Table of Content
- Introduction
- Understanding Heel Bursitis
- Common Causes and Risk Factors
- Symptoms to Watch For
- How Is Heel Bursitis Diagnosed?
- Physiotherapy Techniques That Work
- Heel Bursitis Physical Therapy Exercises
- Home-Based Treatment Strategies
- Bursitis Treatment Options Beyond Physio
- How Long Does It Take to Heal?
- When to See a Physio
- Prevention Tips
- FAQ
- Conclusion
Introduction
Heel bursitis is a painful and often frustrating condition that affects the fluid-filled sacs (bursae) at the back of the heel. These bursae cushion the bones, tendons, and muscles near your joints. When they become inflamed due to overuse, poor footwear, or biomechanical issues, heel pain can quickly limit daily movement. The good news is, there are effective heel bursitis treatment options available especially through physiotherapy. At Go Run Go Physio, our evidence-led approach helps Australians manage and recover from heel bursitis using practical, non-invasive methods.
Understanding Heel Bursitis
The heel contains small fluid-filled sacs called bursae that act as cushions between bones and surrounding soft tissues. When these sacs become inflamed, the result is a condition known as heel bursitis.
There are two main types:
- Retrocalcaneal bursitis: Inflammation of the bursa located between the heel bone (calcaneus) and the Achilles tendon. This type often develops due to repetitive strain or tight calf muscles.
- Subcutaneous calcaneal bursitis: Affects the bursa near the surface of the skin at the back of the heel. It may be caused by poorly fitted footwear or direct pressure on the area.
Both types lead to similar symptoms heel pain, swelling, and discomfort while walking or standing but require slightly different management strategies.
Common Causes and Risk Factors
Heel bursitis doesn’t typically happen overnight. It usually develops from repeated strain or small injuries that add up over time.
Here’s a breakdown of causes and risk factors:
Common Causes vs Risk Factors for Heel Bursitis
| Common Causes | Risk Factors |
| Running on hard surfaces | Ageing (natural wear on bursa tissue) |
| Wearing shoes with hard or narrow heels | Flat feet or poor foot biomechanics |
| Tight calf muscles | Autoimmune conditions (e.g., arthritis) |
| Sudden increase in physical activity | Long hours standing or walking |
| Repetitive impact or jumping | Previous ankle or Achilles injuries |
| Poor walking or running form | High body weight |
Symptoms to Watch For
Recognising symptoms early helps prevent long-term damage. Signs may include:
- Swelling at the back of the heel
- A dull ache or sharp pain when walking
- Warmth or redness in the area
- Pain when standing on tiptoe or wearing certain shoes
- Tenderness when pressing the heel
Pain usually worsens after physical activity or extended time on your feet.
How Is Heel Bursitis Diagnosed?
Diagnosis is generally made through a physical examination by a physiotherapist or GP. The process includes:
- Checking for swelling and tenderness
- Assessing range of motion at the ankle and heel
- Observing your gait or walking pattern
- Referral for imaging (ultrasound or MRI) in persistent or severe cases
Getting an accurate diagnosis ensures that the heel bursitis treatment plan suits your specific condition.
Physiotherapy Techniques That Work
At Go Run Go Physio, we use a combination of techniques to reduce pain, improve mobility, and support long-term recovery.
Manual Therapy
Hands-on treatment including soft tissue release, mobilisation, and joint movements to reduce tension and improve circulation.
Taping and Support
Sports tape or kinesiology tape can help reposition the heel, reduce strain on the Achilles tendon, and improve comfort during movement.
Dry Needling
Targets trigger points in the calf and lower leg muscles to reduce tightness and promote healing.
Ultrasound Therapy
Low-frequency sound waves help stimulate blood flow and reduce inflammation in the affected bursa.
Heel Bursitis Physical Therapy Exercises
A customised heel bursitis physical therapy program can shorten recovery time and prevent flare-ups.
