Foot Fat Pad Atrophy & Augmentation [Causes & Best Home Treatment]
Foot Fat Pad Atrophy and Augmentation – If the foot fat pad degenerates, 95% of the time your pain is due to the bones not being cushioned enough!
- One of the top causes of heel pain is plantar fasciitis, this is damage to a ligament that holds your heel to your toes.
- There are also photos of heel spurs that can occur to the bottom of your heel (plantar fascia insertion) and the back of your heel (Achilles tendon insertion).
- Baxter’s nerve entrapment can also happen at the bottom of the heel.
- An underlying cause is an over pronated flatfoot, or an over supinated high arched foot.
- This can lead to the formation of a heel stress fracture( AKA calcaneus stress fracture.
Please click on the gallery for a guided tour through heel pain conditions!
Foot Fat Pad Atrophy and Augmentation – If the foot fat pad degenerates, you will need to try and cushion it to relieve the gradual aching pain!
- Between the heel bone and the skin at the bottom of the feet is a thick layer of cushioning fat.
- There is also a fat pad in the ball of your feet.
- Fat pads in these two regions are necessary to cushion your heel strikes and push off.
- It is possible for this fat pad to degenerate over time and due to age and overuse.
- Normally they are 1 inch thick in the heel, but get much thinner over time.
- It will feel like you are walking on bone.
- There are numerous treatment options such as using shoes and cushions conservatively.
- Surgical options include fat pad augmentation surgery to restore cushion to your heel.
- Also known as Foot Fat Pad Syndrome.
- Pain under the heel while walking barefoot on a hard surface.
- Pain under the metatarsal heads when walking on a hard surface.
- It feels like a dull ache in the center of the heel.
- It is possible to feel the heel bone with your fingers through the fat pad.
- If it feels like hardly any cushion, atrophy is more likely than fasciitis.
- The pain in your heel is worse the more you walk on it.
- If the pain is worse in the morning and before activity, consider plantar fasciitis.
- A loud knocking noise as you walk barefoot on a hard surface.
- This can occur normally due to the aging process.
- Chronic stress over the fat pad can also cause it to shift of degenerate.
- This is most common in high arched people.
- High arches put more stress on the heel and the forefoot.
- The fat pad in the ball of the foot slides forward and does not protect the bone.
- A history of corticosteroid injections is also possible.
- Acute injury.
Fat Pad Atrophy in the Ball of the Foot:
- Same problem as in the heel, but it is present in the ball of the foot
- The metatarsal heads do not get enough cushion.
- This is felt the most during push-off.
Plantar fasciitis heel pad atrophy:
- Atrophy of the heel pad is actually less common than you think.
- Many patients that we see believe that they are having heel pain because of the atrophy of their steel fat pad.
- The reason over 90% of people have heel pain, is not due to heel fat pad loss. This is due to a condition known as plantar fasciitis.
- To make your life easier, and to make sure that you don’t pursue a very difficult and fruitless treatment, simply consider that your heel pain is very very likely plantar fasciitis, unless you and your podiatrist can prove otherwise with imaging.
- Plantar fasciitis is a condition we see 10 times a day or more, and almost everybody thinks that this heel pain is due to pressure and compression against their heel. This is not the case. This is simply where your plantar fascia inserts into the heel, and as it starts to pull out of your bone, and strain, this causes severe pain.
- Click on this link to follow to our plantar fasciitis treatment guide.
Foot Fat Pad Contusion:
- A heel fat pad contusion is known as a heel bruise.
- It is also known as a stone bruise.
- This is named after the most common cause, stepping on a stone!
Plantar Fat Pad Treatment:
Plantar Fat Pad Taping:
- Icing and fat pad taping is possible.
- But this is not an inflammatory condition.
- This is also not a biomechanical condition that requires taping.
- The fat pad taping would most likely only have a placebo effect.
Foot Fat Pad Conservative Treatment:
- Avoid treating this condition like plantar fasciitis.
- This is a non-inflammatory condition like plantar fasciitis.
- It gets worse with increased weight bearing, whereas plantar fasciitis gets better with movement.
- Plantar fasciitis is helped by wearing rigid orthotics that help control overpronation; fat pad atrophy requires cushioned gel insoles and heel pads.
- The best thing to do conservatively is to get some well cushioned running shoes.
- Add gel heel inserts or full length gel insoles into those shoes.
- See a Podiatrist to rule out heel bursitis.
Procedures For Restoring the Plantar Fat Pad:
- There are many different surgical treatments for atrophy of the plantar fat pad. These are gaining momentum, and some of the treatments are worthwhile.
