Fat Pad Syndrome Taping | San Diego Sports Therapy

Fat pad syndrome taping is an effective way to ease the symptoms of fat pad syndrome. Fat pad syndrome is characterized by plantar heel pain that is worse when pressure is applied to the bottom of the heel. On the bottom of the heel, there is a substantial fat pad which protects our heel bone from impact. With repetitive force (jumping running, especially with less cushioned shoes, walking barefoot on hard surfaces) the fat pad can not sufficiently protect the heel and a bruise begins to form on the bottom of the heel. Also, as we age, our heel fat pad thins out and moves outward towards the bottom, sides of the heel. This results in less cushion around the bottom of the heel, and a greater chance of developing a bruise on the bottom of the heel with impact activities.
The goal with taping for fat pad syndrome is to centralize the fat pad over the painful point of the plantar heel as best as possible. Rock tape for fat pad syndrome is a great choice as rock tape sticks very well to the skin and can last from 1-3 days with proper care. KT tape for fat pad syndrome is also quite effective. The technique shown in the video is very simple for heel pain relief but often times can make a big difference!
Fat pad syndrome can be a standalone injury but often times we see it in conjunction with plantar fasciitis and other types of plantar heel pain. When patients are dealing with plantar fasciitis, they tend to walk in a way that avoids the painful plantar fasciitis point on the medial portion of the plantar heel. This abnormal way of walking/running, sometimes places more pressure directly on the bottom of the heel which can lead to the heel bone becoming inflamed. Patients sometimes are unsure if they have plantar fasciitis vs fat pad syndrome and as mentioned above, they may be dealing with both!
Give the fat pad syndrome taping a try, and see if it helps ease the symptoms. This strategy will need to be performed for several weeks so the heel can sufficiently heal!

[@joanneshaw3071]

Thank you. Trying this taping method. I’ve just purchased better shoes that my podiatrist recommended. Hoping these work. Unfortunately I can’t make any changes in my job. I’m a nurse so on my feet for most of my shift

[@PeakFormHealthCenter]

Hope it helps! Tuli cups also work well with the nurses I treat. Some of the nurses use Birkenstock shoes with success, others have found Hoka shoes to be very comfortable. Definitely find what works for you. Always surprises me the number of steps nurses get during a shift!

[@joanneshaw3071]

@@PeakFormHealthCenter this taping method is helping so much. What are Tuli cups? I also took your advice and always wear something on my feet even when at home and that has helped as well. Thank you

[@PeakFormHealthCenter]

@@joanneshaw3071 Tuli cups are silicone heel pads you stick in your shoes; if you search on Amazon you will find them easily, some running/walking stores have them in stock. Works similarly to what the taping does just more of a convenient method so you do not always have to re-tape your heels.

[@Ladida386]

I worked in the lab. The same problem as with you. All day on my feet. I was wearing wooden clogs with NO problem. No problems with my feet, tiredness yes, but that it. I stopped working in the lab, and then I bought Skechers. Those shoes are the worst! They made so much damage to my feet, because they are too soft. Now I can't rid of the pain. 😭

[@felicial7628]

Mine is finally getting better. I bought some $10 EVA sandals from Amazon and wore those for months. And to my surprise, it retrained my feet. I can walk and stand with my heel elevated. I also bought some deep heel well heel cushions which transformed some shoes that I now love and was about to get rid of. In between times, I purchased some Nike’s Air Max for street running - which has a built in heel well.

[@cornelioleongon4062]

Thanks for tips

[@PeakFormHealthCenter]

You are welcome :)

[@user-io9ih1kb4r]

I read through the answers you have given in the comments and I really appreciate how genuine and good advice your have provided. I have a question, I can't even stand on both feet at the moment, because my heels hurts alot when I try to stand on it, my question is can this be fat pad syndrome? I am quite stress on this as I can read here everyone can stand and walk but not to my circumstances. My feet did get better now, at the beginning, they are very painful when Dr push them with their thumb, I can't even put my feet down like normal because my heels and the rest of the foot balm hurts. Now I can put my leg down like how I used to sit before my feet got injured, with no pain on the heels.

[@PeakFormHealthCenter]

I appreciate the feedback. I try to be a contact for people who may not have access to providers/answers for their conditions. Sounds like fat pad syndrome. When we push into the heel directly and it causes pain that usually represents bone bruising associated with fat pad syndrome. The taping technique in the video can help. Also Heel Cups (find them on amazon/online) can help for a more permanent fix in your footwear. Best.

