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Overview<br>Heel bursitis is specifically the inflammation of the retrocalcaneal bursa, located at the back of the heel, under the Achilles tendon.  There are a handful of factors that put you at risk for developing heel bursitis.  Long distance runners are prone to heel bursitis, due to repeated stress and pounding upon the heel joint.  Engaging in activities such as running, bicycling, walking, jumping, and stair climbing for extended periods of time can overwork the heel joints and start to irritate the bursae.  Suddenly changing to a high-intensity workout regime puts a lot of stress on the heel, making it vulnerable to injury.  Hard blows/bumps to the heel can immediately damage the bursae, leading to swelling and inflammation.  Training at high intensities without stretching and warming up can also contribute to the development of heel bursitis.  Even improper footwear can be a big factor.  Some other conditions can put you at risk as well, such as: tarsal tunnel syndrome, rheumatoid arthritis, plantar fasciitis, muscle weakness, joint stiffness, and [http://dungscroger.wordpress.com/2015/03/15/what-can-cause-adult-aquired-flat-feet heel spurs].  It is very important to get a professional diagnosis if you are having heel pain because heel bursitis is often confused for Achilles tendonitis, and the proper treatments are very different.  The pain could also be plantar fasciitis or general heel pain syndrome.<br><br>Causes<br>Repetitive, vigorous movement, strenuous and unaccustomed activities that put pressure on a joint, or a blow or other injury can bring on bursitis. The cause can vary depending on where the bursitis occurs. In the shoulder, for example, it can be brought on by excessive strain, such as from serving in tennis. Kneeling on a hard floor can cause bursitis of the knee, and similarly, repeatedly resting the elbow on a hard surface (such as a desk) can cause bursitis in that joint. Arthritis, gout, and certain infections can also contribute to the problem. Bursitis, in fact, may signal the onset of arthritis. While getting older isn't a cause of bursitis, older people, especially older athletes, are more likely to develop the condition.<br><br>Symptoms<br>Symptoms include pain at the back of the heel, especially when running uphill or on soft surfaces. There will be tenderness and swelling at the back of the heel which may make it difficult to wear certain shoes. When pressing in with the fingers both sides are the back of the heel a spongy resistance may be felt.<br><br>Diagnosis<br>Before making a diagnosis of retrocalcaneal bursitis, a doctor must rule out other possible problems, such as arthritis, a fracture or tumor. A doctor also will try to determine if the Achilles tendon itself is a source of pain. To make a diagnosis, a doctor will use some or all of the diagnostic tools below Patient interview. A doctor will ask a patient about medical history, and to describe the onset of his or her symptoms, the pattern of pain and swelling, and how symptoms affect lifestyle. For example, doctors may ask patients what types of shoes they wear and what they do for exercise. A patient's reported symptoms are important to diagnosis and treatment. The doctor will also ask what home treatments have helped the condition. Physical exam. A doctor will examine the patient's foot, noting swelling, tenderness and pain points, and range of motion. The doctor also may ask the patient to point and flex the feet and stand on his or her toes.<br><br>Non Surgical Treatment<br>Many cases of retrocalcaneal and retroachilles bursitis can be treated effectively at home. One of the most important factors is eliminating shoe gear that presses against the back of the heel. Comfortable, supportive footwear and frequently resting the foot will minimize friction at the heel and give the inflammation a chance to subside. These steps, along with other methods to alleviate swelling, such as non-steroidal anti-inflammatory drugs (NSAIDs, e.g., ibuprofen), icing the heel, and elevating the foot, are usually successful in treating retrocalcaneal bursitis.<br><br>Surgical Treatment<br>Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help symptoms.<br><br>Prevention<br>Maintain proper form when exercising, good flexibility, and strength around the ankle to help prevent this condition from arising. Proper stretching of the achilles tendon helps prevent injury.