Fat Pad Syndrome

What is it?

The fat pad is a protective shock absorber that sits between your heel bone (calcaneus) and the outer layer of your skin. The fat pads primary role is to reduce the amount of stress going through the heel while you walk/run. The fat pad is held together by small ligamentous structures that can occasionally rupture or elongate, causing the fatty tissue to spread out. As a result, the amount of cushioning present at the heel is reduced producing symptoms like a stone bruise.

Why Did I get it?

• High levels of running

• Direct trauma to heel (e.g. stone)

• Idiopathic (no known cause)

• Biomechanical foot issues (poor alignment)

• Incorrect footwear

Symptoms:

• Experiencing pain in the ball of the foot, worse when barefoot, in heels or thinned soled shoes.

• Pain which is greater when standing and relieved when sitting.

• The feeling of having a small rock in the shoe.

• Callouses may appear and become very thick on the ball of the foot.

• When feeling the balls of the feet, you can feel the bones without much overlying fatty tissue.

How is it diagnosed?

A thorough clinical examination will most commonly diagnose Fat Pad syndrome. Depending on severity of symptoms, you may be referred for an ultrasound to determine the extent of the degeneration or an x-ray to see if any heel spurs are present.

Possible treatments

• Gel heel cup

• Anti-inflammatories (oral)

• Rest, Ice, Compression, Elevation (RICE)

• Footwear advice

• Custom Orthotics

• Strapping

Prognosis:

With the above treatments, Fat Pad Syndrome will heal with time (usually within 1-2 months of commencing treatment). During this process, the focus is on reducing pain levels and providing the area with cushioning and stability in order to inhibit the inflammatory process of the body.