[@dreamitbeit]

Can you demo doing this on your own foot?

[@KagoUma]

Tq

[@juggmane3k830]

ok i fell down a hill but caught myself, ended up hitting my heel hard and its never been the same, when it comes to trauma is there anyway to actually recover unlike the progressive deterioration, or once the trauma has been inflicted the deterioration starts immediately?

[@PeakFormHealthCenter]

It can still heal significantly but depending on the presentation you may need to be aware of it ongoing. If pain starts worsening, really go back to supporting it, taping it etc. Assuming you got it x-rayed/checked out? How long ago was it? Heel fracture would be something I would want to rule out immediately if someone came in with this presentation.

[@lydiaahubbell8545]

squeezing the sides of my heel hurts. bottom of heel hurts when I walk in it. Got a steroid shot months ago that started relieving pain in a couple of days. none of the plantar fasciitis therapies help.

[@PeakFormHealthCenter]

Sounds like you have fat pad syndrome. Sides of the heel and bottom usually represent that. Are you still feeling the pain?

[@theravenmagick]

I wear orthotics 24/7 and have even had ha filler injected in my heels, which did help while it lasted. It’s been 2.5 years with this. I’ll try taping but I hardly do anything and I have so much pain. Can this still heal? I’ll do anything

[@PeakFormHealthCenter]

Ugh sorry to hear that. It can be very frustrating.... Try to cushion the heel as best as possible. With time it can get better but it can still cause symptoms ongoing to some degree for some people. Hard to say online without evaluating your foot.... I hope you are able to find relief!

[@MrFalcon58199]

Hey doc. So I've been having this intense pain in the center of both heels for 3 months so far. Feels like I've jumped from height on concrete and landed on my heels barefoot, or like someone took a hammer and started hitting my heels with it. Pain is present at rest too. Can't go anywhere without crutches. My doc treated it like plantar fasciitis with some therapies like tecar, laser, tens - no change in symptoms. Then I've done 4 sessions of shockwave which made things a lot worse. Then he gave me a shot of cortisone mixed with PRP in the fat pad on my right (worse) heel - no change. I've done MRI and it found bunch of things with the conclusion that states "signs of heel fat pad syndrome". There's also a bit of fat pad atrophy in my left (better) heel. So if that's my diagnosis then I guess my case is pretty severe. Will this thing ever get better? Feels like a lot of the time has passed without any improvement.

[@PeakFormHealthCenter]

Ouch, sounds like quite the process so far. To answer your question, Yes it will get better but will need additional time. Unfortunately I think you were misdiagnosed from the get go and time was wasted with therapies that were not going to help with fat pad syndrome. Shockwave in particular sends sound waves that are strong enough to penetrate tissues; fat pad syndrome is essentially a bruise on the bottom of the heel....so thumping the bruised area with shockwave likely caused further irritation (as you noticed). Now that you know what you are dealing with, you have to treat fat pad syndrome appropriately which is you have to cushion and support the fat pad daily, all day, until the pain goes away completely. This can take a good 4-8 weeks depending on the case. So you need to think of treatment time starting now, the previous time essentially doesn't count because it wasn't used addressing fat pad syndrome. Try this taping technique kzbin.info/www/bejne/eF6XpYCVbM-FbM0 you can try tuli cups in your shoes, don't walk around barefoot, wear supportive cushioned shoes, and wait. Ice can sometimes help when the pain is really present. I hope that helps! Let me know if you have any other questions.

[@MrFalcon58199]

@@PeakFormHealthCenter Thank you for your response, it is informative and gives some much needed moral support because this has been like a neverending nightmare. If I have any more questions I will ask them. Thank you.

[@jameshandysam]

@@MrFalcon58199 thought I would add my 2 cents worth, for what it's worth I'm a final year medical student but this is certainly not medical advice :P I have very severe fat pad syndrome / atrophy secondary to professional skating back in the day. Haven't had issues for 14 years and now its back without an aggravating event. It's been 6 months and while I've treated it as fat pad atrophy from the start - I still can't walk without pain. Moral of the story, this can be a chronic problem unfortunately - also fairly rare/poorly understood by many in the medical community as you unfortunately found out. Now I am not advocating this for you at all.. but I am going to go down the surgery route I think. They can transplant some of your own fat into your heal and this surgery has a 98% success rate - pretty much as good as any surgery can get. For you, depends how much you use and abuse your heals. I've noticed in the past (when I was much younger) I could have pain for 6 months and then when it finally goes I'ld be pain free for years so it can resolve somewhat. Problem is now that I am older (39), it doesn't seem to want to resolve as promptly and I am not happy with not using it / walking around on tip toes or a moonboot which causes other problems too. Not to mention the psychologic distress of not being able to train which is my main coping strategy. This, and other taping techniques and non-invasive techniques can really help and I hope it's all you need

