A patient with suspected fat pad syndrome presents with heel pain; which test would best stress the fat pad?

A patient with suspected fat pad syndrome presents with heel pain; which test would best stress the fat pad?

• A. Plantar fasciitis test
• B. Fat pad squeeze test
• C. Noble
• D. Valgus overload

Answer: (B)

Fat pad syndrome shows up as focal heel pain that worsens with direct loading of the heel, because the cushioning fat pad under the calcaneus is irritated or thinned. The test that best stresses the fat pad is the fat pad squeeze test: the examiner directly compresses the plantar heel pad to reproduce pain. A reproduced pain response indicates the pain is coming from the fat pad itself, since the pad is being loaded rather than the plantar fascia or other structures. By contrast, testing that targets the plantar fascia would be more likely to reproduce pain tied to plantar fasciitis, while tests like Noble or valgus overload stress other structures unrelated to the heel pad.

Fat pad syndrome shows up as focal heel pain that worsens with direct loading of the heel, because the cushioning fat pad under the calcaneus is irritated or thinned. The test that best stresses the fat pad is the fat pad squeeze test: the examiner directly compresses the plantar heel pad to reproduce pain. A reproduced pain response indicates the pain is coming from the fat pad itself, since the pad is being loaded rather than the plantar fascia or other structures. By contrast, testing that targets the plantar fascia would be more likely to reproduce pain tied to plantar fasciitis, while tests like Noble or valgus overload stress other structures unrelated to the heel pad.