Heel bursitis, including retrocalcaneal bursitis, is a common condition that usually affects physically active individuals. It causes pain and discomfort at the back of the heel area. The pain is often worse during and after physical activity, making it difficult to maintain an active lifestyle. If this sounds like what you have been experiencing, read till the end to understand how to manage heel bursitis effectively.
Understanding Heel Bursitis
Heel bursitis is essentially an inflammation of the bursae, which are small fluid-filled sacs between your bones, tendons, and muscles. Bursae help to reduce friction between the structures during movements and cushion impact. We have multiple bursae in various locations of the foot, and you may develop more in areas of high friction.
The most common type of heel bursitis affecting the heel is retrocalcaneal bursitis, which occurs behind the heel where the Achilles tendon attaches to the heel bone (calcaneus). This condition can cause significant pain and swelling, particularly during activities that involve pressure on the heel. Movements such as incline walking, running, or jumping can make the pain worse. Some individuals also report pain when wearing shoes with stiff heel counters.
Common Causes of Heel Bursitis
Overuse Injury
Repetitive stress or excessive activity, such as running or jumping, can create too much friction between the Achilles tendon and the heel bone, leading to irritation and inflammation of the bursa.
Poor Fitting or Improper Footwear
Shoes that do not provide adequate support or fit poorly can contribute to the development of heel bursitis. Shoes that are too small can compress the heel area, increasing friction. You also need to be aware of certain athletic shoes in which the heel counter slopes inwards at a slanted angle, as that will also increase pressure around the back of the heel.
Injury or Trauma
Direct trauma can trigger heel bursitis or retrocalcaneal bursitis. The impact of direct trauma to the heel can cause inflammation of the bursae, causing redness, pain, and swelling.
Foot Structure Abnormalities
Foot structure heavily influences our walking or running pattern. Abnormalities in foot structure can alter foot mechanics and increase stress on muscles, tendons, joints, and bones. Conditions such as high arches or flat feet can increase the pressure between the Achilles tendon and the heel bone, resulting in retrocalcaneal bursitis.
Systemic Inflammatory Conditions
Systemic conditions such as rheumatoid arthritis or gout can trigger inflammation in the bursae. Heel bursitis caused by inflammatory conditions usually has a rapid onset and can be very painful, red, and swollen.
Symptoms of Heel Bursitis
- Pain: Sharp or aching pain at the back of the heel, especially with movement or pressure.
- Redness: Visibly red around the heel region, typically with increased warmth.
- Swelling: Noticeable swelling around the heel area, particularly at the back of the heel bone for retrocalcaneal bursitis.
- Stiffness: Difficulty moving the foot or a feeling of stiffness in the heel, especially after a period of rest.
Heel Bursitis Treatment Options in Singapore
To effectively manage heel bursitis or retrocalcaneal bursitis, you must address the injury and underlying cause concurrently. The usual factors to consider and the recommended treatment options are:
Pain Management
- Rest and Ice: The first step often involves resting the affected foot and applying ice and compression to reduce inflammation and pain.
- Painkillers: Over-the-counter anti-inflammatory medications or pain medication may also help in reducing pain. However, you must understand that you should not take painkillers just to continue your activity or risk causing further damage.
Footwear and Orthotics
- Appropriate Supportive Footwear: It is essential to select shoes that provide adequate support and cushioning to reduce pressure on the heel. Seeing a Podiatrist can help receive guidance in selecting the right pair for you.
- Custom Orthotics: Customised orthotic devices can help correct foot mechanics and alleviate stress on the bursa. This is particularly important if you have a high arch or flat feet.
Physical Therapy and Rehabilitation
- Activity Modification: We highly recommend switching to a lower-impact activity if you are overexerting yourself. An example would be switching from running to swimming.
- Stretching and Strengthening Exercises: A guided rehabilitation program can help strengthen the muscles around the heel and improve flexibility, thereby reducing the strain on the bursa.
Advanced Soft Tissue Therapies
- Trigger Point Release: Techniques such as radial pressure wave or dry needling may be used to release tension and improve muscle flexibility, particularly the calf muscles, in the case of heel bursitis.
- Shockwave Therapy: Extracorporeal shockwave therapy can help to stimulate and accelerate the natural healing process of the body.
Other Invasive Intervention
In rare cases where conservative treatments are ineffective, your medical professional may recommend injections to relieve the inflammation. Surgical options are rarely considered or performed for this condition. This could involve removing the inflamed bursa or addressing any underlying structural issues, such as calf muscle tightness, contributing to the condition.
How to Prevent Heel Bursitis?
To prevent the recurrence of heel bursitis or retrocalcaneal bursitis, you should remember the following:
- Wear Supportive Footwear: Choose shoes with proper heel and arch support and cushioning to reduce stress on the heel.
- Load Management: Excess weight or load can increase pressure on the feet and contribute to bursitis. Do not overexert yourself or risk injury.
- Perform Regular Stretching: Stretching exercises for the Achilles tendon and calf muscles can improve flexibility and help prevent stiffness and strain.
- Avoid Overuse: Gradually increase activity levels and avoid sudden, intense exercises that can strain the foot.
Conclusion
Effective management of heel bursitis, including retrocalcaneal bursitis, requires a comprehensive approach tailored to each individual’s needs. This condition rarely requires invasive methods to achieve optimal relief.
At Straits Podiatry, we are committed to providing top-quality podiatry care and innovative treatments to help you overcome heel bursitis and return to your normal activities. If you’re experiencing heel pain or suspect you may have bursitis, don’t hesitate to contact us for a thorough evaluation and management. Our experienced team of Podiatrists will strive to get you back on your feet.
Frequently Asked Questions (FAQs) About Heel Bursitis
1. What is the difference between retrocalcaneal bursitis and Achilles tendinitis?
Retrocalcaneal bursitis is the inflammation of the bursa located behind the heel bone where the Achilles tendon attaches. In contrast, Achilles tendinitis refers to inflammation or degeneration of the Achilles tendon itself. Both conditions can cause heel pain, but they involve different structures and may require different treatment approaches.
2. How long does it take to recover from heel bursitis?
Recovery time for heel bursitis varies depending on the severity of the condition and the effectiveness of treatment. With appropriate management, many individuals usually experience improvement within a few weeks. However, complete recovery may take up to several months, especially if the condition is chronic or severe.
3. Can I continue to exercise with heel bursitis?
When you have heel bursitis, we recommend modifying your exercise routine to avoid further stress to your heel and foot. Low-impact activities, such as swimming or cycling, are good options to replace running or jumping activities. Consult with a podiatrist to develop an exercise plan that accommodates your condition while promoting healing.
4. Are there any home remedies that can help with heel bursitis?
Yes, there are several home remedies options that you can try, including resting and icing to reduce inflammation and using over-the-counter pain relievers. Wearing proper footwear and performing gentle stretching exercises may also help alleviate symptoms. However, it’s important to consult a podiatrist if you are not getting any relief.
5. When should I see a podiatrist for heel bursitis?
You should see a podiatrist if you experience persistent heel pain, swelling, or discomfort that does not improve with rest and home care. A podiatrist can provide a thorough evaluation, accurate diagnosis, and personalized management plan to address your specific needs and prevent further complications.
Related Articles:
- Anatomy of the Heel: Understanding the Complex Structure
- Lifestyle Changes to Prevent Heel Pain in Singapore’s Urban Environment
- Why Do I Have Heel Pain?
- The Role of Shockwave Therapy in Plantar Fasciitis Treatment