- Some people have historically believed that these were cosmetic treatments, but we definitively know firsthand that this can cause severe pain as you are standing and walking for long periods of time.
- This type of surgery is known as restoring your cushioning, providing a filler, and restoration of fat pad treatments. These types of treatments are considered newer, and unfortunately are not covered by insurance as it is currently described.
- Here we will go over the types of treatments that are available:
- Changing your shoes and patting your feet is definitely annoying but there is no doubt that this is by far the most effective treatment.
- It’s amazing how many times people have come in doubting that orthotics or shoes will work for them, only to come back a couple weeks later saying that 100% of their foot pain has essentially gone away. You have to trust your experience in this case, this works almost every single time!
- If for some reason you have to wear high heels or a very impressive looking shoe for work, this is where you can start looking for other options.
Plantar fat pad surgical options:
- There are three main options to augmentation of the plantar fat pad:
- These three options are injections, the second option is the use of a foreign substance called in allograft, the last is transplanting fat from one part of your body into your feet.
Injectable fillers for foot fat pad:
- These have used for many decades, unfortunately this is not necessarily considered proven treatment and are considered off label.
- There are some offices that do this is a cash pay, but this is not something that’s is covered by insurance.
- There is less overall downtime to this, and they can probably done in the office, but at the same time it is not the most studied or proven thing even though some people do swear by it.
Foot Fat Pad Augmentation Surgery:
- A small incision is made and the tissue matrix is packed in.
- This can be done in the heel.
- It can also be done in the ball of the foot.
- The goal of this tissue matrix is to create a spongy scaffold that your body will incorporate.
- This will become your new “foot fat pad”.
- The procedure could have you back on your feet within 2-3 weeks.
- This is an effective procedure and the thickness of the fat pad is increased.
- Studies show no risk beyond the usual risks of undergoing surgery with no evidence of graft rejection.
Allograft for foot fat pad:
- This is generally a graft matrix sheet.
- This is the surgical process where an incision is made on the bottom of your foot in the graft is installed.
- Once more some people do swear by this, but you are looking at about 6 to 8 weeks of recovery time, without necessarily guaranteed or proven results.
- This is considered more experimental surgery, and it is generally not something covered by insurance.
Transplantation of your own fatty tissue:
- This is something called autolipotransplantation, talk about this is a procedure where you harvest fatty tissue from one site, usually your thigh or your abdomen, and that it is transplanting the bottom of your foot.
- Some plastic surgeons have been known to perform this procedure, but again the research is important was considered more of an experimental procedure.
Foot Fat Pad Augmentation:
- This is a surgical procedure which attempts to implant a “substitute” tissue.
- The ideal tissue substitute would not interact with your body, but would cushion the atrophied area.
- The most common material used is graft jacket.
- Biotape is also possibility.
- These are both tissue matrices.
- Think of them as a scaffold that allows fat pad and healthy tissue to grow into.
- This is similar to a sponge, that is eventually filled in.
- These grafts are acellular, meaning little chance of graft rejection.
Graft Jacket Fat Pad Augmentation:
- Graft Jacket is a human dermal collagen template that is readily incorporated into the body.
- The matrix a process that renders that material essentially acellular.
- It is freeze dried with a process that prevents the formation of ice crystals to preserve the intact matrix including vascular channels.
- Graft Jacket Matrix contains collagen, elastin, hyualuronan, fibronectin and proteoglycans.
- For click here more on this type of treatment
Good Luck with your Foot Fat Pad Atrophy and Augmentation!
Best Heel Pain Products:
- There are usually two phases to treating plantar fasciitis pain.
- The two phases of treatment include controlling the acute inflammation, and correcting the biomechanics which led to the problem in the first place.
- If the tendons and ligaments are inflamed, they are almost frozen in place and cannot function properly.
- Once the inflammation is decreased, we need to correct the bio-mechanical causes to ensure that they can never become over worked and inflamed again!
- This doesn’t matter whether it’s plantar fasciitis, plantar fibroma, sore bottom of foot, or even Achilles tendon pain. Treatment is all roughly very similar.
Plantar Fasciitis or Achilles Tendonitis Inflammation:
Massage & Ice Products:
- Ice is the an excellent option that can be safe for almost everyone.
- There is some debate whether icing is worth doing, but for chronic pain this can help limit the need for medications and keep your options open.
- This works great for your arch, less for the ball of the foot.
- The more muscle and ligament tissue there is, the better ice will work there.
Menthol Based Gels:
- Biofreeze is one of our favorites.
- These gels have been studied to work 2x as long as ice.
