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  1. #1
    Join Date
    Jan 2010
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    In the swamp
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    Anyone knowledgable on feet?

    My left foot has been really in pain for the last week - basically it feels like the muscle is pulled in area just above the foot pad at the back of the foot (that's the only way I can describe it). It went away for two days this week (after I biked) and then just came back.. stepping down is uncomfortable.
    This has happened before when I've worn only flip flops or have gone barefoot for a prolonged period of time. Any thoughts on what this could be and how to treat it?

  2. #2
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    Jan 2010
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    Any help?

  3. #3
    Join Date
    Jan 2006
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    Jackson Hole
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    2,245
    It sounds like fat pad syndrome?

    If it is on the bottom on the heel and in a dispersed general area, you may have shifted the fat pad that cushions the calcaneas. Icy boot packs are a villain as the heel takes a beating. Accentuated by cold.

    Remember:

    Heel spur is pinpoint pain in the middle front of the plantar (bottom) surface of the heel bone. Gets worse during the day. Plantar faciitis is a dull ache to searing pain that runs from the distal plantar heel to just before the 1st metatarsal joint. Goes away during the day.

    Hope this helps. I've seen lots of injuries from skiers getting rattled by firmer conditions. Fat pad syndrome is just one of the hard pack induced problems I see regularly.

  4. #4
    Join Date
    Jan 2006
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    Jackson Hole
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    This may also help:

    From a lecture I use to show medical professionals how to access foot pain...



    Fat Pad Syndrome is best helped by orthotics and associated modifications that have an increased heel cup to stabilize lateral shifting of the fat pad. Off-the-Shelf "heel pain" inserts do pretty well at holding things tight.

    A custom orthotic is best, however it is possible to pad between the liner and shell, creating a heel cup of sorts that holds the heel tight. Thick socks can increase shear in the boot making the problem worse. I'm not a doc, but it was the flip flops that gave it away. No padding or heel protection.

    Climbers frequently get bruised or shifted fat pads on long death march descents.
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  5. #5
    Join Date
    Jan 2010
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    thank you for the advice...that sounds like what it is, most likely. i am going in to see someone next week, but could you advise on how to minimize the pain now? ibuprofen, ice and heat haven't helped.

  6. #6
    Join Date
    Dec 2005
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    sandy, sl,ut
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    7,807
    A couple things reminded me of my foot issues. I have severe overpronation. You saying your feet hurt more after wearing flip flops and less after biking sounds very familiar.

    Regardless of what we say, go to a podiatrist. Feet are nothing to fuck around with, they can completly handicap you if you don't take care of issues with them.

    For now though try balencing on one foot, with your eyes closed if you can, barefoot, on soft carpet. This will work the muscles in the front of your foot which help support your foot and keep it from pronating. Really, you are doing almost this same thing to your feet while mnt biking.
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  7. #7
    Join Date
    Nov 2003
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    Taking names later
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    Sounds like a calcaneal fat pad contusion. Try a heel cup, this will prevent the fat pad from flattening out when you step down. This will decrease your pain if this is the problem. A soft heel cup is ok but try to get the hard heel cup if possible. Check your local pharmacy for these.
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  8. #8
    Join Date
    Jan 2010
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    In the swamp
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    Went to the foot doctor...it is planar facilitis..

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