Do our feet lose padding as we get older. What causes fat pad atrophy in feet. How can we identify signs of foot padding loss. What are effective treatments for lost foot padding.

Understanding Foot Padding and Its Importance

Our feet play a crucial role in our daily activities, absorbing significant pressure with each step we take. The heel alone absorbs three times our body weight, transferring pressure to the balls of our feet as we walk. To cope with this repeated stress, our feet are equipped with thick fat pads under the skin of our heels and metatarsals (the ball of the foot).

These fat pads serve as natural shock absorbers, cushioning the impact of our feet striking the ground. On an average day, our feet bear a collective load of hundreds of thousands of pounds, with the total force absorbed reaching around 26,000 pounds. This load increases substantially during high-impact activities like running or when wearing high heels.

The Function of Fat Pads in Feet

• Absorb shock from walking and running
• Protect bones and soft tissues from impact
• Distribute pressure evenly across the foot
• Provide comfort during movement

Fat Pad Atrophy: Definition and Implications

Fat pad atrophy refers to the gradual loss of the fat pad in the ball or heel of the foot. This condition results in the thinning of the fat layer, exposing sensitive connective tissues to increased strain and pressure. The loss of this natural cushioning can lead to persistent pain and discomfort, potentially impacting one’s quality of life.

According to Dr. Samuel Russ, a foot and ankle surgeon at Summit Orthopedics, our feet can indeed lose padding as we age. This loss can occur in both the heel fat pad and the padding underneath the metatarsals, affecting our comfort and mobility.

Causes of Foot Padding Loss

Several factors contribute to the loss of foot padding over time. Understanding these causes can help in prevention and early intervention.

Age-Related Atrophy

One of the primary reasons for foot padding loss is age-related atrophy. As we grow older, the fat pads in our feet naturally thin out, reducing their shock-absorbing capabilities.

Medical Treatments

Certain medical interventions can inadvertently lead to fat pad loss. For instance, individuals who have received multiple injections in the heel to treat plantar fasciitis may experience a reduction in padding.

Chronic Overloading

Persistent overloading of specific areas of the foot can cause fat pad atrophy. This can result from various factors:

• Regular use of high-heeled shoes
• Being overweight or obese
• Engaging in high-impact activities frequently

Dr. Russ notes that chronic overloading of the ball of the foot can lead to conditions like hammertoes. These deformities can cause the fat pad to shift towards the toes, leaving less padding in the weight-bearing area.

Recognizing the Signs of Foot Padding Loss

Identifying the symptoms of fat pad atrophy early can help in seeking timely treatment. Here are some common signs to watch out for:

1. Pain in the affected area (heel or ball of the foot)
2. Development of thick calluses on the heel or ball of the foot
3. Increased sensitivity when walking on hard surfaces barefoot
4. Feeling the bones within your feet more easily
5. Discomfort or pain when wearing high heels
6. Persistent foot pain despite regular pedicures

Diagnosis of Fat Pad Atrophy

If you suspect you’re experiencing fat pad atrophy, it’s essential to consult a podiatrist or orthopedic specialist. They can provide a proper diagnosis through various methods:

Physical Examination

A healthcare professional will examine your feet, looking for signs of fat pad thinning, callus formation, and any visible foot deformities.

Imaging Tests

X-rays or MRI scans may be used to assess the extent of fat pad loss and rule out other potential foot conditions.

Gait Analysis

Observing how you walk can help identify any alterations in your gait that might be contributing to or resulting from fat pad atrophy.

Treatment Options for Lost Foot Padding

While fat pad atrophy, especially in the heel, can be challenging to treat, several options are available to manage the condition and alleviate discomfort.

Conservative Treatments

Initial treatments often focus on non-invasive methods to provide relief:

• Shoe inserts or orthotics
• Heel cups
• Gel pads for additional cushioning
• Calf stretching exercises

Dr. Russ emphasizes the importance of calf stretching, noting that tight calf muscles can alter the heel strike, causing you to land on the area with the least padding. Stretching can help restore comfort by improving the distribution of impact.

