Retrocalcaneal Bursitis


  • Associated with Haglund’s Deformity and Insertional Achilles Tendinitis.
  • Retrocalcaneal bursitis is a condition characterized by tissue damage and inflammation of the retrocalcaneal bursa causing pain in the heel region.
  • Compressive forces and friction on the retrocalcaneal bursa, or wearing excessively tight shoes may cause retrocalcaneal bursitis.

Diagnostic tips

  1. Pain at the back of the ankle and heel at the Achilles tendon insertion (experienced during activities requiring strong or repetitive calf contractions such as walking, running, jumping or hopping.
  2. Pain is worse with rest after these activities (especially that night or the following morning).
  3. Pain associated with this condition may ‘warm up’ with activity in the initial stages of injury; as the condition progresses, patients may experience symptoms that increase during sport or activity, affecting performance.
  4. Limping.
  5. Tenderness on firmly touching the affected bursa
  6. Swelling around the Achilles region.

Tests and Imaging

  1. Physical examination.
  2. Ultrasound MRI and CT scans confirm diagnosis.

Immediate Treatment

  1. Advise to avoid shoes that will irritate the inflamed and enlarged area behind the heel itself.
  2. Consider heel raise to avoid friction directly on the site.
  3. Guided injection may provide temporary relief.
  4. Advise weight loss.

Possible Referral

  1. Podiatry for biomechanical assessment and heel raises, orthoses, footwear advice.
  2. Orthopaedic foot surgeon for surgical approach if there is deformity.