The shoes you normally put on are suddenly difficult to wear. The outside of your heel is tender, red, and swollen. Come to think of it, so is the outside of your ankle. What’s going on? It sounds like you could have a case of calcaneal bursitis.
BURSAE TO BLAME
Bursae are fluid-filled sacs that act as shock absorbers and cushions for our bones and tendons. There are two such sacs located on the back of your heel. The subtendinous calcaneal, also called retrocalcaneal bursa, is situated between the Achilles tendon and the heel bone (calcaneus). The subcutaneous calcaneal bursa, which is also referred to as the Achilles bursa, is found on the backside of the heel and Achilles. If either or both of these bursae become inflamed, the result is pain and tenderness.
Factors of Inflammation
Cumulative trauma and overuse are the two main reasons for inflammation of the calcaneal bursae. That’s why the condition is often seen in runners who train too much and tend to ignore the symptoms. This is a dangerous approach, however, since continual use can lead to a more serious injury, such as a ruptured Achilles tendon.
Other contributing factors include ill-fitting shoes and conditions like gout, rheumatoid arthritis, or Haglund’s deformity, which is characterized by a bony prominence on the back of the heel. This can also lead to a bursal impingement (compression) between the boney protrusion and the Achilles tendon.
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The “Heel-ing” Process
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Rest, ice, and anti-inflammatory medication will help with pain and swelling. Physical therapy can help stretch the Achilles to relieve any impingement. Also, a switch to properly-fitting shoes will help to prevent the condition from worsening or recurring. You might also find relief with shoe inserts such as heel cups or padding. If you have tried these measures, yet symptoms remain severe and continue to progress, surgical intervention is a possibility. Calcaneal bursitis surgery consists of excision or removal of the inflamed tissues and resection of the boney prominence. Debridement of the affected area near the Achilles may also be performed, as well as repair of the Achilles if the condition has gone so far that the tendon ruptures.
PREVENT THE PAIN
You can avoid the situation all together if you stop activity as soon as you see, and feel, the signs. Many runners attempt to push through pain, but ignoring symptoms only leads to more problems. It’s better to take some time off right away than to end up taking far more time off later. Runners aren’t the only ones at risk. The condition can happen to any type of athlete of any age. For all you women out there who love to wear high-heels—you’re at a greater risk as well. Plus, anyone whose shoes are too tight can end up with calcaneal bursitis, so make sure your footwear fits.
If the outside of your heel and ankle hurts, calcaneal bursitis could be to blame. Get it checked out at Austin Foot and Ankle Specialists in Austin, TX. Call (512) 328-8900 to make an appointment with Dr. Craig H. Thomajan DPM, FACFAS today.