Calf Stretches
Improving calf flexibility helps offload pressure from the heel.
Wall Calf Stretch:
- Place both hands on a wall.
- Step one foot back, keeping the heel on the ground.
- Lean forward into the stretch and hold for 30 seconds.
Foot Intrinsic Muscle Strengthening
Improves foot arch support and stability.
Towel Grab:
- Sit on a chair.
- Place a towel on the floor.
- Use your toes to pull the towel toward you.
Balance and Proprioception Training
Essential for ankle and foot control.
Single-Leg Balance:
- Stand on one foot.
- Progress by closing your eyes or standing on an uneven surface.
Home-Based Treatment Strategies
Recovery doesn’t stop after a physio session. These simple measures can speed up healing at home:
- Apply Ice: 15–20 minutes several times a day to reduce swelling
- Rest: Avoid activities that aggravate symptoms
- Choose Proper Footwear: Use cushioned shoes with firm heel counters
- Heel Cups or Inserts: Help reduce impact while walking
- Anti-Inflammatory Medication: Speak to your GP or pharmacist first
Bursitis Treatment Options Beyond Physio
If physiotherapy alone doesn’t resolve your symptoms, other options may be considered.
- Corticosteroid Injections: Short-term relief from inflammation
- Custom Orthotics: Designed by a podiatrist to support your foot structure
- Surgical Removal of Bursa: Very rare, only in long-term unresponsive cases
Your physiotherapist will discuss these options if your progress stalls.
How Long Does It Take to Heal?
Recovery time depends on severity, lifestyle, and how early treatment begins:
- Mild cases: 2–4 weeks
- Moderate cases: 4–8 weeks with regular physiotherapy
- Chronic or recurring: May take several months
Sticking to your treatment plan and avoiding triggers are key for quicker recovery.
When to See a Physio
If your heel is sore for more than a few days and worsens with walking, don’t delay a professional assessment.
At Go Run Go Physio, you’ll receive:
- Expert assessment
- Individualised rehab program
- Advice on footwear, pacing, and return to activity
The earlier you start, the smoother your recovery will be.
Prevention Tips
To avoid future episodes of bursitis:
- Warm up before running or sport
- Stretch calves daily
- Avoid prolonged standing without breaks
- Replace worn-out footwear
- Maintain healthy biomechanics with orthotics if needed
- Address early signs of heel pain without delay
FAQ
Q1. What is the fastest way to heal heel bursitis?
Answer: Early physiotherapy, combined with rest, stretching, and appropriate footwear, gives the quickest results.
Q2. Can heel bursitis heal without physiotherapy?
Answer: Some mild cases may settle, but physiotherapy improves healing and reduces the chance of recurrence.
Q3. Do calf stretches help with heel bursitis?
Answer: Yes, they reduce stress on the Achilles tendon and help decompress the inflamed bursa.
Q4. How long should I rest if I have heel bursitis?
Answer: Rest until pain eases, but avoid total inactivity. Light movement under guidance is beneficial.
Q5. How is heel bursitis treated at Go Run Go Physio?
Answer: Treatment includes manual therapy, strengthening, stretching, taping, and advice on activity and footwear.
Q6. Can walking worsen heel bursitis?
Answer: Too much walking, especially without heel support, may aggravate symptoms. Stick to short walks with proper shoes.
Q7. What kind of shoes should I wear with heel bursitis?
Answer: Supportive shoes with cushioning, a stable heel, and room in the back are best.
Conclusion
Heel bursitis can interrupt your daily life, but with early action and the right physiotherapy plan, recovery is achievable. Combining expert treatment with at-home care and injury prevention strategies ensures the best outcome. Whether you’re dealing with recent heel pain or an ongoing issue, Go Run Go Physio provides clear, personalised solutions to help you move better and live pain-free. Don’t wait for the discomfort to worsen the path to healing starts with one step in the right direction.