Retrocalcaneal Bursitis Physical Therapy

Retrocalcaneal bursitis is an inflammation of the bursa where the Achilles tendon attaches to the heel bone. The bursa contains fluid and act as a cushion between bones, muscles, tendons and ligaments to reduce friction. Rehabilitating the ankle first involves reducing the swelling and then improving flexibility of the tendon and entire joint.

RICE

• The first step with any acute injury, or a chronic injury that you are only beginning to deal with, is to reduce any swelling that may be occurring. Swelling is the body's response to fight infection or injury by flooding the area with white blood cells. You can slow this down by following the acronym RICE. "R" stands for rest to prevent further injury and allow the area to cool down, lessening blood flow. "I" represents ice. The injured area should be iced for 20 minutes at a time every few hours. "C" stands for compression to help keep swelling down. "E" stands for elevation to help the blood flow move away from the injury.

Gradual Progressive Stretching

• Gradual progressive stretching is a clear-cut method of physical therapy for the heel but many people try to speed it up and only prolong the injury or worsen it. You need to start slowly with a small range of motion and increase this stretch over days or weeks. The best way to stretch this area is to stand with your feet facing a wall. Give yourself a little distance as you will lean toward the wall and balance against it. This will stretch the tendons in the back of the ankle and should be held for 20 to 60 seconds. You can alter the stretch by bending the knee or alternating with a straight leg then a bent knee. As you progress, you can stand at a ledge such as a step or a curb and lower the heel and then raise it up.

Maintaining Activity

• It will be important to refrain from as much weight-bearing activity on the ankle as possible until the bursitis is relieved. Because of this, other workout plans should be made to maintain fitness. Most aquatic exercises are great to improve strength and cardio fitness while reducing the stress on the joint.

Footwear

• Part of healing the ankle is to find footwear that will reduce the friction creating the problem. This may involve cutting away a portion of a shoe cup at the heel. The person may be asked to loosen laces or walk with the shoe untied until the swelling subsides and proper orthotic heel cups can be measured and implemented.