Beneath the plantar surface of the rearfoot is a fat pad that normally cushions us and protects us as we walk. When walking, there is a force comparable to about 2.5 times body weight on the heel during heel strike, therefore it should really be obvious why we require that fat pad. Without that fat pad there would probably be inadequate force reduction which can cause several problems because of that poor cushioning. The most common is simply soreness underneath the rearfoot. The discomfort will typically be present on weightbearing rather than as much on pressing on it. This is not a common reason for heel pain, however it is a significant reason as it may often be wrongly identified as plantar fasciitis along with other reasons. Generally it is not difficult to diagnose as there is certainly just virtually no cushioning below the rearfoot and you will easily feel the heel bone.
Reasons for fat pad atrophy aren't completely obvious. The fat pad does atrophy with age naturally and in many it simply wastes away more quicker. Some individuals just seem to get this while others will not. It is not associated with bodyweight concerns. It may happen in several arthritis conditions and runners because of the years of beating on the rearfoot may perhaps be at a greater risk this condition. Those that have a higher arch foot (pes cavus) also get a shifting of this fat pad which will make a similar issue to the atrophy.
The only way to manage fat pad atrophy is to replace the fat or substitute for the fat. This may be inserted in operatively or a cushioning heel pad in the shoes used which has a comparable consistency to the missing fat pad. Shock absorbing shoes can also be used without or with extra cushioning. Surgically this can be an injectable fillers or perhaps an autograft making use of your own fat tissue.