Heel Pad Syndrome: Causes, Symptoms, Treatment, Diagnoses

Your foot undergoes daily wear and tear, but we often tend to neglect this very important part of our body. Heel pad syndrome is one such condition that can develop due to changes that occur in the elasticity and thickness in your hell pad. It is a condition that is caused by wear and tear of the muscle fibers and fatty tissue that make up the cushioned part known as the pad of the soles of your feet. Here’s everything you need to know about heel pad syndrome.

What is Heel Pad Syndrome?

The heel pad is made up of a thick layer of tissue that is found on the soles of your feet. It is made of a dense pocket of fat that is surrounded by tough, stretchy muscle fibers. So whenever you are walking, jumping or running, your heel pads provide cushioning and distribute your body weight in an even manner. They also absorb shock and provide protection to your bones and joints.

The heels pads are often one of the most ignored parts of your body. Even though we rarely pay any attention to them, your heels actually endure a lot, and this is why it is normal for them to experience wear and tear over a period of time.

However, too much wear and tear are not good for any part of the body, and similarly, too much wear and tear can cause the heel pads to lose their elasticity and shrink in size over time.(1) This makes them less capable of absorbing shock, and they are also unable to provide the same level of protection to your bones and joints. This condition is known as heel pad syndrome.

A person who has heel pad syndrome will find it difficult to stand, walk, and do other day to day activities without experiencing pain, inflammation, and tenderness in either one or both the heels.

Symptoms of Heel Pad Syndrome

The main symptom of heel pad syndrome is deep pain experienced in the middle of your heel. While walking, standing, or running, it is likely to feel like you have a wound or bruise at the bottom of your foot.

When you have mild heel pad syndrome, it might not be noticeable all the time. For example, you may only experience pain when you walk barefoot while running, or while walking on a hard or rough surface. In mild heel pad syndrome, you are likely to experience pain when you press your finger into the heel of the foot.

Causes of Heel Pad Syndrome

The condition of heel pad syndrome is typically associated with wear and tear of the heel and heel pad. There are several factors that cause the development of heel pad syndrome gradually over a period of time. These may include:

Age: The biggest cause of heel pad syndrome is the natural aging process of human that cause the heel pads to lose their elasticity.

Excess Body Weight: Another common cause of heel pad syndrome is being overweight or obese. Carrying around excess body weight ends up putting a lot of extra stress on your heel pad. Due to this, the heel pad may break down more quickly.

Gait and Foot Structure: If your gait is uneven, then the bodyweight gets distributed unevenly across your heel while walking. This causes certain parts of the heel pad to wear down faster than the others over time.

Repetitive Activities: Any type of activity that causes the heel to repeatedly strike the ground, such as running, gymnastics, or basketball, can lead to inflammation that causes heel pad syndrome over time.

Plantar Fasciitis: Plantar fasciitis is one of the most common reasons for heel pain. This condition causes inflammation of a thick strip of tissue running across the bottom of the foot. This band of tissue connects the heel bone to the toes. The condition of plantar fasciitis makes it difficult for your heel to absorb and distribute the impact of activities such as running and even walking. Due to this, the heel pad ends up deteriorating rapidly.(2, 3)

Walking/Running On Hard Surfaces: Regularly walking or running on hard surfaces also increases the risk of developing heel pad syndrome.

Incorrect Footwear: Running or walking barefoot or wearing inappropriate footwear causes your heels to absorb much more impact than they would if you were wearing the right shoes. This increases the wear and tear of your heel pads, causing heel pad syndrome.

Spurs: Heel spurs can contribute to heel pain and increased wear and tear of the heel pads. They also reduce the elasticity of your heel pads.(4)

Fat Pad Atrophy: There are several health conditions, such as lupus, type 2 diabetes and rheumatoid arthritis that cause shrinking of the heel pad, leading to heel pad syndrome.(5)

Diagnosing Heel Pad Syndrome

When you go to your doctor complaining of heel pain, your doctor will first enquire about your medical history and your symptoms. They will also physically examine your foot and ankle. They are likely to prescribe an imaging test such as an ultrasound of an X-ray. These imaging tests help doctors diagnose heel pad syndrome, or also helps rule out the other causes of heel pain.

There are some imaging tests that help your doctor look at both the elasticity and thickness of your heel pad. A healthy heel pad is around one to two centimeters thick.

The elasticity of the heel pad is determined by comparing heel thickness when the foot is supporting the body weight versus when it does not have to support any weight. If the heel pad remains stiff and does not compress as it should when you are standing, then this is considered to be a sign of low elasticity of the heel pad. This helps your doctor diagnose heel pad syndrome.

What is the Treatment for Heel Pad Syndrome?

It is essential to know that there is no cure for heel pad syndrome. Treatment of heel pad syndrome focuses on reducing and managing pain and inflammation. Doctors generally recommend one or more of the following treatment plans:

Plenty of Rest: Staying off your feet and restricting activities that need you to walk around will help you avoid heel pain. Resting your heels is the best way to relieve your symptoms.

Using Orthopedic Footwear: You can visit a podiatrist or a shoe store that specializes in orthopedic footwear. Finding shoes that provide extra support to your heels will help alleviate the pain.

Orthotic Soles and Heel Cups: Heel Orthotic soles are designed specially to provide extra support or cushioning to the heels. Heel cups are specially designed shoe inserts that offer heel cushioning and support. Both orthotic soles and heel cups are available at most pharmacies, and you can find them online as well.

Ice: Icing your heel from time to time, especially while you are resting, can help relieve the pain and also decrease inflammation. You can apply an ice pack to your heel for 20 to 30-minute intervals, especially after doing activities that trigger your heel pain.

Medication: There are many over the counter and prescription pain relief and anti-inflammatory medications that can help relieve pain caused due to heel pad syndrome.

Conclusion

The heel pad is a thick layer of tissue that is found on the soles of your feet in the rear part. Heel pad syndrome develops if the heel pads lose their elasticity and thickness due to normal wear and tear of the heel. Heel pad syndrome does not occur overnight, and it is a progressive condition that develops over time due to repetitive activities, carrying extra weight, and also due to an uneven distribution of body weight as your walk or run. There is no cure for heel pad syndrome, but the symptoms of the condition can be managed with treatment, including rest and icing.

References:

  1. Ozdemir, H., Söyüncü, Y., Ozgörgen, M. and Dabak, K., 2004. Effects of changes in heel fat pad thickness and elasticity on heel pain. Journal of the American Podiatric Medical Association, 94(1), pp.47-52.
  2. Buchbinder, R., 2004. Plantar fasciitis. New England Journal of Medicine, 350(21), pp.2159-2166.
  3. Young, C.C., Rutherford, D.S. and Niedfeldt, M.W., 2001. Treatment of plantar fasciitis. American family physician, 63(3), p.467.
  4. DuVRIES, H.L., 1957. Heel spur (calcaneal spur). AMA Archives of surgery, 74(4), pp.536-542.
  5. Waldecker, U., 2001. Plantar fat pad atrophy: a cause of metatarsalgia?. The Journal of foot and ankle surgery, 40(1), pp.21-27.

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