Yup, I stay up at night thinking about geeky anatomy topics. Lately, I’ve been thinking a lot about feet and the wide range of foot-woes that my clients encounter. Run an internet search and you’ll find lots of info about issues like plantar fasciitis and bunions, but when it comes to pain from foot fat pad atrophy — “FPA” – there’s an acronym for everything these days — there’s just not much information to be found. So, let’s go there now….
Plantar foot pads are the meaty part of the sole of your foot. They’re made of water, collagen and elastic tissue, and provide padding for the many muscles, tendons, ligaments and bones of your foot. We put a lot of pressure on our feet with every step we take, so mother nature has provided us with some lovely natural padding down there. Here’s the thing…..the fat on the bottom of your foot evolves across the span of your lifetime. Sometimes, people never even notice the change. And sometimes, they notice it a lot.
- Try playing with your kid’s feet and you’ll notice that infants and children generally enjoy thick, cushy foot fat pads. Most humans are just born this way. (Don’t freak out if you notice that your infant doesn’t have arches in her feet – those evolve when she starts using her foot muscles while walking.)
- By our mid-30’s, foot fat pads begin to deteriorate or thin. Sometimes, the thinning doesn’t happen evenly.
- By our 50’s, some people lose as much as half of the fat that normally pads and protects the ball and heel area of the foot.
- By our 70’s, the fat pads can be quite thin.
SIGNS of FPA
- 78% of diagnosed sufferers report persistent foot ache.
- 62% of diagnosed sufferers report excessive foot pain after a long walk or long period of standing.
- 2-8% of diagnosed sufferers report tingling, cold or burning sensation in their feet. These sensations are often caused by nerve compression when a significant amount of the fat pad has atrophied.
- Foot pain at rest or at night is common with PFA.
- Pain in both feet is more common with PFA than pain in just one foot.
- You knew this was coming #1…genetics. If one or more of your parents has cranky feet due to thinning of the fat layer on the soles of their feet, you’re more likely to have a similar issue with your feet. Genetics links to only about 30% of our body-experience though — other things influence the health of your feet.
- Body Mass Index (BMI) — your weight in relation to your height — affects the pads on the bottom of your feet. It’s high school physics class all over again. Try placing a stack of books on top of an open tube of toothpaste. What happens? The toothpaste moves, and so will the fat on the bottom of your feet, if you put enough pressure on them. Where does the fat go? After it’s displaced, your body re-absorbs it. I know, kinda weird.
- You knew this was coming #2….poor footwear choices. I love me a pair of sexy heels too, but I limit the amount of time spent in them. A shoe with any type of heel shifts your body weight forward, cantilevering more poundage onto the balls of your feet. When your feet ache after wearing a pair of shoes, that’s a message from them: those shoes are likely not the best choice for everyday wear.
- Hormone shifts due to pregnancy, menopause, hysterectomy, chemotherapy and other hormone-shifting scenarios can also cause your foot fat pads to thin. Hormones are your body’s blueprint – they tell the systems what to do. Change the blueprint, and we sometimes have unexpected body responses. Boooo, hissssss. Forewarned is forearmed though, right? It’s not all in your head – these life-changes can cause foot changes!
- Treatments involving injections into the foot pad — steroid injections are a common treatment for plantar fasciitis — can stimulate thinning of the fat pads. In general, if you poke that tissue too many times with a sharp object, it’s going to move to avoid getting poked again.
- The #1 reported side-effect from prescription statins, prescribed for high cholesterol treatment: muscle pain. Here’s the thing: it’s tough to feel the difference between muscle pain, connective tissue pain, and thinning fat on the bottom of your feet. I’ve seen feet morph in many clients taking statin-blockers – everything from mild plantar fasciitis to ripped connective tissue on the sole of the foot to almost non-existent fat on the bottom of the foot.
WHAT TO DO
- Shoe Intervention – ditch your positive heel shoes – the ones that lift your heel higher than your toes. Any amount of lift is shifting extra pressure into the ball of your foot. Wearing flat shoes will balance your body weight across your foot, evening out the pressure on your plantar foot pads.
PFB foot treatment – the Pain Free Body Foot treatment can help stimulate the natural healing properties in the connective tissue on the soles of your feet, effectively drawing fluid into the fascia layer. This layer feeds and communicates with the fat layer; stimulating it can slow the fat loss process. In the last decade, several studies indicate that fascia stimulation techniques can greatly improve the elasticity and health of the layer between your skin and muscles.
- Talk to your doctor – tell your medical provider about your concerns, especially if you’re considering injections in your feet or statin use. Your doctor can help you monitor and evaluate side effects and help you make smart decisions about treatments that are least likely to have crummy side effects.
Nike Studio Wrap Shoes – for those with thin fat pads who want to partake in traditionally barefoot exercise classes – yoga, Pilates, and ballet-barre fitness — this new product by Nike is a godsend. Similar to padded weight-lifting gloves for your hands, the Studio Wrap shoes provide a thin padded layer in the exact areas where nature puts a plantar fat pad. The shoe is minimal though, so you end up using of the muscles in your foot and leg. The light grip texture on the Studio Wrap’s sole also provides just enough extra traction to keep sweaty feet from sliding. This product is a boon for those with any type of foot inflammation or fat pad atrophy.
About the Author
Christine Binnendyk is the creator of the Ageless Pilates and Barre Fitness exercise programs, taught exclusively at Nike’s World Headquarters in Beaverton, Ore.. Nike employees take her Pain Free Body, Pain Free Athlete and Pain Free at the Office workshops at the Nike Sports Centers. Public workshops are available through Portland Community College. Find her best-selling book “Ageless Pilates” on Amazon.