Between the heel bone and the plantar fascia is a small fluid filled sac that is called the plantar (bottom of) calcaneal (heel bone) bursa. The plantar calcaneal bursa?s job is to allow the plantar
fascia to glide easily over the heel bone without irritation. If this becomes inflamed and irritated a plantar calcaneal bursitis occurs which can be extremely painful and disabling forcing the
athlete to stop training.
Bursitis, tendinitis, and other soft tissue rheumatic syndromes typically result from one or more factors. These include: Play or work activities that cause overuse or injury to the joint areas
Incorrect posture Stress on the soft tissues from an abnormal or poorly positioned joint or bone (such as leg length differences or arthritis in a joint) Other diseases or conditions (rheumatoid
arthritis, gout, psoriasis, thyroid disease, or an unusual drug reaction) Infection.
Pain and tenderness are common symptoms. If the affected joint is close to the skin, as with the shoulder, knee, elbow, or Achilles tendon, swelling and redness are seen and the area may feel warm to
the touch. The bursae around the hip joint are deeper, and swelling is not obvious. Movement may be limited and is painful. In the shoulder, it may be difficult to raise the arm out from the side of
the body. Putting on a jacket or combing the hair becomes a troublesome activity. In acute bursitis symptoms appear suddenly, with chronic bursitis, pain, tenderness, and limited movement reappear
after exercise or strain.
A good clinical practise includes evaluation of the tendon, bursa and calcaneum by, careful history, inspection of the region for bony prominence and local swelling as well as palpation of the area
of maximal tenderness. Biomechanical abnormalities, joint stiffness and proximal soft tissue tightening can exacerbate an anatomical predisposition to retrocalcaneal bursitis, they warrant correction
Non Surgical Treatment
In some cases, physicians may recommend drugs or medications like NSAIDs (non-steroidal anti-inflamatory drugs) to manage pain and inflammation. Alternative medications like cortisone injections are
NOT advised for any type of Achilles Tendon injury or condition. This is because there is an increased risk of rupture of the tendon following a cortisone injection. Medical evidence shows that
cortisone shots can damage the surrounding tissue, fray the Achilles tendon, and even trigger a rupture. Most side effects are temporary, but skin weakening (atrophy) and lightening of the skin
(depigmentation) can be permanent.
Surgery to remove the damaged bursa may be performed in extreme cases. If the bursitis is caused by an infection, then additional treatment is needed. Septic bursitis is caused by the presence of a
pus-forming organism, usually staphylococcus aureus. This is confirmed by examining a sample of the fluid in the bursa and requires treatment with antibiotics taken by mouth, injected into a muscle
or into a vein (intravenously). The bursa will also need to be drained by needle two or three times over the first week of treatment. When a patient has such a serious infection, there may be
underlying causes. There could be undiscovered diabetes, or an inefficient immune system caused by human immunodeficiency virus infection (HIV).
It isn't always possible to avoid the sudden blow, bump, or fall that may produce bursitis. But you can protect your body with measures similar to those that protect you from other kinds of overuse
injuries, such as tendinitis. Keep yourself in good shape. Strengthening and flexibility exercises tone muscles that support joints and help increase joint mobility. Don?t push yourself too hard (or
too long). If you?re engaged in physical labor, pace yourself and take frequent breaks. If you?re beginning a new exercise program or a new sport, work up gradually to higher levels of fitness. And
anytime you?re in pain, stop. Work on technique. Make sure your technique is correct if you play tennis, golf, or any sport that may strain your shoulder. Watch out for ?elbow-itis.? If you
habitually lean on your elbow at your work desk, this may be a sign that your chair is uncomfortable or the wrong height. Try to arrange your work space so that you don?t have to lean on your elbow
to read, write, or view your computer screen. Take knee precautions. If you have a task that calls for lots of kneeling (for example, refinishing or waxing a floor), cushion your knees, change
position frequently, and take breaks. Wear the right shoes. High-heeled or ill-fitting shoes cause bunions, and tight shoes can also cause bursitis in the heel. Problems in the feet can also affect
the hips. In particular, the tendons and bursae in the hips can be put under excessive strain by worn-down heels. Buy shoes that fit and keep them in good repair. Never wear a shoe that?s too short
or narrow. Women should save their high heels for special occasions only. Avoid staying in only one position for too long. Get up and walk around for a while or change positions frequently.