Friday, February 18, 2011

Hey, You! Yeah, You - With the Fat Pad!

One of the things I love about biomechanics and anatomy are the various terms used to describe things - motions, positions, body parts. The language is quite rich, and sometimes a bit strange, And sometimes, the words are perfect for what they describe.

Take "fat pad," for example. The term "fat pad" is used to describe the soft tissues on the bottom and sides of your heels. It is actually largely fatty tissue, and it does serve in fact as a pad. Without it, your heels would be mighty pointy, and barefoot walking would be, well, painful all the time. But good old evolution gave us some cushion in the appropriate places - bottoms of feet, and, well, bottoms, in general.

Sometimes, however, this fat pad starts to break down. It can occur for a variety of reasons, and not all are associated with weight gain, which would be an obvious cause, of course. It may merely be poor biomechanics, especially inversion or eversion of the calcaneus (heel bone.) This causes the impact, or strike forces exerted on the heel to be unbalanced. That is, the forces are less equally distributed. Over time, shorter if accompanied by weight gain, and longer, well, just depending (on the degree of pathomechanics,) the fat pad becomes "displaced." This doesn't mean it has to seek new lodgings. It merely means the tissues break down around the center of the point of impact, and "redistribute" itself toward the outsides of the heel. This becomes more noticeable as one gets older (logical - you've been smacking your feet on the ground longer, ergo...)

There are, as you may suspect, several consequences (thought you'd get off easy, did you?) First, and most obvious, pain, often chronic in and around the calcaneus. There may also be pain around the insertion of the Achilles tendon at the posterior aspect of the calcaneus, though that could be caused by a number of things. Also, a displaced fat pad makes success with orthotic therapy more problematic, as the device has a harder time controlling the calcaneal position during all the weight-bearing phases of the gait cycle.

And one of the other issues that is nearly certain (just hedging this a little, eh?) is the development of calloused tissue around the border of the heel where it rests (well, it doesn't really rest, per se. More like works against,) in the heel cup of the orthotic, which, if not attended to over time becomes thick and hard, then the sucker dries and cracks, and oh, hell, hurts like the blue blazes (invest heavily on a good aloe-based foot cream, and use liberally.) But a deeper heel cup on your orthotic can help alleviate that issue, to some degree. It can also aid the foot in staying properly centered on the orthotic, so you can get the best effect from their use.

And talk to your podiatrist or othotist/pedorthist for other suggestions on dealing with issues related to your fat pad - they can help deal with the issue in numerous ways.

Now, isn't that more about the fat pads than you ever wanted to know?

What? You thought I was talking about that totally cool phat pad owned by P. Diddy?


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