Bilateral Achilles Bursitis

Retrocalcaneal bursitis is an inflammation of the bursa, a small fluid filled sac between the tendon and bone of the heel. It is usually caused by over-use and repetitive trauma, typically at sides of Achilles tendon. Increases in activity without proper training regimes, can lead to the Achilles tendon rubbing against calcaneus causing inflammation and injury. This case study follows a patient who began experiencing pain in the heels and Achilles tendons of both feet. Goals: Reduce pain during everyday activities and physical training.

Practioner: Dr Kirill Shlykov

Patient: Elite sprint distance runner in her 20's


Retrocalcaneal bursitis is an inflammation of the bursae, a small fluid filled sac between the tendon and bone of the heel. There are two types deep - a true anatomical bursae, located within the soft tissues at the posterior aspect of the heel or superficial where a burse forms within the soft tissue superficial to the insertion of the Achilles tendon. They are usually caused by over-use and repetitive trauma, typically at sides of Achilles tendon. Increases in activity without proper training regimes, can lead to the Achilles tendon rubbing against calcaneus causing inflammation and injury.

Current Situation

The patient recently began to experience pain in the heels and achillies tendons of both feet. This made training, competing and every day activity very uncomfortable to the point she had to limp.

Sport: Athletics – Elite sprint distance runner - 800m, 1000m

Current titles: Winner 800m European Athletics Indoor Championships 2011, 2x world record holder in 4x 800m relay (2008, 2010), Russian champion in relay 2008–2010.

Assessment

The patient eventually turned to a Formthotics specialist, Dr. Kirill Shlykov, who diagnosed her complaint as bilateral achillies bursitis.

Dr. Kirill Shlykov fitted the patient with Original Dual Medium Formthotics in her training shoes and Comfort (¾) Single Hard Formthotics in her sprints shoes. Approximately 10 days after the Formthotics were fitted, a wedge was added to both shoes to increase control. She is now also wearing Formthotics in her casual shoes.

On day three of simply being fitted with Formthotics, the patient's left achillies pain and bilateral heel pain had totally subsided, the right achillies pain had also decreased. The patient no longer felt any pain during everyday activities and was able to return to her full training load. With the added wedge adjustments, the patient claimed pain during training was again lessened, furthermore, her feet now felt good during and after training and no longer swell or ache.

Days after being fitted with Formthotics, the patient competed at the Moscow Junior track-and-field Championship, where she gained an out-of-contest officially recorded result of 2.00.27, which was the best time of the season worldwide.

This result was later beaten and she currently holds second place. Following the adjustments to her Formthotics, the patient went on to gain silver in the 1000m at the Russian Winter Race. The patient continued to wear Formthotics throughout the 2011 winter season.