Bursitis Of The Heel Conditions
Overview
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 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.
Causes
The most common cause for bursitis in the heel is overuse. If you repeatedly use your ankle, the bursa becomes irritated, causing swelling and inflammation. This is usually seen in individuals who do too much walking or running. The risk for developing this condition worsens if you suddenly start an intensive workout routine without conditioning your body to become used to the intensity.
Symptoms
What are the symptoms of heel bursitis? pain, swelling, tenderness, redness, and/or warmth at either the bottom of the heel or top of the heel, depending on the degree of swelling, pain may be a dull ache or substantial enough to cause limping, running, jumping, and walking activities may exacerbate pain, wearing poorly fitting, tight, or high-heeled shoes may exacerbate pain.
Diagnosis
Your doctor will examine you, including an evaluation of your gait, while you are barefoot, your doctor will ask you to stand still and to walk in order to evaluate how your foot moves as you walk. An examination of your feet. Your doctor may compare your feet for any differences between them. Then your doctor may examine your painful foot for signs of tenderness, swelling, discoloration, muscle weakness and decreased range of motion. A neurological examination. The nerves and muscles may be evaluated by checking strength, sensation and reflexes. In addition to examining you, your health care professional may want to examine your shoes. Signs of excessive wear in certain parts of a shoe can provide valuable clues to problems in the way you walk and poor bone alignment. Depending on the results of your physical examination, you may need foot X-rays or other diagnostic tests.
Non Surgical Treatment
The patient with retrocalcaneal bursitis should be instructed to apply ice to the posterior heel and ankle in the acute period of the bursitis. Icing can be performed several times a day, for 15-20 minutes each. Some clinicians also advocate the use of contrast baths. Gradual progressive stretching of the Achilles tendon may help relieve impingement on the subtendinous bursa and can be performed in the following manner. Stand in front of a wall, with the affected foot flat on the floor. Lean forward toward the wall until a gentle stretching is felt within the ipsilateral Achilles tendon. Maintain the stretch for 20-60 seconds and then relax. Perform the stretches with the knee extended and then again with the knee flexed. To maximize the benefit of the stretching program, repeat the above steps for several stretches per set, several times daily. Avoid ballistic (ie, abrupt, jerking) stretches. Other treatment options are microcurrent therapy and corticosteriod injection into the retrocalcaneal bursa. If conservation treatment fails then surgery is indicated.
Prevention
Once your pain and inflammation is gone, you can prevent retrocalcaneal bursitis deformity by wearing the best shoes for your foot type. You should high-heels and pumps if possible. Wear orthotics (custom arch supports) or over-the-counter orthotic devices. Perform frequent Achilles tendon stretching exercises to prevent it from becoming tight agian. Avoiding running uphill when training. Try to run on softer surfaces and avoid concrete.