I typically do a month long 850 km walk every spring. I have been doing this since I turned 50 in 2000. On one occasion, I had heel pain at the end and wound up in a walking cast for months with a diagnosis of tarsal tunnel; another time I had lesser pain and stayed off the heel for about 6 weeks — no diagnosis but cortisone shots helped. I’m not really sure what those injuries were but they eventually healed completely.

This past May I had to stop my walk about 350 km in because of heel pain. My heel was bright red, and the size and shape of the redness tracked the heel of my hard orthotic exactly. I was unable to see my sports medicine doctor until about three months later because I was out of the country, and by then the heel was fine. But based on my symptoms (particularly the fact that there was a pain around the edge of my heel noticeable when I pulled on my jeans), he agreed wtih my web research that I probably had an injury to my heel’s fat pad. He also said that given my age, I likely had some plantar fasciitis mixed in for good measure. My feet are fine now, I work out daily with no problem. But I’m nervous about my next walk.

I now have a pair of softer orthotics (kind of a styrofoam-y looking material), which I plan to use next spring when I try a longer 1000 km walk. I’m wondering what if anything I can do to try to avoid the same problem. Heel cups are not possible because of my need for the orthotic, and another sports person I saw said that heel cups may not be good anyway because they prevent the pad from doing its natural splaying.

My doctor suggested slowing down (my natural pace is about 6 km an hour) and making sure my rest stops are short. I also ice every night and typically take 8 200mg ibuprophen spread over the day (only when on these walks). I am also trying to stretch the achilles and plantar faschia every day in case that might help.

If anyone has recommendations or comments on what I’m doing now, or what I can do while walking, I would be so appreciative. I know this is a long post and I apologize for that but I really haven’t found anyone with a lot of knowledge about this fat pad problem.

Thanks so much, Laurie

Hope this helps! Lee Miller

I have been wearing my proper shoes with orthotics and WonderZorbs on top of these when I am inside my house now constantly instead of bare feet, and of course the same when I go outside, my gym shoes are best outside. I get my calf muscles masages my my physio foot specialist weekly and ice my foot every day for half an hour. I have had this for 2 months now and it has been a nightmare I have been a cripple, but am now getting great results from paying attention to what I need to move forward with this now every day.

I hope this helps I understand how debilitating this is….

I’ve tried all kinds of things, ultrasound, laser, heel inserts, orthotics, etc. Nothing seems to work long term. As of last night I deciced to tape my heel as a heel pad injury and see what happpens. If you have any other information on this topic, please let me know.

Thank you.