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What is the Achilles Tendon?

The Achilles tendon is the large tendon that connects the calf muscles to the heel bone (calcaneus) and is used when you walk, run and jump. 

What is Achilles Tendon Bursitis?

Achilles tendon bursitis or retrocalcaneal bursitis is a condition that commonly occurs in athletes. It is a painful condition caused by the swelling of the bursa, a fluid-filled sac that is located at the back of the heel under the Achilles tendon. This retrocalcaneal bursa contains a lubricating fluid that acts as a cushion to reduce friction between muscle and bones. 

What are the Causes of Achilles Tendon Bursitis?

Achilles tendon bursitis is caused by overuse of the ankle from excessive walking, jumping or running, which results in irritation and inflammation of the bursa. Achilles tendon bursitis can also occur in conjunction with Achilles tendinitis, which is the inflammation of the Achilles tendon. 

Children who suddenly increase their level of physical activity are at a higher risk of developing Achilles tendon bursitis. 

What are the Symptoms of Achilles Tendon Bursitis?

The most common symptom of Achilles tendon bursitis is pain and tenderness at the back of the heel, especially while walking or running. Pain increases when standing on tiptoes. In some cases, the skin at the back of the heel may become warm and red. 

How is Achilles Tendon Bursitis Diagnosed?

Your doctor may diagnose the condition based on the symptoms and physical examination of the ankle. Diagnostic tests such as X-rays and MRI scans may be required later if the treatment does not improve the symptoms.

What are the Treatment Options for Achilles Tendon Bursitis? 

The initial treatment for Achilles tendon bursitis includes:

  • Restricting the activities that cause pain.
  • Applying ice on the injured area, which will help to reduce the swelling. Ice should be wrapped in a cloth and applied, instead of placing it directly on the skin.
  • Using non-steroidal anti-inflammatory medications or NSAIDs to reduce inflammation and pain. 
  • Using custom heel wedges to reduce stress on the heel.
  • Physical therapy may be recommended, which will help to restore and improve the flexibility and strength of the muscles, tendons, and joints around the ankle.
  • Corticosteroid injections may be injected into the bursa to reduce swelling and pain. You must ensure that you do not overstretch the tendon after the injection as it may lead to Achilles tendon rupture.
  • If retrocalcaneal bursitis is associated with Achilles tendonitis, it may be necessary to immobilize the ankle for several weeks until healing takes place. This can be done by applying a cast to the ankle, which limits ankle movement and allows the tendon to rest.

Surgery is considered only when all non-surgical treatment fails to resolve pain and inflammation. Bursectomy is a surgical procedure performed to remove an inflamed or infected bursa.

How Can Achilles Tendon Bursitis Be Prevented?

Achilles tendon bursitis may be prevented by observing proper form during sports and exercise. Ensure that you warm up before the start of any sports activity to help prevent injury of the Achilles tendon.

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