The metatarsal fat-pads are cushions made of pockets of fascia filled with fatty acids. The fat pads help reduce torque and shear. With the loss of fat pads, there is less shock absorption and pressure areas develop over the metatarsal area. The fat pads normally atrophy with age but the risk of fat pad loss increases if the individual is overweight, diabetic, has often worn thin-sole or high-heel shoes, or worn cleats in athletic activities to any degree. The treatment of plantar fasciatis with cortisone injections also leads to atrophy of the pads.
Along with the metatarsals, two other fatty pads are below the plantar surface – under the heel and on the outer arch contact area.
Some physicians are injecting the site with Botox to give the area protection, at least for the amount of time Botox remains in the system. The more common and non-invasive way to manage it is with good cushioning and arch supports that take pressure off the metatarsal area.
Other names or similar foot conditions:
- Plantar fat pad atrophy
- Metatarsalgia
Symptoms:
- Pain and tenderness at metatarsal heads
- Ulceration at metatarsal heads
- Heavy metatarsal callusing
Signs to look for:
- Pain and tenderness at metatarsal heads
- Ulceration at metatarsal heads
- Heavy metatarsal callusing
Possible Causes:
- Natural effects of aging
- Diabetes
- Habitual wearing of thin soled and/or high heel shoes
- Athletic activities using cleats
- Arthritis
Goals:
- Take pressure of metatarsal heads
- Restore gait
- Create optimal foot motion
How We Help:
Arch Supports:
- BioOrthotics exercising support with metatarsal lift
- Lower and thinner arch support with longitudinal and metatarsal support for use when shoes cannot accommodate the BioOrthotics exercising support
- Plastazote cushion with arch supports underneath where the supports themselves do not take enough pressure off the forefoot
Shoes:
- Extra depth, double or triple depth shoe with high toe box, firm heel counter, rocker sole and connecting shank
- Smart footwear, such as heel to toe rockers, negative heel shoes or shoes with titanium springs
- Avoid flip-flops. Only wear sandals with a back and only the Orthaheel, Alegria or Aetrex brand
- Wear thin soled shoes, pumps and high heels only as long as absolutely necessary
- Go barefoot on minimal basis only
Other:
- Regular callus filing with pumice device (leaving cutting of calluses to a physician only)
- Metatarsal pads (in addition to the arch supports)
Activities:
- Rotate high impact exercising with low impact exercising, such as jogging or basketball (high impact) with swimming or bicycling (low impact)
This information does not constitute a diagnosis of your condition and does not take the place of a doctor’s care. The information has been compiled from sources available to the general public and referenced below. Copyright 2005-2010 Carole Romig
Sources Image: care.diabetesjournals.org Text: patentstorm.com, ipfh.org