Bursitis is a condition that affects the bursa causing inflammation and pain. This infection causes the bursa to be swollen and cause pain to the area. A bursa is a type of sac that is located in between joints in the body. This might be in the bones, muscles, or tendons. It contains a fluid called synovial fluid.
Retrocalcaneal bursitis is the inflammation and pain of the retrocalcaneal bursa, also called Subtendinous bursa. This is a bursa that is found between the anterior Achilles tendon and the calcaneus. It acts as a lubricant between these two tissues. Inflammation or swelling of this bursa causes pain around the ankle region. However, there is another type of bursa located around the ankle that can be affected. The posterior Achilles tendon, also called subcutaneous bursa.
Signs and Symptoms of Tetrocalcaneal Bursitis?
- A person suffering from this condition will start experiencing pain around the heel and ankles. This type of pain is mostly felt when the area is touched or while running.
- You are likely to experience tenderness in the back part of your heel.
- Increase in pain especially when you stand on your tiptoes.
- Swelling of the affected area.
- The skin around is always warm when touched.
- The skin also starts turning red.
Causes of Tetrocalcaneal Bursitis
There are several causes of this condition which include:
1. Infection. In some cases, your tissues around the bursa might get infections which causes inflammation and pain. These infections get into the body through bacteria when there is an opening of the skin around the bursa. The opening might be as a result of a cut, wound, or puncture.
2. Overuse of the ankle. Since the bursa is used as a cushion or lubricant, excess motion around the ankle causes inflammation. Overuse of these parts may be as a result of running or walking for long distances. Jumping around for an extended period during sports is also a cause.
3. Deformity. This is where a person has a deformed ankle or foot. Due to this, there is considerable weight imbalance on the ankles. This leads to the irritation of the bursa. Such deformity is the Haglund’s deformity.
4. Injuries. This is where there are traumas to the bursa. This causes excess fluid to fill in the bursa. Such traumas may be as a result of direct hit with a hard object.
5. Wrong footwear. Straining of the heels and ankles causes a similar effect to the bursa which in turn becomes swollen. Poorly fitting shoes cause imbalance in the amount of weight carried by the foot. This leads to excess pressure to the bursa which causes inflammation and pain.
Testing of Tetrocalcaneal Bursitis
The first step towards diagnosing the condition is looking at the history. The health specialist will listen to your story and do a check of the affected area. This is to check for tenderness and the red color. Your specialist can also use imaging machines like the MRI and X-ray to check out any other condition.
Aspiration and Laboratory Tests
If the doctor suspects the bursitis to be septic, he or she will do an aspiration to remove the liquid from the sac with a needle and syringe. This relieves the pressure, makes you more comfortable, and at the same time gives a sample of fluid that will be tested for the infection. Common types of tests to detect infection are:
- Gram stain. A test named Gram stain is done to find the presence of certain types of bacteria. This test cannot identify all the kinds of bacteria so if the results are negative, septic bursitis cannot be totally discounted.
- White blood cell count. If the synovial fluid of the bursa shows a higher number of white blood cells, then there is a clear indication of an infection.
- Glucose levels test. If the glucose levels are less than usual, it could indicate presence of infection.
Sometimes the tests give a negative result even if there is an infection present. In such cases, your doctor may still prescribe antibiotics if he or she strongly feels that septic bursitis is indicated.
How Is Tetrocalcaneal Treated?
- Resting. This is the most immediate method of reducing pain more especially if it is the first time you are experiencing bursitis.
- Avoiding of strenuous activities that lead to overuse of your heels. Such activities may include running for a long time in uncomfortable shoes.
- Using medicines that will relieve pain and reduce inflammation. These are like the anti-inflammatory medications e.g. ibuprofen.
- Use of ice packs. When you want to relieve pain and reduce swelling you can apply ice packs at intervals of 10 to 15 minutes for 2 to 3 hours a day.
- Aspiration. This is a process where a doctor uses a needle and a syringe to drain the fluid from your bursa.
A person with this kind of bursitis will be advised to apply an ice pack to the heel and ankle when the bursitis is at an acute stage. The icepack can be applied many times a day for 15 to 20 minutes at a time.
Gentle stretching of the Achilles tendon will help relieve the pain on the bursa. The physiotherapist will advise you to do it like this:
1. Stand erect in front of wall, feet should be flat on the floor. Lean toward the wall until you feel a gentle, but not painful, stretching of the Achilles tendon.
2. Keep the stretch for about a minute or so and then let go.
3. The stretch should be done with the knee extended and also with the knee flexed.
4. To reap the maximum benefit of this physiotherapy program, do these stretches several times a day. Try to avoid jerky movements and forceful stretching. Instead keep it gentle and smooth.
The Bottom Line
Tetrocalcaneal Bursitis is a condition that can also be prevented by wearing the right type of shoes which do not strain your ankles. Perform exercises to strengthen your ankles hence avoiding injuries. However, before taking any step, go and check with a medical expert in order to find out the best practices that you can follow.