Whenever tissues rub against one another, a bursa forms to allow for smooth gliding. A bursa is a fluid-filled sac and occurs normally throughout the body. Only a few cell layers thick, a bursa is
filled with a lubricating fluid. However, when irritated, a bursa can become markedly thickened and painful. This is often referred to as bursitis. The retrocalcaneal bursa is positioned to allow the
Achilles tendon to glide over the back part (posterior aspect) of the heel bone. When this bone becomes enlarged, inflammation of the retrocalcaneal bursa occurs. This inflammation results in
exquisite tenderness along the posterior aspect of the heel.
As ligaments and tendons stretch and tear, blood from ruptured blood vessels becomes trapped in the local tissues. As the trapped blood clots up, it sticks the tissues together creating adhesions.
Adhesions cause pain, inflammation and restricted movement because the layers of tissue that used to slide smoothly across one another now adhere and snap which interferes with normal functioning. It
is essential to break up clotted blood as quickly as possible to prevent adhesions and scar tissue from forming.
Achiness or stiffness in the affected joint. Worse pain when you press on or move the joint. A joint that looks red and swollen (especially when the bursae in the knee or elbow are affected). A joint
that feels warm to the touch, compared to the unaffected joint, which could be a sign that you have an infection in the bursa. A ?squishy? feeling when you touch the affected part. Symptoms that
rapidly reappear after an injury or sharp blow to the affected area.
Gram stain. A lab test called a Gram stain is used to determine if certain troublesome bacteria are present. Not all bacteria can be identified with a Gram stain, however, so even if the test comes
back negative, septic bursitis cannot be completely ruled out. White blood cell count. An elevated number of white blood cells in the bursa's synovial fluid indicates an infection. Glucose levels
test. Glucose levels that are significantly lower than normal may indicate infection.
Non Surgical Treatment
You should rest from all activities that cause pain or limping. Use crutches/cane until you can walk without pain or limping. Ice. Place a plastic bag with ice on the foot for 15-20 minutes, 3-5
times a day for the first 24-72 hours. Leave the ice off at least 1 1/2 hours between applications. Compression. Lightly wrap an elastic bandage from the toes to mid calf, using even pressure. Wear
this until swelling decreases. Loosen the wrap if your toes start to turn blue or feel cold. Elevate. Make sure to elevate the ankle above heart level. To improve symptoms of plantar calcaneal
bursitis after the acute phasetry the baked bean tin stretch, using a baked bean tin roll the foot backwards and forwards. 2 minutes in the morning before putting the foot to the floor. 5-10 minutes
every evening. Contrast foot baths. 10 minutes warm water. 10 minutes cool water morning and evening (morning may be missed if time is restricted). Stretches. Start with 10 stretches per day, holding
the stretch for 30 seconds, then relax and then repeat. Continue this stretch daily until you can no longer feel it pulling on the heel, then progress to stretch. Do 10 per day holding for 30 seconds
per stretch. When you can no longer feel it pulling on the heel proceed to stretches. Do 10 per day holding for 30 seconds on every stretch.
Surgery is rarely done strictly for treatment of a bursitis. If any underlying cause is the reason, this may be addressed surgically. During surgery for other conditions, a bursa may be seen and