Which test would best differentiate fat pad syndrome from plantar fasciitis?

Which test would best differentiate fat pad syndrome from plantar fasciitis?

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

Answer: (C)

Focusing on where the pain originates in the heel is what helps tell fat pad syndrome from plantar fasciitis. The fat pad squeeze test does exactly that by compressing the heel’s fat pad itself. If pressing the central heel pad reproduces focal tenderness under the pad, it points to fat pad pathology. Plantar fasciitis pain, on the other hand, is typically felt along the plantar fascia near the medial calcaneal tubercle and is best elicited by palpation or maneuvers that load the fascia, not by squeezing the fat pad. The other options don’t isolate the fat pad. A plantar fasciitis–focused test would provoke fascia-specific pain, not pad pain. The Noble test targets the iliotibial band/knee region and isn’t relevant to the heel pad. Valgus overload stresses other structures and isn’t specific to fat pad pathology. So, the fat pad squeeze test is the best choice for differentiating fat pad syndrome from plantar fasciitis.

Focusing on where the pain originates in the heel is what helps tell fat pad syndrome from plantar fasciitis. The fat pad squeeze test does exactly that by compressing the heel’s fat pad itself. If pressing the central heel pad reproduces focal tenderness under the pad, it points to fat pad pathology. Plantar fasciitis pain, on the other hand, is typically felt along the plantar fascia near the medial calcaneal tubercle and is best elicited by palpation or maneuvers that load the fascia, not by squeezing the fat pad.

The other options don’t isolate the fat pad. A plantar fasciitis–focused test would provoke fascia-specific pain, not pad pain. The Noble test targets the iliotibial band/knee region and isn’t relevant to the heel pad. Valgus overload stresses other structures and isn’t specific to fat pad pathology.

So, the fat pad squeeze test is the best choice for differentiating fat pad syndrome from plantar fasciitis.