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. 
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
- Shockwave therapy
- Injection therapy (aspiration, injectables)
- Heel raises
- Orthotic correction
- Stretching Alfredson Eccentric Stretches
- Taping
- Home Massage techniques
- Night Splinting
- Surgery
What else could it be? (differential diagnosis)
Other problems that can cause similar pain to a neuroma include:
Insertional Achilles Tendinopathy
Midportion Achilles Tendinopathy
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.