Kager’s Fat Pad Irritation

What is Kager’s Fat Pad?

The Achilles is the tendon that attaches the muscles of the gastrocneumius and soleus (calf) to the back of the calcaneus (heel). The Kager’s fat pad together with the retrocalcaneal bursa make up the “Achilles Enthesis Organ”

What is Kager’s Fat Pad Irritation?

Kager’s fat pad irritation is an inflammation of the fat pad that lies deep to the Achilles.

People with this problem generally present with pain when first getting out of bed which reduces slightly after walking a short distance and then returns again with extended walking.

It commonly presents with Retrocalcaneal Bursitis


What Causes Kagers Fat Pad Irritation?

Certain factors are though to increased the irritation of the Kagers Fat Pad

  • Non- Supportive footwear
  • Flat arched feet
  • High arched feet
  • Sudden increase in activity
  • Trauma
  • Being overweight
  • Connective tissue disorders (Rheumatoid arthritis, spondyloarthritis)
  • Os Trigonum
  • Previous Ankle Surgery
  • Achilles Tendinopathy

Diagnosis of Kagers Fat Pad Irritation

Diagnosis is generally made with specific signs and symptoms – when the pain occurs and the location.

At the Ankle, Foot and Orthotic Centre we are able to provide additional information about the presence of Kagers Fat Pad Irritation with ultrasound imaging.

The ultrasound image taken below shoes a thickened degenerate Achilles, retrocalcaneal bursa and irritated fat pad. The irritated fat pad is evident from the increased echogenicity of the fat and the disorganisation of the normal lobular pattern of the Kagers Fat Pad. Kager's fat pad


Treatment of Kagers Fat Pad Irritation

Treatment aims to reduce the disorganisation of the connective tissue in the Achilles tendon, bursa and Kagers Fat pad. This in addition to minimising the risk factors for re-injury. This can include


What else could it be? (differential diagnosis)

Other problems that can cause similar pain to a neuroma include:

Insertional Achilles Tendinopathy

Midportion Achilles Tendinopathy

Retrocalcaneal Bursitis

Tarsal Tunnel Syndrome

Tibialis posterior tendon dysfunction



The Ankle, Foot and Orthotic Centre’s Northcote Podiatrists can help you with all lower limb complaints, including Achilles pain. Make an appointment to get your foot and ankle pain under control.

Expert Podiatrists and Orthotists in the treatment of Achilles problems servicing the areas of Northcote, Thornbury, Fitzroy, North Fitzroy, Carlton, North Carlton, Alphington, Fairfield, Brunswick, Coburg and Preston

Call The Ankle, Foot and Orthotic Centre in Northcote for further advice on professional management and treatment options.