Prevalence Of Heel Fat Pad Syndrome In Prolonged Standing Population

Abstract

Background - Heel Fat Pad Syndrome (HFPS) is a musculoskeletal condition causing central heel pain due to degeneration, atrophy, or displacement of the heel’s intrinsic cushioning fat pad. This structure absorbs mechanical shock during walking, running, and standing. Repetitive stress, aging, improper footwear, or prolonged standing can reduce its thickness and elasticity, leading to pain and functional limitations. HFPS is often misdiagnosed as plantar fasciitis, making clinical examination and tests such as the heel fat pad squeeze test essential for accurate detection. Occupations involving long hours of standing such as teaching, factory work, and healthcare carry higher risk, yet research on HFPS prevalence in these groups remains limited.

Objective-

1. To study the frequency of population that affected with heel fat pad syndrome in prolonged standing.
2. To focus only on heel fat pad syndrome than other causes of heel pain.

Material And Methodolgy- institutional protocol and ethical committee approval, vide their letter no. KVV/ IEC/01/2025 dated January 23, 2025.This cross-sectional study was conducted in Karad using a survey method over a duration of six months. The sample size was calculated using the formula n = z² × p × q / L², resulting in 130 participants, where z represents the confidence level, p the prevalence, q = 100 – p, and L the allowable error. Data collection involved a validated questionnaire (Google Form), a consent form, and the Fat Pad Squeeze Test. Participants included individuals of both genders engaged in occupations involving prolonged standing. Individuals with a history of recent calcaneal fracture, wounds around the heel, or diabetes mellitus were excluded from the study.

Result- Out of the 130 participants assessed using the Fat Pad Squeeze Test, 16 individuals (12.3%) tested positive for Heel Fat Pad Syndrome (HFPS), while 114 (87.7%) tested negative. The majority of HFPS-positive cases were observed in individuals aged 30–50 years, with a higher prevalence among those standing for more than six hours per day and those with a higher body mass index (BMI). Many reported heel pain worsening after long work shifts, particularly on hard surfaces without supportive footwear. A significant number were unaware of HFPS and often attributed symptoms to fatigue or plantar fasciitis. Participants who used cushioned or orthotic footwear reported reduced discomfort, suggesting a protective effect.

Conclusion- This research found that 12.3% of those in jobs requiring a long standing period were found to be positive for Heel Fat Pad Syndrome (HFPS) using the fat pad squeeze test. Although 87.7% of the respondents were not positive for HFPS, the significant presence of an identifiable minority with positive symptoms clearly signifies occupational risk for enduring standing. This incidence, although relatively low, is high enough to necessitate prevention in high-risk populations like those with poor footgear, hard floor work environments, or high BMI. The findings attest to the importance of early screening and ergonomic interventions in the workplace to alleviate the burden of HFPS and improve the general foot health of workers