[@MrFalcon58199]

​@@jameshandysam Thanks for your input. How severe was your HFPS 14 years ago? Is this time worse than you had it? With all the cushioning in the world, I've seen only a very slight improvement, mostly in my left heel which atrophied more. Right one has enough fat tissue but is non-responsive and very sturdy, seems like it doesn't recover at a meaningful rate at all. Pain at rest is generally reduced but I still can't walk or stand for more than 10 min in one go (still a progress) before I can't take it anymore and have to sit for a few hours to "regenerate". With all the effort I put in so far, it feels like it will last forever. I find your case very interesting, you suffered through it, then you were fine for more than a decade and now you have it again. Gives me some hope it can go away with time but it's also bad it can reappear out of nowhere in the future. And I've also considered fat grafting as a last resort which I could pursue for my left heel but I don't know what to do for the right (worse) one which isn't as atrophied as much. Anyways, I hope you will overcome your current problem just as you did before.

[@jameshandysam]

@@MrFalcon58199 I guess it was severe. I mean, I couldn't/cant sit in a chair resting my feet on the ground without pain. I think last time I didn't use it for too long.. it always hurt and then as soon as I used it it was fine. You have to use it for it get better, but knowing when to use it and when to rest it is really hard! Is such a horrible condition, I'm really sorry you have it too! Absolutely no weightbearing for 3-6 months will probably get you better.. ive had it 4 times now. And I should probably follow my own advice. I didn't weight bear for 4 months but it seems that wasn't long enough :(

[@ParamjitSingh-pu6ul]

Please share link to buy this tape

[@PeakFormHealthCenter]

RockTape Original 2-Inch Water-Resistant Kinesiology Tape a.co/d/3aeoDd3

[@cappeljm]

Thank you for this video! What is your opinion of shockwave therapy for fat pad healing?

[@PeakFormHealthCenter]

Hi Matt, Thanks for the question. Haven't seen any research supporting shockwave for fat pad syndrome. From my experience, I wouldn't recommend shockwave for fat pad syndrome specifically as it wouldn't have an effect on the fat pad itself. If the fat pad has atrophied, or if there was an activity that led to the fat pads inability to absorb the shock, then supporting the fat pad with tape, or heel cups, shoes with deep heel cups etc. will likely be the best route for pain management. Once the symptoms go away, gradual return to activity at that point. If there were other areas around the heel causing some pain (plantar fascia, some achilles/peroneal tendinopathies), shockwave would help with that aspect of the symptoms.

[@cappeljm]

Thanks. I had one session of it after 5 weeks on crutches for fat pad, but it seems to have worsened my pain.. in your experience, does walking/activity delay healing or is it more pain tolerance? Thank you for your help

[@PeakFormHealthCenter]

@@cappeljm In my experience, the more you can pad, support the fat pad, protect the heel, the faster fat pad syndrome resolves. It can be annoying but having shoes that pad the heel that you can use while walking around at home versus being bare foot at home can really help. Obviously I don't know about your case, but any imaging of the heel? With the intensity of your symptoms, needing crutches, etc. Might be time to investigate further with imaging if you have not done so. But work with the provider you are seeing since they obviously have all the info. Good luck, hope it resolves soon!

[@farhanahaque9652]

Hi DR,MRI came back as inflammation on fat pad and oedeama. Having feeling this heel pain for 8 year .was told I had planer facshitis all those years.does feel like I m walking just on my bone..they said no sign of atrophy.is this condition still called fat pad syndrome?when pain is intense which is like 5mins have to sit in wheelchair.pressing in middle of heel doesn't hurt.its just when weight bearing standing and walking.please help

[@utkuunnu4462]

Hi, ı dont know english please answer me, the same condition ı have, do you wear heel cup or shock absorbing insole or skechers shoes, do you have extra weight, how you can survive of your life?

