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Overview<br>During contraction of the calf muscle, tension is placed through the Achilles tendon and this rubs against the retrocalcaneal bursa. Compressive forces and friction may also be placed on the retrocalcaneal bursa during certain ankle movements or by wearing excessively tight shoes. When these forces are excessive due to too much repetition or high force, irritation and inflammation of the bursa may occur. This condition is known as retrocalcaneal bursitis.<br><br>Causes<br>Pain at the posterior heel or ankle is most commonly caused by pathology at either the posterior calcaneus (at the calcaneal insertion site of the Achilles tendon) or at its associated bursae. Two bursae are located just superior to the insertion of the Achilles (calcaneal) tendon. Anterior or deep to the tendon is the retrocalcaneal (subtendinous) bursa, which is located between the Achilles tendon and the calcaneus. Posterior or superficial to the Achilles tendon is the subcutaneous calcaneal bursa, also called the Achilles bursa. This bursa is located between the skin and posterior aspect of the distal Achilles tendon. Inflammation of either or both of these bursa can cause pain at the posterior heel and ankle region.<br><br>Symptoms<br>Pain and tenderness usually develop slowly over time. Applying pressure to the back of the heel can cause pain. Wearing shoes may become uncomfortable. The back of the heel may feel achy. Pain is exacerbated when the foot is pointed or flexed, because the swollen bursa can get squeezed. A person with retrocalcaneal bursitis may feel pain when standing on their toes. Fever or chills in addition to other bursitis symptoms can be a sign of septic bursitis. Though uncommon, septic retrocalcaneal bursitis is a serious condition, and patients should seek medical care to ensure the infection does not spread.<br><br>Diagnosis<br>When a patient has pain in a joint, a careful physical examination is needed to determine what type of movement is affected and if there is any swelling present. Bursitis will not show up on x-rays, although sometimes there are also calcium deposits in the joint that can be seen. Inserting a thin needle into the affected bursa and removing (aspirating) some of the synovial fluid for examination can confirm the diagnosis. In most cases, the fluid will not be clear. It can be tested for the presence of microorganisms, which would indicate an infection, and crystals, which could indicate gout. In instances where the diagnosis is difficult, a local anesthetic (a drug that numbs the area) is injected into the painful spot. If the discomfort stops temporarily, then bursitis is probably the correct diagnosis.<br><br>Non Surgical Treatment<br>Relieving the symptoms of bursitis initially focuses on taking the pressure off the bursa. This can be done with proper cushioning, inserts, or footwear but may require surgery if it is a bone formation problem (i.e. Huglund's Deformity). If your bursitis is caused by an infection (septic bursitis), the doctor will probably drain the bursa sac with a needle and prescribe antibiotics to treat the infection.<br><br>Surgical Treatment<br>Bursectomy is a surgical procedure used to remove an inflamed or infected bursa, which is a fluid-filled sac that reduces friction between tissues of the body. Because retrocalcaneal bursitis can cause chronic inflammation, pain and discomfort, bursectomy may be used as a treatment for the condition  carp work when it is persistent and cannot be relived with other treatments. During this procedure, a surgeon makes small incisions so that a camera may be inserted into the joint. This camera is called an arthroscope. Another small incision is made so that surgical instruments can be inserted to remove the inflamed bursa.
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Overview<br>Heel bursitis is specifically the inflammation of the retrocalcaneal bursa, located at the back of the heel, under the Achilles tendon.  There are a handful of factors that put you at risk for developing heel bursitis.  Long distance runners are prone to heel bursitis, due to repeated stress and pounding upon the heel joint. Engaging in activities such as running, bicycling, walking, jumping, and stair climbing for extended periods of time can overwork the heel joints and start to irritate the bursae. Suddenly changing to a high-intensity workout regime puts a lot of stress on the heel, making it vulnerable to injury.  Hard blows/bumps to the heel can immediately damage the bursae, leading to swelling and inflammation.  Training at high intensities without stretching and warming up can also contribute to the development of heel bursitis. Even improper footwear can be a big factor.  Some other conditions can put you at risk as well, such as: tarsal tunnel syndrome, rheumatoid arthritis, plantar fasciitis, muscle weakness, joint stiffness, and [http://norahredgatee.jimdo.com/2015/06/27/hammer-toe-surgery-physical-therapy heel spurs].  It is very important to get a professional diagnosis if you are having heel pain because heel bursitis is often confused for Achilles tendonitis, and the proper treatments are very different.  The pain could also be plantar fasciitis or general heel pain syndrome.<br><br>Causes<br>Inflammation of the calcaneal bursae is most commonly caused by repetitive overuse and cumulative trauma, as seen in runners wearing tight-fitting shoes. Such bursitis may also be associated with conditions such as gout, rheumatoid arthritis, and seronegative spondyloarthropathies. In some cases, subtendinous calcaneal bursitis is caused by bursal impingement between the Achilles tendon and an excessively prominent posterior superior aspect of a calcaneus that has been affected by Haglund deformity. With Haglund disease, impingement occurs during ankle dorsiflexion.<br><br>Symptoms<br>The signs and symptoms of heel bursitis can include heel pain wearing particular footwear, Pain or discomfort in the heel when walking, jogging or running, Swelling or inflammation in the heel.<br><br>Diagnosis<br>When you are experiencing Achilles pain at the back of your heel, a visit to the doctor is always recommended. Getting a proper diagnosis is important so you can treat your condition correctly. A doctor visit is always recommended.<br><br>Non Surgical Treatment<br>The most important factor in healing bursitis is resting your foot and ankle. This can be difficult when you have to carry on with daily activities, but resting and elevating your foot whenever you can is recommended. During your recovery you will probably have to modify or avoid the activities that stress your bursa until your pain and inflammation settle.<br><br>Surgical Treatment<br>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 symptoms.<br><br>Prevention<br>Once your pain and inflammation is gone, you can prevent retrocalcaneal bursitis deformity by wearing the best shoes for your foot type. You should high-heels and pumps if possible. Wear orthotics (custom arch supports) or over-the-counter orthotic devices. Perform frequent Achilles tendon stretching exercises to prevent it from becoming tight agian. Avoiding running uphill when training. Try to run on softer surfaces and avoid concrete.

