Retrocalcaneal Bursitis at Foot Foundation
Retrocalcaneal bursitis occurs when the bursa between the heel bone and Achilles tendon becomes irritated or inflamed. It often develops alongside tendon issues or Haglund’s deformity.
At Foot Foundation, we provide tailored care including footwear modification, orthotics, shockwave therapy, and rehabilitation strategies to relieve pain and restore function.
What is Retrocalcaneal Bursitis?
Retrocalcaneal bursitis is inflammation of the bursa located between the Achilles tendon and the heel bone (calcaneus). The bursa acts as a friction-reducing cushion, allowing smooth gliding of the tendon. When repeatedly compressed or irritated, the bursa becomes inflamed, leading to pain and swelling at the back of the heel.
It often develops in conjunction with insertional Achilles tendinopathy or Haglund’s deformity (a bony enlargement of the heel). Patients may experience discomfort with footwear pressure or activities that load the ankle into dorsiflexion, such as climbing stairs or running uphill.
Causes & Risk Factors
Repetitive ankle dorsiflexion (running, jumping, stair climbing)
Poor footwear with rigid or high heel counters
Haglund’s deformity (bony prominence at the back of the heel)
Insertional Achilles tendinopathy
Direct trauma or pressure to the heel
Overuse in running or high-impact sports
Systemic conditions such as inflammatory arthritis
Treatment at Foot Foundation
Footwear modification – shoes with soft heel counters and cushioned soles
Heel lifts – reduce compressive load on the bursa
Custom orthotics – correct abnormal biomechanics and offload the tendon–bursa complex
Shockwave therapy (ESWT) – beneficial in chronic cases
Manual therapy and calf stretching – reduce contributing tightness
Strapping and padding – reduce friction from footwear
Referral for corticosteroid injection in resistant cases, used cautiously due to risk of tendon weakening
Surgical referral if bursitis is secondary to a large Haglund’s deformity and fails conservative care
Symptoms
Localised pain and swelling at the back of the heel
Redness and warmth in acute cases
Pain aggravated by uphill walking, running, or tight footwear
Tenderness when squeezing the sides of the heel near the tendon insertion
Discomfort in both activity and rest in more advanced cases
Diagnosis
At Foot Foundation, diagnosis is made through:
Clinical history and palpation of the bursa region
Differentiation from insertional Achilles tendinopathy (pain more focal at tendon insertion)
Assessment of footwear and gait mechanics
Ultrasound to confirm fluid in the bursa and rule out tendon involvement
X-ray if Haglund’s deformity is suspected
Contact us to learn more about Retrocalcaneal Bursitis treatment
If you are dealing with Retrocalcaneal Bursitis, our team can help you find the most suitable Foot Foundation clinic for assessment, diagnosis, and treatment support.
Whether your symptoms are affecting walking, stairs, footwear comfort, exercise, or daily activity, we can guide you towards the right clinician and the right next step for your care.
To learn more about Retrocalcaneal Bursitis treatment and find the most suitable clinic for your care, use the links below:
Podiatrist pricing and availability
Pricing for Retrocalcaneal Bursitis assessment and treatment can vary depending on your consultation, the severity of your symptoms, the treatment approach recommended, and whether ongoing podiatry or rehabilitation care is required.
Your Foot Foundation clinician will assess the source of your heel pain, identify contributing factors such as footwear, biomechanics, tendon irritation, or bony prominence, and explain the most appropriate treatment plan based on your symptoms and recovery goals.
To learn more about our podiatrists and current pricing, use the links below:
Retrocalcaneal Bursitis -
Frequently Asked Questions
What is Retrocalcaneal Bursitis?
Retrocalcaneal bursitis is inflammation of the fluid-filled sac located between the Achilles tendon and the heel bone. This bursa helps reduce friction, but when it becomes irritated or compressed, it can cause pain and swelling at the back of the heel.
What causes bursitis at the heel?
Retrocalcaneal bursitis usually develops from repetitive stress and compression between the Achilles tendon and heel bone. Common contributing factors include poor footwear, excessive loading, Haglund’s deformity, insertional Achilles tendon problems, and repeated uphill running or stair climbing.
How is Retrocalcaneal Bursitis different from Achilles tendinopathy?
While both can cause pain at the back of the heel, Retrocalcaneal Bursitis affects the bursa, whereas Achilles tendinopathy affects the tendon itself. The two conditions can occur together, which is why proper assessment is important.
How long does Retrocalcaneal Bursitis take to heal?
Mild cases may improve within 6 to 8 weeks with the right footwear changes, load management, and treatment. More persistent or chronic cases may take several months, especially when linked with tendon problems or bony irritation.
What treatments are most effective?
Treatment often includes footwear modification, heel lifts, custom orthotics, shockwave therapy in chronic cases, and rehabilitation to reduce load through the Achilles-bursa area and improve movement patterns.
Can orthotics help Retrocalcaneal Bursitis?
Yes. Orthotics can help reduce abnormal biomechanical loading and offload the Achilles-bursa interface, especially in people with excessive pronation, flat feet, or altered gait mechanics.
Should I stop sport if I have bursitis?
A temporary reduction or modification in activity is often needed to allow the irritated tissues to settle. With the right treatment plan, most patients can return to sport gradually and safely.
Is surgery ever needed?
Surgery is not usually the first option. It may be considered in more resistant cases, especially when bursitis is linked to a large Haglund’s deformity or when conservative treatment has not provided enough improvement.
When should I see a podiatrist for bursitis?
If pain at the back of the heel lasts longer than two weeks, worsens with shoes, stairs, or activity, or starts affecting walking and exercise, it is best to get it assessed early.
10,000+
Appointments delivered across our clinics, helping patients improve foot health, mobility, and long-term outcomes.
7 Clinics
Conveniently located across Auckland, Hamilton, and Tauranga, making it easy to access a podiatrist near you.
30+ Treatments
Comprehensive podiatry services including fungal nail care, ingrown toenail treatment, rehabilitation, and general foot care.
Our approach to Retrocalcaneal Bursitis
At Foot Foundation, our approach to Retrocalcaneal Bursitis begins with a thorough assessment to confirm the diagnosis, identify whether the bursa, tendon, footwear, biomechanics, or a bony prominence is contributing to your pain, and understand how load and compression are affecting the back of your heel.
Once the diagnosis is confirmed, we create a personalised treatment plan focused on reducing irritation, improving comfort, and restoring function. Depending on your presentation, treatment may include footwear modification, heel lifts, custom orthotics, shockwave therapy, manual therapy, calf stretching, strapping or padding, and activity modification. In more persistent cases, we may also recommend imaging or referral for further medical opinion where appropriate.
Our goal is not only to reduce your current heel pain, but also to address the underlying cause, reduce recurrence, and help you return to daily activity, exercise, and sport with more confidence.
