Achilles Heel Bursitis [Retrocalcaneal Bursitis Symptoms & Treatment]
Achilles Heel Bursitis: We go over the 100% ABSOLUTE best retrocalcaneal heel bursitis home treatments! We go over the best shoes and orthotics!
Table of Contents
Signs & Symptoms Of Achilles Tendon Bursitis:
- Back of the heel pain upon waking or after rest.
- This usually lasts for about 15-20 minutes.
- Moving around and light stretching make it feel better.
- A soft tissue bump forming at the back of the heel.
- Icing and massage make it feel better.
- History of achilles tendon overuse.
- This may include heavy running.
- History of tight shoes at the heel.
What Is Achilles Tendon Bursitis?
- There are two “gel” sacks in the heel, the pre-Achilles and the retro-Achilles bursa.
- Both pre-Achilles bursitis and retro-Achilles bursitis are possible.
Tendo-Achilles Bursitis Causes:
- Irritation and inflammation are the most common causes of Achilles tendon bursitis.
- The most common cause of this inflammation is Achilles tendinitis.
- Tendinitis is inflammation of the Achilles tendon.
- It is very common for Achilles tendinitis and bursitis to occur together; if the bursa is irritated, then the tendon will be irritated as well!
- It is also very common for the back of the heel to rub against the shoes.
- If you have a low quality or bad heel counter on your shoe, it can compress your heel.
Who Is At Risk For Tendo-Achilles Bursitis:
- Overuse of the Achilles tendon or calf.
- This overuse causes Achilles tendinitis which may lead to further bursitis.
- Repetitive irritation of the back of the heel.
- This can be due tight or improperly fitting shoes.
- More rarely it can be associated with: gout, rheumatoid arthritis and other autoimmune conditions.
- Pre-achilles bursitis is inflammation of the bursa most superficial to the skin.
- The pre-Achilles bursa is between the skin and the Achilles Tendon.
- This is the more visible skin Achilles tendon bursitis.
- Retro-Achilles bursitis is inflammation between the Achilles tendon and the calcaneus.
- This is the more common and more painful Achilles tendon bursitis.
Achilles Bursitis Treatment:
- Treatment is based on decreasing inflammation.
- Then identify and prevent the cause of inflammation.
- Then make sure it doesn’t come back.
- Don’t worry, this can all be done from home.
1) Relieve The Inflammation:
- The pain is usually worst after rest or sleeping.
- This is because the inflammatory cells have settled in that area with decreased blood flow.
- If you ice, massage, apply heat or gently stretch it will feel better.
- It usually takes about 15-20 minutes to feel better.
- Even just walking around will get your blood flowing!
A) Walk Around & Gently Stretch:
- When you get up in the morning massage it out a bit.
- I like to stretch my calf muscles and Achilles tendon while brushing teeth!
- No matter what you do, it will get better in a little while.
B)Ice The Back Of The Heel:
- Do this 2-3x a day for 1-2 weeks.
- It takes this long for the inflammation to die down.
- Icing 2-3x per day for about 15-20 minutes will decrease the flow of inflammatory cells into the muscle.
- Afterwards the arteries will vasodilate further flushing out inflammatory cells from the region.
- Ice has deeper penetrating power than heat.
- But you can use heat as well.
- Just don’t use heat if you recently injured an area.
C) Anti-Inflammatory Medication:
- This can be a topical gel by prescription.
- It can also be oral pills like Ibuprofen or Aspirin.
- Do not take these unless instructed to do so by your physician or podiatrist.
- Take a 1-2 week course to attempt to decrease the inflammation and speed up your healing time.
- Take 2-3x doses per day as instructed, this builds up anti-inflammatory enzyme levels in your system.
- Taking just 1-2 pills and then stopping does nothing for inflammation!
D) Stop Inflammation For 1-2 Weeks:
- It can take up to 1-2 weeks for the inflammation to go down.
- For some mild cases this may only be 1-2 days.
- For more severe cases it could be 2 weeks +.
- Just keep icing, massaging and stretching.
- If it isn’t getting better after about 2 weeks, see your podiatrist!
2) Achilles Tendon Stretching:
- Once the pain starts to decrease, you will be able to stretch.
- Focus on stretching your hamstrings, calf and plantar fascia.
