Plantar calcaneal bursitis is a medical condition in which there is inflammation of the plantar calcaneal bursa, a spongy fluid filled sac that cushions the fascia of the heel and the calcaneus (heel bone). It is characterized by swelling and tenderness of the central plantar heel area. It is sometimes called 'Policeman's heel'. It sometimes was, and should not be, confused with plantar fasciitis, which is inflammation of the plantar fascia and can affect any part of the foot.
Overtraining in a runner (eg, excessive increases in miles or intensity). Tight or poorly fitting shoes that, because of a restrictive heel counter, exert excessive pressure on the posterior heel and ankle
Haglund deformity, causing impingement between the increased posterior superior calcaneal prominence and the Achilles tendon during dorsiflexion. More recent research suggests that a misaligned subtalar joint axis (measured in terms of joint inclination and deviation) in relation to the Achilles tendon can result in an asymmetrical force load on the tendon, disrupting normal biomechanics. This altered joint axis is associated with an increased risk for Achilles pathologies, including bursitis.
Some of the symptoms of bursitis in the heel, or retrocalcaneal bursitis, are as described below. Severe pain in the heel area of the foot, sometimes radiating to the ankle, associated with physical activities like walking, jogging and even on physical contact to the area. The physical signs of heel bursitis, which are noticeable in the heel area, are reddish discoloration of the skin that is warm to touch.
When you are experiencing Achilles pain at the back of your heel, a visit to the doctor is always recommended. Getting a proper diagnosis is important so you can treat your condition correctly. A doctor visit is always recommended.
Non Surgical Treatment
Many times, Achilles tendon bursitis can be treated with home care. However, if self-care remedies do not work, your doctor may need to administer additional treatments. Home care. The most important thing you can do to help your healing is to refrain from activities that could further aggravate the bursitis. Typical home-care treatments for Achilles tendon bursitis include Anti-inflammatory medication. Take over-the-counter pain medication, like aspirin or ibuprofen, to reduce pain and swelling. Heel wedges. An over-the-counter or custom heel wedge can be placed in your shoe to minimize stress in the Achilles tendon. Ice. Apply ice or other cold therapy to your sore heel several times a day. Rest. Limit your activity on the injured leg, avoid putting pressure on it whenever possible. Also, elevate your leg during non-use to help reduce the swelling. The above remedies may be used on their own or in combination with others on the list. Physician-administered treatments. If the above self-care remedies are not effective, you should visit your doctor for additional treatment. Possible Achilles tendon bursitis treatments your doctor may administer include immobilization. If the bursitis is combined with Achilles tendonitis, your doctor may place a temporary cast on the ankle to prevent movement and allow it to heal. Physical therapy. Exercises may be used to improve the ankle's strength and flexibility. Steroids. Injection of steroids into the retrocalcaneal bursa (not the Achilles tendon) may be necessary. Surgery. In very rare circumstances, surgery may be needed to remove the retrocalcaneal bursa, however, this is typically a last resort.
Bursectomy is a surgical procedure used to remove an inflamed or infected bursa, which is a fluid-filled sac that reduces friction between tissues of the body. Because retrocalcaneal bursitis can cause chronic inflammation, pain and discomfort, bursectomy may be used as a treatment for the condition when it is persistent and cannot be relived with other treatments. During this procedure, a surgeon makes small incisions so that a camera may be inserted into the joint. This camera is called an arthroscope. Another small incision is made so that surgical instruments can be inserted to remove the inflamed bursa.
Once your pain and inflammation is gone, you can prevent retrocalcaneal bursitis deformity by wearing the best shoes for your foot type. You should high-heels and pumps if possible. Wear orthotics (custom arch supports) or over-the-counter orthotic devices. Perform frequent Achilles tendon stretching exercises to prevent it from becoming tight agian. Avoiding running uphill when training. Try to run on softer surfaces and avoid concrete.