Posterior Heel Pain

Question 1

What symptonns are associated with a Retrocalcaneal Burstitis

Answer 1

Back of heel pain (swelling to the heel proximal to the calcaneus)

Stiffness affecting ROM of the ankle joint

Exacerbated by compression

Question 2

Describe the characteristics of a Retrocalcaneal Bursitis

Answer 2

Reduce friction between the Calcaneus and the Achilles Tendon

Often associated with Achilles Tendonitis and Haglund’s Deformity

Typical size of Bursa is 1-2cm in diameter

Question 3

What causes the formation of a Retrocalcaneal Bursitis

Answer 3

Impact trauma

Repetitive trauma e.g. excessive loading

Haglund’s Deformity (Bony lump to Achilles insertion)

Excessive pressure at posterior heel e.g. occlusive footwear

Question 4

Assessment of Retrocalcaneal Bursitis

Answer 4

History taking

Evaluate the area (Tendon, bursa, calcaneum)

Palpation (Area of maximal tenderness - Medial calc)

Biomechanical abnormalities e.g. joint stiffness, soft tissue tightening

Question 5

Treatment of Retrocalcaneal Bursitis

Answer 5

Address Biomechanical Deficits e.g. Heel raise, Orthotics

Muscle strengthening to address muscle weakness

Calf stretching

Steroid Injection

Acupuncture

Question 6

Describe the characteristics of Achilles Tendonitis

Answer 6

Overload condition affecting the Achilles Tendon reducing the overload capacity of the structure

Can be midportion or insertional