Revisión de 18:48 11 jun 2017

Overview
Heel bursitis is specifically the inflammation of the retrocalcaneal bursa, located at the back of the heel, under the Achilles tendon. There are a handful of factors that put you at risk for developing heel bursitis. Long distance runners are prone to heel bursitis, due to repeated stress and pounding upon the heel joint. Engaging in activities such as running, bicycling, walking, jumping, and stair climbing for extended periods of time can overwork the heel joints and start to irritate the bursae. Suddenly changing to a high-intensity workout regime puts a lot of stress on the heel, making it vulnerable to injury. Hard blows/bumps to the heel can immediately damage the bursae, leading to swelling and inflammation. Training at high intensities without stretching and warming up can also contribute to the development of heel bursitis. Even improper footwear can be a big factor. Some other conditions can put you at risk as well, such as: tarsal tunnel syndrome, rheumatoid arthritis, plantar fasciitis, muscle weakness, joint stiffness, and heel spurs. It is very important to get a professional diagnosis if you are having heel pain because heel bursitis is often confused for Achilles tendonitis, and the proper treatments are very different. The pain could also be plantar fasciitis or general heel pain syndrome.

Causes
Inflammation of the calcaneal bursae is most commonly caused by repetitive overuse and cumulative trauma, as seen in runners wearing tight-fitting shoes. Such bursitis may also be associated with conditions such as gout, rheumatoid arthritis, and seronegative spondyloarthropathies. In some cases, subtendinous calcaneal bursitis is caused by bursal impingement between the Achilles tendon and an excessively prominent posterior superior aspect of a calcaneus that has been affected by Haglund deformity. With Haglund disease, impingement occurs during ankle dorsiflexion.

Symptoms
The signs and symptoms of heel bursitis can include heel pain wearing particular footwear, Pain or discomfort in the heel when walking, jogging or running, Swelling or inflammation in the heel.

Diagnosis
When you are experiencing Achilles pain at the back of your heel, a visit to the doctor is always recommended. Getting a proper diagnosis is important so you can treat your condition correctly. A doctor visit is always recommended.

Non Surgical Treatment
The most important factor in healing bursitis is resting your foot and ankle. This can be difficult when you have to carry on with daily activities, but resting and elevating your foot whenever you can is recommended. During your recovery you will probably have to modify or avoid the activities that stress your bursa until your pain and inflammation settle.

Surgical Treatment
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 symptoms.

Prevention
Once your pain and inflammation is gone, you can prevent retrocalcaneal bursitis deformity by wearing the best shoes for your foot type. You should high-heels and pumps if possible. Wear orthotics (custom arch supports) or over-the-counter orthotic devices. Perform frequent Achilles tendon stretching exercises to prevent it from becoming tight agian. Avoiding running uphill when training. Try to run on softer surfaces and avoid concrete.

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