What might cause the fat pad under the heel to atrophy?

Beneath the bottom of the rearfoot is a fat pad that naturally cushions us and protects the heel as we walk. When walking, you will find a force comparable to nearly 2.5 times body weight on the heel during heel strike, so it ought to be obvious why we need that fat pad. Without that fat pad there would likely be inadequate shock reduction which may result in a number of conditions because of that inadequate shock absorption. The commonest is simply pain under the heel. The pain sensation will mostly be there on weightbearing and not so much on palpation. This may not be a common reason for heel pain, but it is an important cause because it can often be wrongly identified as heel spurs and other reasons. Usually it is not difficult to diagnose as there is just virtually no cushioning under the heel and you will easily notice the bone.

The causes of fat pad atrophy are not totally clear. The fat pad does atrophy as we grow old naturally and in many it just atrophies more at a faster rate. Some people just seem to develop this while others will not. It's not linked to bodyweight issues. It might occur in a number of arthritis problems and athletes because of the years of hitting on the rearfoot can be at a higher risk this condition. People with a higher arched foot (pes cavus) also get a displacement of this fat pad which might give a similar problem to the atrophy.

The only method to manage fat pad atrophy will be to replace the fat or substitute for the fat. This could be inserted in surgically or a cushioning heel pad in the shoes used that has a comparable uniformity to the missing fat pad. Padded shoes could also be used without or with extra cushioning. Surgically this can be an injectable fillers or an autograft using your own fat tissue.

Common causes of pain on the top of the foot

Running is not always a pain free sport and as much as 75% of runners could possibly get an injury each year. More frequently that not that exercise related injury is not really enough to prevent them exercising and they generally simply have to back off somewhat and use some minimal treatments to let it get better. Sometimes the overuse injury is serious enough that this makes the runner to give up on the running. There are many different injuries that may happen to runners, impacting on numerous areas of the lower limb. One of the most frequent injuries is what has become known non-technically as “top of foot pain” or ToFP. Clinically this is known as dorsal interosseous compression syndrome. This is an exercise related injury that causes pain on the top of the foot, typically around the highest point of the arch of the foot. This generally occurs in barefoot runners as well as runners who have a tendency to forefoot strike as opposed to heel strike first when they are running. Running in this way is likely to try and force the front foot upwards on the rearfoot producing the jamming of the bones of the dorsum of the foot, causing the pain in that location.

At first it is managed with ice to deal with the inflammation and maybe anti-inflammatory drugs to settle it down. The majority of runners will have to reduce their weekly distances run to also help settle it down. The easiest method to take care of this is to use more of a heel strike when running and make use of foot supports to maintain the arch up so the jamming in the midfoot does not happen. Even though the alteration of running technique could very well be a good way to help this, it is not easy to perform, which is frequently avoided originally to try and address the problem without doing that. If the other approaches do not work, then a change in the running technique is most likely indicated.