Heal Pain when Walking & Running – Achilles Bursitis
A painful sensation into the heel that is aggravated when walking or running is a symptomatic sign of Achilles bursitis. Achilles Buristis is a painful heel condition and results in either one or both bursas of the heel becoming inflamed and sore. The heel bone contains two bursas which are fluid filled sacs whose function is to reduce friction between a bone and a tendon or between adjacent tissues such as between a tendon and its overlying skin. In the heel a bursa called the Subcutaneous bursa sits between the Achilles and its overlying skin with a second bursa sitting more deeply between the calcaneal or heel bone and Achilles tendon. This is called the Retrocalcaneal bursa.
Factors that can bring about Achilles Tendonitis include:
Subcutaneous bursa inflammation is often caused by abnormal compression from wearing tight shoes. Repetitive bending of the foot such during walking or running may cause prolonged pressure on the Achilles tendon attachment leading to compression or squeezing or the underlying Retrocalcaneal bursa. Overtime this inflames the bursa causes swelling and soreness. This is termed bursitis of the Achilles tendon. In addition a prominent bony lump can appear on the heel bone called a Haglund’s deformity which can further increase the compression between the heel bone and bursa.
Signs & Symptoms:
Heel pain when walking/running uphill or when walking on a soft surface
Tenderness & Swelling visible on the heel bone.
There is redness and a visible thickening of the skin on the outside surface of the heel bone of the Achilles tendon attachment.
Compression of the front of the Achilles tendon in a pinching grip fashion may indicate bursitis. (This test is best performed by your Physical therapist).
Wearing shoes becomes increasingly painful; patient may have a limp overtime while walking.
Treatment & Management of Achilles Bursitis
Rest & ice treatment to the bursa is the initial treatment coupled with ant-inflammatory medication from your Doctor. Wearing backless shoes such as sandals that do not compress the heel is helpful. Use of a heel lift can help less the tensile stress of the Achilles tendon and lessen the inflammation of the bursa. Patients who have a bony protrusion (Haglund’s Deformity) can wear a foam rubber ring around the bony protrusion to relieve bursa compression. Treatment to the calf muscles will help to correct the lower leg tightness issue that may have led to the bursitis.
Next week, I will discuss further conditions of the foot & ankle.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles.
Contact Number: 0504 26672
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