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Atrophy of the fat pad, also known as fat pad syndrome or fat pad atrophy, refers to the thinning or degeneration of the fat pad that provides cushioning and support in various parts of the body, most commonly in the feet. The fat pad acts as a natural shock absorber, protecting the bones, joints, and soft tissues from excessive pressure and impact during weight-bearing activities.


Heel pad atrophy refers to the thinning or degeneration of the fatty tissue located beneath the heel bone (calcaneus) in the human foot. This fatty tissue, known as the heel pad, serves as a natural shock absorber, helping to cushion the impact of walking, running, and other weight-bearing activities. It also provides protection to the bones and other structures in the foot.


Heel pad atrophy can be caused by various factors, including:

  1. Age: As people get older, the natural fat in the heel pad may gradually diminish, leading to thinning and reduced shock-absorbing capacity.

  2. Weight loss: Significant weight loss can result in a decrease in fat tissue throughout the body, including the heel pad.

  3. Overuse or excessive pressure: Prolonged standing, walking, or running on hard surfaces can lead to the breakdown of the fatty tissue, causing it to thin out.

  4. Certain medical conditions: Conditions like plantar fasciitis, rheumatoid arthritis, diabetes, and certain connective tissue disorders can contribute to heel pad atrophy.

  5. Injuries: Trauma to the heel area, such as a direct impact or repetitive microtrauma, can damage the fatty tissue and contribute to its thinning.

The thinning of the heel pad can result in decreased shock absorption, increased pressure on the bones and joints of the foot, and potential discomfort or pain while walking or standing.

What are the symptoms of Heel Pad Atrophy?

Heel pad atrophy can manifest with various symptoms, primarily centered around discomfort or pain in the heel area. The severity of symptoms can vary depending on the extent of the atrophy and the underlying causes.


Some common symptoms of heel pad atrophy include:

  1. Heel Pain: The most common symptom is pain in the heel area. This pain might be described as a dull ache, soreness, or tenderness in the back of the heel.

  2. Discomfort While Walking: People with heel pad atrophy may experience discomfort or pain when walking, particularly when putting weight on the affected heel.

  3. Reduced Shock Absorption: Thinning of the heel pad leads to decreased shock-absorbing capacity. This can result in increased impact forces on the bones and joints of the foot, potentially leading to discomfort during activities that involve standing or walking.

  4. Feeling of Walking on a Hard Surface: Some individuals may describe the sensation of walking on a hard or uneven surface, even when walking on a regular surface.

  5. Increased Sensitivity: The heel area may become more sensitive to pressure, making activities like standing or prolonged walking less comfortable.

  6. Decreased Cushioning: The reduced cushioning effect of the heel pad might contribute to discomfort, especially on hard surfaces.

  7. Painful First Steps in the Morning: If the atrophy is associated with conditions like plantar fasciitis or other inflammatory conditions, individuals may experience increased pain or stiffness in the heel, particularly during the first steps after waking up in the morning.

It's important to note that while these symptoms are associated with heel pad atrophy, they can also be caused by other foot-related conditions. If you're experiencing persistent heel pain or discomfort, it's advisable to consult a podiatrist for an accurate diagnosis and appropriate treatment recommendations. They can help determine the underlying cause of your symptoms and develop a personalised treatment plan to alleviate your discomfort.

How can you treat Heel Pad Atrophy?

The treatment of heel pad atrophy focuses on alleviating discomfort, improving shock absorption, and managing any underlying conditions that may contribute to the atrophy.


Here are some approaches that can be considered:

  1. Supportive Footwear: Wearing shoes with good cushioning and arch support can help distribute weight more evenly and reduce pressure on the heel pad. Look for shoes that have adequate padding in the heel area.

  2. Orthotic Inserts: Custom or over-the-counter orthotic inserts can provide additional cushioning and support to the heel area. These inserts can help compensate for the reduced natural cushioning of the heel pad.

  3. Heel Cushions or Pads: Specialised heel cushions or pads can be placed inside shoes to provide extra cushioning to the heel. These can help reduce discomfort during walking or standing.

  4. Physical Therapy: A physical therapist can guide you through exercises that focus on improving foot and calf muscle strength, flexibility, and stability. Strengthening these muscles can help improve shock absorption and reduce strain on the heel pad.

  5. Weight Management: Maintaining a healthy weight can reduce the pressure on the heel pad and alleviate discomfort.

  6. Activity Modification: If your daily activities involve prolonged standing or walking on hard surfaces, consider modifying your routines to reduce the strain on the heel. Taking breaks to rest your feet and using supportive footwear can help.

  7. Anti-Inflammatory Measures: If inflammation is contributing to the discomfort (e.g., in cases of plantar fasciitis), anti-inflammatory measures like ice application, non-prescription pain relievers (under medical guidance), and stretching exercises might be recommended.

  8. Corticosteroid Injections: In some cases, a healthcare provider might recommend corticosteroid injections to reduce inflammation and provide temporary relief from pain.

  9. Addressing Underlying Conditions: If there's an underlying medical condition (e.g., rheumatoid arthritis, diabetes) contributing to the heel pad atrophy, managing that condition effectively can help alleviate symptoms.

  10. Surgical Interventions: In rare cases where conservative treatments are ineffective, surgical options might be considered. Surgical procedures for heel pad augmentation involve adding cushioning materials to the affected area to restore shock absorption.

It's important to consult a podiatrist for an accurate diagnosis and personalised treatment plan. They can assess your specific situation, identify contributing factors, and recommend appropriate treatments to address your heel pad atrophy and associated symptoms.




Our team will conduct a full assessment including medical history, foot & lower limb posture, strength & motion tests, gait assessment using pressure plate system, and treatment plan discussion. Following your assessment and review of your medical history, this appoint may suitable to diagnose an treat conditions in the list above.

For this appointment it is important to have the appropriate medical history as this will allow our podiatrists to identify and treat the problem more effectively. If you have any previous GP refferal notes, scans or test results please bring these with you.

You will need the following for your appointment:

A pair of shorts. A selection of footwear, 1 to 3 pairs of shoes (footwear you wear daily/ and or your sporting footwear).

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