Under the bottom of the heel is a fat pad that naturally cushions us and protects us as we walk. When walking, there is a pressure equal to about 2.5 times body weight on the heel during heel strike, so it should be obvious why we need that fat pad. Without that fat pad there would be very poor shock absorption and this can lead to a number of problems due to that poor cushioning. The most common is simply pain under the heel. This is not a common cause of heel pain, but is an important one as it can often be mistaken for plantar fasciitis and other causes. Often it is easy to diagnose as there is just no cushioning under the heel and you can easily feel the bone.
Causes of Fat Pad Atrophy
The causes are not totally clear. The fat pad does atrophy with age naturally and in some it just atrophies more at a faster rate. Some people just seem to develop this and others do not. It is not related to bodyweight issues. It can occur in a number of rheumatological problems and runners due to the years of pounding on the heel may be at a greater risk for this. Those with a higher arch foot (pes cavus) also get a displacement of the fat pad which can give a similar problem to the atrophy.
Treatment of Fat Pad Atrophy
The only way to treat fat pad atrophy is to replace the fat or substitute for the fat. This can be inserted in surgicaly or a cushioning heel pad in the shoes used that has a similar consistency to the missing fat pad. Cushioned shoes can also be used with or without extra padding. Surgically this can be an injectable fillers or an autograft using your own fat cells.
If you want to know what the best options are for you, please come in and see us.
