Heel Fat Pad Syndrome

By Noelle Ihli, medically reviewed by Dr. Kimberly Langdon, M.D.

The fat pad of your heel, also known as the “corpus adiposum,” acts as a cushion and shock-absorber to protect your heel bone and arch.

Each time you walk, run, or jump, your feet absorb and distribute your body weight combined with the force of impact–and usually, they do a great job! However, sometimes overuse, injury, or just general wear and tear can put too much pressure on different parts of the foot.

Over time, the fat pad of the heel can atrophy (or shrink) in size, become worn and thin, or become inflamed and painful, resulting in heel fat pad syndrome. Learning about this syndrome can help you avoid it or treat it successfully:

What Is Heel Pad Syndrome?

Ideally, the fat pad of the heel is thick and dense, the perfect cushion for the bones of your heel and foot. Heel fat pad syndrome develops when the entire fat pad, or smaller sections of the heel fat pad, become thin and damaged.

Your gait and your arch health are two of the biggest factors that influence the health of your heel pad. The force and impact that your feet absorb when you walk is 2.5 times the weight of your body. When you run or jump, that impact increases even more! The way your heel strikes the ground as you move determines where your heel pad will wear down the most quickly.

In the same vein, the health of your foot’s arch makes a big difference in how much force and impact your heel fat pad feels. If your arch is strained, injured, or damaged, it can’t prop up your foot properly, leaving your heel fat pad to bear more force and impact.

Common Causes of Heel Fat Pad Syndrome

Heel pad syndrome can develop from overuse, injury, atrophy, or strain. The following are the most common causes of heel fat pad syndrome:

Improper Gait

If you overpronate or underpronate (the foot leans inward or outward, respectively) while you walk or run, your heel fat pad may break down more quickly in the places your heel strikes the ground most forcefully.

Plantar Fasciitis

As the arch of the foot breaks down and struggles to absorb and distribute impact, the fat pad of the heel can be strained, worn, and injured much more quickly than usual.

Inflammation of the Fat Pad

Inflammation of the heel pad typically happens after repeated, forceful, and prolonged activity, like jumping during basketball or gymnastics.

Fat Pad Displaced or Thinned

In other situations, the fat pad can be displaced or thinned, exposing the heel bone and causing a bruised feeling. You may find it extremely difficult to walk barefoot or on hard surfaces in this situation.

Force or Walking on Hard Surfaces

The force that the heel absorbs during walking or running is the most extreme on hard surfaces while barefoot. Walking or running on hard surfaces while barefoot can quickly lead to a thinning, strained heel fat pad or bruising to the heel bone.

Plantar Fasciitis Vs. Heel Fat Pad Syndrome

Sometimes heel fat pad syndrome can be mistaken for plantar fasciitis. And while it’s true that many people have plantar fasciitis and heel fat pad syndrome at the same time, it’s helpful to understand the difference between the two conditions:

Plantar Fasciitis

Plantar fasciitis (or plantar fasciosis) is a painful condition caused by damage or deterioration to the arch of the foot, the fibrous band of tissue that runs between your heel and the ball of your foot.

A healthy arch acts as a spring, absorbing and distributing the impact of physical activity properly. However, a flat, damaged, or overused arch begins to break down–which can lead to fat pad syndrome as the heel pad sustains more wear and impact. Heel spurs, which may develop as the body tries to prop up the damaged arch, can also dig into the fat pad of the heel and cause pain.

The hallmark symptoms of plantar fasciitis include the following:

  • Pain that’s most severe toward the front of the heel (closer to the toes) and instep
  • Sharp pain or dull, aching pain that is usually worse in the morning
  • Pain that improves with rest and stretching

Heel Pad Syndrome

The heel pain from heel fat pad syndrome is caused by a thin, damaged fat pad that covers the heel bone. When this fat pad isn’t able to cushion effectively, walking and moving can be very painful. While both plantar fasciitis and heel pad syndrome cause pain in the heels, the hallmark symptoms of heel fat pad syndrome are a little different:

  • Pain that is a little duller (more like a bruise), and felt closer to the middle of your heel
  • Pain that you can recreate by pressing your finger into the middle of your heel pad
  • Pain that is made worse when you walk on hard surfaces

Both plantar fasciitis and heel pad syndrome are made worse by weight gain and as we age.

Do Heel Cups Help Fat Pad Syndrome?

One of the best ways to treat and heal heel fat pad syndrome is through using heel cups that recushion the thin or damaged fat pad of the heel, while also supporting and realigning the arch of the foot.

Cost-effective Heel Seats, which use patented Fascia-Bar Technology to lift the arch to the optimal level while applying targeted acupressure and cushioning to the heel for pain relief, actually encourage the heel’s own fat pad to regenerate naturally. Without constant strain and impact reinjuring the area, the body can regenerate your natural fat cushion!

Taping can also be a great way to stabilize and reduce pain in the heel when the fat pad is damaged, and icing can help bring down inflammation and pain associated with flare-ups.

As with most conditions that result from overuse and strain, resting your feet as much as possible while you heal can also help your body rebuild and repair your heel fat pad.

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