Fat Pad Syndrome
Fat Pad Syndrome occurs when the natural cushioning on the bottom of your foot becomes thinner, displaced, or less effective. This cushioning, known as the plantar fat pad, sits under the heel and ball of the foot and acts as a shock absorber. When this padding wears down or shifts out of place, the bones beneath are left with less protection. It can feel like a deep, aching or bruised sensation under the foot, particularly when walking on hard surfaces or spending long periods on your feet.
What Causes Fat Pad Syndrome to Develop?
- Age-related changes: As we age, the fat pads under our feet naturally lose thickness and elasticity, reducing their ability to absorb impact.
- Footwear habits: Shoes with minimal cushioning, thin soles, or poor shock absorption, such as thongs, ballet flats, or worn-out soles, can accelerate fat pad breakdown.
- High-impact activities: Repetitive stress from running, jumping, or long hours of walking, especially on hard surfaces, can strain the fat pad over time.
- Foot structure: People with high arches or certain biomechanical patterns may place extra pressure on specific areas of the foot, increasing wear on the fat pad.
- Previous injuries: Trauma such as a hard fall onto the heel or repeated micro-injuries can damage the fat pad or cause it to shift out of its normal position.
- Weight changes: Increased body weight can place additional load on the foot, leading to degeneration of the fat pad.
- Medical conditions:
Conditions like diabetes or inflammatory joint disorders may affect tissue quality and foot mechanics, increasing susceptibility.
How Does Feet Option Podiatry Treat Fat Pad Syndrome?
After carefully assessing your foot posture, walking pattern, footwear choices, activity levels, and symptoms, our podiatrists develop a personalised management plan to reduce pain and protect your feet long-term. Imaging, such as ultrasound or X-rays, may be used if needed to rule out other causes of foot pain. Treatment options may include:
- Footwear advice: Recommending shoes with proper cushioning, shock absorption, and appropriate soles to reduce pressure on sensitive areas.
- Orthotic therapy: Custom orthotics or specialised insoles designed to redistribute pressure away from painful zones and support healthier foot mechanics.
- Padding and offloading techniques: Strategically placed cushioning or heel cups to provide extra protection and help keep the fat pad in the correct position.
- Activity modification: Guidance on adjusting exercise routines or daily habits to minimise repetitive impact while symptoms settle.
- Strengthening and conditioning exercises: Simple exercises to improve foot stability and reduce excessive loading through painful areas.
- Pain and inflammation management: Advice on icing, topical treatments, or suitable pain relief options to help manage discomfort during flare-ups.
- Injection therapy (when appropriate): In some cases, targeted injections may be considered to help calm inflammation and relieve pain.
- Referral for advanced care: If symptoms persist despite conservative treatment, your podiatrist may discuss further investigation or referral options.
Suspecting You Have Fat Pad Syndrome?
If you’re noticing ongoing soreness under your heel or the ball of your foot, especially pain that worsens on hard floors or barefoot, it’s worth getting it checked sooner rather than later. Ignoring symptoms can lead to compensation patterns, which may cause pain elsewhere in the foot, ankle, or lower limb. In the meantime, avoid unsupportive footwear, limit barefoot walking, and give your feet regular breaks when possible. Early care can make a big difference in managing symptoms and maintaining comfort.
