Retrocalcaneal Bursitis Treatment | Mona Vale Osteopath
Retrocalcaneal bursitis is a common cause of pain at the back of the heel. It occurs when the small fluid-filled bursa between the Achilles tendon and heel bone becomes irritated, leading to pain during walking, running and activities that repeatedly load the Achilles tendon.
At Helix Recovery, we'll determine whether your symptoms are coming from the bursa, the Achilles tendon, or a combination of both before developing an individualised treatment plan.
What is Retrocalcaneal Bursitis ?
The retrocalcaneal bursa is a small fluid-filled sac located between the Achilles tendon and the heel bone. Its role is to reduce friction as the Achilles tendon moves during walking and running.
When the bursa becomes irritated, it can become painful and swollen. This may occur following increased activity, repetitive compression of the area, or alongside insertional Achilles tendinopathy.
Because retrocalcaneal bursitis and Achilles tendinopathy often occur together, a thorough assessment is important to guide appropriate treatment.
Common Symptoms
Pain at the back of the heel, just in front of the Achilles tendon
Swelling around the back of the heel
Pain when walking uphill or climbing stairs
Pain when wearing shoes that press against the back of the heel
Tenderness when squeezing either side of the Achilles tendon near its attachment
Stiffness after periods of rest
How We Assess Retrocalcaneal Bursitis
Several conditions can cause pain underneath the heel, making an accurate diagnosis important.
During your assessment, we'll determine whether your symptoms are most consistent with fat pad syndrome or another condition such as plantar fasciitis, a plantar fascia tear or a calcaneal stress injury.
Assessment may include evaluating the location of your pain, walking pattern, foot and ankle movement, calf strength and factors contributing to repeated heel loading.
How We Treat Retrocalcaneal Bursitis
Treatment depends on how long symptoms have been present, their severity and the activities you want to return to.
Treatment may include:
Osteopathic manual therapy
Shockwave therapy
Progressive exercise rehabilitation
Activity modification and load management
Advice regarding footwear and heel lifts where appropriate
Strategies to reduce compression of the bursa during recovery
Gradual return to walking, running and sport
Shockwave Therapy for Retrocalcaneal Bursitis
Shockwave therapy may be incorporated into your treatment plan to help reduce pain and support your rehabilitation. It is commonly used alongside osteopathic manual therapy, progressive exercise rehabilitation and activity modification to improve your ability to comfortably load the Achilles region.
Common Questions
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No. Retrocalcaneal bursitis involves irritation of the bursa between the Achilles tendon and heel bone, whereas Achilles tendinopathy affects the tendon itself. The two conditions can occur together.
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Shoes with a firm heel counter can place pressure over the inflamed bursa, increasing irritation and discomfort.
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In many cases, yes. Activities may need to be modified temporarily to reduce compression and irritation while maintaining as much activity as comfortably possible.
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Recovery depends on symptom severity, contributing factors and how long symptoms have been present. Most people improve with an appropriate combination of load management and progressive rehabilitation.
Ready to Get Back to Comfortable Movement?
Pain at the back of the heel isn't always caused by the Achilles tendon. We'll identify the source of your symptoms and develop a treatment plan tailored to your goals.