Retrocalcaneal Bursitis

[physiobob]

Definition

Retrocalcaneal bursitis is an inflammation of the bursa at the back of the heel bone (calcaneus). This causes pain with up-and-down movements of the foot.

A bursa is a fluid-filled sac that acts as a cushion and a lubricant between tendons and 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, where the large Achilles tendon connects the calf muscles to the heel bone (calcaneus).

Causes

Repetitive or over use of the ankle, for instance by doing excessive walking, running or jumping, can cause this bursa to become irritated and inflamed. This condition is commonly associated with Achilles tendonitis. Sometimes retrocalcaneal bursitis may be mistaken for Achilles tendonitis.

Those at risk for this condition include people just starting aggressive exercise regimens or having some other sudden increase in activity without proper conditioning.

Comments: As you can see form above the cause is a mechanical one, excessive movement of the rear foot in your shoes. This could be due to the footwear, your walking or running style etc etc. Of course to much to soon is also a possibility as is a reduced healing potential of the body for any other reason. We are constantly renewing body tissues 24hrs a day and if that ability is affected in anyway e.g. diet, rest, another system talking all the 'energy', then other area can break down instead of healing as per normal.

In your case rest and ultrasound is only addressing the symptoms. You need to be assessed for the causes and follow a plan to fix those issues. This is likely to include altered footware, perhaps orthotics, re-structuring of your exercise plan etc. Best of luck

Chronic:

Haglund's deformity

What is Haglund’s Deformity?

Haglund’s deformity is a bony enlargement on the back of the heel that most often leads to painful bursitis, which is an inflammation of the bursa (a fluid-filled sac between the tendon and bone). In Haglund’s deformity, the soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes.

Haglund’s deformity is often called “pump bump” because the rigid backs of pump-style shoes can create pressure that aggravates the enlargement when walking. In fact, the deformity is most common in young women who wear pumps.

What Causes Haglund’s Deformity?

To some extent, heredity plays a role in Haglund’s deformity. People can inherit a type of foot structure that makes them prone to developing this condition.

For example, high arches can contribute to Haglund’s deformity. The Achilles tendon attaches to the back of the heel bone, and in a person with high arches, the heel bone is tilted backward into the Achilles tendon. This causes the uppermost portion of the back of the heel bone to rub against the tendon. Eventually, due to this constant irritation, a bony protrusion develops and the bursa becomes inflamed. It is the inflamed bursa that produces the redness and swelling associated with Haglund’s deformity.

A tight Achilles tendon can also play a role in Haglund’s deformity, causing pain by compressing the tender and inflamed bursa. In contrast, a tendon that is more flexible results in less pressure against the painful bursa.

Another possible contributor to Haglund’s deformity is a tendency to walk on the outside of the heel. This tendency, which produces wear on the outer edge of the sole of the shoe, causes the heel to rotate inward, resulting in a grinding of the heel bone against the tendon. The tendon protects itself by forming a bursa, which eventually becomes inflamed and tender.

Side note for this issue in children: Sever's Disease

Sever's Disease or Calcaneal Apophysitis (Heel Pain in Children)

Description: When recurring heel pain occurs in children, it is usually due to Sever's Disease, while adult heel pain is usually due to heel spurs, plantar fasciitis, or retrocalcaneal bursitis (Haglund's Deformity).

Definitions:

* Apophysitis is an inflammation of a growth plate.
* Calcaneus is the anatomical name of the heel bone.
* Sever's Disease is an inflammation of the growth plate located at the posterior aspect (back) of the heel.