Footwear Modifications

Choosing appropriate footwear can significantly impact comfort levels for those with fat pad atrophy:

• Shoes with extra cushioning
• Avoiding high heels or shoes with minimal support
• Using custom-made shoes if necessary

Surgical Interventions

In severe cases where conservative treatments prove ineffective, surgical options may be considered:

• Heel cord lengthening to address severe heel pain
• Correction of foot deformities causing fat pad displacement
• Fat grafting procedures to restore padding

It’s important to note that surgical interventions are typically considered as a last resort when other treatments have failed to provide relief.

Preventing Fat Pad Atrophy

While some degree of fat pad loss may be inevitable with age, there are steps you can take to minimize its impact:

Maintain a Healthy Weight

Excess body weight increases the pressure on your feet, potentially accelerating fat pad atrophy. Maintaining a healthy weight can help preserve your foot padding.

Choose Appropriate Footwear

Opt for shoes that provide adequate support and cushioning. Limit the use of high heels and avoid going barefoot on hard surfaces for extended periods.

Practice Good Foot Care

Regular foot exercises, proper hygiene, and moisturizing can help maintain overall foot health and potentially slow down fat pad loss.

Manage Underlying Health Conditions

Certain health conditions, such as diabetes, can affect foot health. Properly managing these conditions can help prevent complications that might lead to fat pad atrophy.

Living with Fat Pad Atrophy: Lifestyle Adjustments

For individuals dealing with fat pad atrophy, making certain lifestyle adjustments can significantly improve comfort and quality of life:

Activity Modifications

Consider low-impact exercises like swimming or cycling instead of high-impact activities that put excessive strain on your feet.

Regular Foot Care Routine

Implement a daily foot care routine that includes gentle massage, moisturizing, and inspection for any signs of injury or irritation.

Stress Management

Chronic stress can exacerbate pain perception. Engaging in stress-reduction techniques like meditation or yoga may help manage discomfort associated with fat pad atrophy.

Dietary Considerations

While no specific diet can cure fat pad atrophy, consuming foods rich in vitamins and minerals that support overall foot health may be beneficial. These include:

• Vitamin C for collagen production
• Omega-3 fatty acids for inflammation reduction
• Calcium and Vitamin D for bone health

The Future of Fat Pad Atrophy Treatment

As medical research advances, new treatments for fat pad atrophy are being explored:

Regenerative Medicine

Stem cell therapy and platelet-rich plasma (PRP) injections are being studied for their potential to regenerate fat pad tissue.

Advanced Orthotics

Developments in 3D printing and materials science are leading to more effective, personalized orthotic solutions for individuals with fat pad atrophy.

Minimally Invasive Surgical Techniques

Researchers are working on refining surgical procedures to make them less invasive and more effective in addressing fat pad loss.

While these treatments show promise, more research is needed to establish their long-term efficacy and safety. Always consult with a healthcare professional before considering any new or experimental treatments.

When to Seek Professional Help

If you’re experiencing persistent foot pain or discomfort, it’s crucial to consult a podiatrist or orthopedic specialist. They can provide an accurate diagnosis and recommend appropriate treatment options. Seek medical attention if you notice:

• Chronic foot pain that doesn’t improve with rest
• Difficulty walking or performing daily activities due to foot discomfort
• Visible changes in foot shape or structure
• Recurring calluses or ulcers on the feet

Remember, early intervention can often lead to better outcomes and prevent the progression of foot-related issues.

Understanding fat pad atrophy and its impact on foot health is crucial for maintaining mobility and quality of life as we age. While some degree of padding loss may be inevitable, proper foot care, appropriate footwear choices, and timely medical intervention can help manage symptoms and prevent further complications. By staying informed and proactive about foot health, we can take steps towards ensuring our feet remain comfortable and functional throughout our lives.

Do Our Feet Lose Padding as We Get Older?

