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Achilles Tendon Bursitis

The bursa is a sac-like structure containing a lubricating fluid that acts as a cushion to reduce friction between muscle and bones. The Achilles tendon is a large tendon that connects the calf muscles to the heel bone (calcaneus) and is used when you walk, run, and jump. Achilles tendon bursitis is a painful condition caused by the swelling of the bursa, a fluid-filled sac located between the heel and Achilles tendon.

Achilles tendon bursitis is caused by overuse of the ankle which results in irritation and inflammation of the bursa. The common causes include too much walking, jumping, or running. Achilles tendon bursitis can also occur in conjunction with Achilles tendinitis, inflammation of the Achilles tendon.

Sudden increase in level of physical activity increases the risk of developing Achilles tendon bursitis.

The most common symptom is pain and tenderness at the back of the heel especially while walking or running. Pain increases when standing on the toes. In some cases, the skin at the back of the heel may become warm and red.

Your doctor may diagnose the condition based on the symptoms and physical examination of the ankle. Diagnostic tests such as X-ray and MRI may be required later if the treatment does not improve the symptoms.

The initial treatment for Achilles tendon bursitis includes:

  • Restrict the activities that cause pain.
  • Apply ice on the injured area which will help to reduce the swelling. Ice should be wrapped in a cloth and applied rather than direct application.
  • Non-steroidal anti-inflammatory medications may be prescribed to reduce the inflammation and pain.
  • Custom heel wedges in your shoes can be used to reduce the stress on the heel.
  • Physical therapy may be recommended to restore and improve the flexibility and strength of the muscles, tendons and joints around the ankle.
  • Corticosteroid injections may be injected into the bursa to reduce swelling and pain. You must ensure that you do not over stretch the tendon after the injection as it may lead to Achilles tendon rupture.
  • If bursitis is associated with Achilles tendonitis, it may be necessary to immobilize the ankle for several weeks until healing takes place. This can be done by applying a cast on the ankle, which limits ankle movement and allows the tendon to rest.

Surgery is only considered when all non-surgical treatment fails to resolve pain and inflammation. Bursectomy is a surgical procedure performed to remove an inflamed or infected bursa. Achilles tendon bursitis may be prevented by maintaining proper form during exercises and ensuring warm up exercises before any sports activities.

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