There are several factors which can lead to a person developing retrocalcaneal bursitis. In athletes, especially runners, overtraining, sudden excessive increase in running mileage may lead to retrocalcaneal bursitis. Tight or ill-fitting shoes can be another causative factor as they can produce excessive pressure at the back of the heel due to restrictive heel counter. A person with an excessively prominent posterosuperior aspect of the heel bone (Haglund deformity) may also have a higher predisposition to retrocalcaneal bursitis. In such individuals, pain would be reproduced when the ankle goes into dorsiflexion.
Treatment for retrocalcaneal bursitis can be conservative and includes the application of ice to the heel and ankle when there is an acute episode of pain and inflammation. It can be performed several times a day with each episode lasting about 15-20 minutes. Rehabilitation is also recommended by progressively stretching the Achilles tendon as it may relieve the impingement of the bursae. Rehabilitation is advised to be continued with a gradual increase of activities and aims to return the patient to their previous level of function. The activity should also be limited or modified. It can be done by choosing a recommending a different activity such as swimming and other aquatic exercises as it helps to maintain strength and cardiovascular fitness.