- Pick one exercise for the hamstring, one for the calf and one for the plantar fascia.
- All stretches should be for 15-30 seconds until tightness (not pain).
- Do these 2-3x per day.
- The entire stretching session should take less than 5 minutes per day.
3) Get Some Achilles Tendon Support:
- Make sure you don’t fall into the bad habits that caused this pain.
- Get good rigid shoes with heel support.
- Measure your shoes properly.
- Get a good over the counter pair of orthotics.
A) Achilles Tendon Supporting Shoes:
- Get a good running shoe.
- Make sure it has a stiff base.
- May sure it is not too flexible.
- Make sure there is enough room for your big toe and pinky toes.
- The heel counter should be rigid.
- The average running shoe should be worn less than 400 miles or so.
- This is about 3-6 months, don’t keep a shoe for years!
- I’m as frugal as it gets, but you can get a good new shoe for $35 on sale.
- Don’t risk your future mobility!
B) Correctly Size The Shoes:
- Fit your shoes in the evening.
- Your feet are the most swollen at night.
- Use a Brannock device to measure your size properly.
- Measure your foot length.
- Measure your arch length.
- Measure your foot width length.
C) Get A Good Orthotic:
- Most people have been burned by poor orthotic purchases.
- Don’t by a crummy gel cushion, that is only for a poorly cushioned heel (fat pad atrophy).
- Gel pads only mask the pain temporarily, they do not fix it!
- The Dr. Scholl’s machines work well, but the orthotic can be 60$ or so.
- Consider something like a powerstep ordered online (20-30$ range).
- If you have insurance, get a custom orthotic made, these are the best if available.
C) Get A Good Ankle Brace:
Check below for great ankle brace options.
If That Didn’t Cure You:
Consider Plantar Fasciitis:
- If your pain is at the bottom of the heel.
- Consider plantar fasciitis as a cause!
Back of the heel pain treatment:
Best Back of Heel Pain Treatment:
- There are usually two phases to treating back of the heel pain.
- The two phases of treatment include controlling the acute inflammation and correcting the biomechanics, which led to the problem in the first place.
- If the tendons and ligaments are inflamed, they are almost frozen in place and cannot function properly.
- Once the inflammation is decreased, we need to correct the biomechanical causes to ensure that the Achilles tendon can never become overworked and inflamed again!
- This doesn’t matter whether it’s The back of the heel spur, fat pad atrophy, insertional Achilles tendinitis, Achilles tendinitis, or even Achilles tendinosis.
- If you do have an Achilles tendon rupture or tear, seeing podiatrist care immediately.
Achilles Tendon Natural Treatment:
Massage & Ice Products:
- Ice is an excellent option that can be safe for almost everyone.
- There is some debate about whether icing is worth doing, but this can help limit the need for medications and keep your options open for chronic pain.
- This works great for your arch, less for the ball of the foot.
- Manual massage on the Achilles tendon & calf muscle is a natural treatment that can also be considered physical therapy for your back of the heel pain.
- This works well for calf muscle pain and Achilles tendon pain.
- The more muscle and ligament tissue there is, the better ice will work there.
Menthol Based Gels:
- Biofreeze is one of our favorites.
- These gels have been studied to work 2x as long as ice.
- This works great for the ball of the foot.
- This can be very effective for pain relief, but this can decrease inflammation in the calf muscle and Achilles tendon.
- These can work great for loosening your muscles.
- This allows less tightness and pressure onto the plantar fascia and heel.
- This is very effective for the arch, the gastrocnemius, calf muscle, and the hamstring and thigh muscles.
- This also works very well for the gluteus muscles if you are having butt cheek or hip pain.
- The massage stick can break up lumps in your Achilles tendon and heel pain.
Remove the Achilles tendon tightness.
- The key is to prevent future pain stress and trauma to the Achilles tendon muscle.
- This means keeping you active while keeping stress off of your Achilles tendon. This will prevent future re-injury and the development of plantar fasciitis.
- If you can get rid of the pain and swelling, this will let you start walking normally.
- If you can walk normally, the vast majority of your pain should gradually start to go away.
- The best way to ensure that your plantar fascia, foot, and ankle ligaments are not overworked is to support them.
- The best way to support them is to use great orthotics and great shoes.
