Fat Pad Syndrome Treatment | Mona Vale Osteopath
Heel fat pad syndrome is a common cause of pain underneath the heel and is often mistaken for plantar fasciitis. Unlike plantar fasciitis, which typically causes pain near the inside of the heel, fat pad syndrome usually causes pain directly beneath the centre of the heel where the body's weight is absorbed during standing and walking.
At Helix Recovery, we'll determine whether your symptoms are arising from the heel fat pad or another structure before developing an individualised treatment plan.
What is Fat Pad Syndrome?
The heel fat pad is a specialised cushion beneath the heel bone that absorbs impact with every step.
Fat pad syndrome occurs when this cushioning becomes irritated, thinned or less effective at absorbing force. This can result in pain during activities that place repeated pressure through the heel, such as walking, standing or running.
Symptoms may develop gradually over time or follow a direct impact to the heel.
Common Symptoms
Pain directly beneath the centre of the heel
Pain when standing or walking on hard surfaces
Tenderness when pressing into the middle of the heel
Pain that worsens with prolonged standing
Reduced discomfort when wearing cushioned footwear
Pain that is often easier to pinpoint than plantar fasciitis
How We Assess Fat Pad Syndrome
Several conditions can cause pain underneath the heel, making an accurate diagnosis important.
During your assessment, we'll determine whether your symptoms are most consistent with fat pad syndrome or another condition such as plantar fasciitis, a plantar fascia tear or a calcaneal stress injury.
Assessment may include evaluating the location of your pain, walking pattern, foot and ankle movement, calf strength and factors contributing to repeated heel loading.
How We Treat Fat Pad Syndrome
Treatment depends on how long symptoms have been present, their severity and the activities you want to return to.
Management may include:
Osteopathic manual therapy
Shockwave therapy
Progressive exercise rehabilitation
Activity modification and load management
Advice regarding footwear and cushioning
Temporary heel padding or taping where appropriate
Gradual return to walking, running or sport
Shockwave Therapy for Fat Pad Syndrome
Shockwave therapy may be incorporated into your treatment plan to help reduce pain and improve your ability to tolerate rehabilitation. It is used alongside osteopathic manual therapy, exercise rehabilitation and strategies to reduce pressure through the heel.
Common Questions
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No. Although both cause pain underneath the heel, fat pad syndrome typically causes pain in the centre of the heel, whereas plantar fasciitis usually causes pain closer to the inside edge of the heel.
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For many people, shoes with good cushioning or temporary heel pads can reduce pressure on the heel and improve comfort while symptoms settle.
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This depends on your symptoms. Activities that significantly increase heel pain may need to be modified temporarily while maintaining as much activity as comfortably possible.
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Recovery varies depending on symptom severity, activity levels and contributing factors. Many people improve over several weeks with appropriate management, while more persistent cases may take longer.
Ready to Walk Comfortably Again?
Heel pain isn't always plantar fasciitis. An accurate diagnosis is the first step toward effective treatment. We'll identify the source of your symptoms and develop a management plan tailored to your goals.