Foot Focus Podiatry

Mon - Fri : 08:30 - 5:30   |   reception@footfocuspodiatry.com.au
08 9258 4152 |
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Plantar Fat Pad Atrophy / Heel Pad Inflammation

Plantar fat pad atrophy refers to the thinning or breakdown of the fat pads on the bottom of the hell or forefoot. As a result, the bones are placed under increased pressure and are more susceptible to injury. Plantar fat pads are located at the heel and at the ball of the foot.

Causes

Age is the most common cause of progressive thinning of the plantar fat pad. Other causes may include:

  • Genetic predisposition
  • Medical conditions such as diabetic neuropathy
  • Surgery/trauma
  • Certain medications
  • Certain footwear such as high heels can cause increased pressure on the plantar fat pad.

Symptoms

When plantar fat pads are thinned or broken down, the bones will start taking on a much heavier load and the feet will not be able to absorb shock as effectively. This can cause:

  • Pain and tenderness in the areas of atrophy
  • Inflammation
  • Callous and/or corns
  • Ulceration

Treatment

As the damage and thinning to the plantar fat pads is largely irreversible, treatments will largely focus on increasing the cushioning and shock absorption under the areas of atrophy. This is often done through a combination of good footwear as well as orthoticsAvoiding activities that exacerbate the symptoms such as walking in bare feet and maintaining a healthy weight can also help minimise the onset of painful symptoms.

For best management of fat pad atrophy symptoms please visit Foot focus Podiatry in Perth by calling 9258 4152 or booking online.

  • Winograd procedure- This procedure will be done in hospital setting under local and or general anaesthesia and it is reserved upon failure of the phenolization or if there is significant amount of skin overlapping the nail with soft tissue growth. This procedure involves removing a portion of the skin along with the nail down to the level of the bone. Sutures (stitches) will be applied to close the surgical site. The procedure takes about 10-15 minutes to be performed and your foot will be bandaged. You will be seen within first 5 days and then the sutures will be removed in 10-14 days. Currently this procedure can only be performed by Reza Naraghi (podiatric surgeon).  He will prescribe appropriate pain medication for your post-operative pain management. You will be in open sandal and or post op shoe for 2 weeks. This is not for everyone (especially if you don’t like seeing surgical procedures) but should you be keen to see a step by step process involved in a Winograd then please click here.
  • Zadik Procedure- This procedure is used with permanent total nail removal is desired. The indications for the procedure are significant ingrowing nail on both borders, thickened and painful nails and bony growth under the nailbed. This procedure can be done under local with sedation and or under general anaesthesia at a hospital and or day surgery centre. Sutures will be applied and will be removed 14 days post surgery. You can not get your foot wet and your foot will be in a sterile bandage for 2-3 weeks. You may need pain medication post surgery. On average it will take six weeks for your nail bed area to heal. Following that you can wear most close shoes.

Matrixectomy with phenolization- This procedure involves removing the nail partially or totally and ablating (destroying) the root using a weak acid called phenol. This will cause permanent ablation of the root of the offending nail and prevent ingrown nail recurrence. This procedure is successful 95% of the time. The procedure takes about 10-15 minutes and can be performed in our rooms using local anaesthesia with or without sedation. Post operatively you will be required to soak your toe and apply a daily dressing. Wearing open toe shoes for at least 3-4 days is recommended. You maybe required to take oral antibiotics. Most patients do not require pain medication following the procedure, and if needed Panadol is sufficient for pain management. You can go back to regular shoes after one week.  This is not for everyone (especially if you don’t like seeing surgical procedures) but should you be keen to see a step by step process involved in a partial nail matrixectomy with phenolisation then please click here.