- Some people may also need to rely on supportive ankle braces and other supportive modalities.
Best Shoes for Back of Heel Pain:
- Getting a great supportive pair of Achilles tendonitis shoes will ensure that there is pressure removed from the heel and plantar fascia region.
- This is especially important if you have plantar fasciitis, heel spur pain, or Achilles tendonitis as well.
- Consider Achilles tendonitis shoes combined with a good supportive orthotic for best pain relief!
- The following link will show you what our favorites are.
Best Achilles Tendonitis Insoles:
- These are our recommended orthotics for Achilles tendonitis.
- Custom orthotics can work very well, but they should not be the first line of treatment due to the cost.
- There are different types of different shoes.
- Women’s shoes usually need a less bulky orthotic but allow for less correction.
- A full-length orthotic requires a running shoe, boot, or comfortable walking/dress shoe.
- We recommend doing everything you can to get a good supportive shoe that can fit a full-length orthotic.
- A further home remedy tip for Achilles tendonitis pain is cutting out a hole where the nodule uses scissors or a knife. Be careful and start with a very low-cost orthotic.
Best Full Length Achilles tendonitis Orthotics:
- These will only work in wider shoes or a good supportive running shoe.
- This will not work in sandals, flats, or most women’s dress shoes.
Best Dress Shoe Achilles tendonitisOrthotics:
- These are a great choice for dress orthotics.
Best 3/4 Length Achilles tendonitis Orthotics:
- These are great options for women’s dress shoes and thinner shoes.
- These are not the most supportive pair of orthotics.
Get A Great Dynamic Stretch:
- It is possible to stretch on your own, but these products can also really help!
- This will take pressure off of the ball of your foot.
- This form of the back of the heel pain physical therapy breaks up the scar tissue.
- We personally prefer this method of stretching.
Get A Great Static Stretch:
- These devices are great for stretching while you are resting.
- This is an excellent Achilles tendonitis physical therapy that you can do at home.
- This will also help take pressure off of the ball of your foot.
- This works great for plantar fasciitis.
- The static night splint can use it while watching TV or at night time.
Best Heel Compression Brace:
- A good compression brace can stabilize your foot from turning outward.
- This prevents your foot from pronation.
- The pronated foot will turn your foot outward, in your foot will rub on the outside of the shoe.
- This has solved their pain for many of her patients and is very comfortable to wear inside your shoe.
- This solves both pain and outward pronation for a relatively low cost.
Best Heel Stability Brace:
- The stability brace goes a little bit further than the compression brace to stop your foot from turning out.
- This takes the pressure off of your heel and plantar fascia.
- At the same time, this is a little bit bulkier and does not affect every shoe.
- We find people are a little bit happier trying the compression brace before the stability brace.
Severe Achilles tendonitis Pain:
- If you think you might have a broken heel, a calcaneal stress fracture, or something of similar severity, these products might help!
- Always remember to see a foot and ankle specialist like a podiatrist if you have plantar fasciitis or more severe pain!
Plantar Fascia Tear, Broken Heel Bone, Achilles Tendon Tear:
- If you have a traumatic injury such as a torn plantar fascia ligament, calcaneus stress fracture, heel fracture, or insertional Achilles tendon injury: consider protecting your foot!
- The best way to do this is, of course, to see your podiatrist and get evaluated with an x-ray, ultrasound, and potentially even an MRI or CT scan.
- If you cannot do so, it may benefit you to be in a cast, fractured boot, or even keep the weight off of it with a rolling knee scooter or other protective devices.
- We as podiatrists frequently take patients off work for very long periods of time when they suffer a traumatic injury. Unfortunately, there is no other way around us in labor jobs.
- If you have a sit-down job, there are ways to get people back to work quicker, but this can be not easy otherwise.
Heel Injury Boot Treatment:
- There are pros and cons to using a boot to treat your heel injury. The Pros are that your injured heel will hopefully have a chance to heal gradually! If you are immobilized too long, the cons are that you will gradually become stiff and overworked to your other leg.
- Our favorite fracture boots and their supplies:
Offloading and Scooter treatment:
- These are favorite knee scooters and walking devices.
- If your Achilles tendonitis pain is severe, offloading can be very effective until the pain calms down.