pain and swelling at the back of the heel.

What are the primary causes of retrocalcaneal bursitis?

The main causes include overuse (e.g., standing for long periods or excessive physical activity), tight muscles or poor flexibility, improper footwear, and mechanical imbalances in the foot and leg. Additionally, aging, previous injuries, or certain occupations (like teaching or nursing) increase the risk.

How can retrocalcaneal bursitis be differentiated from Achilles tendonitis?

Although both conditions affect the Achilles tendon, retrocalcaneal bursitis specifically occurs at the insertion point of the tendon into the heel bone, whereas Achilles tendonitis typically occurs 2-6 cm above the heel. Bursitis is more localized to the heel and can be associated with swelling and redness in the bursa area.

What are the common symptoms of retrocalcaneal bursitis?

Common symptoms include pain, redness, and swelling at the back of the heel, specifically around the Achilles tendon. The affected area may feel hot and inflamed, and movement or pressure on the area can intensify the pain.

What is the role of the retrocalcaneal bursa?

The retrocalcaneal bursa acts as a cushion, preventing friction between the Achilles tendon and the heel bone during movement. It allows the tendon to glide smoothly without rubbing directly against the bone.

How is retrocalcaneal bursitis diagnosed?

Diagnosis typically involves a biomechanical assessment by a podiatrist, who looks for imbalances or tight muscles. An X-ray may be used to check for heel spurs, while an MRI or ultrasound may be conducted if there is significant tendon or bursa damage.

What types of physical activities are most likely to cause retrocalcaneal bursitis?

Activities that involve long periods of standing, running, jumping, or sprinting are most likely to cause retrocalcaneal bursitis. This includes occupations such as teaching or nursing, as well as athletic activities like long-distance running or sprinting.

What is the first step in treating retrocalcaneal bursitis?

The first step is to reduce inflammation through rest, ice, and anti-inflammatory medications. It's also helpful to switch to low-impact exercises, like cycling or swimming, to avoid further strain on the Achilles tendon.

How do orthotics and footwear help in treating retrocalcaneal bursitis?

Proper footwear and orthotics provide support and reduce pressure on the heel. Shoes should have stiff heels and flexible toes to minimize strain on the Achilles tendon. Orthotics, either over-the-counter or custom-made, can help correct alignment and reduce the risk of further irritation to the bursa.

When is surgery necessary for retrocalcaneal bursitis?

Surgery may be considered if there is severe damage, such as a significant heel spur causing persistent pain despite conservative treatments. In such cases, surgical removal of the spur or other damaged tissue may be required.