Bursitis is inflammation of a bursa, a small, fluid-filled sac that reduces friction between tissues. Achilles bursitis affects the bursae around the Achilles tendon, causing pain and discomfort in the heel and ankle. This condition can impact daily activities and physical performance. Understanding its causes and management is important for those with heel pain.
Understanding Achilles Bursitis
The Achilles tendon, the body’s thickest and strongest tendon, connects the calf muscles to the heel bone (calcaneus). It plays a central role in movements like walking, running, and jumping by helping raise the heel and propel the body forward. Several bursae are positioned around the Achilles tendon to facilitate smooth movement and reduce friction.
Achilles bursitis involves two primary bursae. The retrocalcaneal bursa, also called the subtendinous bursa, is located deep between the Achilles tendon and the heel bone. The superficial calcaneal bursa lies just under the skin and behind the Achilles tendon. Bursitis occurs when one or both sacs become irritated and inflamed.
Common Causes and Risk Factors
Achilles bursitis often develops from repetitive stress and overuse of the ankle, especially from activities like walking, running, or jumping. Athletes are commonly affected due to continuous strain on the heel during training and competition. A sudden increase in activity intensity or duration without adequate conditioning can also elevate the risk.
Improper footwear is another contributing factor; shoes that are too tight, lack proper support, or have a stiff heel can create undue pressure and friction on the bursae. High heels can strain the Achilles tendon, increasing the likelihood of bursitis. Tight calf muscles can also contribute by increasing tension on the Achilles tendon. Certain medical conditions, such as rheumatoid arthritis, gout, and other inflammatory arthropathies, can predispose individuals to bursitis.
Identifying the Symptoms
Individuals with Achilles bursitis experience pain at the back of the heel. This pain often worsens with activity like walking, running, or standing on tiptoes. Discomfort may be noticeable when first waking up or after periods of rest.
Common signs of inflammation include swelling, redness, and warmth around the affected area of the heel. The heel may also feel tender to the touch. Stiffness in the ankle can occur, and the skin over the bursa may appear thickened or develop a bony-like protrusion, sometimes called a “pump bump” or Haglund’s deformity.
Approaches to Treatment and Recovery
Initial management of Achilles bursitis involves conservative, non-surgical methods. Resting the affected ankle and avoiding activities that worsen symptoms is a primary step. Applying ice packs to the heel for 15-20 minutes several times daily can help decrease swelling and discomfort.
Over-the-counter pain relievers, such as NSAIDs, can be used to manage pain and reduce inflammation. Footwear modifications are often recommended, including shoes with softer backs, open-backed designs, or heel pads to alleviate pressure on the bursa. Gentle stretching exercises for the calf muscles and Achilles tendon improve flexibility and reduce tension. Strengthening exercises for the calf muscles also provide better ankle support. Consulting a healthcare professional for an accurate diagnosis and tailored treatment plan is advisable.
Preventing Recurrence
Preventing Achilles bursitis involves addressing common risk factors and promoting ankle health. Gradually increasing activity levels is important, especially for those new to exercise or returning after a break. Avoiding sudden increases in workout intensity or duration helps the body adapt without undue stress on the heel.
Wearing supportive, properly fitting footwear that does not rub or place pressure on the back of the heel is crucial. Regularly stretching the calf muscles and Achilles tendon improves flexibility and reduces tightness contributing to bursitis. Strengthening exercises for the calf muscles help stabilize the ankle and support the Achilles tendon, minimizing strain on the bursae. Listening to the body and resting when experiencing pain can prevent minor irritation from escalating.