A 32 year old presented with complaints of pain around the lateral aspect of the heel. The pain started after running a long marathon.
Performing an ultrasound of the lateral aspect of the heel indicated a large area disruption to the normal plantar fat pad around the lateral calcaneal tubercle
(see the smaller arrows on the right heel).
This type of trauma to the fat pad can occur with sudden overuse or longstanding repetitive trauma. It is made worse in those with a higher arch foot posture and wearing poor non supporting shoes due to the increased trauma to the heel.
This problem resolves slowly. To minimise the pain options include:
– Gel heel cups to offload the heel
– A more supportive shoe
-Reducing the trauma to the fat pad
– Taping the heel to stop the fat from displacing outwards (creating more cushioning)
– Orthotics to support and offload the heel