Bursitis means inflammation of the bursa. A bursa is a sac-like structure that contains a lubricating fluid. A bursa is located anywhere you need a lubricating cushion-like where a muscle or tendon
rubs over a bone or another muscle. Normally a bursa does its job unnoticed, but if you engage in some strenuous activity, for example, it can let you know exactly where it is. When a bursa is
repeatedly irritated, the body begins to deposit calcium spicules in that location (often these deposits can be seen on X-rays). The spicules are like ground glass in the bursa, and the more you move
that part of your body, the more intense the pain.
Overtraining in a runner (eg, excessive increases in miles or intensity). Tight or poorly fitting shoes that, because of a restrictive heel counter, exert excessive pressure on the posterior heel and
Haglund deformity, causing impingement between the increased posterior superior calcaneal prominence and the Achilles tendon during dorsiflexion. More recent research suggests that a misaligned
subtalar joint axis (measured in terms of joint inclination and deviation) in relation to the Achilles tendon can result in an asymmetrical force load on the tendon, disrupting normal biomechanics.
This altered joint axis is associated with an increased risk for Achilles pathologies, including bursitis.
Limping. Decreased movement. Your ankles may feel stiff or unable to move as well as they usually do. Pain or tenderness in the back of the ankle. It may be worse at the beginning of exercise, or
when running uphill. You may also have pain when wearing shoes. Redness and warmth. If the bursa is infected, the skin over the heel may be red and warm. You may also have a fever. Swelling on the
back of the heel.
Your doctor will take a history to find out if you have the symptoms of retrocalcaneal bursitis. By examining your ankle, he or she can generally tell the location of the pain. The physician will
look for tenderness and redness in the back of the heel. The pain may be worse when the doctor bends the ankle upward (dorsiflex), as this may tighten the achilles tendon over the inflamed bursa.
Alternatively, the pain may be worse with toe rise, as this puts stress on the attachment of the achilles tendon to the heel bone. Imaging studies such as X-ray and MRI are not usually necessary at
first. If initial treatment fails to improve the symptoms, these studies may be obtained. MRI may show inflammation.
Non Surgical Treatment
Conservative treatment of bursitis is usually effective. The application of heat, rest, and immobilization of the affected joint area is the first step. A sling can be used for a shoulder injury, a
cane is helpful for hip problems. The patient can take nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofin, and naproxen. They can be obtained without a prescription and relieve the
pain and inflammation. Once the pain decreases, exercises of the affected area can begin. If the nearby muscles have become weak because of the disease or prolonged immobility, then exercises to
build strength and improve movement are best. A doctor or physical therapist can prescribe an effective regimen. If the bursitis is related to an inflammatory condition like arthritis or gout, then
management of that disease is needed to control the bursitis. When bursitis does not respond to conservative treatment, an injection into the joint of a long-acting corticosteroid preparation, like
prednisone, can bring immediate and lasting relief. A corticosteroid is a hormonal substance that is the most effective drug for reducing inflammation. The drug is mixed with a local anesthetic and
works on the joint within five minutes. Usually one injection is all that is needed.
You can avoid the situation all together if you stop activity as soon as you see, and feel, the signs. Many runners attempt to push through pain, but ignoring symptoms only leads to more problems.
It?s better to take some time off right away than to end up taking far more time off later. Runners aren?t the only ones at risk. The condition can happen to any type of athlete of any age. For all
you women out there who love to wear high-heels-you?re at a greater risk as well. Plus, anyone whose shoes are too tight can end up with calcaneal bursitis, so make sure your footwear fits. If the
outside of your heel and ankle hurts, calcaneal bursitis could be to blame. Get it checked out.