man holding his leg for painIn considering retrocalcaneal vs. subcalcaneal bursitis, the pathology is essentially the same but the location is different. The definition of bursitis is an inflammation of a fluid-containing sac (bursa) which is located between a bone and tendon. The function of a bursa is to cushion and reduce friction between body tissues, most commonly ligaments, tendons, and bone. When running and performing repetitive motions of the foot and ankle, irritation and inflammation of the bursa may occur which can result in pain and dysfunction. Some common causes of a retrocalcaneal or subcalcaneal bursitis include: overuse and overtraining, tight/poorly fitting running shoes, lack of stretching, fat pad atrophy, and Achilles pathology. 

Retrocalcaneal bursitis:

There are two distinct bursa present at the back of the heel: the retrocalcaneal bursa is located between the Achilles tendon and the calcaneus (heel bone) while the subcutaneous bursa is located between the Achilles tendon and the skin. If you have pain, warmth, swelling, and/or redness at the back of your heel near the Achilles tendon, you may have a retrocalcaneal bursitis.  Inflammation of either of these bursa can be mistaken for Achilles tendonitis.

Subcalcaneal bursitis:

The subcalcaneal bursa is located underneath the central portion of the calcaneus (heel bone). The subcalcaneal bursa is located near the attachment of a ligament (plantar fascia) to the calcaneus. Ever hear of plantar fasciitis? Subcalcaneal bursitis can contribute or be mistaken for this pathology. If you have pain, warmth, swelling, and/or redness underneath your heel, you may have a subcalcaneal bursitis. 

Treatment:

  • Rest, ice, and elevation

  • NSAID’s/anti-inflammatories

  • Orthotics and heel lifts

  • Laser therapy

  • Physical therapy

  • Stretching exercises to increase your flexibility and range of motion of your calf 

  • Surgical excision of the bursa

It is important to note that overuse and repetitive motion are the main causes of bursitis and the longer treatment is delayed the worse the symptoms can become.  Please call us today at 406-721-4007 if you are suffering from these symptoms.

Take the First Step Toward a Pain-Free Future

If you’re suffering from foot and ankle pain, help is available. At Alpine Foot & Ankle Clinic, our foot and ankle podiatrist provides treatments go beyond typical offerings—giving patients access to world-class interventions right here under the Big Sky. Don’t travel to Seattle, Denver, or Salt Lake City for next-level podiatric care and pain relief. Get the highly skilled foot and ankle care needed to recover and return to your favorite activities closer to home. Contact us today to schedule an appointment at our Missoula podiatry office.