Bursa is a fluid filled sac of tissue that is often found around the bony prominences over which tendons and soft tissues rub. This therefore helps the tendons to glide with least amount of friction.
Retrocalcaneal bursa is found behind the heel under the Achilles tendon. Retrotendoneal bursa is found on the back of the attachment of the tendon where the shoe rubs on the skin. This can cause
swelling, pain and difficulty in footwear. Sometimes there is a bony prominence on the heel bone that predisposes to this condition (Haglund?s deformity). Treatment of this can be modification of
footwear. However surgery is often required which involves excision of the bursa and also the bony prominence on the heel bone.
A bursa acts as a cushion and lubricant between tendons or muscles sliding over bone. There are bursas around most large joints in the body, including the ankle. The retrocalcaneal bursa is located
in the back of the ankle by the heel. It is where the large Achilles tendon connects the calf muscles to the heel bone. Repeated or too much use of the ankle can cause this bursa to become irritated
and inflamed. Possible causes are too much walking, running, or jumping. This condition is usually linked to Achilles tendinitis. Sometimes retrocalcaneal bursitis may be mistaken for Achilles
tendinitis. Risks for this condition include starting an aggressive workout schedule, or suddenly increasing activity level without the right conditioning.
You might have Retrocalcaneal Bursitis if you notice any of the following symptoms. You have pain or tenderness at the back of the heel where the Achille's tendon attaches. Have swelling near the
attachment of the tendon to the heel bone. You have noticed a slowly growing bump on the back of the heel. The back of the heel turns red after getting rubbed in shoes. The back of the heel hurts
worse when you run, walk up hill or wear high heels.
After you have described your foot symptoms, your doctor will want to know more details about your pain, your medical history and lifestyle, including whether your pain is worse at specific times of
the day or after specific activities. Any recent injury to the area. Your medical and orthopedic history, especially any history of diabetes, arthritis or injury to your foot or leg. Your age and
occupation. Your recreational activities, including sports and exercise programs. The type of shoes you usually wear, how well they fit, and how frequently you buy a new pair.
Non Surgical Treatment
Relieving the symptoms of bursitis initially focuses on taking the pressure off the bursa. This can be done with proper cushioning, inserts, or footwear but may require surgery if it is a bone
formation problem (i.e. Huglund's Deformity). If your bursitis is caused by an infection (septic bursitis), the doctor will probably drain the bursa sac with a needle and prescribe antibiotics to
treat the infection.
Only if non-surgical attempts at treatment fail, will it make sense to consider surgery. Surgery for retrocalcanel bursitis can include many different procedures. Some of these include removal of the
bursa, removing any excess bone at the back of the heel (calcaneal exostectomy), and occasionally detachment and re-attachment of the Achilles tendon. If the foot structure and shape of the heel bone
is a primary cause of the bursitis, surgery to re-align the heel bone (calcaneal osteotomy) may be considered. Regardless of which exact surgery is planned, the goal is always to decrease pain and
correct the deformity. The idea is to get you back to the activities that you really enjoy. Your foot and ankle surgeon will determine the exact surgical procedure that is most likely to correct the
problem in your case. But if you have to have surgery, you can work together to develop a plan that will help assure success.