Definition
Bursitis subachillae is the medical term for the inflammation of a bursa below the Achilles tendon (subachillae). The fluid-filled bursa serves to reduce friction and pressure forces on tendons, bones and joints. As a result of constant incorrect strain, inflammation can occur, which can be either acute or chronic.
The causes
The causes are manifold. In addition to prolonged incorrect or excessive strain, wearing the wrong shoes (shoes that are too tight in the area of the Achilles tendon and the heel), incorrect positions in the area of the foot and the ankle joint (e.g. hollow foot, flat foot, splayfoot, etc.) as well as too quickly increased training volumes lead to subachillary bursitis in athletes.
The occurrence of a so-called heel spur is also counted among the causes. This is a spur-like, usually pointed bone protrusion in the area of the heel or heel bone. The consequences are constant irritation and increased pressure in this area. In rare cases, bacterial inflammation can also lead to the clinical picture.
The accompanying symptoms
The main symptom of the disease is pain at rest and under stress. At the same time, increased fluid formation leads to swelling, redness and warming as well as thickening of the affected tendon. In addition, movement restrictions in the ankle joint and foot may be possible.
The diagnosis
The diagnosis is made, in addition to the detailed physical examination by the attending physician, by means of an ultrasound examination. This allows the extent of the inflammation as well as any existing damage to the Achilles tendon to be depicted very well. In order to be able to accurately assess the position and shape of an existing heel spur, an X-ray of the foot is taken in two different visual planes. In some cases, an MRI (magnetic resonance imaging) is also necessary for an accurate diagnosis.
The treatment
The time to full recovery depends on how advanced the inflammation is and whether other structures are affected as a result. At the same time, the recovery time varies depending on the choice of therapy (conservative or surgical). Under normal circumstances, a significant improvement in symptoms occurs after a few weeks if the reasons for the disease have been identified and treated accordingly.
If this is not the case, the inflammation can also become chronic, which can then only be remedied by surgery. In principle, the disease can be treated relatively easily and completely if it is detected early enough. As a preventive measure, care should be taken to strengthen tendons and muscles well and to avoid permanent pressure on the structures mentioned.
