Lower limb

Calcaneal and malleolar bursae

Bursae calcaneae et malleolares

Origin

Group of synovial bursae at the heel and malleoli: retrocalcaneal bursa (between Achilles tendon and calcaneus), subcutaneous calcaneal bursa, and subcutaneous malleolar bursae

Insertion

Cover the posterosuperior calcaneal tuberosity and subcutaneous bony peaks of the medial and lateral malleoli

Function

Facilitate smooth gliding of the Achilles tendon over the calcaneus and cushion malleoli from footwear friction

Innervation

Sensory branches of sural and tibial nerves

Movement & chain

High compression during terminal stance dorsiflexion

Palpation

Two-finger squeeze test anterior to the Achilles tendon insertion for retrocalcaneal bursitis

Clinical

Retrocalcaneal bursitis / Haglund's syndrome (painful heel deformity from rigid shoe counters); subcutaneous malleolar bursitis from tight boots

Segmental innervation

S1, S2 spinal levels

In clinical practice

Heel lifts to diminish tendon compression, footwear modification (soft heel counter), eccentric calf stretches, and surgical bursectomy/Haglund resection

Region in the model

Lower limb