The heel fat pad septae are fibrous septa within the plantar heel fat pad that divide it into compartments, providing the shock-absorbing and load-distribution properties that protect the calcaneus during heel strike.
Absorb and distribute the impact of heel strike during walking and running, protect the calcaneal periosteum from direct impact, and maintain the structural integrity of the plantar heel pad.
Heel fat pad atrophy (from corticosteroid injection, ageing, or repetitive trauma) causes loss of septae integrity and reduced shock absorption, producing heel pain in thin-soled shoes. Silicone heel cups compensate for fat pad atrophy. Repeated plantar fascia corticosteroid injections can accelerate fat pad atrophy.
Progressive plantar heel fat pad septae destruction from repeated corticosteroid injection producing loss of shock absorption and chronic heel pain on hard surfaces, managed by heel cushioning and avoidance of further injections.
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