A properly functioning heel is essential to normal, smooth, and painless gait. The heel is the first area to strike the ground during normal gait, which means it takes the brunt of the stress
incurred during walking and running activities. Of course, this also means that the heel is highly prone to injury. One such injury is called heel bursitis.
The most common cause of bursitis is repeated physical activity, but it can flare up for no known reason. It can also be caused by trauma, rheumatoid arthritis, gout, and acute or chronic
Pain at the back of the heel, especially when running uphill. Pain may get worse when rising on the toes (standing on tiptoes). Tenderness at the back of heel. Swelling at the back of heel.
Medical examination is not necessarily required in light cases where the tenderness is minimal. In all cases where smooth improvement is not experienced, medical attention should be sought as soon as
possible to exclude a (partial) rupture of the Achilles tendon or rupture of the soleus muscle. This situation is best determined by use of ultrasound scanning, as a number of injuries requiring
treatment can easily be overlooked during a clinical examination (Ultrasonic image). Ultrasound scanning enables an evaluation of the extent of the change in the tendon, inflammation of the tendon
(tendinitis), development of cicatricial tissue (tendinosis), calcification, inflammation of the tissue surrounding the tendon (peritendinitis), inflammation of the bursa (bursitis), as well as
Non Surgical Treatment
Podiatric Care may include using anti-inflammatory oral medications or an injection of medication and local anesthetic to reduce the swelling in the bursa. An injection may be used for both diagnosis
and for treatment. When you go to your doctor, x-rays are usually required to evaluate the structure of your foot and ankle to ensure no other problems exist in this area. They may advise you on
different shoewear or prescribe a custom made orthotic to try and control the foot structure especially if you have excessive pronation. Sometimes patients are sent to Physical Therapy for treatment
as well. To aid in relief of pressure points, some simple padding techniques can be utilized. Most all patients respond to these conservative measures once the area of irritation is removed.
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.
Protect that part of the body that may be most vulnerable, If you have to kneel a lot, get some knee pads. Elbow braces can protect tennis and golf players. If you are an athlete or avid walker,
invest in some good walking or running shoes. When doing repetitive tasks have breaks. Apart from taking regular breaks, try varying your movements so that you are using different parts of your body.
Warm up before exercise. Before any type of vigorous exercise you should warm up for at least 5 to 10 minutes. The warm up could include walking at a good speed, slow jogging, or a cycling machine.
Strong muscles add extra protection to the area. If you strengthen the muscles in the area where you had bursitis (after you are better), especially the area around the joint, you will have extra
protection from injury. Make sure you do this well after your bursitis has gone completely.