One of the most common foot pains in athletes, especially runners, is Achilles bursitis, which may be defined as swelling of the Achilles bursa (subcutaneous calcaneal bursa). The Achilles bursa is located between the skin and the posterior aspect of the distal Achilles tendon. A burse is a fluid filled sac that decreases friction between two tissues

  • A direct blow to the Achilles bursa can produce inflammation and irritation.
  • A fall where one lands improperly on the ankle or Achilles bursa.
  • Constant pressure on the Achilles bursa from use of the ankle.
  • Repeated stress injury to the Achilles bursa and tendons from a high level of activity, which can also cause tendonitis in addition to bursitis.
  • Complications from rheumatoid arthritis, osteoarthritis or gout.
  • Infection of the Achilles bursa or ankle.
  • Achilles bursa can become swollen as a response to other ankle conditions.
  • Pain and tenderness over the location of the Achilles bursa along the back of the ankle near the heel
  • Swelling
  • Loss of motion of the ankle
  • Pain with activities that stress the Achilles bursa like walking, jumping, running or activities that cause stress on the tendons that are lubricated by the Achilles bursa

Avoiding the activities that produce the pain or stress the Achilles bursa is the first line of treatment.

  • Avoiding activities that produce pain or stress of the Achilles bursa and associated tendons (jumping, running, etc.)
  • RICE: (Rest, Ice, Compression, Elevation) should be used to reduce the stress on Achilles bursa
  • The use of ice to reduce inflammation and pain.
  • NSAIDS (nonsteroidal anti-inflammatory drugs)
  • Physical Therapy
  • Drainage of the fluid in the Achilles bursa for severe cases. Fluid can be checked for possible infection.
  • Antibiotic in the case of infections of the Achilles bursa
  • Steroidal injections in non responsive cases
  • Surgery to remove the Achilles bursa may be indicated in extreme cases if the problem becomes chronic.

Physical Therapists are professionals, educated and trained to administer interventions. As defined by The Guide to Physical Therapist Practice, interventions are the skilled and purposeful use of physical therapy methods and techniques to produce changes consistent with the diagnosis, prognosis and the patient or client’s goals. Physical therapy for an ankle bursitis must remain conservative at the onset in order to not aggravate the condition. Emphasis will be in rest, reducing the inflammation and increasing the blood circulation for healing. Once the initial inflammation has reduced a program of stretching and light strengthening will be initiated to restore full motion and improve strength to reduce stress on the tendons and ankle joints.

Common Physical Therapy interventions in the treatment of Achilles bursitis include:

  • Manual Therapeutic Technique (MTT): hands on care including soft tissue massage, stretching and joint mobilization by a physical therapist to regain mobility and range of motion of the ankle. Use of mobilization techniques also help to modulate pain.
  • Therapeutic Exercises (TE) including stretching and strengthening exercises to regain range of motion and strengthen muscles of the ankle to support, stabilize, and decrease the stresses place on the Achilles bursa and tendons of the ankle joint.
  • Neuromuscular Reeducation (NMR) to restore stability, retrain the lower extremity and improve movement techniques and mechanics (for example, running, or jumping) of the involved lower extremity to reduce stress on Achilles bursa and tendons in daily activities.
  • Modalities including the use of ultrasound, electrical stimulation, ice, cold laser and others to decrease pain and inflammation of the Achilles bursa.
  • Home program including strengthening, stretching and stabilization exercises and instructions to help the person perform daily tasks and advance to the next functional level.

Prognosis

In general, patients respond well to conservative treatment of ankle bursitis. It is important that once the pain and inflammation is reduced and motion and strength are restored that the patient gradually returns back to full activities. Instruction in daily activities or sport performance is helpful to reduce the chance of a reoccurrence of the bursitis. In most cases full return to activity will take from 2-6 weeks depending on the severity of the condition. As a preventive measure individuals should:

  • Make modifications in work or daily activities and avoid positions that stress the Achilles bursa or wearing protective equipment to avoid prolonged pressure or unexpected blows on the Achilles bursa.
  • Maintain strength and flexibility to reduce stress on the Achilles bursa and tendons of the ankle.
  • Avoid highly repetitive activities whenever possible.

Schedule an
Appointment!

Get back to doing what you love.

We are dedicated physical therapists that genuinely care. We strive to restore you to your former self, no matter the injury.

SCHEDULE APPOINTMENT

Real People, Real Testimonials.

“I loved being a patient at your facility because your therapist went by my and the doctors needs. I was there not only at the old location in somerset but also I went to the new location to in North Brunswick, which I loved it was bigger and better. All of the therapist are so friendly and nice and treated you with respect. I was treated by not only Melvie but also Nick and both are so professional and gentle of the way they did my treatments. If I ever need to have physical therapy in the future I will definitely come back to your facility for you are very professional and well organized. I have been to other places but your facility beats them all.”

Christine

"Although getting released from physical therapy is a great thing, today was bitter sweet. How often do you get to rehab with your twin daughters at a place that makes you feel important, special and at home? Twin Boro Physical Therapy in Middletown has been our home away from home for the past three months. We always looked forward to our sessions because they helped us gain back the life we had before. From the phone calls with Stephanie scheduling appointments (all three of us simultaneously) to our awesome therapists: Andrew, Chris, Sydney, Brad, Justin & Anthony, to our PT assistants: Ryan, Gerard, Julian and the girls, we can't thank you enough! We couldn't even walk on two feet when we arrived. Today, we successfully completed "Boot Camp' running, hopping and jumping! We appreciate all that you have done. We will truly miss you all, but you have taught us well. We are forever grateful."

Denise M.

"Eric was an excellent physical therapist. I made tremendous improvement during my time there. Rachel & Brittany were always smiling and creating a positive environment. Highly recommend using twinboro EHT!!!"

Ella G.

"After my back surgery my doctor wanted me for physical therapy. He suggested Twin Boro Physical Therapy as one of the locations to go to. I checked out all the locations in the area and decided to go to Twin Boro. I stopped by on a Saturday but they were closed. Someone was at the desk doing paperwork and gave me all the information that i needed to fill out. She put the paperwork through and gave me a schedule to return on Monday for my first visit.The therapist ( Andrew ) examined me an put me through a series of work outs three times a week along with his daily exam. As each exercise became easier I was given something a little harder. They were slowly building up the strength in my lower back, core, legs and arms. After years of back pain I am now able to begin to get back to a normal life. I had a chance to work with other therapist there, they are all fantastic and there to help us return to a healthy life. The entire staff is was a pleasure to work with. They listen to what you have to say and and pay attention to what you said. I looked forward to going there, the staff was caring, kind and funny at times. I would highly recommend Twin Boro for physical therapy."

Victor S.

View all Testimonials

We have 23 convenient locations

We love being close to our patients. Find out which of our premier facilities is nearest you!

VIew a list of all locations