Between the heel bone and the plantar fascia is a small fluid filled sac that is called the plantar (bottom of) calcaneal (heel bone) bursa. The plantar calcaneal bursa?s job is to allow the plantar
fascia to glide easily over the heel bone without irritation. If this becomes inflamed and irritated a plantar calcaneal bursitis occurs which can be extremely painful and disabling forcing the
athlete to stop training.
Bursitis, tendinitis, and other soft tissue rheumatic syndromes typically result from one or more factors. These include: Play or work activities that cause overuse or injury to the joint areas
Incorrect posture Stress on the soft tissues from an abnormal or poorly positioned joint or bone (such as leg length differences or arthritis in a joint) Other diseases or conditions (rheumatoid
arthritis, gout, psoriasis, thyroid disease, or an unusual drug reaction) Infection.
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.
Diagnosis is first by clinical suspicion of symptoms. This can be mistaken for gout or infection especially in the big toe region. A diagnosis of bursitis is usually used in combination of the
underlying cause, for instance a bunion deformity, Haglund's deformity, or Heel Spur Syndrome. Many times the cause needs to be addressed to rid the problem of bursitis.
Non Surgical Treatment
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.
Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help