Why does the pad at the bottom of my foot feel thinner?

If the bones at the bottom of your feet feel more prominent, and the pad at the bottom of your feet – beneath your forefoot or your heel – feels thinner, then you may have fat pad atrophy.

Plantar fat pad atrophy describes the thinning or breakdown of the fat pad at the bottom of our feet. Patients describe the feeling of a thin fat pad as walking or hard stones or marbles. These pads are there to help protect our joints and tissues, absorbing shock, cushioning and dissipating the heavy forces that our feet are exposed to every day. A thin pad renders our feet more vulnerable to injuries such as stress fractures, bone bruising and balance problems.

Why do our fat pads get thinner?

Generally, our fat pads naturally thin as we grow older, and may become very thin in our oldest years. This is a normal part of the ageing process, though it occurs more quickly for some than others. Other causes of fat pad atrophy include:

• Overtraining and excessive force to the bottom of our feet
• Cortisone injections
• Medical conditions, like diabetic neuropathy
• Surgery on the feet
• Injuries such as stress fractures.
• High heels and other shoes that place more pressure on the fat pads
• Certain medications

Aside from the fat pad thinning and degenerating, it may also be displaced to a different area of the foot.

What are the symptoms?

When our fat pads thin, they will expose our bones more prominently, namely the metatarsal heads at the ball of our feet, and our heel bone. The bones will then start taking on a much heavier load and the feet will not be able to absorb shock as effectively. This can cause:

• Pain, tenderness and bruising
• Inflammation
• Formation of callus and/or corns
• Ulcers
• The feeling of walking on a marble

How to help thin fat pads

There is currently no medical treatment to increase or replace the fat cells in your feet. Once they are gone, they will not return. This means the best solution is to: 

Help prevent the fat pad from thinning further

Supplement the fat pad with in-shoe cushioning using an orthotic

Here at The Podiatrist, we do this by ensuring you have the right footwear with custom made and podiatrist-prescribed orthotics. These orthotics will ‘fill in the gaps’ where your fat pads have thinned, helping to restore some of the missing cushioning and shock absorption while you are wearing them. 

We understand how important it is to be able to keep mobile and independent, so will also examine other ways to help you feel comfortable and confident on your feet.

If you’re worried about your feet, we’d love to help. We’ve been helping our community in Toowoomba & Darling Downs for over 20 years. To book an appointment, call us on (07) 4638 3022 or book your appointment online here.