Bursae are situated in various locations throughout the body where friction between tissues commonly occurs. These sacs are designed to help reduce friction and prevent pain. Repetitive movements or prolonged and excessive pressure are the most common causes of bursal inflammation, though traumatic injury may also cause this painful problem. In fact, the body sometimes creates bursal sacs in response to trauma or tissue damage.
The most common cause of bursitis is repeated physical activity, but it can flare up for no known reason. It can also be caused by trauma, rheumatoid arthritis, gout, and acute or chronic infection.
Your feet are extremely resilient and are designed to stand up to the pressures of day-to-day living. In some cases, though, foot structures may break down when subjected to chronic stress associated with prolonged periods of weight-bearing activity on concrete, asphalt, or other hard surfaces (especially when your footwear does not allow for appropriate weight distribution). Foot problems, including infracalcaneal bursitis, are often exacerbated by poorly designed footwear, and pressure, impact, and shear forces can damage your feet over time. Bursal sacs are intended to minimize this damage, but sometimes the bursa itself becomes inflamed.
Plain radiographs of the calcaneus may reveal a Haglund deformity (increased prominence of the posterosuperior aspect of the calcaneus). However, on weight-bearing lateral radiographs, the retrocalcaneal recess often appears normal even in patients with retrocalcaneal bursitis, limiting its usefulness in making this diagnosis.Radiographs may be used as a diagnostic measure to support a clinician?s diagnosis of retrocalcaneal bursitis. Individuals with retrocalcaneal bursitis may have an absence of the normal radiolucency (ie, blunting) that is seen in the posteroinferior corner of the Kager fat pad, known as the retrocalcaneal recess or bursal wedge. This may occur with or without an associated erosion of the calcaneus.
Non Surgical Treatment
During the initial acute phase of the condition, patients should apply ice to the back of the heel for 15 to 20 minutes and follow the R.I.C.E.R regime. Avoid activities that cause pain. Gradual progressive stretching of the calf muscle and Achilles tendon is also advocated. Changing the footwear. Wearing an open-backed shoe may help relieve pressure on the affected region. For those whose symptoms were caused by a sudden change from wearing high-heeled shoes to flat shoes, the temporary use of footwear with a heel height in between may be helpful. Inserting a heel cup in the shoe may help to raise the inflamed region slightly above the shoe?s restricting heel counter and relieve the pain. It is advisable to also insert the heel cup into the other shoe to avoid any leg-leg discrepancies that can lead to other problems. Training frequency and intensity should be gradually progressed with adequate rest between trainings.
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.