Achillobursitis is an inflammation of the bursa, usually the bursa which is between the Achilles tendon and the heel bone. If this is inflamed, it is easy to treat.

1. What is achillobursitis or inflammation of the bursa?
2. What causes inflammation of the bursa?
3. Diagnosis: how do I recognise achillobursitis?
4. Treating achillobursitis
5. Duration of achillobursitis treatment

1. What is achillobursitis or inflammation of the bursa?

The word achillobursitis stems from the word ‘bursa’, meaning a fluid-filled sac. Its job is to prevent frictional forces from affecting the Achilles tendon. Such forces are particularly common in the region of the heel bone. For this reason, there are two bursas here:

• Retrocalcaneal bursa: the bursa between the heel bone and the Achilles tendon
• Subcutaneous calcaneal bursa: the bursa between the skin and the Achilles tendon

Both bursas contain synovial fluid, which enables the Achilles tendon to glide in this critical area without being subject to frictional forces.

Achillobursitis, also called inflammation of the bursa, is an inflammatory reaction of these fluid-filled sacs.

2. What causes inflammation of the bursa?

Constant overloading of the bursa can lead to inflammation. This is then referred to as achillobursitis (words ending with -itis always refer to inflammation).

This usually affects the retrocalcaneal bursa, as this is where the greatest frictional forces arise.

 
3. Diagnosis: how do I recognize achillobursitis?

Pain just above the heel bone

• particularly to the left and right of the tendon
• swelling and redness in the area
• pain when wearing closed footwear (no pain when barefoot)
• pain when lifting the back of the foot

Please note: pain in this area, that is, just above the base of the Achilles tendon on the heel bone, can also be a sign of

• insertional tendinopathy – degeneration of the tendon at its base, that is, on the heel bone, or
• Haglund’s deformity – a protrusion on the heel bone.

4. Treating achillobursitis – what can be done?

In the acute phase, the area can be cooled, measures can be taken to bring down the swelling and/or measures against inflammation implemented.

After that there is a range of therapeutic measures including physiotherapy, shockwave therapy, strength training (e.g. eccentric strength training, but only lowering the heel to floor level), or wearing FALKE Achilles socks when you are able to do light exercise. However, please ensure that you obtain information on the right type of treatment for you from your doctor or physiotherapist.

5. Duration of treatment of achillobursitis:

• patience is required: up to one year!
• return to sporting activity after approx. 5 months*
• full-weight-bearing exercise with extreme loads on the Achilles tendon/bursa after one year

*Please note: a return to full-weight-bearing exercise within the scope of Achilles tendon treatment depends on

•  the healing process, which differs from one person to the next and of course also depends on the methods used;
• the type of sport: in the case of sporting activities with predominantly cyclical movements, such as jogging, the process is faster (approx. four to five months); in the case of sports involving greater loads such as jumping and especially all sports with rapid changes of direction and sudden stops and acceleration, it normally takes longer.

You must always consult your therapist to see when a return to sport will be possible.