Subcutaneous Calcaneal Bursitis


What is the Subcutaneous Calcaneal Bursa?

The Achilles is the tendon that attaches the muscles of the gastrocneumius (calf) and soleus to the back of the calcaneus (heel). The Subcutaneous bursa is a fluid filled sack that lies between the back of the calcaneum and the deep subcutaneous tisssue. It forms part of the “Achilles Enthesis Organ”


What is Subcutaneous Calcaneal Buritis?

Subcutaneous Calcaneal bursitis is an inflammation of the bursa that lies at the back of the heel

People with this problem generally present with pain when first getting out of bed which reduces slightly after walking a short distance and then returns again with extended walking.


Causes of Subcutaneous Calcaneal Bursitis?

Certain factors are though to increased the irritation of the subcutaneous calcaneal bursa

  • Non- Supportive footwear
  • Irritation from tight fitting shoes
  • Flat arched feet
  • High arched feet
  • Sudden increase in activity
  • Trauma
  • Being overweight
  • Connective tissue disorders (Rheumatoid arthritis, spondyloarthritis etc)

Diagnosis of Subcutaneous Calcaneal Bursitis?

Diagnosis is generally made with specific signs and symptoms – when the pain occurs and the location.

At the Ankle, Foot and Orthotic Centre we are able to provide additional information about the presence of subcutaneous calcaneal bursitis with ultrasound imaging.

Inflammation of the bursa presents as an enlargement of the subcutanous bursa (see below)

Ultrasound imaging showing a thickening of the subcutaneous calcaneal bursa. See the ultrasound picture below of a normal subcancaneal bursa compared to an irritated subcalcaneal bursa

Treatment of Subcutaneous Calcaneal Bursitis

Treatment aims to reduce the irritation of the Subcutanous Calcaneal Bursa. This can include

  • Footwear modification – stretching the shoe to reduce the irritation at the back of the heel
  • Injection therapy (aspiration, injectables)
  • Heel raises
  • Orthotic correction
  • Stretching Alfredson Eccentric Stretches
  • Taping
  • Home Massage techniques
  • Night Splinting


What else could it be? (differential diagnosis)

Other problems that can cause similar pain to a neuroma include:

Insertional Achilles Tendinopathy

Midportion Achilles Tendinopathy

Kagers Fat Pad Inflammation

Retrocalcaneal Bursitis

Tarsal Tunnel Syndrome

Tibialis posterior tendon dysfunction



The Ankle, Foot and Orthotic Centre’s Northcote Podiatrists can help you with all lower limb complaints, including Bursa pain surrounding the Achilles. Make an appointment to get your foot and ankle pain under control.

Expert Podiatrists and Orthotists in the treatment of Achilles problems servicing the areas of Northcote, Thornbury, Fitzroy, North Fitzroy, Carlton, North Carlton, Alphington, Fairfield, Brunswick, Coburg and Preston

Call The Ankle, Foot and Orthotic Centre in Northcote for further advice on professional management and treatment options.