Bursitis occurs when bursae become inflamed. What the heck even is this? A bursa is a closed, fluid-filled sac that works as a cushion and gliding surface to reduce friction between tissues of the body. The major bursae (this is the plural of bursa) are located next to the tendons near joints. A common location for bursitis is the foot, especially among athletes. Below you can understand how to prevent foot bursitis and how to treat it — and we can help!
Foot bursitis is fairly common, especially among athletes and runners. In general, foot pain may affect 14 to 42 percent of adults at any one time.
The bursa is a small, fluid-filled sac that cushions and lubricates your joints and bones. Although your foot has just one natural bursa, other bursae can form in injured areas of your foot and ankle.
When the bursa itself becomes inflamed, it causes pain, swelling, and redness. Sometimes the pain can be disabling. The condition is called bursitis. The technical name for foot bursitis is retrocalcaneal bursitis.
What does foot bursitis feel like?
When the bursa on your foot is inflamed, you may have symptoms such as:
- swollen, red, and warm heel
- your heel’s painful to the touch
- painful walking and running
- increasing pain, especially when you stand on your tiptoes or bend your foot
Almost all people with foot bursitis get better in time with conservative treatment alone.
Conservative treatment primarily includes self-care practices such as:
- Taking a break. Rest and elevate your foot. Avoid activities, even temporarily, that make your heel more painful.
- Wearing the right shoes and socks. Wear good-fitting shoes that support your feet properly, cushion your heel, and are sized appropriately. The American Academy of Podiatric Sports Medicine recommends socks made from synthetic fabric and wearing them when you try on and buy athletic shoes.
- Stretching. Your doctor can recommend exercises and stretches to help your foot heal. This may include stretching your calf muscle and other specific stretches.
- Taking anti-inflammatory medications. Ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin are available over-the-counter or through a prescription.
- Icing it. Use ice if recommended by your doctor.
- Using shoe inserts. Your doctor may prescribe orthotics or other shoe inserts, such as a heel cup or arch support, to take pressure off your heel.
- Trying different shoes. Try wearing open-backed shoes if your pain is very bad.
- Massaging your foot. Generally, massage is not recommended for bursitis but avoiding the site of pain and massaging the surrounding areas of your arch or even as far up your legs as your calf, may be beneficial due to the benefit of increased circulation. Elevating your foot might also do this adequately.
Your doctor may inject cortisone into your heel if your pain remains severe, but this can have a risk of rupturing your Achilles tendon.
The need for surgery is rare. However, if your injured bursa doesn’t improve after six months to a year, your doctor may recommend surgery to repair the damage.
Ways to prevent foot bursitis
There are several things you can do to prevent heel bursitis from starting and from recurring.
- Make sure your shoes fit well and the heels aren’t worn down. Shoes should cushion your heel area and have plenty of room in the toe box so your toes aren’t compressed.
- Wear padded socks to help protect your feet and prevent the formation of bursae in other areas of your foot.
- Warm up properly before playing sports or exercising.
- Avoid walking barefoot on hard, uneven, or rocky ground.
- If you use a treadmill, reduce stress on your heels by varying the incline.
- Maintain a healthy weight. This will lessen the stress on your heels when you walk.
Managing bursitis as an athlete
Heel bursitis is common among athletes, especially runners. You may have to cut back on your training and other activity until your bursitis is no longer painful. As with the recommendations listed above, tips for athletes in particular include:
- Make sure your athletic shoes give you proper support. Use a heel lift or other insert, if recommended.
- Use a stretching and strengthening exercise routine that doesn’t put stress on your heel. Make sure to stretch your Achilles tendon regularly. Your doctor may recommend a splint to wear at night to stretch the tendon.
- See a physical therapist to develop a safe exercise routine to keep you in shape and strengthen your legs and feet.
- Don’t run. If you’re in a lot of pain, don’t run or participate in your team sport. It may worsen your condition.
It may take a few weeks to feel better, but it’ll take longer if your bursa becomes inflamed again.
Why does foot bursitis happen?
Foot bursitis is usually the result of an injury or overuse of the feet. Your feet take a lot of stress, especially on hard floors or playing fields. Being overweight also stresses your feet.
Foot bursitis often happens from a sudden impact in contact sports or from repetitive impact motions.
Other possible causes of foot bursitis include:
- badly fitting shoes or unsuitable shoes for a particular sport
- running, jumping, and other repetitive activities
- inadequate warmup or stretching before exercise or activities
- walking in high heels
- Haglund’s deformity, where a bony enlargement on your heel forms from rubbing against your shoes
- arthritis, thyroid conditions, or diabetes
- infection, though this is rare
How is bursitis diagnosed?
Your doctor will examine your foot and ask you to describe the pain and when it began. They’ll also want to know your medical history, your daily activity level, and your routine. They may ask:
- What type of exercise do you get?
- What sports are you involved with?
- Do you stand a lot for your job or does your work involve repetitive motions?
Your doctor may order some tests to make sure you don’t have a fracture or other injury. They may also look for a Haglund’s deformity. These tests may include:
- blood tests
- removal of fluid from the bursa to check for gout or an infection
If you have pain in your heel that doesn’t go away, see your doctor. Getting a diagnosis and treatment early on can save you from future pain.
Your doctor may refer you to a specialist, such as an orthopedist, podiatrist, or a rheumatologist, depending on the extent of your heel injury.
Other causes of foot pain
Your heels and feet can be painful for many different reasons. Some common causes for heel pain are:
- Plantar fasciitis. The tissue (fascia) connecting your heel bone to the base of your toes can become inflamed from running or jumping, causing severe pain at the heel bottom. The pain may be worse when you get up in the morning or after sitting for a long time.
- Heel spur. This is a calcium deposit that can form where the fascia meets the heel bone. A 2015 review of heel pain estimated that about 10 percent of people have heel spurs, but most don’t have any pain.
- Stone bruise. If you step on a stone or another hard object, it can bruise the bottom part of your heel.
- Haglund’s deformity. This is a bump that forms on the back of your heel where your Achilles tendon is. It’s also known as “pump bump” because it can be caused by ill-fitting shoes that rub against your heel.
- Achilles tendinopathy. This is a swelling and tenderness around your Achilles tendon. It can occur along with bursitis in your heel.
- Sever’s disease. This can affect children in early puberty when the heel is still growing. Heel tendons may become tight and sports activities can put pressure on the heel, injuring it. The technical name for this is calcaneal apophysitis.
- Trapped nerve. Most commonly known as a pinched nerve, this may cause pain, especially if it’s the result of an injury.
Your foot has only one natural bursa, located between your heel bone and Achilles tendon. This bursa reduces friction and protects your tendon from the pressure of your heel bone whenever you’re on your feet.
Bursitis in your heel is fairly common, especially among athletes. Most people get better in time with conservative treatment. Surgery is an option if your pain persists for more than six months.
Want to learn more? Did you know that we offer nutritional services as part of our programs? We recognize that to get you to optimal health, we need to cover all the bases and your whole health. Connect with us to discuss your challenges or concerns at (561) 278-6055 -- and stay connected and join our Facebook page!