Summit Orthopedics foot and ankle surgeon Samuel Russ, M.D., gives his insight into how feet can lose foot padding over time and what we can do about it.

Our feet work hard for us as we go about our daily activities. With every step, our heels absorb three times our body weight and transfer some of that pressure to the balls of our feet as we prepare to take the next step. To deal with this repeated pressure, our feet have thick pads of fat under the skin of our heels and our metatarsals (the medical term for the ball of the foot). But what happens if those fat pads thin out? Do our feet lose padding as we get older?

The short answer, according to Summit Orthopedics foot and ankle surgeon Samuel Russ, M.D., is yes. “People can lose padding in the heel fat pad, which is important for absorbing the heel strike as you walk,” Dr. Russ said. “They can also lose padding underneath the metatarsals. That’s important for when you toe off at the end of each step. ”

Why we lose foot padding

There are a few reasons that our feet might lose padding over time. “Some of it is age-related atrophy,” Dr. Russ said. If an individual has had many injections in the heel to treat plantar fasciitis, that could lead to a loss of padding as well.

Another potential cause is chronic overloading in the ball of the foot. This can happen for a variety of reasons, everything from wearing high-heeled shoes every day to being overweight. “People who chronically overload the ball of their foot can get hammertoes,” Dr. Russ said. “That condition can draw the fat pad toward the toes, leaving less padding in the area that takes the weight.”

Signs of loss of fat padding in the heel or ball of the foot include pain in the affected area, development of thick calluses on the heel or ball of the foot, and feeling the bones within your feet more easily.

Ideas to treat loss of foot padding

Heel fat pad atrophy can be a tough problem to treat. Treatment options include shoe inserts, heel cups, or gel pads to add some cushion in the shoe.

Another effective treatment is stretching the calf. “Most people have tight calf muscles,” Dr. Russ said. “This can alter your heel strike so you strike your heel in the place where you have the least padding. Stretching the calf back out can be helpful in restoring comfort.”

If these nonsurgical options are not effective and the pain is severe, a foot and ankle surgeon may be able to perform surgery to lengthen the heel cord and help address the issue.

For fat pad loss in the ball of the foot, treatment options include an orthotic device to offload that area as well as calf stretching. “If the heel lifts off before it should because the calf is tight, that puts more load on the ball of the foot,” Dr. Russ said.

If there is an overarching foot deformity causing the fat pad to move out of place, correcting the problem surgically is also an option.

More resources for you:

• Meet Dr. Russ in this introductory video.
• Learn how to avoid developing foot problems.
• Check out part 1 and part 2 of our “Why Do My Feet Hurt?” series.
• Learn how our footprints can indicate foot health.
• Watch this video on the difference between foot sprains and fractures.
• Take a look at this common foot and ankle sports injuries video.

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No Fat on the Bottom of Your Feet? What You Need to Know About Fat Pad

Do your feet feel painful after you walk on a hard surface without shoes? Are high-heels completely out of the question due to intense pain? Do you always seem to have calluses, regardless of how many pedicures you get? If so, you might have fat pad atrophy.

Losing fat is often the topic of conversation on health blogs for reasons like improved health, better cardiovascular fitness, boosted confidence, and more. But in the case of fat pad atrophy in the feet, that isn’t the case. In fact, when you lose the fat on your feet, you are faced with persistent pain that can prevent you from living a happy and fulfilling life.

Today we’re going to do a deep dive into fat pad atrophy. What is fat pad atrophy? Why is there fat on the bottom of your feet? What are the symptoms and causes of this condition? And finally, what you can do about it.

What is fat pad atrophy?

Fat pad atrophy is the gradual loss of the fat pad in the ball or heel of the foot. This thinning of the fat exposes the sensitive connective tissues to strain and pressure. It’s essential to have fat pads on the feet, because these act as cushioning to soften the impact of your feet hitting the ground every day.

