In this video on the talk about Richard calcaneal bositis managed to say it that’s besides that you get on the back of your heel behind they can spend it’s quite common goals for pain on that first report of the healing you’ll usually see a little bit of puffiness as well Sir for those of you not don’t know me my name’s marica I’m one of the physiotherapist from spot treat my keys.com we can get online physiotherapy assessment as well as treatment for injuries however the description of all of this video if you want a link to our website.
Okay so the bursa is a fluid filled sac but you get between your heel bone and your can you stand it so if you can look at the picture thank you it’s a picture of your foot and then you’ve got your leg coming up you’ve got thank you Stan and then between the heel bone and they can extend and you can see the bus. So we looked at the just blown up you can see the bus was grown in the US blue little sock. No that’ll suck you get buses all over the body but always between tendons I have within them so close together old Whittington this custom quote I think jobs to prevent friction and absorb a little bit of compression so they protecting the tendons now if that force becomes excessive that can cause that person to become sore and painful actually there’s more than one closer. Let’s. Differential diagnosis, so there’s 3 main things that can cause the person to be sore and tender and swell up the first, will be if you’ve got an inflammatory reaction or inflammatory conditions such instance out can cause not conditions like rheumatoid arthritis can cause that but any other inflammatory type disease can cause a rhetorical Peniel besides this to develop so that’s one thing if you know that you’re you have something like that in your family it’s worth tasting with full and also in the dock then the next one is trauma so if you get it all written knock and.
All not go so it can puff up dramatically in the super fight painful. And then thirdly and this is probably one of the most common ways that I see people who’s gone beside this is when it’s chronic overuse an acute increase in compressive forces on that basis so if we think of how the person works. This is your point this is your leg comes they personalize on the predicted then can you see as you run walk and you come over that base compression on by now that’s absolutely normal but it’s when it’s an excessive force or lots of compression really quite frequently but the best I can get irritated because it’s just not used to that. Compression in itself is not the problem it’s how much compression not what can lead to overload with compression forces it can be if you suddenly switch from always wearing shoes with a slight heel toe shoes that’s really reflect all walking barefoot feet not walking barefoot in the house might not be a problem but say for instance you go on holiday and most of your life in the U. K. you spend in shoes and shoes with a heel I know your holiday flip flops or barefoot on the beach and what models so you can always so nice to walk barefoot on the beach let’s go walk a long distance so the signs causing it to die to tilt in mobile we are here to drop more than usual C. getting an increase in compressive force which is not used to you’re walking quite a long way in flip flops so short period well the issue long buried too much because it’s not used to it and that makes flare up other things if you suddenly take up hill running hill walking especially fost walking up hill because going up a hill will increase that angle increased the pull of the key statement over the boat I think we still compression on the on the vessel what else yes a very common one is over stretching so if we think of the typical cost stretch a specially deep stretches and yoga and really dipping into the downward dog and getting the heel down.
If you too severe with it and you’re not very careful with how you do it and how you ease into it over time that can actually be enough to flared up. So what can you do about that well first of all if you know that you are prone to inflammatory disease it’s worth testing it because anti inflammatories can make a massive difference if you have an inflammatory condition in your body to get the information down but it’s worth checking with your GP because not everybody is okay with anti inflammatory so you need to make sure that you take medication that’s safe for you. Ugh even in cases where it’s not due to inflammatory disease at the property may be useful but it wouldn’t necessarily be my first port of call I would do a few of the other things first. The second thing and this is probably the most important what to start doing immediately is to offload bump us up so just give it a little bit of spice give it a little group of breathing breeding were up in space that can calm down and by far the easiest way to do is just show up with a deal but now that you know the press is onto it to make sure your shoe doesn’t press directly on to that area but anything that lifted up so if we think of the for the game in this position so the amount of compression that can you see if I left my heel up I’m going to ease off on how much that Achilles tendon pulls over the hill are we going to ease the pressure on the bus up so what my patients find useful is they might have to wear shoes with a slight heel on all day long in the house or even put an extra heel lift in may at the end I’m more of a draw the flex position.
