Retro Calcaneal Bursitis

Retro Calcaneal Bursitis

bursitisRetro calcaneal bursitis is a swelling of the bursa at the back of the calcaneus (heel bone). A bursa is a fluid-filled sac that acts as a cushion and a lubricant between tendons and muscles sliding over bone. Repetitive or over use of the ankle, by doing excessive walking, running, or jumping, can cause this bursa to become irritated and inflamed.


retro calcaneal bursitis –


The retro calcaneal bursa can be found where the Achilles tendon inserts into the heel bone. This is an anatomical bursa (in other words it should be there and has not developed as a result of trauma). Its normal job is to allow the smooth movement of the Achilles against the heel bone. However if irritated it can swell and become painful.


The area between the Achilles tendon and the heel bone will be tender to the touch. The area will be warm and possible also red. The area will also look and feel swollen. The Achilles tendon should not itself feel sore, if it is see Achilles tendinitis.

Events that can cause retro calcaneal bursitis may include:

Poor biomechanics.

Hill running or stair climbing.

Overuse resulting from the natural lack of flexibility in the calf muscles.

Rapidly increasing mileage or speed.

Starting up too quickly after a layoff.

Trauma caused by sudden and/or hard contraction of the calf muscles when putting out extra effort such as in a final sprint.

Tight muscle groups in the back of the leg

Irritation from the heel counter of a sports shoe


treatment in the acute phase



Remember, many retro calcaneal problems occur at contact phase of gait (when the foot hits the ground) due to increased biomechanical stress at this point. It is therefore vital to improve your biomechanics with orthotics designed for your chosen sport.

Golden rule- Don’t ignore the problem, it won’t go away!

The way we function biomechanically is predominantly controlled by genetics, its hereditary (runs in the family). The way you function is set and cannot be cured. What you can do however is control lower limb biomechanics by altering foot position during the contact phase of gait. This can only be done by wearing a good shoe (see our shoe guide) and with orthotics (foot beds).
This is the cheapest and most cost effective way for any athlete to reduce the risks of injury from occurring and from helping to prevent re-injury. Overall costs for the average athlete will run into pennies per mile/hour of sport.

Orthotics are designed to alter the biomechanics during the time the foot is on the ground. They are also used to provide increased shock absorbency working in harmony with the sport shoe worn.

Check your running shoes, are they worn, how long have you had them? Trainers used for running are designed to last at most about 750 miles. If you think you have done more mileage then replace them with a new pair. Read the running shoe page to get practical advice on running shoes.

Check the heel counter on the shoe. Is it too restrictive or too rigid. Usually the bursa is irritated by the frictional forces of poor biomechanics combined with an extrinsic component usually the shoes.

Returning to Activity

The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity is determined by how soon your heel recovers, not by how many days or weeks it has been since your injury occurred.

You may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:

You have full range of motion in the injured leg compared to the uninjured leg.

You have full strength of the injured leg compared to the uninjured leg.

You can jog straight ahead without pain or limping.

You can sprint straight ahead without pain or limping.

You can do 45-degree cuts, first at half-speed, then at full-speed.

You can do 20-yard figures-of-eight, first at half-speed, then at full-speed.

You can do 90-degree cuts, first at half-speed, then at full-speed.

You can do 10-yard figures-of-eight, first at half-speed, then at full-speed.

You can jump on both legs without pain and you can jump on the injured leg without pain.