During a typical day, your feet bear the collective load of hundreds of thousands of pounds. On average, your feet absorb a total force of 26,000 pounds. Wearing high heels or doing high-impact exercise like running drastically increases the total amount of force your feet absorb.

The fat pad in the foot is a thick layer that lies on the plantar surface, cushioning the forefoot and heel when it makes contact with the ground. This function is necessary, helping to shield the feet from damage and repeated stress.

When plantar fat pad atrophy occurs, it can be devastating. Inflammation and micro-tears occur. This leads to intense pain and confusion, as oftentimes, the source of the pain isn’t clear. Severe atrophy can prevent you from walking or standing on your feet for long periods of time, because the impact is taking its toll.

Fat pad atrophy is often associated with heel pad syndrome. This is a pain that occurs in the center of the heel, but is due to fat pad atrophy. Heel pad syndrome can present alongside plantar fasciitis.

What does fat pad atrophy feel like?

● Pain under the heel or ball of the foot

● Difficulty walking on a hard surface without shoes

● A burning sensation

● Dull ache

● A sensation that you are stepping on pebbles

What are other symptoms of fat pad atrophy?

Aside from the aforementioned symptoms associated with pain, fat pad atrophy is linked to other symptoms. For example, if you have chronic calluses on your feet, it may be indicative that the fat is thinning. In the case of heel pad syndrome, if you have been diagnosed with plantar fasciitis, this can be connected to fat pad atrophy.

Many people with this condition have reported a feeling that they are walking “directly on the bone” and even hearing the bone make contact with the ground with each step. As unpleasant as this sounds, it’s a tell-tale indicator of fat pad atrophy.

You may be asymptomatic. You may only consider there to be an issue after performing high-impact exercise or standing on your feet for an extended period of time. If this sensation occurs, don’t ignore it, to prevent it from getting worse.

What are the risk factors for fat pad atrophy?

● Obesity – The increased load from excess body weight can cause the fat pad to lose its protective resiliency.

● Plantar fasciitis – Studies show that having plantar fasciitis is linked to a thinner metatarsal fat pad.

● Rheumatoid arthritis (RA) – RA is associated with atrophy of the muscles, cartilage, bones and fat tissue, caused by inflammation. This happens all around the body, and the feet are no different.

● High-impact exercise – High-impact exercise like running or jumping can cause the thinning of fat pads over time. This aggravates the foot, and can exacerbate the loss.

● Wearing high-heels – Wearing high-heels shifts your weight to the front of your weight, placing excessive mechanical stress and pressure on the balls of your feet. In general, wearing poorly cushioned shoes can also exacerbate this condition.

How to treat fat pad atrophy

The first point-of-call is to meet with a podiatrist to get the condition diagnosed. If fat pad atrophy is severe, it will require medical intervention to treat it most effectively.

If you want to try and treat this condition yourself, the first thing you need to do is to replace the fat pad with shock absorption from the outside of the foot. In short, wear better shoes. Look for shoes with added cushioning. This will give your feet the support they need so the wearing down of the pads starts to halt. This may give your feet the chance to repair themselves naturally, rebuilding the fat tissue that has been lost.

Wearing orthotics or shoe inserts is a go-to treatment for many podiatrists. As stated by John Steinberg, DPM, chief of podiatric surgery at Medstar Georgetown Hospital in Washington, DC. “Conservative treatment can be quite successful; it can ease pain and prevent symptoms from getting worse.” Simply getting insoles for your shoes that you wear on a daily basis can help to give your feet a break, to repair. Click here to shop for custom insoles.

Steinberg can be quoted again to say, “Patients with heel fat pad atrophy often do well with viscoelastic orthotic devices, heel cushions, and heel cups—and any material that has at least 3 to 5 mm of cushion.” The goal is to give your feet what they are lacking – cushioning! They

don’t have to be ugly orthopedic shoes either – check out the fashionable range of shoes

In severe cases, you may have to treat fat pad atrophy with fat grafting. While it is effective, most patients prefer to use this as a last resort.

without statute of limitations e-mail.indd

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