[@PeakFormHealthCenter]

You need to protect your heel with shock absorbing insoles, taping the heel like in the video, using Tuli heel cups in your shoes to help protect the heel. Don't walk around barefoot (where shoes at home) or where shoes that have very thin padding. Pressing in the center of the heel doesn't always cause the pain, you have to push pretty hard to elicit a response. But standing with the pain, walking with the pain and MRI with fad pad inflammation is pretty telling.

[@jeslinchng]

What is the width of the tape?

[@PeakFormHealthCenter]

2 inches

[@jeslinchng]

@@PeakFormHealthCenter thank you

[@bonham_music]

Accidentally jumped barefoot onto a hammer in the garage a few years ago (heel landed on it), but really started noticing this heal pain about 8 months ago. Can I still heal it or have I done irreversible damage by not addressing it quickly enough?

[@PeakFormHealthCenter]

Ooph that sounds painful! So, I tell patients who have had trauma like that that they are likely dealing with fat pad syndrome and to get it to heal properly, you have to use heel cups, cushioned shoes, taping like in the video, and do it very consistently. Most cases you need to wear slippers, shoes, etc around the house etc. Once the pain dissipates then you can go back to "normal" but even then the pain may creep back if you walk barefoot a lot or wear shoes that do not support the fat pad.

[@soren5621]

Will this aid recovery or is this just for Pain relief ? I mean it is actually good for The foot or is it temporary relief?

[@PeakFormHealthCenter]

If you have fat pad syndrome, it will allow the heel to heal. It helps with pain AND will allow for healing of the bone

[@soren5621]

@@PeakFormHealthCenter allright, Thank you

[@soren5621]

How long is expected recovery time ? And how long should you keep The tape on at a time ?

[@soren5621]

Is laser or shockwave recommend to aid healing ?

[@PeakFormHealthCenter]

@@soren5621minimum 8 weeks with proper cushioning/protection. Sometimes it lasts 6 months. Laser may help with healing; shockwave can aggravate it

[@alexgberg1991]

Is it possible for it to go away completely or will it keep coming back as I go faster in runs? Vaporflys are my go to shoes trying to only wear them once a week. I got a cortisone shot in my foot and that took the pain right away but I can see it coming back. Starting to develop Achilles tendon pain on the other foot idk if it’s related to this issue. I wear custom orthotics. Just pissing me off trying to keep a consistent training schedule. I’m taking dyclofenac sodium I’m hoping this is t causing weight gain and putting more pressure on the heal. Any thoughts?

[@PeakFormHealthCenter]

Fat pad syndrome can go away, you just really have to protect it so it has time to heel up. Do you have plantar fasciitis? Usually pain with fast running will exacerbate PF. Fat pad usually just hurts all the time and then worse with jumping, hard heel striking when running. Carbon plated shoes/high stack will put more stress into the plantar fascia and Achilles, so possibly related. Also, I would discuss the custom orthotic with a run specific provider. Depending on what it is addressing, what materials, etc. can cause more force into all those same areas... Hard to offer and specific advice, but it all comes down to load management. You can train through all those types of pain but it is a balancing act of not doing too much but also not doing too little. So working on volume/intensity and how it relates to symptoms is huge to be able to run consistently and avoid excessive time off. Strength training is huge as well to help support the calf/achilles/Plantar.

[@alexgberg1991]

@@PeakFormHealthCenter I saw a podiatrist she thought it was a mix of pf and fat pad, but all the pain is only in the center of the heel. I ran two fast halfs in the vaporflys 1:18 and 1:19 and I think that started the injury but I’m not sure. As for a run person do you mean like an ortho surgeon or a podiatrist who specializes in running?

[@PeakFormHealthCenter]

@@alexgberg1991 Someone who knows running injuries, and treat running injuries regularly. Most commonly a Physical therapist, Sports chiro, a good running coach (who also knows strength and conditioning). In my experience orthos and podiatrists have very poor skills (or don't want to spend the time)at discussing a training load management plan, go through the specific exercise progressions etc. For specific orthotics, injections, procedures, 100% podiatrists/orthos are the way to go but that doesn't sound like what you need at the moment.

[@alexgberg1991]

@@PeakFormHealthCenter I’ve been going to the chiropractor as well so I’m doing exercises. They seem to agree that the insoles I bought are good cause I tend to over pronate a bit and it’s got like that heal thing in the back like a heel raise piece. Vaporfly seems to hurt it more but I need them to go fast in. Just wish it would heal

[@alexgberg1991]

@@PeakFormHealthCenter what kind of exersizes are best for fat pad sydrome?