admin@thefeetpeople.com.au

(07) 3356 3579

BOOK NOW
BOOK NOW

Fat Pad Atrophy

Jump to section

What is fat pad atrophy?
Causes
 Symptoms
 Diagnosis
 Distinguishing fat pad atrophy from other conditions
 Treatment
 FAQs

Fat pad atrophy occurs when the fat pads on the bottom of the foot thin and become less effective at protecting the bones beneath, increasing our likelihood of foot pain and injury.

What Is Fat Pad Atrophy?

We have cushion-like fat pads at the bottom of our heels, as well as the balls of our feet, that are designed to help protect the underlying bones and tissues. They absorb shock and ease the large load placed on our feet on a daily basis. Unfortunately, over time, this protective layer of fat can break down and become thin, or displace forwards, leaving the underlying bones and joints more vulnerable to pressure-related discomfort and pain.

What Causes Fat Pad Atrophy?

The natural ageing process is the most common cause for this gradual fat pad thinning, occurring as the fat content within the pad reduces and structural changes within the connective tissues occur. This diminishes the effectiveness of the fat pad as a shock absorber. Other causes or contributing factors include:

• Repetitive stress and pressure: prolonged periods of standing, walking or other weight-bearing activities, especially on hard surfaces, can accelerate fat pad atrophy
  

• Footwear: shoes with inadequate cushioning or improper support can also exacerbate fat pad atrophy. Shoes that lack proper shock absorption may contribute to increased pressure on the fat pad, accelerating its degeneration
  
• Certain medical conditions such as diabetes, rheumatoid arthritis, or other systemic disorders can affect the integrity of the plantar fat pad, as can certain medications
  

• Trauma or injury: direct trauma or injury to the heel, such as repetitive impact or localised trauma, can lead to the breakdown of the plantar fat pad. This is why it’s not uncommon to see stress fractures at the heel present together with fat pad atrophy. Another cause of trauma can be from surgery on the foot.
  

Fat Pad Atrophy Symptoms

While symptom severity will vary from person to person, thinner fat pads will make our bones more prominent and vulnerable to damage, particularly at our metatarsal heads (at the ball of the foot) and at the heel. As such, most symptoms will occur in these two areas and can include:

• Persistent pain, tenderness or discomfort that may be exacerbated during weight-bearing and may feel like walking on a marble at times
  
• An increased sensitivity to pressure on the bottom of the foot that is noticeable when walking on hard surfaces or wearing shoes with insufficient cushioning
  
• Inflammation at the heels or forefoot
  
• A burning sensation which is also exacerbated by prolonged periods of standing or walking
  
• Calluses and corns may develop as the body responds to increased pressure beneath the foot
  
• Ulcers are more likely to develop in the area, which is a major concern, especially if you have diabetes or neuropathy
  

Diagnosing Fat Pad Atrophy

Your podiatrist can confidently diagnose fat pad atrophy with a clinical exam that involves palpating the heels and soles of your feet to check for prominent bones and damage, as well as getting to know your medical history. If your podiatrist suspects that as a result of your fat pad atrophy there has been damage to the bones or structures in the heel or forefoot, then imaging may be used to better understand the nature of these injuries. Our podiatrists are also able to use pressure mapping to understand how weight is being distributed across your feet and where bony prominences may be putting you at risk of pain and injury.

Distinguishing Fat Pad Atrophy from Other Foot Conditions

There are several conditions that may present with similar symptoms to fat pad atrophy, which is why it’s important to work with an experienced podiatry team that will investigate thoroughly to rule out the alternative causes for your foot pain. These involve plantar fasciitis that produces pain at the bottom of the heel, metatarsalgia, arthritis, tarsal tunnel syndrome and more.

Treating Fat Pad Atrophy

The fat cells in your feet can’t regenerate once the fat pad has broken down, so the goal of your treatment is to both substitute the ‘cushioning’ your feet are now lacking in other ways, while ensuring that the rate of any further fat pad atrophy is not accelerated. Our podiatrists achieve this by:

• Replacing or modifying your footwear: choosing shoes with superior cushioning and support in the right places is an essential part of managing fat pad atrophy. We may recommend that you change certain shoes that you wear on a regular basis - particularly if you’re in flat and firm shoes that offer little shock absorption. If you have shoes that are otherwise structurally sound, we are also able to make modifications directly to your existing shoes to offer you more support and cushioning as needed.
• Custom foot orthotics: these are a fantastic and effective way to provide additional cushioning and support to the heels and balls of the feet. Custom orthotics are prescribed following a very comprehensive assessment, so are tailored to the unique characteristics of your foot and the severity of your fat pad atrophy. They will also help with optimal foot posture and alignment to further support good weight distribution throughout your feet.
  
• Padding and cushions: typically as a temporary measure until your custom foot orthotics are ready, we can use padding inserts into your shoes to help give you some much needed relief and support.
  
• Physical therapy: exercises focused on stretching and strengthening the foot muscles may also be beneficial in promoting optimal foot posture and alignment, and therefore better distribution of forces through the feet.
  
• Activity modifications: until you’re able to have the right support in place for your feet, we may recommend some activity modifications, particularly if you regularly participate in activities like high impact interval training.
  
• Foot mobilisation: is a hands-on therapy for stiff joints that supports optimal movement of the feet, and therefore may help with better weight loading through the feet and reduced pressure through areas of the heel and forefoot.
  
• MLS laser: this treatment is a proven, painless and safe way to help manage a range of pains while reducing any inflammation, helping manage the tender and uncomfortable symptoms that can present with fat pad atrophy.
  

Frequently Asked Questions

Can fat pad atrophy be prevented?

While we can’t prevent the natural effects of ageing, we may be able to slow the start and progression of fat pad atrophy by maintaining a healthy weight, choosing supportive footwear with proper cushioning, and opting for lower impact exercises as opposed to high-intensity repetitive movements.

What is the recovery time after treatment?

As most of the uncomfortable symptoms of fat pad atrophy are associated with having insufficient cushioning in the area, as soon as we are able to provide that using a combination of footwear or orthotics, you should notice an immediate difference. If you have any conditions alongside the atrophy, such as joint inflammation, then it may take several weeks (if not longer) to allow that to heal and return to a minimally painful state.

Are there home remedies for pain relief?

You can start getting some relief before you can make it in to see your podiatrist by applying ice packs to the feet, elevating the feet, and using over-the-counter anti-inflammatory medications. Wear shoes with adequate cushioning both inside and outside of the home.