The fat pad on the underside of your heel helps your foot disperse the weight of your body as you walk in order to protect the bones and soft tissues in the area. However, like many structures in our body, this fat pad can slowly break down over time as a result of natural wear and tear or injury. This is known as fat pad atrophy, and when it develops, your heel bones are at a greater risk for injury because the lack of cushioning exposes these structures to more stress.
If you’ve begun to develop heel pain, or you’re noticing more discomfort with every step you take as you put weight on the heel area, you’ll want to bring this up to your primary care physician or a foot specialist like Dr. McDonald. In today’s blog, we take a closer look at heel pad atrophy and how to make physical activities more comfortable if you’ve lost some of the natural padding on the underside of your heel.
Causes And Symptoms Of Heel Pad Atrophy
As we noted in the introduction, one of the most common causes of heel pad atrophy is natural wear and tear. With each step you take, pressure that is equal or greater to 2.5 times your body weight is placed on your heel and forefoot, so even if you have an ideal body weight, your heel will handle a significant amount of stress as you walk. This pressure can also be amplified if you are heavier or performing more strenuous activities like running or jumping. These actions won’t cause problems for your fat pad overnight, but over the course of many years, some of this natural fat protection can diminish.
Of course, heel pad atrophy can also be expedited if you are not careful. Acute stress or injury to the heel can speed up fat pad atrophy. Being overweight or wearing shoes that don’t adequately support your foot or your heel (like high heeled shoes) can also put increased pressure on certain areas of your feet, expediting tissue breakdown in these spots. And while we mentioned that normal stress on the area can serve to break down the heel pad over the course of decades, that’s not to say that physical activity is your enemy. Inactivity will actually serve to weaken supportive tissues in the heel area, which can lead to faster fad pad breakdown during activity, so don’t think you’re protecting your heels by avoiding physical activity. Regular exercise, wearing supportive shoes and maintaining a healthy weight are three of the best ways to prevent and treat fat pad atrophy and any associated symptoms.
Symptoms of fat pad atrophy include pain while walking or bearing weight through your feet, heel soreness after spending a lot of time on your feet, the formation of calluses on the underside of your heel and the sensation that you’re stepping on a rock or pebble when walking or running.
Diagnosing And Treating Fat Pad Atrophy
If you’re dealing with any of the above symptoms, reach out to your primary care physician or a foot specialist like Dr. McDonald. He’ll take a closer look at your foot and why conduct some movement tests and exercises to see how the area responds to pressure. Imaging tests may be taken in order to rule out a calcaneal fracture or to better examine the soft tissues in the area, but they aren’t always necessary.
If no other underlying issues are discovered during the assessment, your foot specialist will likely walk your through some simple conservative techniques to reduce or fully alleviate this discomfort while walking. You won’t be able to regenerate fat pad loss, but there are some ways that you can help to take stress off the heel. Oftentimes the most common first step is to set the patient up with a more supportive shoe or a custom orthotic insert. Shoes and orthotic inserts that have more heel cushioning will help to disperse stress to other areas of the foot, taking strain off the heel pad. Diet and exercise improvements to help a patient reach a more manageable weight can also greatly reduce heel discomfort.
In more severe cases, patients may benefit from the above techniques in combination with a foot injection and physical therapy. An injection can help to calm inflammation, while physical therapy can strengthen structures around the heel so it can better handle stress. Surgery is not typically performed in order to address fat pad loss, although it may be necessary if fat pass atrophy has contributed to a calcaneal fracture or destabilization of the lower ankle complex.
Fat pad atrophy will usually only get worse unless treatment is pursued, and since treatment usually only involves orthotic inserts and weight management, there’s no reason to shy away from treating the problem head on. Left untreated, symptoms can worsen and your gait can be affected, which can cause additional problems for your ankle, knees and hips. Confront your heel discomfort and make it a thing of the past by working with a foot specialist like Dr. McDonald. For more information, or for help with a different foot or ankle issue, reach out to his office today at (860) 244-8889.