• What is Heel Bursitis?

Heel bursitis, also known as retrocalcaneal bursitis, is  the inflammation of the bursa located between the Achilles tendon and the back of the heel bone (calcaneus). The retrocalcaneal bursa acts as a cushion, reducing friction between the Achilles tendon and the heel bone during movement. Bursitis can occur under the heel, and around the back of the heel bone and will often coexist with plantar fasciitis and Achilles Tendinopathy.

What causes Heel Bursitis?

This condition usually develops due to overuse and/or repetitive movements or pressure on the back of the heel and ankle area, which leads to irritation and inflammation of the bursa. Activities that involve repetitive or forceful pushing off of the foot, such as walking, running or jumping can all contribute, making it common amongst athletes, dancers, runners, gymnasts etc. It can also be caused by incorrect footwear that does not fit properly, or lacks adequate cushioning, tight calf muscles, and Haglund’s deformity.

Heel Bursitis Symptoms

• Pain and tenderness at the back of the heel; painful to the touch
• Swelling and redness around the heel
• Increased pain with movement, standing or when bending your foot or applying pressure on the affected heel
• Limited ankle movement and stiffness
• Calf muscle pain
• Increasing pain when standing on your toes or bending your foot

Heel Bursitis Treatment

A thorough history and physical examination will often differentiate between all heel conditions, and the use of medical imaging including X-Ray, Ultrasound & MRI can be utilised if necessary to ensure the correct diagnosis. 

• REST: Rest, Ice, Compression and Elevation
• Ice application to reduce inflammation and provide pain relief
• Modification of footwear
• Custom Orthotics – Heel lifts or shoe inserts to help reduce pressure on the bursa/to provide cushioning
• Physical therapy – to improve calf flexibility and strengthen the surrounding muscles

Invasive and treatments required for severe cases:

• Corticosteroid injections to reduce inflammation
• Surgery to remove the inflamed bursa