Plantar calcaneal bursitis - Sports podiatry

Plantar calcaneal bursitis symptoms can be very similar to plantar fasciitis. The athlete usually notices a dull ache under the heel directly under the fat pad.

Anatomy of the plantar calcaneal bursa

Between the heel bone and the plantar fascia is a small fluid filled sac that is called the plantar (bottom of) calcaneal (heel bone) bursa. The plantar calcaneal bursa's job is to allow the plantar fascia to glide easily over the heel bone without irritation. If this becomes inflamed and irritated a plantar calcaneal bursitis occurs which can be extremely painful and disabling forcing the athlete to stop training.

Symptoms of plantar calcaneal bursitis

A dull ache under the heel when not weight bearing.

Sometimes severe pain when walking.

Pain can increase after resting (sleeping or sitting) then standing and placing pressure on the area again.

Throbbing under the heel.

Swelling may be identified as a discernible lump under the heel. This is the swollen calcaneal bursa itself.

Tingling under the heel as swelling affect the plantar nerves.

Pains shooting into the foot or up the leg.

Causes of plantar calcaneal bursitis

High impact activity, such as running.

Trauma to the heel such as jumping from a height.

Increase in training levels.

Lack of shock absorbency in the trainers worn.

Worn running shoes.

Poor biomechanics.

Loss of the fat pad under the heel.

Ins crease in weight.

Treatment for plantar calcaneal bursitis in the acute phase

In the initial phase

To improve symptoms of plantar calcaneal bursitis after the acute phase

baked bean tin stretch

using a baked bean tin roll the foot backwards and forwards as in the diagram below.

2 minutes in the morning before putting the foot to the floor.

5-10 minutes every evening.

contrast foot baths

10 minutes warm water.

10 minutes cool water morning and evening (morning may be missed if time is restricted).

stretches

(a) (b) (c)

Start with 10 stretches per day as in diagram (a) holding the stretch for 30 seconds, then relax and then repeat.

Continue this stretch daily until you can no longer feel it pulling on the heel, then progress to stretch in diagram (b). Do 10 per day holding for 30 seconds per stretch. When you can no longer feel it pulling on the heel proceed to stretches as in diagram (c). Do 10 per day holding for 30 seconds on every stretch.

Preventing Plantar calcaneal bursitis

1. Check your footwear

Are your running shoes worn and in need of replacing? If so change them. Plantar calcaneal bursitis can be caused by high impact forces so a good shock absorbing shoe is a must. For more advice on running trainers our running shoe advice page is worth reading. Read more->

Below are a selection of trainers that are ideal for athletes.

Trainers for a neutral or under pronating foot type

Trainers for over pronators

2. rectify Poor biomechanics

The way your foot strikes the ground and the forces that are placed on it can have a direct effect on causing plantar calcaneal bursitis and also delaying healing times. Check our biomechanics page for detailed information. Read more->

3. Improve shock absorbency

Plantar calcaneal bursitis is primarily caused by high impact forces. Purchasing some shock absorbing heel pads or insoles is a cheap and effective way of vastly improving shock adsorbents under the heel and foot.

4. Night splint

Consider a night splint. Excellent for improving symptoms and preventing the condition from returning.

Plantar calcaneal bursitis prevention checklist summary

Returning to sporting activity after plantar calcaneal bursitis

The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your plantar calcaneal bursitis could lead to permanent damage. Everyone recovers from injury at a different rate. How quickly you return return to your activity is determined by how soon your bursitis abates, not by how many days or weeks it has been since your injury occurred.

You may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:

You have full range of motion in the injured leg compared to the uninjured leg.

You have full strength of the injured leg compared to the uninjured leg.

You can jog straight ahead without pain or limping.

You can sprint straight ahead without pain or limping.

You can do 45-degree cuts, first at half-speed, then at full-speed.

You can do 20-yard figures-of-eight, first at half-speed, then at full-speed.

You can do 90-degree cuts, first at half-speed, then at full-speed.

You can do 10-yard figures-of-eight, first at half-speed, then at full-speed.

You can jump on both legs without pain and you can jump on the injured leg without pain.