The Center for Podiatric Care and Sports Medicine

Six Easy Ways to Help with Forefoot Fat Pad Loss Pain

Posted by on Monday, October 29th, 2012


We’ve talked about losing fat in the pad that cushions your heel, but guess what? There’s another part of your foot that can also thin out. Today let’s find out about the fat pad on the ball of your foot and how that can get thinner.

Umm, can you remind me where the ball of my foot is? Nothing on my foot looks like a ball. Sure! I know we talk all the time about the ball of your foot, but let’s be clear about what that means. The “ball” of your foot is where the heads of the metatarsals are found. The metatarsals are those long bones that run from your midfoot to the base of your toes; the heads are the tops of those bones that meet the bottom of your toe bones. The ball of your foot is also commonly referred to as the forefoot.

(I hope that helps; I spent years in dance classes listening to the teacher say, “Use the ball of your foot!” and not really feeling sure I knew what she meant. No wonder I’m a terrible dancer.)

So what about that pad? Five fatty pads at the head of each metatarsal form a cushion across the ball of your foot which helps protect your bones and foot from the impact of each step or jump you take–and the metatarsal heads take a lot of impact with each of your steps.

When you lose the fat in this pad, it’s called plantar fat pad atrophy (atrophy is a general term to describe a wasting away or loss of something, such as muscle tone). Losing that pad can lead to pain in your forefoot, or ball of your foot.

That’s not the kind of fat loss I usually hope for! What causes it? Several things:

Well, how would I know that I have a thinning fat pad on the ball of my foot and not just some other ball of my foot problem? Good question–forefoot pain can be lots of things, such as metatarsalgia, neuromas, or stress fractures. It’s a good indication that you have fat pad loss if:

  • you feel pain in your forefoot;
  • pain is especially strong when walking barefoot;
  • calluses forming on your forefoot;
  • the metatarsal head is noticeably visible (ohhhh, that’s….yucky).

To make sure that your pain is due to fat pad loss, and not something else, you should see a podiatrist at The Center for Podiatric Care and Sports Medicine ( 212.996.1900 ).

Suppose the sad word has come down and I do have plantar fat pad atrophy. What do I do?

  1. You can find pads that cushion your metatarsals in many drugstores or they are easily available online.
  2. Your podiatrist may recommend orthotics that provide cushioning for your forefoot and correct any problem that might be causing wear on your foot pad.
  3. Choose shoes that have some padding in the soles.
  4. Try not to walk barefoot. Thick socks can help if you’re going without shoes; some hiking socks have padding added to the soles.
  5. High heels are a big no–the last thing your poor metatarsals need is to have to bear the weight of your entire body.
  6. Avoid any activity where you are putting all the weight on the balls of your feet; if you’re a baseball catcher, you need to move to another position. It also will help if you keep your weight appropriate to your height–your forefeet don’t need to carry anymore than they have to.

Some doctors have been treating fat pad loss with injections of Botox, but that doesn’t last long and each treatment is expensive.  It’s also not likely to be covered by your insurance.

The balls of your feet are surely the only place on your body where you don’t want to lose weight (well, other than your heel pad), but alas, it happens! Pain in your forefoot is like a ringing phone–it’s annoying to stop and deal with it, but if you answer it, you may learn something important and helpful. So get your foot checked!


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.