What is bursitis of the heel?
A bursa is a fluid-filled structure. It is located in places where bone and tendon are directly above each other. The bursa in between is intended to reduce friction between the tendon and the bone.
In addition, the wider contact surface of the tendon on the bone distributes the load over the entire joint. The bursa can thicken and become inflamed, especially if the heel is overstressed. In doing so, it presses on surrounding structures and thus causes pain. This pain is most noticeable when walking and running.
Medical term
The medical term for bursitis of the heel is bursitis calcanea.
Causes
The inflammation causes the bursa to thicken and thus leads to pain in the surrounding tissue. Especially when overstrained in running sports (handball, basketball, soccer, jogging, triathlon, athletics) the bursa can easily become inflamed. Other causes can be already existing inflammations on the foot, which spread to the bursa.
A bacterial inflammation of the bursa at the heel is also possible. This is called septic bursitis. If the inflammation develops as a result of trauma, bleeding into the bursa is often the cause.
In this case it is called hemorrhagic bursitis. When jogging, the entire body is caught by the foot with every step. Especially those runners who start their step with the heel (in contrast to forefoot runners who start with the ball of the foot first) suffer more often from bursitis of the heel.
The inflammation can be triggered by an excessive running pace or a rapid increase in the pace. New jogging shoes also change the strain and can cause bursitis of the heel, as can jogging on hard and/or uneven surfaces such as cobblestones. The Haglund’s heel is a disease in which the attachment of the Achilles tendon to the bone is altered.
The tendon attachment at the back of the heel is ossified. This disease can occur during a growth phase as well as later in adulthood. A too hard or too tight shoe, which irritates the tendon over a longer period of time, is discussed as a possible cause.
The ossification of the tendon attachment leads to an overload of the bursa, which is located between the heel and the bone. In the long run, this leads to bursitis. The treatment of the Haglund’s heel consists of relief and possibly pain-reducing medication.
In the case of a kinked foot, the inner side of the foot is lowered, while the outer side is raised more. Due to this malposition of the foot, the axis of the foot changes minimally, which leads to a changed direction of traction of the Achilles tendon. The bursa, which is located between the Achilles tendon and the bone, is designed to prevent friction between these two structures.
However, it is anatomically oriented to a specific direction of traction of the Achilles tendon. If this direction changes, the bursa becomes permanently irritated, which can lead to bursitis. The bursa below the heel is also subjected to different loads than anatomically planned. Thus, incorrect loading can lead to inflammation there as well. You can find more information on this topic under: Snap Foot
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