Under the plantar surface of the heel is a fat pad that normally cushions us and guards us as we walk. When walking, we have a force comparable to around 2.5 times our weight on the heel during heel strike, so it should be obvious why we require that fat pad. Not having that fat pad there would certainly be inadequate shock reduction and this can lead to several conditions due to that inadequate cushioning. The commonest is simply soreness under the heel bone. The pain will largely be present on weightbearing and not so much on palpation. This may not be a common explanation for heel pain, however it is a vital one as it may often be wrongly identified as plantar fasciitis as well as other causes. Typically it is not hard to identify as there is just not any cushioning beneath the rearfoot and you can easily feel the bone.
The causes of fat pad atrophy aren't totally understood. The fat pad does atrophy as we grow older normally and in many it simply wastes away more quicker. Many people just seem to develop this while others do not. It is not connected with bodyweight concerns. It could happen in numerous arthritis problems and runners as a result of years of beating on the heel could very well be at a higher risk for this. People who have a higher arch foot (pes cavus) will also get a displacement of this fat pad which might make a similar issue to the atrophy.
The only method to manage fat pad atrophy is to replace the fat or substitute for the fat. This may be inserted in surgically or a cushioning heel pad in the footwear used that features a equivalent uniformity to the atrophied fat pad. Cushioned footwear can also be used without or with extra padding. Surgically this can be an injectable fillers or an autograft making use of your own fat cells.