Ankle achilles and retrocalcaneal bursitis

Retrocalcaneal bursitis and Achilles bursitis are the most widely spread types of ankle / heel bursitis out there.

However, there are several bursa lubrication fluid sacs behind the heel bone protecting this area that may become irritated, inflammed and painful.

Common types of ankle bursitis

Calcaneal / Retrocalcaneal bursitis

In your calf at the back of the lower leg sit two major muscles (gastrocnemius and soleus), both held by the Achilles tendon (Equinus). Between the Achilles tendon and the heel bone is a bursa sac called a retrocalcaneal bursa ('calcaneus' = 'heel bone' and 'retro' = 'behind').

During contraction of the calf muscles, the Achilles tendon rubs against the retrocalcaneal bursa, which can become irritated as a result.

Achilles bursitis

The inflammation of the Achilles bursa is not to be confused with the - more common - retrocalcaneal bursitis. Although the retro-calcaneal and Achilles bursae are in the similar region of the heel and their irritation gets treated in almost an identical way, they are two different things.

Causes of ankle bursitis


Overusing your calves, ankles and heels during inappropriate or excessive training or doing repetitive motions for prolonged periods of time can contribute to the development of the this painful ankle Achilles and retrocalcaneal bursitis aliment.

Bursitis in this part of the body often occurs in professional or recreational athletes. Walking, running and jumping can do some damage. (I loved to skip rope before I suffered my severe hip bursitis.)


This condition may also develop following trauma such as a direct, hard hit to your heal.


Poorly fitting shoes that are too tight, too large or have heels can all cause excessive pressure or friction over the bursa in the heel.


Medical problems, such as rheumatoid arthritis or gout, sometimes lead to bursitis.

It is not unusual to have Achilles bursitis and tendonitis (inflamed tendon) at the same time.


Ankle bursitis is often a genetic condition where you simply inherited a foot type - for example a heel bone with a prominence, high arch or tight Achilles tendon - that is more prone to the mechanical irritation that leads to the bursitis.

Muscle weakness, joint stiffness and poor flexibility (particularly of the calf muscles) are certainly contributing factors too.

Symptoms of ankle bursitis

  • Pain or tenderness at the back of the heel around the Achilles region.
  • Increased pain during activities with strong, repetitive calf contractions - walking (uphill), stair climbing, running, jumping
  • Pain may be worse with rest after activity (that night or the next morning) or at the beginning of the excercise
  • Pain when wearing shoes and the heel is getting rubbed
  • Bump forming on the back of the heel
  • Limping
  • Stiffness
  • Decreased range of motion
  • Redness and warmth (if the bursa gets infected)

Treatment of heel and ankle bursitis

Most patients with achilles and retrocalcaneal bursitis heal well with appropriate physiotherapy and other usual bursitis conventional and natural cures being administered.

Specific treatments for ankle / heel bursitis may include:

Footwear correction

Get well-fitting, soft-backed (or even open-backed whenever possible) shoes for both day to day wear and exercise.

High-heels should really be a no no or worn sparingly, ladies.

Heel protectors

Heel pads and heel lifts are great simple solutions to cushion and protect the Achilles area from the irritation of the shoes.


There are various orthotic devices out there (some only available over-the-counter). One example is a custom arch suppport.

These can control abnormal motion in your feet by lining them up correctly in your shoes to help you move in the right matter so the bursitis heals faster and does not return back again.

Exercise modification

Stretch your heel - mainly Achilles tendon - frequently, particularly before and after excercise or prolonged sitting.

If you are a jogger, try to run on softer surfaces (no hard concrete, please). Running uphill training is best to be avoided by Achilles and retrocalcaneal bursitis sufferers.

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