Retrocalcaneal Bursitis Treatment at Arunalaya Healthcare

Best Retrocalcaneal Bursitis Treatment in Delhi

What is Retrocalcaneal Bursitis ?

Retrocalcaneal bursitis is an inflammation of the bursa (a fluid-filled sac that reduces friction) located between the Achilles tendon and the calcaneus (heel bone).

Causes Retrocalcaneal Bursitis

Repetitive Friction/Overuse: Most common cause, often from repetitive activities like running, jumping, or prolonged walking
Improper Footwear: Shoes with a rigid or ill-fitting heel counter that rub against the back of the heel, particularly in athletes.
Tight Achilles Tendon: A tight Achilles tendon increases friction on the bursa during ankle movement.
Haglund’s Deformity (Pump Bump): A bony enlargement on the back of the heel bone can irritate the bursa.
Foot Biomechanics: Overpronation or other gait abnormalities can contribute.
Inflammatory Arthritis: Conditions like rheumatoid arthritis, gout, or ankylosing spondylitis can cause bursitis.

Symptoms

Pain: Localized pain at the back of the heel, especially during weight-bearing activities or when pushing off the foot.
Tenderness: Significant tenderness when pressing on either side of the Achilles tendon insertion point.
Swelling: Soft, palpable swelling on either side of the Achilles tendon, sometimes causing a visible bulge.
Redness and Warmth: The affected area may feel warm and appear red.
Pain with Dorsiflexion/Plantarflexion: Pain can worsen with passive ankle dorsiflexion (stretching the Achilles tendon) or active plantarflexion (pushing off).
Difficulty with Footwear: Pain and discomfort when wearing shoes, especially those with stiff heel counters.
Pain in the Morning: Stiffness and pain upon waking or after periods of rest.

Advanced Physiotherapy

Acute Pain & Inflammation Management:-
- Ice/Cold Therapy: Regular application to reduce swelling and pain.
- Taping: Kinesio taping to support the Achilles tendon and reduce pressure on the bursa.
- Footwear Modification: Advising on open-backed shoes, shoes with softer heel counters, or using heel lifts/pads to reduce friction.
Addressing Underlying Biomechanics:
- Achilles Tendon Flexibility: Gentle, progressive stretching of the calf muscles (gastrocnemius and soleus) to improve ankle dorsiflexion and reduce Achilles tension.
- Foot & Ankle Mobility: Manual therapy techniques (mobilizations) to improve joint play in the ankle and foot, addressing any restrictions.
- Myofascial Release: Addressing tightness in the calf muscles and plantar fascia.
Strengthening & Motor Control:-
- Calf Strengthening: Gradual eccentric and concentric strengthening of calf muscles (e.g., heel raises) once pain allows, to improve tendon load tolerance and muscle endurance.
- Foot Intrinsic Muscle Strengthening: Exercises for the small muscles within the foot to improve arch support and foot stability.
- Proximal Strengthening: Strengthening hip and core muscles to improve lower limb alignment and reduce compensatory movements during gait.
Functional Retraining & Return to Activity:
- Gait Analysis & Retraining: Analyzing walking/running patterns to identify and correct biomechanical faults (e.g., overpronation, excessive heel strike) that contribute to bursal irritation.
- Progressive Loading: A carefully structured program to gradually reintroduce aggravating activities (e.g., running program) with strict monitoring of symptoms.
- Proprioceptive Training: Balance and stability exercises to improve neuromuscular control of the ankle and foot.

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