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Achilles tendon bursitis, also known as retrocalcaneal bursitis, is a common foot pain in athletes, particularly runners. It can often be mistaken for achilles tendonitis or can also occur in conjunction with achilles tendonitis.
Symptoms include pain at the back of the heel, especially when running uphill or on soft surfaces. There will be tenderness and swelling at the back of the heel which may make it difficult to wear certain footwear. When pressing the sides and back of the heels, a spongy resistance may be felt.
What is achilles bursitis?
A bursa is a small sack of fluid that sits between a tendon and a bone to help the tendon move smoothly over the bone. The retrocalcaneal bursa in situated in the feet between the Achilles tendon and the calcaneus or heel bone. With repeated trauma the bursa can become inflamed.
Achilles tendon bursitis is often mistaken for achilles tendinitis. It is possible for the athlete to have both achilles tendinitis and achilles tendon bursitis at the same time which is known as Haglund's syndrome.
What can the athlete do?
Rest the foot, refraining from activity as much as possible until symptoms ease, and apply cold therapy or ice. Ice should not be applied directly to the skin as it may cause ice burns, so wrap the ice pack in a wet tea towel. Commercially available hot and cold packs are often more convenience than using raw ice. Taping the bursa with a donut-shaped pad to take some of the pressure from footwear may help.
What can a sports injury specialist or doctor do?
A doctor may prescribe anti-inflammatory medication e.g. ibuprofen to reduce the pain and inflammation. Applying electrotherapy such as ultrasound may reduce inflammation and swelling. A steroid injection followed by 48 hours rest may be given for persistent cases. If the bursitis is particularly bad and does not respond to conservative treatment then surgery is also an option. See rehabilitation for more detailed information.