- This works great for the ball of the foot.
- This can be very effective for bottom of the heel and Achilles tendon sore regions.
- These can work great for loosening your muscles.
- This allows less tightness and pressure on the ball of your foot.
- This is very effective for the arch, the gastrocnemius or calf muscle and for the hamstring and thigh muscles.
- This also works very well for the gluteus muscles if you are having butt cheek or hip pain.
Remove the Plantar Fascia or Achilles Tendon Stress:
- The key is to prevent future pain.
- This means keeping you active while keeping stress off of your plantar fascia tendon. This will prevent future re-injury and development of plantar fasciitis.
- If you can get rid of the pain and swelling, this will let you start walking normally.
- If you can walk normally, the vast majority of your pain should gradually start to go away.
- The best way to ensure that your plantar fascia, foot and ankle ligaments are not overworked is to support them.
- The best way to support them is to use great orthotics and great shoes.
- Some people may also need to rely on supportive ankle braces and other supportive modalities.
The Best Heel Pain & Plantar Fasciitis Shoes:
- Getting a great supportive pair of shoes will make sure that there is pressure removed from the heel and plantar fascia region.
- This is especially important if you have plantar fasciitis, heel spur pain or Achilles tendonitis.
- Consider shoes combined with a good supportive orthotic for best pain relief!
- The following link will show you what our favorites are.
Best Heel Pain & Plantar Fasciitis Orthotics:
- These are our recommended orthotics for plantar fasciitis.
- Custom orthotics can work very well, but they should not be a first line of treatment.
- There are different types for different shoes.
- Women’s shoes usually need a less bulky orthotic, but allow for less correction.
- A full length orthotic requires a running shoe, boot or comfortable walking/dress shoe.
- We recommend doing everything you can to get a good supportive shoe that can fit a full length orthotic.
- This is the best way to maximize your orthotics for great results.
Best Full Length Orthotics:
- These will only work in wider shoes or a good supportive running shoe.
- This will not work in sandals, flats or most women’s dress shoes.
Best Dress Shoe Orthotics:
- These are a great choice for dress orthotics.
Best 3/4 Length Orthotics:
- These are great options for women’s dress shoes and thinner shoes.
- These are not the most supportive pair of orthotics.
Get A Great Dynamic Stretch:
- It is possible to stretch on your own, but these products can also really help!
- This will take pressure off of the ball of your foot.
- We personally prefer this method of stretching.
Get A Great Static Stretch:
- These devices are great for stretching while you are resting.
- This will also help take pressure off of the ball of your foot.
- This works great for plantar fasciitis.
- It can be used while watching TV or at night time.
Best Heel Compression Brace:
- A good compression brace can stabilize your foot from turning outward.
- This prevents your foot from pronated.
- Pronated foot will turn your foot outward in your foot will rub on the outside of the shoe.
- For many of her patients this has solved their pain and is very comfortable to wear inside your shoe.
- This solves both pain and outward pronation for a relatively low cost.
Best Heel Stability Brace:
- Stability brace goes little bit further than the compression brace to stop your foot from turning out.
- This takes pressure off of your heel and plantar fascia.
- At the same time this is a little bit bulkier and does not affect every shoe.
- We find people are little bit happier trying the compression brace before the stability brace.
- If you think you might have a broken heel, a calcaneal stress fracture or something of similar severity, these products might help!
- Always remember to see a foot and ankle specialist like a podiatrist if you are having plantar fasciitis or more severe pain!
Plantar Fascia Tear, Broken Heel Bone, Achilles Tendon Tear:
- If you have a traumatic injury such as a torn plantar fascia ligament, calcaneus stress fracture, heel fracture or insertional Achilles tendon injury: consider protecting your foot!
- The best way to do this is of course to see your podiatrist and get evaluated with an x-ray, ultrasound and potentially even an MRI or CT scan.
- If you are unable to do so it may benefit you to be in a cast, fractured boot, or even keep the weight off of it with a rolling knee scooter or other protective devices.
- We as podiatrists frequently take patients off work for very long period of time when they suffer a traumatic injury, unfortunately there is no other way around us in labor jobs.
- If you have a sit down job there are ways to get people back to work quicker, but this can be very difficult otherwise.
Heel Injury Boot Treatment:
- There are pros and cons to using a boot to treat your heel injury. If you are immobilized too long the cons are that you will gradually become stiff and overworked to your other leg. The Pros are that you injured heel will hopefully have a chance to gradually heal!
- Our favorite fracture boots and their supplies:
Offloading and Scooter treatment:
- These are favorite knee scooters and walking devices: