The Use of Cushioned Heel Pads for Fat Pad Atrophy

There are many different causes for pain under the foot and that can sometimes be a challenge even for the experts to diagnose it. One of those problems that is not so common is an atrophy of the fat pad that is supposed to cushion and protect the foot. This fat pad protects the bones and other structures under the foot. This can especially be true and important in athletes who participate in sports that have a lot of hard impacts with the ground such as running. In running they do have the added protection of a running shoe to cushion the foot and lesson those impacts. The main symptoms of this problem are somewhat vague and non-specific, so often the expert clinician has to rule out other conditions and eliminate them as the cause of the symptoms to leave this atrophy of the fat pad as the cause of the problem. The most common symptom is just a vague ache under the ball or heel of the foot, that is worse when standing and even worse if doing high impact activities. Not only is it painful under the foot, the lack of cushioning can have impacts further up the body.

The cause of this atrophy or wasting away of the fat pad is not clear. It does get a bit thinner as people get older, so it is a natural process. In most it is not a problem unless the wasting is substantial or activity levels are high. It just appears that as we age some atrophy at a faster rate than others and the reason for that is not clear.

When the atrophy of the fat pad is established as the cause of the problem the best treatment is to put some cushioned padding under the foot in the shoe. The density of this material has to be the same as the density of what the fat pad would be in order to do its job properly. If it is too soft, then it will just flatten under the foot and do nothing. If it is too hard, then it will make no difference to the problem. All too often the cushioned heel pads are too soft. A soft pad might feel good if you poke it with your fingers, but if your fingers can flatten the pad, then body weight is also going to flatten it and do nothing. These cushioned heel pads can be very effective if you get the right one.

Another option is to use fat grafting. This is a surgical procedure that involves taking fat cells and tissue from another part of the body and inserting them under the heel and ball of the foot. While this procedure is generally helpful it is not something that is done routinely as there is a surgical risk with any procedure and the use of the cushioned heel pads is usually more than helpful, so the use of surgical grafting of fat is only going to be done in the most severe cases.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.