Foot Fat Pad Atrophy and Augmentation

Foot Fat Pad Atrophy & Augmentation

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!



Foot Fat Pad Atrophy and Augmentation
Foot Fat Pad Atrophy and Augmentation

Plantar Fat Pad Atrophy:

  • 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.


Plantar Fat Pad Atrophy
Plantar Fat Pad Atrophy is very commonly caused by cavus or high arched feet. This is because all the weight is concentrated on the heel and the metatarsal heads.

Causes Of Plantar Fat Pad Atrophy:

  • 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.
  • Diabetes.
  • Smoking.


Causes Of Plantar Fat Pad Atrophy
Causes Of Plantar Fat Pad Atrophy include aging, smoking and diabetes. Increased weight, overuse and cavus feet also increase the odds.


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.
Plantar Fat Pad Taping
Plantar Fat Pad Taping is only effective in that if provides cushion at the bottom. Use a gel insert and good shoes instead.

Symptoms of Plantar Fat Pad Atrophy:

  • 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.


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.



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!

Jump To Our Heel Bruise Or Stone Bruise Guide.


Foot Fat Pad Treatment
Foot Fat Pad Treatment is largely dependent on good cushioning. Get a good pair of shoes and some gel inserts.


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.



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.


Foot Fat Pad Augmentation
Foot Fat Pad Augmentation is usually performed with a collagen tissue matrix inserted under the heel or ball of foot. This adds extra padding & tissue can grow in.


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.


Foot Fat Pad Atrophy Augmentation Surgery
Depending on the site of the incision, you will be in a surgical shoe for 2-3 weeks most likely.


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.


Good Luck with your Foot Fat Pad Atrophy and Augmentation!