Retrocalcaneal Bursitis — Can You Repeat That Please?

When my sports chiropractor, Derek Gearhart, of Advanced Sports Chiropractic, first said “retrocalcaneal bursitis” was the reason for the searing pain in my heel, I said, “Can you repeat that, please?” I thought I needed flash cards to break down the name of the pain that had sidelined me from running.

But, when you break it down, it makes sense — it is the swelling of the fluid-filled sac (bursa) at the back of the heel (calcaneus). The RCB is tucked in the back of the ankle, just at the heel, where the Achilles tendon connects the calf muscle and heel bone.

I first noted the pain, which felt like someone side-chopping my heel, during the middle of an eight mile run. I had to run/walk the last several miles back. I tried to ignore the pain and do some extra stretches, avoiding the doctor with my own self-diagnosis skills on the Internet (note: not a smart idea). However, when the pain started making me limp and hobble just when trying to walk, I knew something had to change. Even worse, I had to wear tennis shoes to work. A definite first.

I hobbled into Gearhart’s office afraid that I might never run again. Gearhart confirmed that I had not torn my achilles tendon or developed a stress fracture (my worst fear). Whew. I began to breathe a little bit easier. It’s taken a few weeks, but I am slowly beginning to run again, if crawling counts.

Here are some tips from what I have learned from this experience. Check back tomorrow for a post from Anna about stretching the Achilles tendon.

CAUSES:
- Overtraining.
- Sudden increases in mileage.
- Tight shoes.

SYMPTOMS:
- Pain in the back of the heel (especially when running up hills).
- Pain when  you press on both sides of the heel.
- Pain when you stand on your tippy-toes.
- Redness around the back of your heel.

EXAMS AND TESTS:
- While diagnostic ultrasound, X-ray, and MRI tests, can be used, most cases of RCB or Achilles Bursitis can be dianosed without formal testing.

TREATMENT:
- (The biggy) Avoid or modify ALL activities that cause pain (yes, this means tabling running for a few weeks) – if it is any consolation try low impact sports such as swimming or yoga. Use this time as an opportunity to sign up for your favorite spin class or work on your balance and flexibility.
- Ice & Heat. Ice can help reduce the inflammation. Grab those frozen peas at the back of the freezer before watching American Idol. After twenty minutes of ice, apply a source of heat. I alternated with soaking my heel in hot water with espom salt.
- Anti-inflammatory medicine such as ibuprofen
- Vinegar??? – Yes, I recycled a home remedy from my great-grandmother, taking strips of brown paper, soaking them in vinegar and wrapping my foot. I am not guaranteeing that it will work for you, but it certainly has helped me. Apparently it helps increase the circulation and flush out toxins.
- See a sports injury specialist. For me, Gearhart has helped with his knowledge of Active Release Technique (ART).
- Ditch the high heels.

PREVENTION:
- Strengthen the muscles and tendons around the ankle.
- Proper stretching of the Achilles Tendon (see tomorrow’s post from Anna for more specific stretches).