What is Heel Fat Pad Atrophy?

What is Heel Fat Pad Atrophy?

Heel fat pad atrophy is a condition that is characterized by the thinning or degeneration of the fat pad located in the heel area of the foot. The fat pad acts as a natural cushioning and shock-absorbing structure, protecting the heel bone and surrounding tissues from excessive pressure and impact during walking, running, and other weight-bearing activities. The loss of that natural cushioning and shock absorption mechanism from the atrophy of the fat pad can result in a number of symptoms.

This atrophy could be a normal physiological process (eg aging) or a pathological process from things like repeated trauma or a disease process such as rheumatoid arthritis.

The typical symptoms of heel fat pad atrophy is just increasing pain under the heel from the lack of cushioning. People often complain of feeling like they are walking on the bone. On palpation the plantar area of the heel bone feels very prominent.

The best way to treat heel fat pad atrophy is to “replace” the fat. This can be done in one of two ways:

  1. Using heel cushioning heel pad or cushioning insoles of a similar density to the fat pad in the shoes (“external fat pad replacement”)
  2. Surgical replacement, either as a graft or with artificial material (“internal fat pad replacement”)

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