The commonly prescribed calf and Achilles stretches for heel bursitis can actually make your injury worse or be the main reason your pain isn’t going away. Sports physio Maryke Louw explains why this is and what you can do instead for heel bursitis pain relief. Remember, if you need help with an Achilles injury, you're welcome to consult one of our team via video call.
The terms tendinitis, tendonitis, tendinosis, and tendinopathy mean the same thing for all practical purposes, and we use these interchangeably in most of our articles.
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Quick recap on heel bursitis
Your heel (or retrocalcaneal) bursa is a fluid-filled sac between your Achilles tendon and your heel bone. You get heel bursitis when something has irritated your bursa, causing it to be inflamed, swollen, and painful.
Why are people told to do stretches for heel bursitis?
There is a common misperception that heel bursitis is caused by a tight Achilles tendon or calf muscles. However, this “theory” is not supported by the research. You can find a detailed discussion of what causes heel bursitis here.
Yes, your calf and Achilles may feel tight when you have heel bursitis. However, rather than being the cause of the problem, this is usually a reaction to the pain and irritation of the inflamed bursa, and that tight feeling will only go away once the bursa has calmed down.
Why can stretches aggravate heel bursitis?
The typical stretch people are told to do for heel bursitis is a calf stretch, where you move your toes closer to your shin. You might be told to do this standing (like the typical runner’s stretch) or by pulling your foot back with a band – I show common examples of calf stretches in the picture below.
When you take your foot into this position, it pulls the Achilles tendon tighter over the heel bone, squashing the bursa. Now, for a healthy bursa, this isn’t a problem. But if your bursa is already irritated and inflamed, it usually makes it worse.
Don’t just take my word for it - test it!
It’s fine if you don’t believe me – in fact, it is good to be sceptical. Here’s how you can test it if you are currently doing calf and Achilles stretches for heel bursitis:
Stop doing the stretches for a week or two.
At the same time, take steps to reduce the stretch on your heel during normal daily activities, e.g. wear shoes with a slight heel on them or place heel lifting inserts into your shoes (I provide more options in this article).
Observe how your pain changes.
What to do instead to fix your heel bursitis
If your calves feel very tight, foam rolling can help to loosen them without aggravating the bursa. I demonstrate how to do it for Achilles tendonitis in this video, and the same applies to heel bursitis.
Other than that, you DON'T have to do any exercises. Unlike Achilles tendonitis, you usually don’t have to strengthen anything when you have heel bursitis. The most effective treatments for heel bursitis are calming down the inflammation and reducing the strain on the irritated bursa.
How we can help
Need help with your Achilles injury? You’re welcome to consult one of the team at TMA online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. All of us have a wealth of experience working with athletes across a broad variety of sports and ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.