Beneath the bottom of the heel is a fat pad that normally cushions us and protects the heel as we walk. When walking, you will find a pressure equal to nearly 2.5 times body weight on the heel during heel strike, so it ought to be no surprise that we require that fat pad. Without that fat pad there would most likely be poor impact moderation which may lead to a number of conditions resulting from that poor padding. The commonest is just soreness below the rearfoot. The discomfort will mostly be there on weightbearing instead of so much on touching it. This isn’t a frequent reason for heel pain, however it is an important one because it can often be mistaken for heel spurs along with other reasons. Generally it is not difficult to diagnose as there is certainly just not any cushioning underneath the heel and you can easily notice the calcaneus.
The causes of fat pad atrophy are certainly not totally clear. The fat pad does waste away as we grow older naturally and in some it just wastes away more at a quicker rate. Many people just seem to develop this yet others tend not to. It’s not connected with bodyweight issues. It could appear in a number of rheumatological conditions and athletes due to the many years of beating on the rearfoot could be at a higher risk this problem. Those that have a higher arched foot (pes cavus) will also get a shifting of this fat pad which might give a comparable problem to the atrophy.
The only method to manage fat pad atrophy would be to replace the fat or substitute for the fat. This could be inserted in surgically or a cushioning heel pad in the footwear used which has a comparable consistency to the missing fat pad. Shock absorbing shoes may also be used with or without extra cushioning. Operatively this could be an injectable fillers or an autograft using your own fat cells.