Foot

What It Is

This common cause of heel pain is often seen in active people, especially runners. It is very often linked to Achilles tendonitis (inflammation of the Achilles tendon), and it is sometimes mistaken for it (MedlinePlus, 2024). Common symptoms include pain at the back of the heel, especially with walking or running, or when the area is touched. The pain may get worse when you stand on tiptoes, and the skin over the back of the heel may be red and warm (MedlinePlus, 2024). Swelling and tenderness at the back of the heel can make it difficult to wear certain types of shoes.

A bursa is a small fluid-filled sac that acts as a cushion and lubricant between a tendon and bone, to help the tendon glide smoothly over the bone (NHS, 2023; MedlinePlus, 2024). The retrocalcaneal bursa is located between the heel bone and the Achilles tendon. Repeated or too much use of the ankle, for example from too much walking, running or jumping, or suddenly increasing your activity level, can cause the bursa to become irritated and inflamed (MedlinePlus, 2024).

Retrocalcaneal Bursitis Anatomy

The feet are full of flexible structures consisting of bones, muscles, joints and soft tissues that allow you to stand upright and perform activities such as running, walking and jumping. The foot is often described in three sections:

The forefoot contains the long bones of the foot and the toes.
The midfoot is a collection of bones forming the arches of the foot.
The hindfoot is made up of the ankle and the heel. The heel bone is the largest bone in the foot.

Tendons, muscles and ligaments run along the surface of the feet, allowing the complex movements needed for balance and motion. The Achilles tendon connects the calf muscles to the heel bone (MedlinePlus, 2024), which is essential for jumping, running and being able to stand on your toes.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Retrocalcaneal Bursitis

Physical therapy to improve flexibility and strength around the ankle, focusing on stretching the Achilles tendon, can help the bursitis improve and stop it coming back (MedlinePlus, 2024), and gentle stretching exercises can help (NHS, 2025). I can guide you through stretching and strengthening for your calf and ankle, with hands-on work and advice on getting back to running. See the My Approach tab for how I work.

1. Ice

Gently hold an ice pack (or a bag of frozen peas) wrapped in a towel on your heel for up to 20 minutes every 2 to 3 hours (NHS, 2025). Avoid applying the ice directly to the skin, to prevent ice burns.

2. Rest

Avoid activities that cause pain (MedlinePlus, 2024). Rest and raise your heel when you can, and avoid walking or standing for long periods, especially barefoot (NHS, 2025). I can advise you when to return to running.

3. Heel Support and Footwear

Heel wedges in your shoes can help decrease stress on the heel (MedlinePlus, 2024). Wear wide, comfortable shoes with a low heel and soft sole, and try soft insoles or heel pads (NHS, 2025).

Tips

MedlinePlus lists non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, and the NHS suggests painkillers such as paracetamol or ibuprofen gel (or ibuprofen tablets if needed), to help with heel pain and inflammation (MedlinePlus, 2024; NHS, 2025). (This medicine information comes from MedlinePlus and the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)
When running, make sure to wear proper footwear with enough arch support, and use proper form when exercising (MedlinePlus, 2024).
Keep up stretching of the Achilles tendon and strength around the ankle to help prevent the problem coming back (MedlinePlus, 2024).
See your family doctor or nurse practitioner if your symptoms have not improved after 1 to 2 weeks of treating them yourself, if the pain is severe or keeps coming back, or if you have a high temperature or feel hot, cold or shivery (NHS, 2023; NHS, 2025).
Get urgent medical help if you have severe heel pain after an injury, heard a snap or popping noise at the time of injury, cannot walk or walk on tiptoes, or have swelling and bruising in your calf and ankle, as these might be signs of a broken heel bone or ruptured Achilles tendon (NHS, 2025). If your foot or ankle has changed shape or is at an odd angle, call 911 or go to the emergency room at your nearest hospital.

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Steroid injection: if other treatments do not work, a doctor may inject a small amount of steroid medicine into the bursa. After the injection you should avoid overstretching the Achilles tendon, because it can tear (rupture) (MedlinePlus, 2024).
Surgery: very rarely, surgery may be needed to remove the inflamed bursa (MedlinePlus, 2024; NHS, 2023).
Ultrasound treatment: a physiotherapist may use ultrasound treatment to reduce inflammation (MedlinePlus, 2024).

How I can help (see the My Approach tab)

Hands-on work for the calf and ankle, keeping pressure off the bursa
Gentle stretching and strengthening for the calf and ankle
Footwear, heel support and return-to-running advice

Treatment

My Approach

The bursa at the back of your heel is a small cushion that doesn't like being squashed or rubbed, and it often flares alongside an irritated Achilles tendon. My aim is to settle it down, take pressure off the back of the heel, and then build strength and flexibility in your calf and ankle so they cope with walking and running again.

I start by assessing how your foot and ankle move, testing your calf strength, watching how you walk (and run, if that's part of your life), and looking at your shoes and training.

When It's Sore

No pressure on the bursa itself and no rubbing over it; I work the calf and the muscles around the ankle from a distance
Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
Cutting back the activities that flare it, rather than stopping everything
Gentle, pain-free ankle movement, and light drainage work if the heel is swollen
Shoe changes, heel wedges or soft heel pads so nothing presses on the back of the heel, and taping, which I'll show you how to do yourself

As It Settles

Myofascial and trigger point work through the calf, with gentle stretching of the calf and Achilles; I keep stretches gentle and avoid hanging your heel off a step, as that can squeeze the bursa
Calf strengthening, from holds to slow heel raises on two legs, then one, plus hip and balance work so the whole leg shares the load
A home programme to do between visits, and a gradual return to running, building the load back up step by step

If the back of your heel becomes hot, red and swollen and you feel feverish or shivery, or you feel a snap and can't stand on tiptoes, get medical help promptly (see Tips).

What to Expect

Typical Course

Typical course: Most people come once or twice a week at first, then weekly, with a reassessment at about 4 to 6 weeks, then less often as you manage more on your own. Usually the pain starts to ease within a few weeks once the heel is protected, and it can take a few months to settle fully if it's been going on a while.

What I Focus On

Assessment

Protecting the Bursa

Calf & Ankle Release

Gentle Stretch & Strength

Footwear & Return to Running

Sources

References

MedlinePlus, US National Library of Medicine (2024) Bursitis of the heel. Available at: https://medlineplus.gov/ency/article/001073.htm (Accessed: 7 October 2026).
NHS (2023) Bursitis. Available at: https://www.nhs.uk/conditions/bursitis/ (Accessed: 7 October 2026).
NHS (2025) Heel pain. Available at: https://www.nhs.uk/symptoms/foot-pain/heel-pain/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooRetrocalcaneal Bursitis

What It Is

Retrocalcaneal Bursitis Anatomy

Self-Care & Treatment

How to Treat Retrocalcaneal Bursitis

1. Ice

2. Rest

3. Heel Support and Footwear

Tips

Treatments you may want to discuss with your family doctor or nurse practitioner

My Approach

When It's Sore

As It Settles

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooRetrocalcaneal Bursitis

What It Is

Retrocalcaneal Bursitis Anatomy

Self-Care & Treatment

How to Treat Retrocalcaneal Bursitis

1. Ice

2. Rest

3. Heel Support and Footwear

Tips

Treatments you may want to discuss with your family doctor or nurse practitioner

My Approach

When It's Sore

As It Settles

Typical Course

References

Related Conditions

Achilles Tendinopathy

Extensor Hallucis Tendinopathy

Extensor Tendinopathy of the Foot

First Metatarsophalangeal Joint Sprain

Book a session