The heel pad under the heel bone normally acts as one of the body's most effective shock absorbers. When the connective tissue weakens, the fat pad can be pushed outward and lose its shock-absorbing function, leading to pain and discomfort when weight is applied. The condition, often called fat pad syndrome, can make it difficult to walk or stand for long periods.
What is a worn-out heel cushion?
A flattened heel cushion is a condition where the fat pad under the heel loses its shock-absorbing function. When the tissue is squeezed out to the sides, protection against shocks decreases, and the load on the heel bone increases.
Normally, the fat tissue is held in place by small connective tissue compartments that stabilize the cushion under the heel bone. When these structures weaken, the fat pad can be pushed out to the sides instead of lying protectively under the heel. The result is poorer shock absorption and increased stress directly on the heel bone.
Symptoms
- Heel pain when walking and putting weight on the heel
- Soreness around the edges of the heel
- Calluses along the outer edge of the heel
- Angular or wider shape of the heel
- The heel cushion feels thin, and the heel bone is clearly felt when pressed.
The symptoms of a worn-out heel cushion are often worsened by activities where the heel is exposed to repeated impacts or prolonged stress.
When does a worn-out heel cushion hurt the most?
The pain often occurs in situations where the heel is exposed to repeated impact or pressure.
When walking on hard surfaces
Asphalt, concrete, and other hard surfaces increase the load on the heel when shock absorption is reduced.
During longer walks or standing work
When the heel is loaded for a long time, the pain can gradually increase.
When you go barefoot
Without shoes or shock-absorbing material, the heel bone is exposed to direct pressure against the surface.
When wearing thin or hard shoes
Shoes without sufficient shock absorption can make the discomfort more pronounced.
Common causes & risk factors
A worn-out heel cushion is often caused by prolonged stress on hard surfaces, especially in shoes with poor shock absorption. Repeated impacts from, for example, running or work where you walk and stand a lot, can contribute to the gradual weakening of the fat pad.
Other factors that can increase the risk are rapid weight gain, walking barefoot on hard surfaces, and natural age-related changes in the connective tissue that cause the fat pad to lose its elasticity. With increasing age, the tissue often becomes thinner, which can reduce shock absorption.
When should you seek medical attention?
If you have persistent heel pain that does not improve despite weight-bearing, better shoes, or shock-absorbing aids, you should contact your healthcare provider for an assessment. The same applies if the pain is severe or if you have difficulty putting normal weight on your foot.
Recommended protection & support
In the case of a worn-out heel cushion, the right protection and shock absorption can help reduce pain and increase comfort in everyday life. A heel cup is often the most effective aid because it combines shock absorption and stabilization.
The heel cup collects the fat pad under the heel bone and prevents the tissue from being squeezed out to the sides. In this way, a more natural shock absorption is restored, and the load on the outer edge of the heel is reduced. Anatomically designed heel cups in durable and shock-absorbing materials can therefore provide significant relief and make it easier to walk and stand without pain.
See all protections and supports that can relieve pressure on a worn-out heel cushion
Related injuries
For more information about the foot and heel, you can read more in the Injury Guide Foot & Heel. You can also go to the Injury Guide's main page to read about other injuries and symptoms.
