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Flexibility exercise in its simplest form stretches and elongates muscles. Disciplines which incorporate stretching with breath control and meditation include yoga and tai chi. The benefits of greater flexibility may go beyond the physical to the improvement of stress reduction and the promotion of a greater sense of well-being. Retrocalcaneal bursitis is an inflammation of the bursa at the back of the heel bone. A bursa is a fluid-filled sac that acts as a cushion and a lubricant between tendons and muscles sliding over bone. Repetitive or over use of the ankle, by doing excessive walking, running, or jumping, can cause this bursa to become irritated and inflamed. Symptoms of bursitis include pain in the heel, especially with walking, running or when the area is touched. 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 under the large Achilles tendon that 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. It may be caused by too much walking, running, or jumping. This condition is very often linked to Achilles tendinitis. Sometimes retrocalcaneal bursitis may be mistaken for Achilles tendinitis. Heel pain can be a common problem. Though the cause is rarely serious, the pain can be severe and sometimes disabling. Heel pain is often the result of overusing your foot. Causes may include, running, especially on hard surfaces like concrete, tightness in your calf, or from Achilles tendonitis inflammation of that large tendon that connects your calf muscle to your heel , shoes with poor support, sudden inward or outward turning of your heel, or landing hard or awkwardly on your heel after a jump or fall. Problems related to heel pain include bursitis inflammation of the bursa at the back of the heel , bone spurs in the heel, and plantar fasciitis swelling of the thick band of tissue on the bottom of your foot. Heel pain is something you can usually treat at home. If you can, try resting as much as possible for at least a week. Apply ice to the painful area twice a day or so, for 10 to 15 minutes. Take acetaminophen or ibuprofen for pain and inflammation. If you need to, you can buy a heel cup, felts pads, or shoe inserts to comfort your heel. You should call your doctor if your heel pain does not get better after two or three weeks of home treatment. But also call your doctor if your pain is getting worse, or your pain is sudden and severe, your feet are red or swollen, or you can't put weight on your foot. If you visit the doctor, you may have a foot x-ray. Your treatment will depend on the cause of your heel pain. You may need to see a physical therapist to learn exercises to stretch and strengthen your foot. To prevent future heel pain, we recommend you exercise. Maintaining flexible, strong muscles in your calves, ankles, and feet can help ward off some types of heel pain. And do yourself a favor, trade those sleek high heels in for a comfortable, properly fitting pair of shoes. Your health care provider will take a history to find out if you have symptoms of retrocalcaneal bursitis. An exam will be done to find the location of the pain. The provider will also look for tenderness and redness in the back of the heel. The pain may be worse when your ankle is bent upward dorsiflex. Or, the pain may be worse when you rise on your toes. Most of the time, you will not need imaging studies such as x-ray and MRI at first. You may need these tests later if the first treatments do not lead to improvement. Inflammation may show on an MRI. Have physical therapy to improve flexibility and strength around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis improve and prevent it from coming back. If these treatments do not work, your provider may inject a small amount of steroid medicine into the bursa. After the injection, you should avoid overstretching the tendon because it can tear rupture. If the condition is connected to Achilles tendinitis, you may need to wear a cast on the ankle for several weeks. Very rarely, surgery may be needed to remove the inflamed bursa. Contact your provider if you have heel pain or symptoms of retrocalcaneal bursitis that do not improve with rest. Heel pain and plantar fasciitis: hindfoot conditions. Philadelphia, PA: Elsevier; chap Pain in the foot. Differential Diagnosis of Common Complaints. Wilkins AN. Foot and ankle bursitis. Essentials of Physical Medicine and Rehabilitation. Reviewed by: C. Also reviewed by David C. Editorial team. Home Health Library. Bursitis of the heel Insertional heel pain; Retrocalcaneal bursitis. Causes A bursa acts as a cushion and lubricant between tendons or muscles sliding over bone. Risks for this condition include: Starting a very intense workout schedule Suddenly increasing activity level without the right conditioning Changes in activity level History of arthritis that is caused by inflammation. Symptoms Symptoms include: Pain at the back of the heel, especially with walking, running, or when the area is touched Pain may get worse when standing on tiptoes Red, warm skin over the back of the heel. Exams and Tests Your health care provider will take a history to find out if you have symptoms of retrocalcaneal bursitis. Treatment Your provider may recommend that you do the following: Avoid activities that cause pain. Put ice on the heel several times a day. Try using over-the-counter or custom heel wedges in your shoe to help decrease stress on the heel. Try ultrasound treatment during physical therapy to reduce inflammation. Outlook Prognosis This condition most often gets better in several weeks with the proper treatment. When to Contact a Medical Professional Contact your provider if you have heel pain or symptoms of retrocalcaneal bursitis that do not improve with rest. Prevention Things you can do to prevent the problem include: Maintain good flexibility and strength around the ankle to help prevent this condition. Stretch the Achilles tendon to help prevent injury. Wear shoes with enough arch support to decrease the amount of stress on the tendon and inflammation in the bursa. Use proper form when exercising. Find a Doctor Request an Appointment.

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When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance. In bursitis there is thickening and proliferation of the synovial lining, bursal adhesions, villus formation, tags, and deposition of chalky deposits. This may result from repetitive stress, infection, autoimmune disease, or trauma. Key diagnostic findings are localized pain and tenderness over a bursa and swelling if superficially sited. Treatment for nonseptic bursitis involves modified physical activity, rest, and analgesia. Corticosteroid injections are reserved for those cases that do not respond to conservative management. Bursal excision is a last resort. The first-line treatment for septic bursitis is aspiration and antibiotic therapy. Surgical debridement and lavage may be required. Bursitis is an acute or chronic inflammatory condition of a bursa. A bursa is a jelly-like sac that usually contains a small amount of synovial fluid. A bursa lies between a tendon and either bone or skin to act as a friction buffer and facilitate movement of adjacent structures. Over bursae are located throughout the human body. Some are superficial and more vulnerable e. In primary care, bursitis most commonly presents in the knee, subacromial subdeltoid , trochanteric, retrocalcaneal, and olecranon bursae. Use of this content is subject to our disclaimer. For any urgent enquiries please contact our customer services team who are ready to help with any problems. OK Cancel. Last reviewed: 22 Sep Last updated: 10 May Bursitis is acute or chronic inflammation of a bursa. Key diagnostic factors pain at site of bursa tenderness to palpation at site of bursa decreased active range of motion Full details. Other diagnostic factors low-grade temperature swelling erythema warmth of overlying skin painful arc on shoulder abduction subacromial lateral hip pain trochanteric pain at the extremes of hip rotation, abduction, or adduction trochanteric pain of contraction of the hip abductors against resistance trochanteric pseudoradiculopathy: pain radiating down the lateral aspect of the thigh trochanteric impalpable patella prepatellar palpable bump over heel retrocalcaneal Full details. Risk factors occupation that causes mechanical stress on bursa rheumatoid arthritis gout or calcium pyrophosphate deposition disease penetrating injury osteoarthritis of the hip infection in a nearby joint lower limb length discrepancy iliotibial band contracture lumbar spondylosis valgus knee deformity low-riding shoes anatomic or functional impingement within the coracoacromial arch Full details. Tests to consider Gram stain and culture of fluid aspirate crystal analysis x-ray of affected region MRI ultrasound Full details. Peer reviewers. Steven C. I have some feedback on: Feedback on: This page The website in general Something else. I have some feedback on:. Submit Feedback. Thank you.

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