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fat pad syndrome?

Just got back from a PT appointment.  He has been working on my "plantar Fascitis" for the past 6 weeks and I am getting very little improvement. Today he mentioned that the fascia all feels normal but there is still a lot of nastiness in the fat pad. Of course I went straight home and googled "heel pain in fat pad" and found a condition called "fat pad syndrome" . The symptoms listed are spot on... Tenderness to pressure in a dime sized spot on the medial aspect of the calcaneous bone. Feels like a deep bruise.  It does not seem to get any worse with running, although I took 4 weeks completely off running. Anyone else have trouble with this?

Comments

  • Interesting, I've had a similar pain that my Dr's haven't been able to diagnose.  So far it's not too bad, more a warning sign.  Thanks for the information!

     Harry

  • You can try various taping techniques to keep the fat pad 'in place' when you walk/run to minimize how much it moves around. 
  • Not sure what is going on.. Initial area of pain ( dime sized area directly at insertion point on medial aspect of heel) is gone. Now pain in more diffuse across lateral aspect of foot, entire length of foot. Pain also at insertion of achilles. Seeing podiatrist again next week. Frustrated, but still running. 

  • Compensatory pain from altering your gait pattern?  Possible 5th ray issues?
  • Its possible to develop pain of the lateral aspect of the foot due to altered gait or running pattern when you tape your foot and wear insoles to improve your arch support. Achilles pain can also be caused due to altered gait or running pattern because of 'new' stresses placed on it. I'm a physical therapist and I recommend my patients to do a lot of eccentric heel raises, calf stretching, plantar fascia stretching, good arch support, proper footwear, and ice when painful. Also doing strengthening exercises for the foot intrinsic muscles is beneficial. Good luck. 

  • My dumb suggestion is run on the ball of your foot without a heel strike.
  • Thanks all,

    I definitely think the new pain is from altering my gait due to the orthotics. I took them out yesterday and did yesterday and today's run without them. I think things are improving. I am still able to do all my runs and hit my paces without too much carnage afterwards. Unfortunately running on the balls of my feet is when the discomfort is most persistent. The push off is where I feel most of the stress in the arch and across the lateral aspect of the foot. I am being very diligent with stretching, icing, and wearing a night splint. I have also been taking Naproxyn as needed after a workout. The podiatrist prescribed 500 mg twice a day for a full month, but I am just not super comfortable doing that.  BTW, got the bill today from the cortisone injection... $355 for office visit, $224 cortisone injection, $228 follow up office visit for Naproxyn prescription. Not sure I am going for my next follow-up on Tuesday. I think the stretching, icing, splint have been more successful than his recommendations not to mention more cost-effective!

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