Bursitis Of The Heel

Notes: Scutaro misses the suicide squeeze sign

BOSTON -- Locked in a 1-1 tie in the bottom of the 12th inning Monday night, the Red Sox thought they saw an opening.

Louis Coleman, the fifth Kansas City Royals pitcher of the game, had thrown wildly to first on a pickoff try, enabling Josh Reddick to go all the way to third.

With Marco Scutaro at the plate, the Red Sox put on the suicide squeeze play.

Heavy on the suicide.
    
"After action like that,'' recounted Terry Francona, "we thought it was a good opportunity."

Problem was, while Reddick got the sign, Scutaro did not. Two innings later, when the Royals scored twice in the top of the 14th, the Red Sox had themselves a frustrating 3-1 loss.
    
"We got half of it right,'' said Francona ruefully. "We didn't get the whole thing right."

Scutaro took full responsibility for the play.

"I didn't see the sign . . . it was my fault," said the infielder. "I just missed the sign. I can't really say nothing else. It's my fault."

Reddick had broken for the plate with the pitch from Coleman. Scutaro had to twist a bit to get out of the way of an inside pitch.

Asked what he was thinking as he spied Reddick barreling toward the plate, Scutaro said: "[Messed] it up. I didn't see him right away because he was kind of hidden. But after the pitch inside, I took a look and was like, 'Oh . . . missed a sign.'

"We had an opportunity to win this game and we didn't do the little things. Beside bad baserunning, we didn't bring the guy home from third base. We just threw this one away pretty much."
 
Scutaro half-expected that the bunt play might be put on.

"I was kind of watching (for) the sign," he said. "But I didn't see the squeeze. To be honest, I was watching (third base coach Tim Bogar), but I didn't see the squeeze. I was kind of focused on getting a good pitch to hit to drive the guy in.

"Like I said, it's my fault. I should have been more aware of the sign. It feels bad, man. It feels like all your teammates, your manager, all the fans just want to kill you. It's a bad feeling."

"Sometimes, it's how the game goes," said Reddick, who had three hits, including two doubles. "Stuff happens and you try to get out of it . . . I was just trying to get back to third base and keep us in the game. That's all you can really do in that situation.

When is Achilles Tendonitis not Achilles Tendonitis? When it is ...

Retrocalcaneal bursitis is the inflammation of the fluid-filled sac (bursa) at the back of the heel bone (calcaneus). The retrocalcaneal bursa is located between the Achilles tendon and the heel bone and is designed to reduce friction between the Achilles tendon and the heel bone. During contraction of the calf muscle, tension is generated through the Achilles tendon and it rubs against the retrocalcaneal bursa. When there is excessive friction due to repetitive rubbing of the tendon against the bursa or high impact force translating through the Achilles tendon, irritation and inflammation of the bursa may occur. The inflammation can also be aggravated by pressure, such as when athletes wear tight-fitting shoes.

This condition is often mistaken for Achilles tendinitis but it can also occur in conjunction with Achilles tendinitis.

Signs and Symptoms

In retrocalcaneal bursitis, pain at the back of the heel is the main complaint from patients. Pain may worsen when tip-toeing, running uphill, jumping or hopping. Often, those who are accustomed to wearing high-heeled shoes on a long-term basis may also complain of pain at the back of the heel when switching to flat shoes. This is because when in high-heeled shoes, the calf muscle and the Achilles tendon are in a shortened position. Switching to flat shoes would cause an increased stretch to the calf muscle and Achilles tendon, irritating the Achilles tendon and the retrocalcaneal bursa. Other symptoms may include redness and swelling at the back of the heel.

What leads to Retrocalcaneal bursitis?

There are several factors which can lead to a person developing retrocalcaneal bursitis. In athletes, especially runners, overtraining, sudden excessive increase in running mileage may lead to retrocalcaneal bursitis. Tight or ill-fitting shoes can be another causative factor as they can produce excessive pressure at the back of the heel due to restrictive heel counter. A person with an excessively prominent posterosuperior aspect of the heel bone (Haglund deformity) may also have a higher predisposition to retrocalcaneal bursitis. In such individuals, pain would be reproduced when the ankle goes into dorsiflexion.

How do we tell that it is not Achilles Tendonitis?

Careful examination by your physician or physiotherapist can determine if the inflammation is from the Achilles tendon or from the retrocalcaneal bursa. Tenderness due to insertional Achilles tendinitis is normally located slightly more distal where the tendon inserts into the back of the heel, whereas tenderness caused by the retrocalcaneal bursa is normally palpable at the sides of the distal Achilles tendon.

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