It’s a mild case don’t have to wear it in the house but just when they go for longer walks so depends on how sensitive your sis but if when it happens you can immediately offloaded and give it a little bit of breathing space to take the pressure off it I knew quite severe with it for a few days you really protect it you’ll see that it costs down much more quickly than if you try to write it and just keep on holding a vote things that will work for ones where you’re going to die recall mas well because again it just needs to be offloaded for awhile because it the body will repair it it just needs time we’re not talking about a few days it can take a few weeks put to properly calm down. Then if we think off training and things like that hope we all flew to 3 Dutch. Stick to flat so avoid the hills or just boycott fost so go for strolls rather than fost walks if you can’t run without paying on the fact stick to the flat stick to slow running probably the foster running and if we think of running shoes again choose one with a heel drop so he usually trend of facts you might have to either get a you lift temporarily but the buy shoes out where you can be on even that you can take out again or if you do have trainers with the heel that could really help just check because I have had patients wait was actually the pressure of the shoe that they will that was really tight on that hill but because the compression of the irritation of the best sub so check that your shoes doesn’t bode press directly on that. And then one of the most important things this is quite shocking because when I look on the internet I see people prescribing cough stretches and Dorsey flexion stretches for bursitis please do not stretch your call or your Achilles tendon pulled into Dorsey flexion if you have a scientist because it’s increased compression all purpose up that’s because the irritation you’re not going to get that better through increasing back even more now I know why people do it because the car feels tight and they they think if I can release the call will release the pressure and then the bus will be happy.
That is tight because you’ve got pain in your heel I’m awful state tight until the pain in the heel settles down it won’t settle down the tightness unless you can fix this but I think you’re going to continue to stretch you’re going to continue pushing on this type of structure at the bottom and it’s not gonna settle down. If you want to do something for your cough that’s tight you can use a message government obviously not on the hill that sold on the muscle, by all means, you can phone role you can get a muscle it again don’t let anybody rub into the office or anything they’ll just make it worse because rubbing and massaging on the process again compression okay. Yeah that’s basically it so if however sometimes you get once there’s really resistant to treatment so you’re really offloading at and you’ve done that for several weeks office here feel that you’ve done it properly for long enough. You’ve tried to avoid all positions and activities that really aggravate it and you’ve also gone to the doctor had to anti virus and fall short period of time remember it’s only 5 to 10 days ever for that type of thing and it’s not made a difference then you could get at injection into the bus as well now it is usually a steroid injection that they use for that and I would say if you’re gonna have that make sure they do it on the altar some guidance because you want that injection to go into the bestseller so they have to look at where they inject because remember corticosteroids is not good for the day and it’s safe you can inject it directly into the thing that you could put yourself at higher risk of getting a tendon rupture.
Also the reason. Of course because there were 3 well to calm the person down but the reason I’m leaving it for lost is because even though you’re injecting it directly into the bus on not the tendon they also close together that’s some of that back we’ll take a steroid will mix and go to the tended so you will still have a little bit of a fake thing nope. All right doesn’t mean that you will stop protecting it just isn’t that great for 10 and health so yes if you’ve got a persistent besides just the doesn’t want to react to anything else I would say have one but make sure you have off loaded properly you’ve done everything else probably before you get that. You may also exercise what exercise should you do to fix this. To be honest there’s not any you don’t need strength training or anything for this because this is not a strength deficit the difficult and that it’s a compression thing so it’s more about avoiding the compression and slowly easing back into those positions over time however it can often come in combination with the insertional Achilles tendinopathy in that case you will have to do exercises for the tendinopathy to get back stronger and get that better but honestly get some guidance from a video about this because you want to limit the range that you do your exercise in so that you don’t always more compression so there’s not a one size fits all with that it’s going to be something that works for you and for your specific case. Sir let me know if you’ve got any questions and remember if you need more help with your Kelly’s injury you’re welcome to consult one of us by a vehicle link to the website is in the description of this video. Thank.
